Refugee doctors for refugee health

TORONTO – Syrian refugees are often portrayed as an unwelcome drain on the communities to which they relocate, especially with regard to health care. But, for those escaping Syria’s civil war, ignorance of their plight is overshadowed only by the reality of their needs – and the diversity of their expertise.

Thursday, December 07, 2017
Vural u00d6zdemir

TORONTO – Syrian refugees are often portrayed as an unwelcome drain on the communities to which they relocate, especially with regard to health care. But, for those escaping Syria’s civil war, ignorance of their plight is overshadowed only by the reality of their needs – and the diversity of their expertise. Although refugees do bring with them extensive health-care issues, they also bring years of experience in the medical profession that, if put to proper use, could be a boon to the communities that receive them, not to mention for other refugees.

One of the biggest challenges for refugees anywhere is finding a doctor. In many host countries, inadequate treatment is the result of xenophobia, language barriers, or insufficient supply of medical staff. This is especially true for Syrians, who are scattered across the Middle East, North Africa, Europe, and North America.

But many Syrian refugees are also highly educated. As they settle in places far from the hospitals and clinics in which they once practiced, Syria’s doctors simply want to get back to work. Isn’t it time that they did?

In the United Kingdom, efforts are underway to make that happen. The National Health Service and the British Medical Association have begun retraining refugee doctors, including many from Syria and Afghanistan, to fill the ranks of depleted clinics in UK. Through English-language training, postgraduate study, and professional registration, programs in London, Lincolnshire, and Scotland aim to reintegrate refugee doctors into the medical profession. These efforts should be lauded.

Retraining refugee doctors is not only a moral exercise; it also makes practical sense. Displaced doctors are better able to treat refugee patients’ ailments. Refugee doctors can also help ensure that the flood of new patients does not overwhelm host countries’ health-care systems. And retraining a refugee doctor is cheaper and faster than educating a new medical student. With approximately 600 refugee doctors living in Britain, the well of untapped talent in the UK is deep.

Moreover, refugee patients benefit when treated by doctors who understand their circumstances, including the enormous psychosocial stress that displacement causes. Translators can help, but they are not always available in crisis settings. Doctors who understand refugees emotionally and culturally are better equipped to put patients at ease.

Britain is not alone in recognizing the potential of refugee doctors. In Turkey, Syrian doctors and nurses have received training to help them become familiar with the Turkish health-care system. The goal is to enable qualified Syrian professionals to treat refugee patients, thus mitigating the language and logistical barriers to effective, accessible, and dignified care.

But other host countries have not been as forward thinking. In Lebanon and Jordan, for example, where more than 1.6 million registered Syrian refugees currently live, efforts to allow Syrian doctors to care for refugee patients have been criminalized. Doctors ignoring the law face arrest and possible deportation. Even Canada, a country that generally welcomes diversity and values human rights, is behind the curve on innovative approaches to refugee health. Syrian doctors face "many, many years” of retraining in Canada, and often struggle to fund the high cost of recertification.

Amid this resistance, refugee health care should be viewed as more than a set of logistical and operational challenges, but also as an inherently political process. Two dimensions of the issue must be addressed if refugee patients are ever to be properly cared for, and refugee doctors properly deployed.

For starters, refugee doctors may struggle to be accepted by their local colleagues, owing to political or personal bias. Recognizing the potential for local resistance to integration programs for refugee doctors is essential to develop proactive policies that ensure success.

Moreover, refugee doctors must be trained to address the diversity of medical needs they will face in their adoptive homes. For example, in many countries where refugees originate, lesbian, gay, bisexual, transgender, and intersex (LGBTI) health concerns remain taboo, even among medical professionals. For refugee doctors relocating to countries where LGBTI health and rights are recognized, integration curricula should include training on LGBTI health, particularly the rights of exceptionally vulnerable LGBTI refugees. Improving health for LGBTI refugees can serve as a foundation for a more open society.

The refugee crisis that has engulfed Syria is just one ripple in a tidal wave of global displacement. Around the world, some 22.5 million people are officially registered as refugees, and nearly 66 million have been forced from their homes. These numbers are unlikely to fall in the near term, as calamities caused by climate change, and by human and natural disasters, continue to push even more people from their communities.

Every one of these future refugees will need access, at some point, to medical professionals trained in refugee health, diversity, and inclusion. Empowering refugee doctors to become part of the solution will help overcome entrenched dogmas toward refugee diversity and social identities. But, just as important, it will mark a crucial step forward in ensuring more inclusive refugee health.

Vural Özdemir is a medical doctor, independent writer, and adviser on technology, society, and democracy.

Copyright: Project Syndicate.