Meeting the health needs of refugee children
With the last of the unaccompanied asylum seeking children in Calais now being moved from the camp, the work to assess their eligibility to come to the UK continues.
Hundreds of unaccompanied children have legally come to the UK already to join family members, or are in the process of doing so. Others have been transferred to the UK under the Dubs amendment where it is in their best interests.
Securing their safety, after these children have lived in squalid conditions, and endured dangerous journeys to flee war zones, has been a priority. But equally important is ensuring they get the support they need to recover from their ordeals and to flourish in their new country. Healthcare professionals will be among those at the front-line who will play a vital part in this.
It's important to understand the experience and ordeals that many children who are coming to the UK from Calais may have been through. Many will have travelled across Europe for weeks and months, sometimes having being drugged and sometimes exposed to smugglers and traffickers. Once in the camp they will have been living in dangerous, unsanitary conditions with inadequate nutrition and makeshift shelter for accommodation. They will often have unrecorded health conditions and hazy vaccination histories as a result of their experiences so getting a full picture can be problematic. In the absence or records, details about family medical history, surgery, previous injuries, jaundice and fevers may need to be pieced together through conversations as well as examinations. Translators may be necessary for this.
It is unsurprising that this group of children can be deeply traumatised from seeing the effects of conflict or their attempts to escape it. Mental health problems including post-traumatic stress disorders are not uncommon. Some of these problems may not materialize until children are in a place of safety, with some blocking out the worst of their experiences.
Many of these children will have difficulties sleeping as a result of traumatic experiences and the unstable, disruptive conditions they have been living in. The Refugee Council tells me they often have to teach children how to sleep again, and work closely with them so they become familiarised with normal routines.
Common conditions in their country of origin, which vary from region to region, need to be considered. By being on the move, living in densely populated and unhygienic environments, children may have come into contact with diseases and infections such as TB so screening should be considered.
Meeting the health needs of unaccompanied children as they begin to settle in the UK is complex. From a public health perspective, it requires coordinated services, awareness and confidence at an individual healthcare professional level and a response that is varied and flexible enough to reflect the different experiences of these vulnerable children. It's a vital part of recovery however, and essential to building the bright new future they are so looking forward to.
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