Refugee Healthcare: Towards Healing Relationships

Geraldine Frances Duncan


Do Australian doctors provide competent and appropriate healthcare to refugee patients? What facilitates pathways and removes barriers towards optimal healthcare?
This essay explores literature regarding health professionals’ abilities, when providing healthcare to refugees and asylum seekers towards optimal health status facilitating progress with their lives. It reflects upon factors affecting quality primary care delivery to refugees in Australia including reference to overseas literature.
Method: A literature search was undertaken including Google, Google Scholar, ANU online library; Factiva; Pub Med and the RACGP website. Ultimately 77 references were selected with nine themes identified regarding the provision of healthcare to refugees; particularly what aided development of healing relationships between doctors and refugee patients.
Conclusion: Australian studies do suggest that general practitioners have enthusiasm and resilience when working with refugees. Significant factors include sustainability of health-services, risk of burnout of providers, the need for peer support and the ability to control workload. Enablers include deriving strength and resilience from working with marginalised groups, recognition and pride in the advocacy role while valuing ethics and social justice issues in healthcare.



Refugees; Primary health care; Minority healthcare; Health care access; Trust; Health literacy; Interpreter

Full Text:



Adams, K. M., Gardiner, L. D., & Assefi, N. (2004). Healthcare challenges from the developing world: post-immigration refugee medicine. BMJ, 328(26), 1548-1552.

Ager, A., & Strang, A. (2008). Understanding integration: A conceptual framework. Journal of Refugee Studies, 21(2).

Apalata, T., Kibiribiri, E. T., Knight, S., & Lutge E. (2007). Refugees’ perceptions of their health status & quality of health care services in Durban, South Africa: A community-based survey. Published by Health Systems Trust.

Attard, M., McArthur, a., Riitano, D., Aromataris, E., Bollen, C., & Pearson, A. (2013). Improving communication between health-care professionals and patients with limited English proficiency in general practice setting. Australian Journal of Primary Health, 21(1) 96-101.

Australian Government; National Health and Medical Research Council. (2005, December 9). Cultural competency in health: A guide for policy, partnerships and participation. Retrieved from

Babacan, H. (2006). Family in the context of migration: Challenges of inclusion in Multicultural Australia. Published by the University of the Sunshine Coast.

Bean, R. (2006). The effectiveness of cross-cultural training in the Australian Context. Report for Department of Immigration and Multicultural Affairs.

Benson, J. (2004). –Helping refugees integrate into our community–Reflections from general practice. Australian Family Physician, 33(1), 214.

Berlin, E. A., & Fowkes, J. R. (1983). A teaching framework for cross-cultural health care. Western Journal of Medicine, 139(6), 934-938.

Brough, M., Gorman, D., Ramirez, E., & Westoby, P. (2003). Young refugees talk about well-being: A qualitative analysis of refugee youth mental health from three states. Australian Journal of Social Issues, May.

Clark, K., & Phillips, J. (2010). End of Life Care: the importance of culture and ethnicity Clark, K. Phillips, J. End of Life Care: The importance of culture and ethnicity. Australian Family Physician, 39 (4), 177-256

Cooper, L. A., beach, M. C., Johnson, R. L., & Inui, T. S. (2006). Delving below the surface: Understanding how race and ethnicity influence relationships in health care. Journal General Internal Medicine, 21, S21-27.

Dade, S. J. (2008). Australia’s rural and remote health: A social justice perspective (2nd ed.). Tertiary Press Victoria.

Dastjerdi, M., Olson. K., & Ogilvie, L. (2012). A Study of Iranian immigrant’ experiences of accessing Canadian health care services: A grounded theory. International Journal for Equity in health, 11, 55. Retrieved from

Dogra, N., Giordano, J., & France, N. (2007). Cultural diversity teaching and issues of uncertainty: The findings of a qualitative study. BMC Medical Education, 7(8). doi: 10.1186/1472-6920-7-8. Retrieved from

Eisman, D. P., Keller, A. S., & Kim, G. (2000). Survivors of torture in a general medical setting: how often have patients been tortured, and how often is it missed? Western Journal of Medicine, 172, 301-304.

Farley, R., Askew, D., & Kay, M. (2012). Caring for refugees in general practice: Perspectives from the coalface.
Australian Journal of Primary Health, 9999(9999).

Feldman, C. T., Bensing, J. M., & de Ruitjer A. (2007). Worries are the mother of many diseases: General practitioners and refugees in the Netherlands on stress, being ill and prejudice. Patient Education and Counselling, 65(3), 369-380.

