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Health Beliefs and Barriers to Healthcare of Rohingya Refugees

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Abstract

In recent years, over 1,000 Rohingya families have been resettled to Milwaukee, Wisconsin from areas where they faced trauma and health disparities. To better understand their health beliefs and barriers to healthcare, we conducted a qualitative study with ten community health workers and stakeholders serving the Milwaukee Rohingya community. Interviews were transcribed, coded, and analyzed. Themes included: 1) health is defined as being able to meet basic needs of the family/community; 2) prior and existing mistrust and fear of systems of authority impact healthcare seeking behavior; 3) past-trauma negatively impacts physical and mental health; 4) religion and spirituality influence beliefs about illness, recovery, and wellbeing; 5) linguistic, cultural, and educational barriers impact access, quality of care, and understanding of disease. These results begin to address the significant gap in our knowledge of the health beliefs and needs of the local Rohingya community and underscore the need for tailored interventions.

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Data Availability

De-identified transcripts of interviews will be provided upon request.

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References

  1. A Lindblom EM, T Motala, K Munyan. Persecution of the Rohingya Muslims: is genocide occurring in Myanmar's Rakhine State? New Haven, CT: Yale Law School & Fortify Rights; 2015. Available from: https://www.fortifyrights.org/downloads/Yale_Persecution_of_the_Rohingya_October_2015.pdf.

  2. Mahmood SS, Wroe E, Fuller A, Leaning J. The Rohingya people of Myanmar: health, human rights, and identity. Lancet. 2017;389(10081):1841–50. https://doi.org/10.1016/S0140-6736(16)00646-2.

    Article  PubMed  Google Scholar 

  3. R Sollom PP. Stateless and starving: persecuted Rohingya flee Burma and starve in Bangladesh. Washington, DC: 2010.

  4. Rohingya Refugee Crisis: Medecins Sans Frontieres; [cited 2020]. Available from: https://www.msf.org/rohingya-refugee-crisis-depth

  5. Marques TV. Refugees and migrants struggle to obtain health care in Europe. CMAJ. 2012;184(10):E531–2. https://doi.org/10.1503/cmaj.109-4214.

    Article  PubMed  PubMed Central  Google Scholar 

  6. UNHCR. Report on irregular maritime movements in South-East Asia. Geneva, Switzerland: United Nations, Jan-Nov 2014.

  7. Watch HR. Southeast Asia: End Rohingya Boat Pushbacks2015.

  8. Chun Tie Y, Birks M, Francis K. Grounded theory research: A design framework for novice researchers. SAGE Open Med. 2019;7:2050312118822927. https://doi.org/10.1177/2050312118822927.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Abbas M, Aloudat T, Bartolomei J, Carballo M, Durieux-Paillard S, Gabus L, et al. Migrant and refugee populations: a public health and policy perspective on a continuing global crisis. Antimicrob Resist Infect Control. 2018;7:113. https://doi.org/10.1186/s13756-018-0403-4.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Weida EB, Phojanakong P, Patel F, Chilton M. Financial health as a measurable social determinant of health. PLoS One. 2020;15(5):e0233359. https://doi.org/10.1371/journal.pone.0233359. interest: This study was funded by the Claneil Foundation, Inc. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

  11. Johnson R, Grove A, Clarke A. It’s hard to play ball: A qualitative study of knowledge exchange and silo effects in public health. BMC Health Serv Res. 2018;18(1):1. https://doi.org/10.1186/s12913-017-2770-6.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Yasin B, Yusuf YQ, Junita M. Acehnese Teachers Teaching English to Rohingya Refugees: Process and Cultural Barriers. SAGE Open. 2018;8(2):2158244018782574. https://doi.org/10.1177/2158244018782574.

    Article  Google Scholar 

  13. Shohel MMC. Education in emergencies: challenges of providing education for Rohingya children living in refugee camps in Bangladesh. Education Inquiry. 2020:1–23. https://doi.org/10.1080/20004508.2020.1823121.

  14. Hoque M. Chittagonian Variety: Dialect, Language, or Semi-Language? IIUC Stud. 2016;12:41. https://doi.org/10.3329/iiucs.v12i0.30580.

    Article  Google Scholar 

  15. Rahman MR, Faiz MA, Nu MY, Hassan MR, Chakrabarty AK, Kabir I, et al. A Rapid Assessment of Health Literacy and Health Status of Rohingya Refugees Living in Cox's Bazar, Bangladesh Following the August 2017 Exodus from Myanmar: A Cross-Sectional Study. Trop Med Infect Dis 2020;5(3). https://doi.org/10.3390/tropicalmed5030110.

  16. Bhatia A, Mahmud A, Fuller A, Shin R, Rahman A, Shatil T, et al. The Rohingya in Cox’s Bazar: When the Stateless Seek Refuge. Health Hum Rights. 2018;20(2):105–22.

