image: This week, the open-access journal PLOS Medicine launches its latest Special Issue, focused on research and commentary about the health of refugees and migrants.
This week, the open-access journal PLOS Medicine launches its latest Special Issue, focused on research and commentary about the health of refugees and migrants.
As discussed in a recent Editorial in the journal, in recent years there has been a large increase in the number of people migrating both within countries and internationally, voluntarily or otherwise. Migration can be motivated by diverse factors, including conflict and violence, population growth and environmental degradation, and escape from economic hardship. The health of those people migrating can be adversely affected by the situation which led to their displacement, and further threats to their safety, health and wellbeing may arise during the process of migration or in a destination country.
Continued growth in migration is expected, and the aim of the Special Issue is to document the health challenges faced by refugees and migrants in different settings worldwide, and to highlight opportunities to develop policy and practice aimed at improving their health and wellbeing. Guest editors Paul Spiegel, Terry McGovern and Kolitha Wickramage have advised on the content of the issue, which begins with a report from Megan Doherty of the Children's Hospital of Eastern Ontario, Ottawa, Canada, and colleagues.
In the past 5 years, large numbers of Rohingya people have been displaced from Myanmar into neighbouring Bangladesh. Doherty and co-authors studied 311 people, 156 with serious health problems and 155 caregivers, living in refugee camps in 2017. Among those reporting health problems, 64% had a significant physical disability, 21% reported having treatment-resistant tuberculosis, and 10% had cancer. Caregivers were often family members, and reported providing more than 13 hours of care per day, on average. Importantly, 62% of those with health problems reported experiencing significant pain, and the majority of available pain treatments were judged to be ineffective, indicating a need to provide palliative care components in humanitarian settings.
In a second research study, Sarah Crede and colleagues from the University of Sheffield, UK report on the use of paediatric emergency care by mothers in Bradford born outside, as compared with those born in, the UK or Ireland. Among 10,168 mothers in the Born in Bradford study who gave birth to children in the period from April 2007 to June 2011, about one third were born outside the UK.
Crede and colleagues found that mothers born outside the UK were less likely to make a first visit to the emergency department with their children (odds ratio 0.88, 95% CI 0.80-0.97, p=0.012), which could indicate a limited awareness of, or hesitancy about attending, health care by some migrant groups. Reasons for attending and the proportions admitted to hospital were similar across the two populations. On the other hand, among the study participants using the emergency department, utilization rates were higher for children of migrant mothers (incidence rate ratio 1.19, 95% CI 1.01-1.40, p=0.04). Migrants from Europe and those who had been in the UK for longer than 5 years had higher utilization rates. Studies of this type in high-income countries can help to guide provision of appropriate health services for children, and highlight populations for whom access should be improved.