Treating refugee patients 

30 August 2019

When the Editor of GP Pulse attended a CORNERSTONE® assessment at Porirua Union Health Service (PUCHS), she was on a mission to find a story. Much to her excitement, she learnt the practice ran a refugee clinic.

PUCHS serves a diverse population including 700 refugee patients through a nurse-led clinic, many of them children under the age of 15. The refugee clinic has been operating since 2005 and started off with around 50 patients, rising significantly the last few years.

The clinic is run by Refugee Nurse, Maire Christeller (pictured left) and Cross Cultural Support Worker, Jacqueline Biggins who work together to meet the health needs of the local refugee population. 

Maire tells us the clinic gets new families every three months.

“Our refugee patients typically come from Syria, Burma, Thailand and Colombia and they’re all allocated their own GP which is great for continuity of care,” says Maire. 

The practice operates a half-day nurse led clinic and two shorter nurse clinics every day to cope with demand. The Refugee Nurse carries out an initial assessment of each new patient and allocates them to an appropriate GP and Nurse team. 

“We pay careful consideration when allocating patients with GPs – women and children see female doctors whereas males aged 18 and over see male doctors.”

One of the biggest challenges Maire mentioned is patients not attending their initial appointment.

“We've been working on how we communicate with the patients with the help of the Refugee Red Cross Resettlement to help make the most of the clinic and patients time.”

“Another challenge is the language barrier and face to face interpreters are very expensive and easily dry up your funding, so language line is heavily relied on for most appointments and interaction. The practice also has a staff member who is able to interpret for Spanish speakers”

“Refugee patients are offered double appointments which allowing for interpreting and  patients really benefit from it.”

Ioana tells us that us that the refugee population have enormous health needs very complex, very different to the rest of New Zealand.  

“We continue to support our refugee patients, many require long-term mental health support, understanding of the New Zealand health system, language, social, housing, education, or adjustment to a new lifestyle such as food and culture.

“The team continue to try and meet the needs of patients through liaison with specialist providers such as Refugee Trauma Recovery, Regional Public Health, Primary Mental health services and an innovative flexible team here at PUCHS.”

Syrian, Columbian and Burmese refugees make up most of the patients and to help the staff with cultural awareness, an in-house training session was delivered by an Egyptian tutor from the E-Learning centre Porirua.  

Not surprising, many of the patients have distressing stories. Many of them have lost connections with their family and friends and been displaced from their homeland. But with that, comes determination.

“They’re determined to adjust and they have a true appreciation for their new home and local community, they’re enjoying learning English and some have even learnt Te Reo or Pacific languages.”

“It's rewarding to see that we can make a difference to the refugee community and that they are living in peace and a better lifestyle in New Zealand.”

PUCHS have been supported by NUHS (Newtown Union Health Service) who have been helpful - both clinics are leaders with refugee care. For best practice and lessons learnt, please get in touch with Ioana Viliamu-Amusia, Clinical Coordinator.