Topic: CALD and refugee

NSW Health is providing access to free public hospital services for people fleeing the Israel-Gaza war who arrived in Australia on, or after, 17 October 2023.

This is a temporary arrangement under the NSW Health policy for asylum seekers as many who fled the Israel-Gaza war did so on a visitor/tourist visa which does not generally include access to Medicare.

NSW Health public hospitals, mental health services, NSW Ambulance and NSW Health Pathology are required to waive fees for public health services such as emergency care, ambulatory and outpatient care, maternity services (antenatal and postnatal care), mental health services and ambulance transport for emergencies.

Patients will need to provide relevant documentation such as a visa, passport or travel documents.  

For more information:

Free public healthcare (English)

Free public healthcare (Arabic)

Free public health care (Hebrew)

Torture & trauma service Referrals can be made to STARTTS. Medicare is not required. Call 9646 6800 and ask for the Intake Counsellor.

Emergency financial assistance: Red Cross

For any further information call the NSW Refugee Health Service on 9794 0770.

An inspiring celebration of cultures and a confronting simulation of the refugee journey were among the local activities held to mark Refugee Week in June.

SWSPHN Integration and Priority Populations Coordinator Navnita Chetty (pictured) was in Fairfield for both activities.

On 16 June, Navnita attended the Refugee Week Festival at Fairfield Youth Centre where cultural performances included Afghan dancers, a flute player, Chilean dancers, Cambodian musicians and Lebanese drummers.

In a region where 2,300 refugees settle every year, it was also a chance to hear first-hand of the many refugee success stories.

“It was amazing to watch all the different cultural performances, and it was so inspiring listening to the challenges faced and how people overcame adversity to create a better life for themselves and give back to their communities,” Navnita said.

Navnita also joined the Refugee Camp in My Hospital at Fairfield Hospital on 19 June.

The tours are designed to give health professionals a small insight into the refugee experience and the healthcare challenges they face moving to Australia.

The interactive tours are delivered by guides from a range of refugee and asylum seeker backgrounds, and NSW Refugee Health staff, and help participants:

• understand how the refugee experience can impact on wellbeing
• develop an understanding of risk factors for this group
• improve the ability of health professionals to engage effectively with people from refugee backgrounds

Navnita said the camp provided an insight into the lives and struggles of refugees as they fled their countries and sought refuge in neighbouring countries, in crowded refugee camps.

“We listened to refugee stories, witnessed refugee camp set ups, experienced travelling by boat and arriving in Australia where your identity is replaced with a number,” she said.

“We were then welcomed to Australia, where you have access to healthcare and working rights, however nothing makes sense because you don’t speak the language,” she said. 

Video for health professionals

Video for community

Refugee Week Festival.

Service Navigators who will link people from Culturally and Linguistically Diverse (CALD) and refugee backgrounds, and people who are homeless or at risk of homelessness, with appropriate primary healthcare services in South Western Sydney will be available across our region early next year.

South Western Sydney PHN has funded Settlement Services International (SSI) – an organisation with known expertise and experience in delivering support and programs to South Western Sydney’s diverse community – to provide the service.

Chief Executive Officer, Dr Keith McDonald PhD, said SWSPHN designed the Service Navigator in partnership with community, service providers, healthcare professionals and people with lived experience, after identifying a need in our community.

In South Western Sydney, about 42 per cent of people were born overseas, reflecting our region’s demographics.

CALD and refugee communities face specific health challenges, with priority needs centred around chronic disease management, sexual and reproductive health, domestic violence and infectious diseases.

These communities report significant disparities in healthcare experiences, including not feeling understood and supported by healthcare providers, inadequate information to manage their health effectively, insufficient social support systems and reduced likelihood of having a regular GP.

More than 12,000 people across South Western Sydney were homeless or at risk of homelessness, according to the 2021 Census.

Community feedback identified several barriers for people who are homeless or at risk of homelessness, when accessing primary healthcare.

These barriers include financial hardship, limited awareness of available healthcare services, challenges in physical access to facilities, social stigma associated with homelessness, difficulties in accessing mental health services, and a lack of well-defined referral pathways between service providers.

