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

2. Refugees and Asylum Seekers in Australia

3. 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”.

4. 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

5. 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 https://www.immi.gov.au/media/fact- sheets/60refugee.htm Onshore asylum approvals: Afghanistan Iran Iraq Sri Lanka Other Total7,504 Source: DIMA

6. Immunisation needs

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

8. 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

10. 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

11. 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

12. Immunisation eligibility

13. 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?

14. Immunisation eligibility Use the Victorian Immunsation Schedule

15. Refugee and Asylum Seeker Management Tips

16. Use interpreter services Translating and Interpreting Service (TIS) National Doctors Priority Line: 1300 131 450 Advance bookings: http://www.tisnational.gov.au/

17. Have a written plan Use a written plan

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

19. Seek advice Refugee Health Program 8792 1911 www.semml.com.au Monash Community Refugee Health Nurses and Refugee Health Fellow 9792 8100