A Galway conference has highlighted issues affecting non-nationals. Lorna Sigginsreports.
Doctors, asylum seekers and refugees are forced to communicate with gestures, miming, dictionaries and the help of children, according to research by NUI Galway's department of general practice.
Such informal methods cannot hope to address the complex health needs that may relate to the aftermath of torture, sexual violence and mental health issues, according to Dr Anne MacFarlane, who led the research.
"The cornerstone of good medicine is good communication," she says, and lack of formal interpretation can leave patients confused or ill-informed after medical appointments.
MacFarlane's team conducted its study among a group of Serbo-Croat and Russian speaking refugee and asylum-seeking patients and GPs in Galway city. Reliance on children for interpretation was identified as a cause of concern by both GPs and patients, given the sensitive and personal nature of some issues.
The impact of language barriers in primary care was just one of a number of issues affecting non-nationals debated at a conference hosted by NUIG, HSE West and the Galway Refugee Support Group (GRSG) at the weekend in Salthill. It focused on the needs of and inter-agency responses to the healthcare of ethnic minorities - be they members of the Travelling community; asylum seekers who are fleeing persecution and applying for the protection of the State; or refugees who have completed asylum procedures and have been granted protection.
Ironically, the venue was within a stone's throw of the Eglinton Hotel where a South African-born asylum seeker died of malnutrition earlier this month. Nomvuna Khanyile (27), her husband Bashiru Mohammed Dauda (30) from Nigeria and their two-year old daughter had sought self-catering accommodation from the Reception and Integration Agency (RIA) last year, as Khanyile couldn't eat the food at the direct provision hostel.
The requests were supported by doctors' letters, and the RIA says it did offer to relocate the family to Mosney, Co Meath, on December 15th last - just three weeks before Khanyile died. Her husband says he found his two-year-old child in the room with her mother's body on returning from a trip to Dublin on January 6th.
Direct provision - where accommodation, a basic allowance and all meals are provided to asylum seekers on contract to the RIA - has long been criticised as unsuitable for those non-nationals waiting several years for the State's response to their applications. The added isolation of being unable to seek work can exacerbate trauma experienced before arriving in Ireland.
Recently published research on the mental health promotion needs of asylum seekers and refugees found that 47 per cent of interviewees had spent more than two years in direct provision accommodation and 70 per cent had children living back in their home country. Some 88 per cent were still dealing with past traumas, according to the study by Regine Stewart for Galway City Development Board and HSE West.
Interviews conducted among 17 asylum seekers living in direct provision accommodation and six in private-rented housing in Galway found that 88 per cent of respondents identified unemployment as the biggest barrier to integration.
The Minister for Justice's preference for "detention centres" under his proposed new legislation in immigration may only exacerbate these and other health problems outlined at the conference.
Keynote speaker at the conference, Alice O'Flynn of the HSE, outlined some of the "messages" transmitted during preparation of the national health intercultural strategy, including provision of services for ethnic minorities which were appropriate and sensitive to their needs, and a preventative approach to service delivery. The strategy is due to be completed in April.