Health seeking narratives of unwell Sri Lankan Tamil refugees in Melbourne Australia
Sophia Samuel A C , Jenny Advocat B and Grant Russell B
+ Author Affiliations
- Author Affiliations
A Monash University, School of Primary and Allied Health Care, Southern Academic Primary Care Research Unit, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia.
B Monash University, School of Primary and Allied Health Care, Department of General Practice, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic 3168, Australia.
C Corresponding author. Email: sophia.samuel@emphn.org.au
Australian Journal of Primary Health 24(1) 90-97 https://doi.org/10.1071/PY17033
Submitted: 13 April 2017 Accepted: 29 August 2017 Published: 29 November 2017
Abstract
Sri Lankan Tamil refugees are among the largest group of refugees to resettle in Australia in the last decade. The aim of this study is to characterise the narratives of health-seeking among unwell Sri Lankan Tamil refugees in Melbourne, Victoria, Australia. Drawing on a qualitative, phenomenological perspective, we conducted in-depth interviews in Tamil and English with 12 participants who identified as being unwell for 6 months or more. Findings revealed three narratives of health-seeking: the search for the ‘good life’ that was lost or never experienced, seeking help from familiar channels in an unfamiliar context, and the desire for financial and occupational independence. These three narratives are undergirded by the metanarrative of a hope-filled recovery. These narratives of Tamil refugees’ lived experience provide new insights into clinical care and health service delivery.
Additional keywords: health-seeking narratives, qualitative methods.
References
Barnes DM, Almasy N (2005) Refugees’ perceptions of healthy behaviours. Journal of Immigrant Health 7, 185–193.| Refugees’ perceptions of healthy behaviours.Crossref | GoogleScholarGoogle Scholar |
Birbili M (2000) Translating from one language to another. Social Research Update (31). Available at http://sru.soc.surrey.ac.uk/SRU31.html [Verified 18 February 2013]
Borrell-Carrió F, Suchman AL, Epstein RM (2004) The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Annals of Family Medicine 2, 576–582.
| The biopsychosocial model 25 years later: principles, practice, and scientific inquiry.Crossref | GoogleScholarGoogle Scholar |
Bull M, Schindeler E, Berkman D, Ransley J (2012) Sickness in the system of long-term detention. Journal of Refugee Studies 25, 47–68.
| Sickness in the system of long-term detention.Crossref | GoogleScholarGoogle Scholar |
Carroll J, Epstein R, Fiscella K, Volpe E, Diaz K, Omar S (2007) Knowledge and beliefs about health promotion and preventative health care among Somali women in the United States. Health Care for Women International 28, 360–380.
| Knowledge and beliefs about health promotion and preventative health care among Somali women in the United States.Crossref | GoogleScholarGoogle Scholar |
Cheng I-H, Russell GM, Bailes M, Block A (2011) An evaluation of the primary healthcare needs of refugees in South East Metropolitan Melbourne. A report by the Southern Academic Primary Care Research Unit to the Refugee Health Research Consortium. Southern Academic Primary Care Research Unit, Melbourne, Vic., Australia.
Culhane-Pera KA, Her C, Her B (2007) ‘We are out of balance here’: a Hmong cultural model of diabetes. Journal of Immigrant and Minority Health 9, 179–190.
| ‘We are out of balance here’: a Hmong cultural model of diabetes.Crossref | GoogleScholarGoogle Scholar |
Department of Immigration and Citizenship (2011) Australia’s Humanitarian Program – Information Paper April 2011. (Australian Government: Canberra, ACT, Australia) Available at http://www.immi.gov.au/media/publications/pdf/hp-client-info-paper.pdf [Verified 11 October 2012]
Department of Social Services (2014) The Sri Lanka-born Community. (Commonwealth of Australia: Canberra, ACT, Australia) Available at https://www.dss.gov.au/our-responsibilities/settlement-and-multicultural-affairs/programs-policy/a-multicultural-australia/programs-and-publications/community-information-summaries/the-sri-lanka-born-community [Verified 11 October 2017]
Douglas M (2002) ‘Purity and Danger: an Analysis of the Concepts of Pollution and Taboo.’ (Taylor & Francis Taylor: London, UK)
Esposito N (2001) From meaning to meaning: the influence of translation techniques on non-English focus group research. Qualitative Health Research 11, 568–579.
| From meaning to meaning: the influence of translation techniques on non-English focus group research.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvnslOhuw%3D%3D&md5=a829d4e68645c75c54f7f220ae207279CAS |
Foster GM (1976) Disease aetiology in non-Western medical systems. American Anthropologist 78, 773–782.
