Handbook of Refugee Health
For Healthcare Professionals and Humanitarians Providing Care to Forced Migrants

This book helps to recognize the rights of refugees and provides a framework to identify and approach health needs, from basic elements like service mapping and initial interventions to more complex elements of ongoing healthcare and support and broader topics such as migration public health, migration policy and health systems. Beyond biomedical frameworks, it draws on socio-ecological models to inform assessments and integrated models of care to improve health and health equity. Set out in three comprehensive sections: public health theory (Part 1), applied public health (Part 2), and clinical approaches (Part 3), this book draws on multiple disciplines and insights from humanitarians, academics, policy experts, and clinicians from diverse contexts, with expertise in forced migration, to create an accessible reference tool to inform healthcare professionals? interactions with forcibly displaced individuals and populations in all contexts for both high and low resource countries. Apart from providing information across the spectrum of health issues, clinical specialties and global contexts, it discusses associated areas, including human rights and law, public health, medical anthropology and cultural awareness.

Key Features:

• Bridges the gap between existing academic literature on refugee health and guidelines for health management in humanitarian emergencies
• Helps to develop an integrated approach to healthcare provision, allowing healthcare professionals and humanitarians to adapt their specialist knowledge for use in forced migration contexts and with refugees.
• Recognizes the complex and interconnected needs in displacement scenarios and identifies holistic and systems-based approaches.
• Covers public health theory, applied public health and clinical aspects of forced migration.

Table of Contents

PART ONE: PUBLIC HEALTH THEORY

Introduction

1. The global reality: forced migration and health

1.1 Introduction to migration and global health

1.2 Forced migration and global health governance

1.3 Why are people forced to displace and seek refuge?

2. International standards, humanitarian principles and forced migration

2.1 Refugee health policy, international standards and humanitarian principles

2.2 The right to health for forced migrants

3. Refugee health needs and response

3.1 Health needs of refugees and internally displaced persons in camp settings

3.2 Health cluster coordination mechanism

3.3 The needs of migrants in transit

3.4 Lived experiences of refugees and accessing services in a host country

3.5 Cultural competency and cultural adjustment of services

PART 2: APPLIED PUBLIC HEALTH

Introduction

4. Health needs assessments in the context of forced displacement

5. Mainstreaming refugee health

5.1 Providing healthcare in protracted refugee situations: a health system-strengthening approach

5.2 Health policy and advocacy to improve the health of forced migrants

5.3 Considerations in the initial healthcare assessment for new arrivals

5.4 Facilitating access to healthcare

6. Safeguarding and supporting vulnerable groups

Introduction

6.1 Protecting and supporting children on the move

6.2 Sexual and reproductive health, maternity and newborns

6.3 Gender-based violence and migration

6.4 Trafficking

6.5 Disability

6.6 Older people

6.7 Detention

7. The humanitarian practitioner

7.1 The professional humanitarian practitioner

7.2 Personal ethics in humanitarian practice

7.3 Resilience and mental health

7.4 Ongoing education and maintaining competencies

7.5 Managing team dynamics and effective communication

7.6 Accountability and sustainability

PART 3: CLINICAL CHAPTERS
Introduction

8. Emergency Scenarios

8.1 An approach to medical emergencies in forced displacement settings

8.2 Triage

8.3 Specific Emergency Conditions in Forced Displacement Settings

9. Communicable diseases

9.1 Communicable diseases

9.2 Surveillance systems

9.3 Sepsis

9.4 Respiratory infections

9.5 Gastrointestinal infections

9.6 Urinary tract infections, genital ulcers and syphilis

9.7 Central nervous system infections

9.8 HIV and its complications and needlestick injuries

9.9 Tropical, subtropical and vaccine preventable infections, including malaria

9.10 Skin, soft tissue and bone infections

10. Mental health and psychosocial support

10.1 Mental health and psychosocial support

10.2 Mental health: clinical issues

10.3 Culture and context in refugee mental health

10.4 Support for humanitarian workers

11. Non-communicable diseases

11.1 Non-communicable diseases

11.2 Cardiovascular diseases

11.3 Endocrine diseases

11.4 Gastrointestinal diseases

11.5 Nephrology

11.6 Neurological diseases

11.7 Respiratory diseases

11.8 Oncology

12. Palliative care

13. Paediatrics

13.1 General assessment of children and young people

13.2 Management of the sick child

13.3 Neonatal care

13.4 Management of common illness

13.5 The child with a fever or a rash

13.6 Specific infections in children

14. Sexual and reproductive health

14.1 Sexual and reproductive health in forced migration

14.2 Identification, management and prevention of sexually transmitted infections

14.3 Gynaecology, fertility and family planning

14.4 Pregnancy, delivery and postpartum

14.5 Sexual and gender-based violence

15. Care of survivors of torture, gender-based violence and trafficking

Dr Miriam Orcutt (MBBS, MSc), Lead Editor, is a Senior Research Fellow in Forced Migration and Health at the Institute for Global Health, University College London, a humanitarian consultant, and trained physician.

Dr Clare Shortall (BSc MBBS MRCPCH DMCC DTMH MSc) is a Health Adviser for Première Urgence Internationale (PUI), France.

Dr Sarah Walpole (BSc, MBChB, MRCP, PG Cert, MSc(Res), DTM&H) is currently working as a Specialist Registrar in Infectious Diseases and General Internal Medicine in the North East of England Deanery.

Dr Aula Abbara MBBS DTMH MD(Res) is a consultant in Infectious Diseases/ General Internal Medicine at Imperial College NHS Healthcare Trust, London and an Honorary Researcher at Imperial College.

Dr Sylvia Garry (BA BMBCh MRCPCH DTMH MSc (PH) MFPH) is a Public Health Registrar in North London in the National Health Service (NHS).

Dr Rita Issa BSc MBBS DTMPH is an Academic Clinical Fellow in General Practice in London.

Sir Professor Alimuddin Zumla GCDS., MD., MSc., PhD., FRCP(Lond)., FRCP(Edin)., FRCPath., FAAS.,FRSB., is Professor of Infectious Diseases and International Health in the Division of Infection and Immunity, University College London; and is Consultant Infectious Diseases Physician at University College London Hospitals NHS Foundation Trust, London, UK. He serves as visiting Professor at several institutions in Africa, Europe and the Middle East.

Professor Ibrahim Abubakar (MBBS, DPH, MSc, PhD, FFPH, FRCPE, FRCP.,FMedSci) is Director of the University College London Institute for Global Health (IGH) and Chair of Lancet Migration, and previously of the UCL-Lancet Commission on Migration and Health. He is an NIHR Senior Investigator and honorary professor at the London School of Hygiene and Tropical Medicine.