Refugee health has been called “a public health crisis of this century,” needing as much attention and collaboration over resources as global epidemics such as polio and HIV/AIDS.
From war trauma to women’s health, refugees have a complex spectrum of medical needs, bringing challenges for displaced populations, their host countries and aid organizations.
Many refugees who have fled war or ethnic and political violence are exposed to exploitation and abuse along their migration route, leaving them vulnerable to mental health issues such as depression, schizophrenia and post-traumatic stress disorder (PTSD). Some children born in conflict zones may have to deal with toxic stress for their entire lives.
Most refugees live in developing countries with scarce public health resources that are limited even for their own population, making it harder for refugees to get medical treatment or requiring them to pay out of their own pocket.
Sexual and reproductive healthcare is often lacking in crisis situations, which makes it a “leading cause of death, disease and disability among displaced women and girls of reproductive age,” according to the Women’s Refugee Commission.
Whether they are on the move or stuck in camps with limited medical care, refugees can also be particularly vulnerable to epidemics – as well as acute and chronic diseases.
In the fourth installment of our “Experts to Watch” series, we introduce 11 experts whose work on refugee health offers invaluable insight into this pressing issue.
Lenio Capsaskis is a senior academy fellow with the Centre on Global Health Security at Chatham House. She is researching how to improve access to healthcare for migrants and refugees in Greece for a report to be published later this year, focusing on equity, appropriateness and long-term health system planning for improved health outcomes. From 2015, she worked with the large Greek NGO PRAKSIS, initially as the field coordinator of a refugee crisis response team on the Greek islands, and then in Athens, managing public health programs and medical activities and working for the improvement of health services for vulnerable populations. Capsaskis has also worked in child health policy and advocacy in Sierra Leone, Mozambique and Uganda. She’s on Twitter: @leniocaps.
Karl Blanchet is the director and cofounder of the Health in Humanitarian Crises Centre at the London School of Hygiene and Tropical Medicine. He studies the resilience of health systems during conflicts and disease outbreaks, particularly using the notions of system dynamics and complexity science. He has worked in public health in Cambodia, Rwanda, Bosnia, Somaliland, Lebanon, Bangladesh and Nepal, among other places. His current research projects include a study of Syrian-led health initiatives in Lebanon. Blanchet is also the lead educator of the free online course Health in Humanitarian Crises.
Paul Spiegel is the director of the Johns Hopkins Center for Humanitarian Health and professor of the practise in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. His research interests include epidemiological methods, health information systems and HIV. He has spent decades working in the field of refugee health, including with Medecins Sans Frontieres, the U.S. Centers for Disease Control and Prevention and the U.N. refugee agency (UNHCR). Previously, he was the deputy director of the Division of Programme Support and Management at UNHCR. Spiegel has won the CDC’s Charles C. Shepard Award for Outstanding Scientific Contribution to Public Health and Assessment and Epidemiology. He is on Twitter: @pbspiegel.
Branka Agic is the manager of health equity at the Centre for Addiction and Mental Health (CAMH) in Toronto. She was a doctor in Sarajevo before fleeing during the Bosnian war and coming to Canada in 1994. Agic leads CAMH’s Refugee Mental Health Project. She is currently tracking the mental health needs of Syrian refugees coming to Canada, as a co-investigator on the study “Exploring the mental health and service needs of Syrian refugees.” She is also a member of a UNHCR regional Beyond Detention strategy working group and Ontario’s advisory table on Syrian refugee resettlement.
Fouad M. Fouad
Fouad M. Fouad is codirector of the Refugee Health Program at the American University of Beirut (AUB). In Syria, Fouad served as director of the Syrian Center for Tobacco Studies and was previously the director of public health in Aleppo. He left his country after the war broke out but continues his work from Lebanon. An assistant research professor at AUB’s Faculty of Health Sciences, his research focuses on the Syrian refugee crisis, including displacement inside Syria and neighboring countries and its impact on refugees’ health and well-being. He has written about Syria’s health crisis in the Lancet and the International Journal of Public Health and has contributed to U.N.-ESCWA research on rebuilding the public health system in Syria.
Richard F. Mollica
Richard F. Mollica is a professor of psychiatry at Harvard Medical School and director of the Harvard Program in Refugee Trauma (HPRT) at Massachusetts General Hospital. Since 1981, he has focused on the medical and mental healthcare of survivors of mass violence and torture in the U.S. and abroad. Under Mollica’s direction, HPRT conducts clinical, training, policy and research activities for populations affected by mass violence around the world. He is also active in the development of a Global Health curriculum, focusing on trauma and recovery. The Global Mental Health: Trauma and Recovery certificate program is the first of its kind in global mental health and post-conflict/disaster. Mollica has published more than 160 scientific manuscripts and has recently published his first book, “Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World.”
Aula Abbara is an infectious diseases physician in the U.K. Having worked in Syria before the war, she has since worked extensively on healthcare for Syrian refugees. She is the project lead for the Syrian American Medical Society’s (SAMS) project, providing primary healthcare to refugees in Greece. She has volunteered with SAMS since 2012 on various projects with refugees in Turkey and Jordan, including infectious diseases, primary healthcare, teaching and training. Abbara is on the steering committee of the Syria Public Health Network.
Sandra Krause is the Reproductive Health Program director of the Women’s Refugee Commission. She has been working on reproductive health issues in refugee and internally displaced settings for more than 20 years. Krause has established health programs for refugees and internally displaced persons in Somalia, Sudan and Malawi and has conducted reproductive health needs assessments in several countries. She’s on Twitter: @SandraWRC.
Ang Swee Chai
Ang Swee Chai was the first female consultant trauma and orthopaedic surgeon at St. Bartholomew’s and the Royal London hospitals. She was born in Malaysia and raised in Singapore; after her husband went into exile in 1977, she came to the U.K. as a refugee. In the 1980s and early 1990s, she worked in refugee camps in Lebanon and witnessed the Sabra and Shatila massacre there in 1982. She later worked for the United Nations in Gaza and the World Health Organization in the West Bank and cofounded the charity Medical Aid for Palestinians. Ang has told her personal story in her 1989 book “From Beirut to Jerusalem: A Woman Surgeon With the Palestinians” and in a recent TED Talk.
Patricia Walker is a professor of medicine at the University of Minnesota and senior research fellow at HealthPartners Center. She has been a clinician and medical educator focused on refugee and immigrant healthcare since 1979, when she responded to the Southeast Asian refugee crisis as a third-year medical student, and is regarded as a pioneer in refugee health. Her career focuses on best practice in care and medical education and reducing health disparities for people on the move.
Francesco Checchi is a professor of epidemiology and international health at the London School of Hygiene and Tropical Medicine. He is an expert in quantitative public health measurement and disease control in crises, such as armed conflict, natural disaster and epidemics. His study on the 2010–12 famine in Somalia illuminated the scale of the death toll from the crisis and he recently coauthored a commentary warning the humanitarian community not to repeat the mistakes as famine looms again in the country. He has worked for Medecins Sans Frontieres, the World Health Organization and Save the Children.