Dr McDonald said the Service Navigator would improve access to primary healthcare, enhance connection to community health services and provide financial relief through subsidised primary care costs, for these targeted populations.

The Service Navigator will:

• serve as a single point of contact for individuals from CALD and refugee backgrounds, or people who are homeless or at risk of homelessness
• provide ongoing service navigation support to ensure comprehensive care coordination
• connect clients with community health services
• connect clients with a regular GP for ongoing care
• set clients up with a Medicare card where eligible
• work with each client to provide personalised support tailored to their specific health needs
• promote access to preventative healthcare measures such as cancer screening

“We would like to thank all those who contributed to the design of this service which is an important step towards ensuring everyone in our community, especially our most vulnerable, have equal access to culturally appropriate, trauma-informed and person-centred care,” Dr McDonald said.

“We’re looking forward to working with SSI to ensure the service’s success and improve health outcomes for our community.”

The NSW Multicultural HIV and Hepatitis Service (MHAHS) offers a dedicated HIV Clinical Concierge Program to support people from culturally and linguistically diverse backgrounds who are living with HIV.

This free, confidential program provides personalised support.

The program matches clients with bilingual/bicultural Clinical Concierges who are carefully selected and trained to deliver culturally appropriate, in-language support and education.

The aim of the program is to enhance HIV health literacy, support treatment initiation and adherence, and to facilitate health system navigation and engagement with various HIV clinical and support services.

The program is overseen by the program coordinator, a senior social worker who provides clinical supervision to all Clinical Concierges, monitors client progress and regularly updates referrers.

GPs can easily refer patients to the HIV Clinical Concierge Program using the e-referral form or contact the program coordinator on 0436 850 905 to discuss if the program is right for your patient.

Find more information by downloading the Service Provider flyer.

Access comprehensive HIV information for clients with the multilingual booklet, HIV: What you need to know, available in eight languages.

Download or order free print copies from the MHAHS website.

Research shows an individual in South Western Sydney is 2.6 times more likely to speak a language other than English, and 1.6 times more likely to be born in a country other than Australia, when compared to the rest of NSW. 

The Australian Bureau of Statistics states culturally and linguistically diverse communities report significant disparities in their healthcare experience, including: lower levels of agreement in feeling understood and supported by health providers; not having sufficient information to manage their health; not receiving enough social support to manage their health; being less likely to have a regular GP; and being more likely to go to a hospital emergency department when they need after-hours medical care.  

The culturally diverse nature of South Western Sydney presents unique opportunities to collaborate with a wide range of people.  

Embracing these opportunities is a priority for South Western Sydney PHN, which is actively developing innovative projects and activities to improve healthcare access and outcomes for Culturally and Linguistically Diverse (CALD) communities.

A co-creation project currently underway aims to identify healthcare gaps across the region and then develop recommendations which will guide the commissioning of future services. 

The first step in the process has been to consult with healthcare and service providers, and multicultural and refugee communities to better understand their health needs. 

Over the course of several months, SWSPHN project team members conducted 16 interviews with GPs, service providers and allied health professionals.

They also ran a series of focus groups with the Vietnamese, Arabic, Mandarin and refugee communities, as well as conducting two surveys for consumers and providers. 

Discussion focused on identifying the health needs and risk factors for multicultural and refugee communities, as well as the barriers to accessing healthcare.

Team members also sought to identify the opportunity and priority areas to improve health outcomes. 

Chronic disease, domestic violence, infectious disease, and sexual and reproductive health issues were identified as significant issues and the barriers to care included language difficulties and cost of services. 

Priority areas included the need for improved access and quality of care, resources to improve health literacy, support for health professionals to deliver culturally safe care and further research and consultation to understand the health and service needs.   

SWSPHN took the information gathered during the initial consultations to develop three new initiatives:  

• service navigator, a service which seeks to put people from vulnerable communities in contact with healthcare services   
• community chronic disease education sessions for multicultural communities 
• trauma informed care and domestic violence training for health providers  

The next step in the process, the co-design of the service navigator, is currently underway. The codesign sessions give people from culturally and linguistically diverse backgrounds an opportunity to give feedback on the proposed services.

Find out about participating in the codesign of the service navigator