Disability in refugee children and youth in south western Sydney: Double jeopardy

Background and Aims: The health needs of refugee children and young people have been well described in the international literature; similarly research studies have established that refugee children in Australia have... [ view full abstract ]

Background and Aims:
The health needs of refugee children and young people have been well described in the international literature; similarly research studies have established that refugee children in Australia have significant health needs. There is less known about the burden of disability in newly arriving refugee children in Australia. Our aims were to determine the health, social and service needs of refugee children and youth presenting with developmental disability to refugee clinics in South Western Sydney (SWS).

Methods:
Clinical data were collated on children (<18 years) attending the paediatric refugee clinic in SWS between 2010 and 2014, with a focus on those with a disability. Simple descriptive analysis was performed using SPSS V10. A case study of a 17 year old profoundly disabled refugee youth who required prolonged hospitalisation to manage health and support needs is presented.

Results:
A total of 137 children were seen in the paediatric refugee clinic in the period. Mean age was 7.3 years, 60% were male, most were of Middle-Eastern origin. The proportion of children with developmental disability went from an average of 12% of patients seen in 2010 to 2013; to 37% in 2014. More presentations with severe/profound disability with co-morbidities were seen in 2014. Immigration policy changes to health status criteria for refugee applicants occurred in 2012, most likely accounting for this rise. The case study demonstrated the challenges for health, disability, education and welfare services in coordinating care.

Conclusions:
Disability and co-morbid chronic health conditions appear to be emerging issues in newly arriving refugee families. These children and young people are among the most vulnerable in our population. Better coordination by health and welfare professionals is essential to assist refugee families as they deal with compounded settlement stress, as well as navigating health, education, welfare and support service systems.