Refugees, Asylum Seekers and Trauma

A mind-blowing book to read

There are some books and movies that really leave an impact on a person, and "The Body Keeps The Score" by Bessel Van der Kolk is no different.  

The author himself is a psychiatrist and researcher who specifically focused on trauma induced mental health.  His writings look in detail as to how patients with PTSD act and how ignoring their preceding trauma can result in their mis-treatment. He argues that trauma, or cumulative trauma does not only explain mental health patterns but also tells us about a patients physical health behaviours.   

I currently work in a practice with a high density of refugees. They have either fled conflicts or lived in terrible circumstances and have come to the UK to seek a better life for them and their families. They are not alone however, as in 2020, 80 million people worldwide were estimated to have been displaced. This is staggering especially as most of us reading this newsletter reside in relative security.  

These patients have had and continue to have distressing experiences. Some of these could be perceived as mundane from our point of view but continue to be traumatic for them. Some of these include: 

• Their experiences in international conflict zones 

• Feeling "unwelcomed" in the countries where they have sought refuge.  

• Frustrated as they are often misunderstood either due to their language or differences in health beliefs 

• Going back and forth with immigration and often facing barriers to support even once settled.  

• Being placed in poor accommodation where the space is limited or there are structural issues such as damp.  

• Having a general "distrust" of government authorities as they originate from places of political repression.  

These patients have years of lived experiences and they often struggle to articulate themselves. I recently had a patient who came from Syria and was suffering from severe memory loss. He was only 45 and dementia is something that doesn't really come to mind. His wife explained that he often forgets the names of his own children and they put it down to the fact that he suffered from repeated head injuries due to rubble dropping on his head. I proceeded to do a routine CT scan which was reported as normal. However, he continues to have this issue and it is clearly making him very upset. This is certainly a manifestation of his trauma.  

So what can we do to help? As I said on my previous post on chronic pain – we definitely aren't psychologists and unpacking all of this can be quite difficult in 10 minutes. However, here are some useful tips that have worked for me:

• Smile and be welcoming. Many of these patients don't feel welcomed (as they have told me themselves).

• If you're in primary care, consider booking a double appointment.  

• Use a translator wherever possible.

• If they understand English, consider slowing down your speech and use simpler terminology.

• Use the armoury of services available to you including social prescribers and charities such as Refugee Action. 

• Ensure they have access to allied health services including an optician and a dentist. We need to be advocates for their health.  

• Try and explain to them the various ways they can get help. My practice have a number of "useful numbers" documents translated in different languages. This could even be a potential QIP idea for you!

Let's be the advocates for those who feel they are alone.  

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What I'm watching 

I'm currently watching the cricket world cup. While I'm not supporting a team, there is something relaxing about watching a batsman hit a six out of the stadium. My money is on India to win but in this sport, anything can happen! 

Who do you think will win?

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November CPD lecture dates have been released 

As we approach the end of October, we reflect on the brilliant month we've had delivering content to you all.

We have just had our ECG Masterclass which was attended beyond expectations and here is a review from one of our participants: 

“I found the ECG master class to be a proactive immersive and I feel it has enriched the knowledge and understanding of ECG interpretation. The host came across as a very knowledgeable and passionate about the topic. And he spent time clarifying points and answering questions.”

So don't miss out and sign up for our awesome line up of upcoming events 

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