1. Hearing the Voice of Refugees in Policy and Practice Hilaire Agnama : RRF Member hilaire@globalteach.co.uk 07807837405 https://www.youtube.com/watch?feat ure=player_embedded&v=eaBGcNZ myJQ#t=16 2.11

2. Strategy (1)The first is to raise awareness of who we really are and the situation we face (2) The second level is to influence Policy (3) And the 3 rd level is to influence the design and delivery of Services, so that they are accessible and effective

3. OLGA’S STORY

4. Working with the School of Health and Social Care Teesside University to help develop the Pre-registration nursing curriculum and the knowledge and skills of students Aim: To ensure that the service user perspective: influences all aspects of the curriculum design to help students develop key interpersonal skills and their understanding of person centred care to help students develop their understanding of peoples health and nursing care needs and that there is concentrated emphasis throughout the programme on the core values of nursing and the fundamentals of caring, compassion and communication Hearing the Voice of Refugees in Policy and Practice

5. Knowledge or understanding of who an asylum seeker /refugee is important in order to provide effective care

6. Some cultural beliefs and practices Female Genital Mutilation Oldest male seen as decision maker for family. Interest and honour of the family are more important than those of individual family members. In some communities women are not to be seen by male doctors or nurses. Stigmatization will cause an individual not to disclose symptoms of mental health or STDs. In some communities eye contact is not established as a sign of respect. Preference for male child. (manifests itself in neglect, deprivation and discriminatory treatment of the girl child). Personal health is a private affair in certain communities. (disclosure is important so they can get the help they need.).

7. Patients are often willing to share their customs with those who seek to understand them. In some communities use of Contraceptives is forbidden leading to many unwanted pregnancies. In some communities the extended family has significant influence. Mental behaviours that indicate lack of self control will bring shame on family. Patients will refrain / be reluctant to discuss symptoms. Injection ( some communities believe that unless an injection is administered they have not been treated properly. Respect for authorities. (agree to treatment but not follow). Time Culture ( In some communities being late for an appointment is not seen as a problem as long as they turn up).

8. Many have physical problems that affects their day to day life. Anxiety and Depression Social Isolation as a result of separation from families/children. War and Imprisonment Physical and Sexual violence. Witnessing Violence to others. Traumatic Bereavement. Complications from injuries as a result of torture and violence. Female Genital Mutilation victims. HIV/AIDS Pregnant Women (Rape Victims). Starvation Genocide Victims of domestic and sexual abuse. Specific health needs presented by asylum seekers and refugees that nurses needs to be aware of

9. Hearing the Voice of Refugees in Policy and Practice VOICE & EMPOWERMENT ‘A Trans-national Network: Hearing the voices of Refugees in Policy and Practice in the European Union’ for the European Commission, 2000 “ Evidence shows that those who are the target beneficiaries of a policy must be a part of the process through which they receive those benefits in order for that policy to be effective.”