    PubMed  PubMed Central  Google Scholar 

  17. Morris MD, Popper ST, Rodwell TC, Brodine SK, Brouwer KC. Healthcare barriers of refugees post-resettlement. J Community Health. 2009;34(6):529–38. https://doi.org/10.1007/s10900-009-9175-3.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Rayes D, Karnouk C, Churbaji D, Walther L, Bajbouj M. Faith-Based Coping Among Arabic-Speaking Refugees Seeking Mental Health Services in Berlin, Germany: An Exploratory Qualitative Study. Front Psychiatry. 2021;12:595979. https://doi.org/10.3389/fpsyt.2021.595979.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Rees S, Pease B. Domestic Violence in Refugee Families in Australia. J Immigr Refug Stud. 2007;5(2):1–19. https://doi.org/10.1300/J500v05n02_01.

    Article  Google Scholar 

  20. Martin LJ. Domestic Violence at the Margins: Readings on Race, Class, Gender, and Culture. Contemp Sociol. 2007;36(4):344–5. https://doi.org/10.1177/009430610703600417.

    Article  Google Scholar 

  21. Bhuyan R, Mell M, Senturia K, Sullivan M, Shiu-Thornton S. “Women Must Endure According to Their Karma”: Cambodian Immigrant Women Talk About Domestic Violence. J Interpers Violence. 2005;20(8):902–21. https://doi.org/10.1177/0886260505277675.

    Article  PubMed  Google Scholar 

  22. Yoshioka MR, Dinoia J, Ullah K. Attitudes Toward Marital Violence: An Examination of Four Asian Communities. Violence Against Women. 2001;7(8):900–26. https://doi.org/10.1177/10778010122182820.

    Article  Google Scholar 

  23. Runner M, Yoshihama M, Novick S. Intimate Partner Violence in Immigrant and Refugee Communities. Princeton, NJ: Robert Wood Johnson Foundation; 2009.

    Google Scholar 

  24. Hawkins MM, Schmitt ME, Adebayo CT, Weitzel J, Olukotun O, Christensen AM, et al. Promoting the health of refugee women: a scoping literature review incorporating the social ecological model. Int J Equity Health. 2021;20(1):45. https://doi.org/10.1186/s12939-021-01387-5.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Greene MC, Rees S, Likindikoki S, Bonz AG, Joscelyne A, Kaysen D, et al. Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania. Confl Health. 2019;13:38. https://doi.org/10.1186/s13031-019-0222-0.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Khan S, Haque S. Trauma, mental health, and everyday functioning among Rohingya refugee people living in short- and long-term resettlements. Soc Psychiatry Psychiatr Epidemiol. 2021;56(3):497–512. https://doi.org/10.1007/s00127-020-01962-1.

    Article  PubMed  Google Scholar 

  27. Riley A, Akther Y, Noor M, Ali R, Welton-Mitchell C. Systematic human rights violations, traumatic events, daily stressors and mental health of Rohingya refugees in Bangladesh. Confl Health. 2020;14:60. https://doi.org/10.1186/s13031-020-00306-9.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Slewa-Younan S, Yaser A, Guajardo MGU, Mannan H, Smith CA, Mond JM. The mental health and help-seeking behaviour of resettled Afghan refugees in Australia. Int J Ment Health Syst. 2017;11:49. https://doi.org/10.1186/s13033-017-0157-z.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Richard L, Richardson G, Jaye C, Stokes T. Providing care to refugees through mainstream general practice in the southern health region of New Zealand: a qualitative study of primary healthcare professionals’ perspectives. BMJ Open. 2019;9(12):e034323. https://doi.org/10.1136/bmjopen-2019-034323.

    Article  PubMed  PubMed Central  Google Scholar 

  30. The Rohingya people: past, present, and future. Lancet. 2019;394(10216):2202. https://doi.org/10.1016/S0140-6736(19)33139-3

  31. Address root causes of the Rohingya refugee crisis, urges UN chief2020. Available from: https://news.un.org/en/story/2020/08/1071052.

  32. Akhter S, Kusakabe K. Gender-based Violence among Documented Rohingya Refugees in Bangladesh. Indian J Gend Stud. 2014;21(2):225–46. https://doi.org/10.1177/0971521514525088.

    Article  Google Scholar 

  33. Braveman P, Gottlieb L. The social determinants of health: it’s time to consider the causes of the causes. Public Health Rep. 2014;129(Suppl 2):19–31. https://doi.org/10.1177/00333549141291S206.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Gany FM, Herrera AP, Avallone M, Changrani J. Attitudes, Knowledge, and Health-Seeking Behaviors of Five Immigrant Minority Communities in the Prevention and Screening of Cancer: A Focus Group Approach. Ethn Health. 2006;11(1):19–39. https://doi.org/10.1080/13557850500391394.

    Article  PubMed  Google Scholar 

  35. Islam MM, Nuzhath T. Health risks of Rohingya refugee population in Bangladesh: a call for global attention. J Glob Health. 2018;8(2):020309. https://doi.org/10.7189/jogh.08.020309.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Lewa C. North Arakan: an open prison for the Rohingya in Burma 2009; (32).

