Example- Health and Culture of Iraqi Refugee in Australia Availability, accessibility and acceptability Example- Health and Culture of Iraqi Refugee in Australia Gargi SINHA

Purpose Acceptability Accessibility Availability To understand the issue of availability, accessibility and acceptability, and of public health services for Iraqi refugee in Australia . Who are iraqi refugee ? Department of Immigration and Border Protection (2015) identified refugee as the people ,“subject to persecution ” in their home country and “are in need of resettlement”. During the gulf war in 1991, more than 11 million people flee from Iraq and since then many Iraqi people came to Australia under Refugee and Special Humanitarian Programs (Department of Social Services, 2015).

Structural factor Low income Federation of Ethnic Communities’ Councils of Australia (2010) identifies low income as a factor for not taking up cervical cancer screening program. However, the cause of less money is a complex interplay of various other factors such as unemployment and education (Germov, 2014). Low income Unemployment Limited English knowledge Overseas education not valid

Cultural factors Different language and lack of understanding of health system are the key barrier for accessibility. In Arab culture screening of cancer is perceived as ‘punishment of sin’ or ‘death sentence’ Muslim unmarried women are prohibited to attended program which challenge their modesty Iraqi female may not feel culturally acceptable to have been examined by opposite gender practitioners .

Cross –cultural communication Woman from middle east are not able to communicate with health professional due to the limited ability of English (Slewa-Younan et al., 2014)

Health Professional Behaviour cervical cancer screening is used by medical professionals to show power and control over the people who are ignorant about such screening practices. Germov (2014, p. 471) further explain that although, biomedical model of health snuggles with individualist health promotion, however it may lead to victim blaming health professionals gives strong emphasis on human body and neglect empathy and consideration. For instance, a health provider may explain about type of cancer however may not address patients concern such as fear of pain during cervical examination which may be the primary reason for not giving consent for screening.

Cross –cultural communication Woman from middle east are not able to communicate with health professional due to the limited ability of English (Slewa-Younan et al., 2014)

Health Professional Behaviour cervical cancer screening is used by medical professionals to show power and control over the people who are ignorant about such screening practices. Germov (2014, p. 471) further explain that although, biomedical model of health snuggles with individualist health promotion, however it may lead to victim blaming health professionals gives strong emphasis on human body and neglect empathy and consideration. For instance, a health provider may explain about type of cancer however may not address patients concern such as fear of pain during cervical examination which may be the primary reason for not giving consent for screening.

Service structure and organization and functioning Many organizations in Australia hire an interpreter to provide a solution for cultural issues. However, sensitive matter such as cervical screening requires a culturally competent health professional Due to a particular type of attire such as veil, it is easy to distinguish a Muslim woman and often made as stereotype (Chakraborti & Zempi, 2012).

Social Justice Germov (2014, p. 95) explain that social justice paradigm derives the concept of a fair distribution of resources among the member of society. Clearly, distribution of health resources for Iraqi refugee is unjust (Harding & Libal, 2012). To improve the health of Iraqi refugee four recommendation can be proposed on the principles of social justice. Access can be enhanced by distributing information in Arabic language. Equity-implementing fair policies for Iraqi people. Right is achievable by providing culturally competent and same gender health professional to deal with Iraqi women. Participation - empowering women by promoting group discussion on screening programme

Conclusion Drawing from above analysis of evidence it is suggested that health is a complex mixture of factors for Iraqi refugee living in Australia. addressing health disparity requires a holistic approach which involves overcoming language and cultural barrier. Rather than solving problems from the biomedical perspective it is better to have culturally competent health professionals to tackle the issue of Iraqi refugee health. Overall, instead of stereotyping people in a host country, it would be better to understand root problem to address the underlying problems causing health inequities.

Resources Casimiro, S., Hancock, P., & Northcote, J. (2007). Isolation and Insecurity: Resettlement Issues among Muslim Refugee Women in Perth, Western Australia. Australian Journal of Social Issues, The, 42(1), 55-69. Chakraborti, N., & Zempi, I. (2012). The veil under attack: Gendered dimensions of Islamophobic victimization. International Review of Victimology, 18(3), 269-284. Department of Immigration and Border Protection. (2015). Fact sheet - Australia's Refugee and Humanitarian programme. Retrieved from https://www.border.gov.au/about/corporate/information/fact-sheets/60refugee Department of Social Services. (2015). Syrian/Iraqi humanitarian crisis. Retrieved from https://www.dss.gov.au/about-the-department/freedom-of-information/information-publication-scheme Federation of Ethnic Communities’ Councils of Australia. (2010). Cancer and Culturally and Linguistically Diverse Communities. Retrieved from http://www.fecca.org.au/images/stories/pdfs/cancer_cald_communities_report2010.pdf Germov, J. (2014). Second opinion: an introduction to health sociology (Vol. Fifth;5;5th;). Australia: Oxford University Press. Harding, S., & Libal, K. (2012). Iraqi refugees and the humanitarian costs of the Iraq war: What role for social work? International Journal of Social Welfare, 21(1), 94-104. doi:10.1111/j.1468-2397.2011.00780.x Slewa-Younan, S., & Radulovic, M. (2013). Emerging data on resettled Iraqi refugees in Australia: 10 years after the 2003 Iraq conflict. Australian Nursing Journal: ANJ, The, 20(11), 42.