| Disease aetiology in non-Western medical systems.Crossref | GoogleScholarGoogle Scholar |
Frye BA, D’Avanzo C (1994) Themes in managing culturally defined illness in the Cambodian refugee family. Journal of Community Health Nursing 11, 89–98.
| Themes in managing culturally defined illness in the Cambodian refugee family.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c3ptlSmtA%3D%3D&md5=cb6ddf4afbdd9dface8a79bbfa94b199CAS |
Fuglerud O (1999) ‘Life on the Outside: Tamil Diaspora and Long Distance Nationalism.’ (Pluto Press: London, UK)
Gostin LHJ, Valentine N, Nygren-Krug H (2003) ‘The Domains of Health Responsiveness: a Human Rights Analysis.’ (World Health Organization: London, UK)
Guribye E, Sandal GM, Oppedal B (2011) Communal proactive coping strategies among Tamil refugees in Norway: a case study in a naturalistic setting. International Journal of Mental Health Systems 5, 9
| Communal proactive coping strategies among Tamil refugees in Norway: a case study in a naturalistic setting.Crossref | GoogleScholarGoogle Scholar |
Harrison F (2013) ‘Still Counting the Dead: Survivors of Sri Lanka’s Hidden War.’ (Portobello Books: London, UK)
Human Rights and Equal Opportunity Commission (2012) Immigration detention and human rights: how long are people detained? Available at http://www.hreoc.gov.au/human_rights/immigration/detention_rights.html#howmany [Verified 11 October 2012]
Kleinman A (1988) ‘The Illness Narratives: Suffering, Healing and the Human Condition.’ (Basic Books: New York, NY, USA)
Kleinman A, Eisenberg L, Good B (1978) Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine 88, 251–258.
| Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE1c7it1artA%3D%3D&md5=04dd6d0694f1e37b368ad0b6204ef612CAS |
Komesaraff P, James P, Sundram S (2013) After the war: why Sri Lankan refugees continue to come to Australia. The Conversation, 10 June 2013. Available at http://theconversation.com/after-the-war-why-sri-lankan-refugees-continue-to-come-to-australia-14638 [Verified 28 February 2017]
Markovic M, Manderson L, Kelaher M (2002) The health of immigrant women: Queensland women from the former Yugoslavia. Journal of Immigrant Health 4, 5–15.
| The health of immigrant women: Queensland women from the former Yugoslavia.Crossref | GoogleScholarGoogle Scholar |
Marlowe JM (2010) Beyond the discourse of trauma: shifting the focus on Sudanese refugees. Journal of Refugee Studies 23, 183–198.
| Beyond the discourse of trauma: shifting the focus on Sudanese refugees.Crossref | GoogleScholarGoogle Scholar |
Mckay FH, Thomas SL, Kneebone S (2012) ‘It would be okay if they came through the proper channels’: community perceptions and attitudes to asylum seekers in Australia. Journal of Refugee Studies 25, 113–133.
| ‘It would be okay if they came through the proper channels’: community perceptions and attitudes to asylum seekers in Australia.Crossref | GoogleScholarGoogle Scholar |
Miles MB, Huberman AM (1994) ‘Qualitative Data Analysis.’ (Sage Publications: Thousand Oaks, CA, USA)
Mischler EG (1981) ‘Social Context of Health, Illness and Patient Care.’ (Cambridge Press: New York, NY, USA)
Mishler EG (1984) ‘The Discourse of Medicine: Dialectics of Medical Interviews.’ (Ablex: Norwood, NJ, USA)
Murray SB, Skull SA (2005) Hurdles to health: immigrant and refugee health care in Australia. Australian Health Review 29, 25–29.
| Hurdles to health: immigrant and refugee health care in Australia.Crossref | GoogleScholarGoogle Scholar |
Murray KE, Davidson GR, Schweitzer RD (2008) ‘Psychological wellbeing of refugees resettling in Australia. A literature review prepared for the Australian Psychological Society.’ (The Australian Psychological Society Ltd: Melbourne, Vic., Australia)
Nussbaum JF, Parrott R, Thompson TL (2011) ‘The Routledge Handbook of Health Communication.’ (Routledge: London, UK)
Organization for Economic Cooperation and Development (2012) ‘Health Status and Access to Health Care.’ (OECD Publishing: Paris, France)
Paton MQ (2002) ‘Qualitative Research and Evaluation Methods.’ (Sage Publications: Thousand Oaks, CA, USA)
Pickwell SM (1999) The Health of Cambodian refugees Journal of Immigrant Health 1, 49–52.
