1. Refugees, Asylum Seekers and Immunisation ABC Immunisation Update 5thAugust 2014 Dr. I-Hao Cheng Refugee Health Program Manager & General Practitioner UNHCR

2. Refugees and Asylum Seekers in Australia

3. A refugee: • Any person who has been determined as: having a well-founded fear of being persecuted, outside the country of his nationality, unwilling to return. • Given rights, protection and assistance associated with “refugee status”.

4. An asylum seeker: • An individual whose application for refugee status is still pending a final decision… • Not given rights, protection and assistance associated with UNHCR Refugee status

5. New settlers 2012/13 Source: DIMA Offshore refugee arrivals: • Iraq 4,064 • Afghanistan 2,431 • Burma (Myanmar) 2,352 • Bhutan 1,023 • Iran • DR Congo, Somalia, Sudan, Eritrea, Ethiopia, Other • Total 12,515 • https://www.immi.gov.au/media/fact-sheets/60refugee.htm Onshore asylum approvals: • Afghanistan • Iran • Iraq • Sri Lanka • Other • Total 7,504

6. Immunisation needs

7. Refugee health assessment • Comprehensive history, • examination, investigations, • plan of management. • MBS #701, 703, 705, 707

8. Prior immunsation • Overseas childhood schedules WHO - EPI • - Childhood and other schedules less than Australia • Pre-departure health check • Immigration detention facility • On-arrival health assessment • Other services

10. Prior immunsation • Overseas childhood schedules WHO - EPI • Refugee pre-departure health check • - MMR x1 • Asylum seeker immigration detention facility • - MMR x1-2, Hep B x1-3 • On-arrival health assessment • - Variable • Other services

11. Prior immunsation • Overseas childhood schedules WHO - EPI • Pre-departure health check • Immigration detention facility • On-arrival health assessment • Other services • - Health services, English language schools

12. Immunisation eligibility

13. Health service eligibility • Does the patient have a • Medicare card? • Does the patient have a • Health Care Concession card? • Is the patient linked with a • support agency?

14. Immunisation eligibility • Use the Victorian Immunsation Schedule

15. Refugee and Asylum Seeker Management Tips

16. Use interpreter services • Translating and Interpreting Service (TIS) National • Doctors Priority Line: 1300 131 450 • Advance bookings: http://www.tisnational.gov.au/

17. Use a written plan Have a written plan

18. Coordinate with settlement and humanitarian case workers • AMES Settlement • Red Cross • Other

19. Seek advice • Refugee Health Program 8792 1911 www.semml.com.au • Monash Community • Refugee Health Nurses and • Refugee Health Fellow • 9792 8100