Fergusen, W. J., & Candib, L. M. (2002). Culture, language, and the doctor-patient relationship; modern culture and physician-patient communication. Family Medicine, 34(5), 353-361.

Fontes, L. A. (2008). Interviewing Clients Across Cultures: A Practitioners Guide The Guilford Press. A Division of Guilford Publications Inc. ISBN 978-1-59385-710-3 (hardcover) ISBN 978-1-60623-405-1 (paperback).

Furler, J., & Kokanovic, R. (2010). Mental health cultural competence. Australian Family Physician, 39(4), 177-256.

Furler, J., Kokanovic, R., Dowrick, C., May, C., Gunn, J., & Newton, D. (2010). ‘Treading softly softly’: A qualitative study of family physicians’ experiences of identifying, managing and treating depression among patients from three ethnic communities. Annals of Family Medicine 8(3). Retrieved from

Hannah, C. T., & Lě, Q. (2012). Factors affecting access to healthcare services by intermarried Filipino women in rural Tasmania: A qualitative study. Rural and Remote Health, 12, 2118. Retrieved from

Henderson, S., & Kendall, E. (2011). Culturally and linguistically diverse peoples’ knowledge of accessibility and utilisation of health services: exploring the need for improvement in health service delivery. Australian Journal of Primary Health, 17, 195-201. Retrieved from http://

Jackson B. E., & Cheng, I. (2010). Meeting the primary health care needs of refugees and asylum seekers. Research Roundup Primary Health Care Research and Information Service. Retrieved from

Jacobi, T. (2011). Education: Multicultural consultations. Retrieved May 6 from http://

Johnson, D. R., Zierch, A. M., & Burgess, T., (2008). I don't think general practice should be the front line: Experiences of practitioners working with refugees in South Australia. Biomed Central. Australia & New Zealand Health Policy, 5, 20. Published Online 2008 August 8. doi: 10.1186/1743-8462-5-20 PMCID: PMC2531177

Kai, J., Beavan, J., Faull, C., Dodson, L., Gill, P., & Beighton, A. (2007). Professional uncertainty and disempowerment responding to ethnic diversity in health care: A qualitative study. PLoS Medicine, 4(11), e323. doi:10.1371/journal.pmed.0040323 Pub Nov 13, 2007

Kalengayi, F. K. N., Hurtig, A., Ahlm, C., & Ahlberg, B. M. (2012). “It is a challenge to do it the right way”: An interpretive description of caregivers’ experiences in caring for migrant patients in Northern Sweden. BioMedCentral BMC Health Services Research, 12, 433. Published online 2012 November 29. doi: 10.1186/1472-6963-12-433 PMCID: PMC3557194

Kay, M., Jackson, C., & Nicholson, C. (2010). Refugee health: A new model for delivering primary healthcare. Australian Journal of Primary Health, 16, 98-103. CSIRO publishing. Retrieved from

Kleinman, A., & Benson, P. (2006). Anthropology in the clinic: The problem of cultural competency and how to fix it. PLoS Medicine, 3(10), e294. doi 10.1371/journal.pmed0030294. Retrieved from

Lee, R. (2010). Culture and diversity. Australian Family Physician, 39(4), 177-256.

Lyons, Z., & Laugharne, J. (2011). An overview of undergraduate training in cultural competency and cross-cultural psychiatry. Education Research and perspectives, 38(2).

Millbank, A., Phillips, J., & Bohm, C. (2006). Australia’s settlement services for refugees and migrants. Online only. Retrieved September 19 from

Moore, A. R. (2005). The Missing Medical Text. Melbourne University Press.

Murray, S., & Skull, S. (2005). Hurdles to health: Immigrant and refugee healthcare in Australia. Australian Health Review February, 29(1).

NSW Government Department of Health. (2011). Refugee health plan 2011-2016. Retrieved from

Oliff, L., & Mohamed, F. (2007). Settling in: How do refugee young people fair within Australia’s settlement system? Centre for Multicultural Youth Issues Melbourne. Retrieved from

Peterson, P., Sackey, D., Correa-Velez, I., & Kay, M. Building trust: delivering health care to newly arrived refugees. Retrieved from

Phillips, C., Smith, M. M., Kay, M., & Casey, C. (2011). The refugee health network of Australia: Towards national collaboration of health care for refugees. Medical Journal of Australia, 195(4).

