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Looking beyond: complex holistic care needs of Syrian and Iraqi refugee children and adolescents
  1. Kristen Lindsay1,2,
  2. Gemma Hanes1,
  3. Raewyn Mutch1,2,3,
  4. Elizabeth McKinnon3,
  5. Sarah Cherian1,2,3
  1. 1Refugee Health Service, Department of General Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia
  2. 2Discipline of Paediatrics, Medical School, The University of Western Australia, Perth, Western Australia, Australia
  3. 3Telethon Kids Institute, Nedlands, Western Australia, Australia
  1. Correspondence to Dr Sarah Cherian, Refugee Health Service, Department of General Paediatrics, Perth Children's Hospital, Nedlands, WA 6840, Australia; sarah.cherian{at}health.wa.gov.au

Abstract

Objective Protracted international conflict has seen escalating numbers of displaced and resettled Syrian and Iraqi refugees, raising concerns for their health and well-being. This paper describes the demographic and clinical profiles of recently resettled Syrian and Iraqi refugee children and adolescents across physical, psychosocial, developmental and educational domains using standardised multidisciplinary assessments.

Design A cross-sectional observational study was undertaken of initial specialist paediatric multidisciplinary Refugee Health Service assessments completed at the tertiary paediatric hospital (Western Australia) between June 2015 and September 2019.

Results Three hundred and twenty-seven children and adolescents (264 Syrian, 63 Iraqi) were assessed following resettlement. Witnessed trauma (86%) and disclosed adversity (median Refugee Adverse Childhood Experiences score 3, range 1–14) were universally high. Almost all patients had health issues identified across physical (99%), psychosocial (76%) and developmental/educational (75%) domains. Interrupted education (65%) and death of a family member (16%) were significantly associated with psychological morbidities. Common comorbidities included dental caries (78%), non-infectious disease (76%), vitamin D deficiency (72%), malnutrition (46%; overweight/obesity 23%), and psychological (32%; post-traumatic stress disorder 4.3%) and developmental (9.5%) concerns. Emerging and alarming child protection concerns were prevalent (17%), with females demonstrating especially high risks.

Conclusion This is the largest comprehensive study demonstrating the complex and cross-dimensional health needs and specific vulnerabilities of resettled Syrian and Iraqi refugee children and adolescents. Early comprehensive standardised multidisciplinary paediatric assessments, and culturally safe, trauma-informed interventions and follow-up are required to optimise resettlement outcomes and promote well-being.

  • paediatrics
  • adolescent health
  • global health
  • child development
  • child protective services

Data availability statement

Data may be obtained from a third party and are not publicly available. These data are not in a repository (eg, deidentified hospital data) within the Child and Adolescent Health Service (CAHS), Perth, Western Australia.

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Data availability statement

Data may be obtained from a third party and are not publicly available. These data are not in a repository (eg, deidentified hospital data) within the Child and Adolescent Health Service (CAHS), Perth, Western Australia.

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Footnotes

  • Twitter @kristenjlindsay

  • Contributors KL conceptualised and designed the study, collected data, conducted statistical analyses and interpretation, assisted with design and production of figures and tables, drafted the initial manuscript, and reviewed and revised the manuscript. SC aided in conceptualisation and study design, supervised the data collection, analyses and interpretation, and critically reviewed and revised the manuscript and is overall responsible for the content. GH and RM contributed to data acquisition and interpretation, and reviewed and revised the manuscript. EM undertook the statistical analyses and assisted with interpretation, preparation of tables and creation of figures, and revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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