  37. Milton AH, Rahman M, Hussain S, Jindal C, Choudhury S, Akter S, et al. Trapped in Statelessness: Rohingya Refugees in Bangladesh. Int J Environ Res Public Health. 2017;14(8). https://doi.org/10.3390/ijerph14080942.

  38. Nelson-Peterman JL, Toof R, Liang SL, Grigg-Saito DC. Long-Term Refugee Health: Health Behaviors and Outcomes of Cambodian Refugee and Immigrant Women. Health Educ Behav. 2015;42(6):814–23. https://doi.org/10.1177/1090198115590779.

    Article  PubMed  Google Scholar 

  39. Philbrick AM, Wicks CM, Harris IM, Shaft GM, Van Vooren JS. Make Refugee Health Care Great [Again]. Am J Public Health. 2017;107(5):656–8. https://doi.org/10.2105/AJPH.2017.303740.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Refugees UNHCo. Workshop on operational guidance on the use of special nutritional products to reduce micronutrient deficiencies and malnutrition in refugee population. Geneva, Switzerland: United Nations, 2012.

  41. Riley A, Varner A, Ventevogel P, Taimur Hasan MM, Welton-Mitchell C. Daily stressors, trauma exposure, and mental health among stateless Rohingya refugees in Bangladesh. Transcult Psychiatry. 2017;54(3):304–31. https://doi.org/10.1177/1363461517705571.

    Article  PubMed  Google Scholar 

  42. Riza E, Kalkman S, Coritsidis A, Koubardas S, Vassiliu S, Lazarou D, et al. Community-Based Healthcare for Migrants and Refugees: A Scoping Literature Review of Best Practices. Healthcare (Basel) 2020;8(2). https://doi.org/10.3390/healthcare8020115.

  43. Simone Cazares JH. 'You Always Keep Worrying': Rohingya Refugee In Milwaukee Says About His Family In Myanmar. In: Simone Cazares JH, editor. WUWM 897: Milwaukee’s NPR. Milwaukee, Wisconsin: Milwaukee Public Media; 2021.

  44. McConnan I. Humanitarian Charter and Minimum Standards in Disaster Response. 1st final ed. Project S, editor. Geneva Oxford: Sphere Project; Distributed by Oxfam Publishing; 2000. 320 p. p.

  45. Tay AK, Riley A, Islam R, Welton-Mitchell C, Duchesne B, Waters V, et al. The culture, mental health and psychosocial wellbeing of Rohingya refugees: a systematic review. Epidemiol Psychiatr Sci. 2019;28(5):489–94. https://doi.org/10.1017/S2045796019000192.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Teng TS, Zalilah MS. Nutritional status of Rohingya children in Kuala Lumpur. Malays J Med Health Sci. 2011;7:41–9.

    Google Scholar 

  47. Thomas RE, Gushulak B. Screening and treatment of immigrants and refugees to Canada for tuberculosis: Implications of the experience of Canada and other industrialized countries. Can J Infect Dis. 1995;6(5):246–55. https://doi.org/10.1155/1995/271936.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Wali N, Chen W, Rawal LB, Amanullah ASM, Renzaho AMN. Integrating human rights approaches into public health practices and policies to address health needs amongst Rohingya refugees in Bangladesh: a systematic review and meta-ethnographic analysis. Arch Public Health. 2018;76:59. https://doi.org/10.1186/s13690-018-0305-1.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Walther L, Amann J, Flick U, Ta TMT, Bajbouj M, Hahn E. A qualitative study on resilience in adult refugees in Germany. BMC Public Health. 2021;21(1):828. https://doi.org/10.1186/s12889-021-10817-6.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Wheeler S. Failing Rohingya Rape Victims in Bangladesh. Refugees from Burma Lack Access to Crucial Services [Internet]. 2018.

  51. Wylie L, Van Meyel R, Harder H, Sukhera J, Luc C, Ganjavi H, et al. Assessing trauma in a transcultural context: challenges in mental health care with immigrants and refugees. Public Health Rev. 2018;39:22. https://doi.org/10.1186/s40985-018-0102-y.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Ahmed T, Mahfuz M, Ireen S, Ahmed AM, Rahman S, Islam MM, et al. Nutrition of children and women in Bangladesh: trends and directions for the future. J Health Popul Nutr. 2012;30(1):1–11. https://doi.org/10.3329/jhpn.v30i1.11268.

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

Funding was provided by the Advancing a Healthier Wisconsin Endowment and the Medical College of Wisconsin Cancer Center to the senior author, Melinda Stolley, PhD.

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Shabi Haider and Aniya Maheen developed the study protocol and conducted the interviews for this qualitative study. Mr. Haider, Ms. Maheen, and Mr. Ansari analyzed the data. All four authors contributed equally to the writing of the manuscript. All work was conducted under the mentorship of Dr. Melinda Stolley.

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Correspondence to Melinda Stolley.

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Haider, S., Maheen, A., Ansari, M. et al. Health Beliefs and Barriers to Healthcare of Rohingya Refugees. J. Racial and Ethnic Health Disparities 10, 1560–1568 (2023). https://doi.org/10.1007/s40615-022-01342-2

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