| The Health of Cambodian refugeesCrossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MrltVymsw%3D%3D&md5=021d75e4ea2bd7d268c95707e49dcf0eCAS |
Schulz PM, Resick PA, Huber LC, Griffin MG (2006) The effectiveness of cognitive processing therapy for PTSD with refugees in a community setting. Cognitive and Behavioral Practice 13, 322–331.
| The effectiveness of cognitive processing therapy for PTSD with refugees in a community setting.Crossref | GoogleScholarGoogle Scholar |
Schweitzer RD, Brough M, Vromans L, Asic-Kobe M (2011) Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience. The Australian and New Zealand Journal of Psychiatry 45, 299–307.
| Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience.Crossref | GoogleScholarGoogle Scholar |
Sharareh A, Bildt C, Wamala S (2007) The health of female Iranian immigrants in Sweden: a qualitative six-year follow-up study. Health Care for Women International 28, 339–359.
| The health of female Iranian immigrants in Sweden: a qualitative six-year follow-up study.Crossref | GoogleScholarGoogle Scholar |
Silove D, Steel Z, McGorry P, Mohan P (1998) Psychiatric symptoms and living difficulties in Tamil asylum seekers: comparisons with refugees and immigrants. Acta Psychiatrica Scandinavica 97, 175–181.
| Psychiatric symptoms and living difficulties in Tamil asylum seekers: comparisons with refugees and immigrants.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3gt1ejtw%3D%3D&md5=6f0e9df59fb4e8b605c24dc08c528208CAS |
Silove D, Steel Z, Bauman A, Chey T, McFarlane A (2007) Trauma, PTSD and the longer-term mental health burden amongst Vietnamese refugees: a comparison with the Australian-born population. Social Psychiatry and Psychiatric Epidemiology 42, 467–476.
| Trauma, PTSD and the longer-term mental health burden amongst Vietnamese refugees: a comparison with the Australian-born population.Crossref | GoogleScholarGoogle Scholar |
Sontag S (2001) ‘Illness as Metaphor & AIDS and its Metaphors.’ (Picador: New York, NY, USA)
Taylor J (1998) ‘Ubu and the Truth Commission.’ (Juta Academic: Cape Town, South Africa)
Temple B, Young A (2004) Qualitative research and translation dilemmas. Qualitative Research 4, 161–178.
| Qualitative research and translation dilemmas.Crossref | GoogleScholarGoogle Scholar |
United Nations High Commission for Refugees (2012) A guidance note on health insurance schemes for refugees and other persons of concern to UNHCR. Available at http://www.unhcr.org/4f7d4cb1342.pdf [Verified 31 July 2017]
US Department of Health & Human Services (2015) Health Insurance. Available at https://www.acf.hhs.gov/orr/health [Verified 31 July 2017]
van Nes F, Abma T, Jonsson H, Deeg D (2010) Language differences in qualitative research: is meaning lost in translation? European Journal of Ageing 7, 313–316.
| Language differences in qualitative research: is meaning lost in translation?Crossref | GoogleScholarGoogle Scholar |
Victorian Department of Human Services (2008) ‘Refugee health and wellbeing action plan 2008–2010: current and future initiatives.’ (Department of Human Services: Canberra, ACT, Australia)
Williams GH (2003) The determinants of health: structure, context and agency. Sociology of Health & Illness 25, 131–154.
| The determinants of health: structure, context and agency.Crossref | GoogleScholarGoogle Scholar |
Wilson JP, Drožđek B (Eds) (2004) ‘Broken Spirits: the Treatment of Traumatized Asylum Seekers, Refugees, War and Torture Victims.’ (Brunner-Routledge: New York, NY, USA)
Yeoh SW, Furler J (2011) Perceptions of health and diabetes in a Melbourne South Sudanese community. Journal of Immigrant and Minority Health 13, 914–918.
| Perceptions of health and diabetes in a Melbourne South Sudanese community.Crossref | GoogleScholarGoogle Scholar |
Ziaian T, de Anstiss H, Antoniou G, Sawyer M, Baghurst P (2012) Depressive symptomatology and service utilisation among refugee children and adolescents living in South Australia. Child Adolescent Mental Health Journal 17, 146–152.
| Depressive symptomatology and service utilisation among refugee children and adolescents living in South Australia.Crossref | GoogleScholarGoogle Scholar |