Pieper, H-O., & MacFarlane, A. (2011). “I’m worried about what I missed”: GP registrars views on learning needs to deliver effective healthcare to ethnically and culturally diverse patient populations. Education for Health, 24(1). Retrieved from

Pollock, G., Newbold, K. B., Lafreniere, G., & Edge, S. (2012). Discrimination in the doctor’s office: Immigrants and refugee experiences. Critical Social Work, 13(2), 60-79. Retrieved from

Pottie, K., Greenaway, C., Feightner, J., Welch, V., Swinkels, H., Rashid, M., … Tugwell. (2011). Evidence-based clinical guidelines for immigrants and refugees. CMAJ, 183(12), E 824-E925. CMAJ 2011. doi: 10.1503/cmaj.090313

Ribera, J., M., Hausmann-Muela, S., Greitens, K. P., & Toomer, E. (2008). Is the use of interpreters in medical consultations justified? A critical review of the literature. PASS International v.z.w. Partners for Applied Social Sciences. Retrieved from

Royal Australasian College of Physicians. (2007). Towards better health for refugee children and young people in Australia and New Zealand: The RACP perspective. Sydney: Paediatric and Child Health. Retrieved from

Scott, J. G., Cohen, D., Di Cicco-Bloom, B., Miller, W. L., Stange, K. C., & Crabtree, B. F. (2008). Understand healing relationships. Annals of Family Medicine, 6(4). Retrieved from

Shannon, P., O’Dougherty, M., & Mehta, E. (2012). Refugees perspectives on barriers to communication about trauma histories in primary care. Ment. Health Fam. Med. 9(1), 47-55.

Smith, M. (2003). Health care for refugees. Asia Pacific Family Medicine, 2, 71-7.

Spencer, C., Macdonald, R., & Archer, F. (2008). Surveys of cultural competency in health professional education: A literature review. Journal of Emergency Primary Care (JEPHC), 6(2). Article 990250 ISN 1447-4999. Retrieved from

Stewart, M., Belle B. J., Weston, W. W., McWhinney, I. R., McWilliam, C. L., & Freeman, T. R. (2003). Patient-centred medicine transforming the clinical method (2nd ed.). ISBN 1 85775 981 8 Radcliffe Medical Press Ltd.

Sypek, S., Clugston, G., Phillips, C. (2008). Critical health infrastructure for refugee resettlement in rural Australia: Case study of four rural towns. Aust J Rural Health, 16(6), 349-54. doi: 10.1111/j.1440-1584.2008.01015.x

Tiong, A. C., Patel, S. P., Gardiner, J., Ryan, R., Linton, K. S., Walker, K. A.,…Biggs, B. (2006). Health Issues in newly arrived African refugees attending general practice clinics in Melbourne. Medical Journal of Australia, 185 (11/12), 4-18.

Wall, S., Santalucia, Y., Salem, M., Giacomin, D., McDonald, R., & Bosnjak, F. (2011). Enhancing the lives of older refugees: A self improvement resource for community service providers. ISBN 978 1 74079 138 0.

Wiking, E., Sundquist, J., & Saleh-Statten, N. (2013). Consultations between Immigrant patients, their interpreters, and their general practitioners: Are they real meetings or just encounters? A qualitative study in primary health care. International Journal of Family Medicine, 2013. Article ID 794937. Retrieved from

Wilson, J. P., & Drozdek, B. (Ed.). (2004). Broken spirits: The treatment of traumatised asylum seekers, refugees, war and torture victims. Taylor& Francis Books, Inc.

Winkleman, M. (2009). Culture and health; applying medical anthropology. Published Jossey Bass; Copyright John Wiley and Sons.

Zepheniah, B. (n.d.). We refugees. Retrieved From



  • There are currently no refbacks.

Copyright (c) 2015 Canadian Social Science

Share us to:   


  • How to do online submission to another Journal?
  • If you have already registered in Journal A, then how can you submit another article to Journal B? It takes two steps to make it happen:

1. Register yourself in Journal B as an Author

  • Find the journal you want to submit to in CATEGORIES, click on “VIEW JOURNAL”, “Online Submissions”, “GO TO LOGIN” and “Edit My Profile”. Check “Author” on the “Edit Profile” page, then “Save”.

2. Submission

  • Go to “User Home”, and click on “Author” under the name of Journal B. You may start a New Submission by clicking on “CLICK HERE”.
  • We only use three mailboxes as follows to deal with issues about paper acceptance, payment and submission of electronic versions of our journals to databases:;;

 Articles published in Canadian Social Science are licensed under Creative Commons Attribution 4.0 (CC-BY).


Address1020 Bouvier Street, Suite 400, Quebec City, Quebec, G2K 0K9, Canada.

Website: Http:// Http://,

Copyright © Canadian Academy of Oriental and Occidental Culture