Refugees looked after by South Auckland GP

Refugee Omar Azima and his GP Ali Numan, who says refugee patients struggle with language and cultural barriers

A South Auckland GP who treats hundreds of refugees, sees them struggling with daily tasks as they deal with huge amounts of trauma.

Ali Numan, a GP at Bakerfield Medical and Urgent Care, which has 400 refugee patients on its books, spoke to a group of 85 GPs and other healthcare providers at an evening session at the Mangere Refugee Resettlement Centre on Tuesday night.

In what was often an emotional presentation, Dr Numan talked of children getting no sleep because they are screaming all night, parents flummoxed by application forms for school or university, and significant mental health need, as just some of the problems he sees with his refugee patients.

With other doctors, volunteers and staff from refugee resettlement programmes, Dr Numan shared his work and concerns about how best to help those who have come to New Zealand from dangerous and traumatic parts of the world.

Thousands of refugees in New Zealand

Project manager for Asian, migrant and refugee health at Waitemata and Auckland DHBs, Raj Singh presented the latest statistics on refugees in New Zealand, covering quota refugees who come through the UNs refugee system.

There have been 2465 such refugees settled in Auckland since 2006, with numbers decreasing in recent years. Eighty-eight were settled last year and the most common suburbs in Auckland in which they settle are Manurewa, Otara, Mangere and Papatoetoe.

The quota refugees come from a range of countries and backgrounds, and have unique healthcare needs, Mr Singh says.

The three Auckland DHBs have a wrap-around agreement for refugees, including free consultations or extended consultations for a small copayment, at 64 participating practices across the region.

Desire to help children succeed

Dr Numan, who speaks Arabic and English, says he has people coming into his office waiting for a break when they can ask him about application forms, utility bills and other aspects of life in New Zealand with which they struggle for reasons of language or culture.

Common problems are language difficulties, understanding the school system and helping children succeed, securing work, securing accommodation, accessing services, transportation and cultural barriers.

Mental health issues are common and include post-traumatic stress disorder, flashbacks, severe anxiety and depression.

Many refugees dont want to recognise they have depression, they dont like the name of the word and do not want to go for counselling, Dr Numan says.

Mental health problems may not manifest themselves in the same way they do in western culture, he says.

Chronic conditions are also common, and some include psychosomatic symptoms.

Cultural sensitivity vital

The approach for managing refugee health involves education for both doctor and patients, and extra time in which to build a rapport, Dr Numan says.

Cultural sensitivity is highly important as refugees can have different views on procedures and tests such as mammograms and cervical smears.

People from some cultures, for instance, are uncomfortable with telling their parents they have cancer, which can put doctors in a difficult position.

Children not interpreters

Red Cross volunteer Sarah MacDonald spoke to the group about her work helping refugees settle in New Zealand.

Some of the biggest problems Ms MacDonald sees are around understanding, both of patients and practitioners.

She called on doctors to make full use of official translation services, rather than family members, to avoid children being traumatised by having to act as translators for their parents.

It was important people were aware asylum seekers did not have access to the same integration services available to quota refugees, Ms MacDonald says.

Waiting times a challenge

One of Dr Numans patients, Omar Azima refugee from Syria who came to New Zealand a year ago, also presented with the help of an interpreter.

He told the audience the healthcare provided to him by Dr Numan and the wider New Zealand health service has been good, with the exception of waiting times.

There have always been interpreters available for him, he says, but when asked what could improve, he says he has experienced a lot of waiting for limited health benefit.

The evening was hosted by Auckland Regional Refugee Health Network, run by Aucklands DHBs.

The next session will be held on 8 November in Western Springs, and will have a stronger focus on asylum seekers, who are not eligible for the same support as quota refugees.