Australian doctors should be mindful about the needs of refugees, many of whom are likely to be confused by an unfamiliar health system, say the authors of a new study.
Although people on refugee visas have the same Medicare and social benefits as other permanent residents, many have mental health issues and illnesses that may be unusual in Australia.
This, together with language and cultural barriers, means they may not receive the medical help they need.
Australia welcomes more than 20,000 refugees a year, but there are serious inconsistencies in care, according to the study.
"Refugees face profound and complex health and social problems," said lead author Professor Grant Russell, Director of the Southern Academic Primary Care Research Unit at Monash University.
He gives an example of man from Somalia who ruined $5000 worth of medicine because a pharmacist did not realise he could not understand refrigeration instructions.
"There is a big need for interpretation and for continuing support until refugees understand the health system," Prof Russell said.
"The system is patchy. West Australia and Northern Territory have worked out good systems for ensuring co-ordinated care. But the risk of refugees falling through the cracks is high in some other areas.
"Nearly all refugees have had a fairly traumatic experience before coming to Australia. They would not be refugees otherwise," Prof Russell said.
"Ironically psychologists and other allied health professionals do not have access to the same free translation services as GPs."
The report suggests refugees receive six months of focussed care and support, after which they could be integrated into mainstream health services.
The idea is not to create parallel systems, said co-author Dr I-Hao Cheng, a Melbourne GP who works with refugees.
Service providers would benefit from education on how to communicate with refugees and to be sensitive to their needs, he said.
"GPs should use interpreters and be mindful of the particular health needs of refugees."
This could mean extra help with setting up appointments or better explanations about how a prescription is used.
"In Afghanistan, for example, community health is based on workers who go into people's homes, who engage with them on the street or in markets. But in Australia people need an appointment at a GP or a clinic.
"The Commonwealth government needs to work closely with the states and territories to develop a strategic and integrated approach to health care."
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