Refugees, Asylum Seekers and Immunisation Immunisation Update 5 th August 2014 Dr. I-Hao Cheng Refugee Health Program Manager & General Practitioner UNHCR ABC

Refugees and Asylum Seekers in Australia

A refugee: Any person who has been determined as: having a well-founded fear of being persecuted, outside the country of his nationality, unwilling to return. Given rights, protection and assistance associated with “refugee status”.

An asylum seeker: An individual whose application for refugee status is still pending a final decision… Not given rights, protection and assistance associated with UNHCR Refugee status

New settlers 2012/13 Offshore refugee arrivals: Iraq 4,064 Afghanistan2,431 Burma (Myanmar) 2,352 Bhutan1,023 Iran DR Congo, Somalia, Sudan, Eritrea, Ethiopia, Other Total12,515 sheets/60refugee.htm Onshore asylum approvals: Afghanistan Iran Iraq Sri Lanka Other Total7,504 Source: DIMA

Immunisation needs

Refugee health assessment Comprehensive history, examination, investigations, plan of management. MBS #701, 703, 705, 707

Prior immunsation Overseas childhood schedules WHO - EPI - Childhood and other schedules less than Australia Pre-departure health check Immigration detention facility On-arrival health assessment Other services

Prior immunsation Overseas childhood schedules WHO - EPI Refugee pre-departure health check - MMR x1 Asylum seeker immigration detention facility - MMR x1-2, Hep B x1-3 On-arrival health assessment - Variable Other services

Prior immunsation Overseas childhood schedules WHO - EPI Pre-departure health check Immigration detention facility On-arrival health assessment Other services - Health services, English language schools

Immunisation eligibility

Health service eligibility Does the patient have a Medicare card? Does the patient have a Health Care Concession card? Is the patient linked with a support agency?

Immunisation eligibility Use the Victorian Immunsation Schedule

Refugee and Asylum Seeker Management Tips

Use interpreter services Translating and Interpreting Service (TIS) National Doctors Priority Line: Advance bookings:

Have a written plan Use a written plan

Coordinate with settlement and humanitarian case workers AMES Settlement Red Cross Other

Seek advice Refugee Health Program Monash Community Refugee Health Nurses and Refugee Health Fellow