Programme no. 135-OP
Public Health
Experiences of human suffering and resilience – a GP meets asylum seekers and immigrants at a Refugee Health Clinic in Gothenburg, Sweden
Kristian Svenberg*1
1Refugee Health Clinic, Närhälsan,Gothenburg,Sweden;Department of Primary Health Care, ,Institute of Medicine, University of Gothenburg,Gothenburg,Sweden
* = Presenting author
Objectives: To report experiences – medical as well as psychological - during one year (2014) of encounters with asylum seekers and newly arrived refugees who have been granted political asylum

Background: Due to war, political conflict, human rights violations and persecution an increasing number of asylum-seekers arrive in Sweden to seek protection. The flight to Sweden is often dangerous and has taken place under extreme conditions. Their countries of origin vary, the majority coming from Syria, Eritrea, Somalia and Afghanistan as well as being stateless.

The Refugee Health Clinic, founded in 2008, has two major goals. 1. To carry out health checks on asylum-seekers. 2. To meet newly arrived refugees with health problems within their first two years in Sweden, referred to the clinic by the State Employment Office.

Results: A majority of asylum-seekers undergoing health checks were found to be physically healthy but suffering from different degrees of mental stress. Those with physical problems suffered results of abuse, bullet injury and other kinds of trauma related to war. Of the referred patients, a majority suffered physically and mentally, especially those having experienced torture, rape and other kinds of severe abuse.

Factors encouraging coping and resilience were: family reunification, proper housing, prospects of work, functional language studies and the quality of the encounter with Swedish Health Care.

Material/Methods: Observational and descriptive data were obtained from encounters with approximately 300 patients analysed from a GP:s point of view
Conclusion: Asylum-seekers and newly arrived refugees constitute a heterogenous group of patients. In the medical encounter, an individual approach should be adopted, along with an awareness of the impact of collective experiences of flight and exile. Core values when meeting these patients are quality and continuity of care, respect and curiosity. These are universal values in Health Care but of special significance in relation to patients with a history of persecution and/or traumatic experiences. Stereotypical explanations and generalisations as to the state of both physical and mental health should be avoided.
Points for discussion: How to achieve care for asylum-seekers and newly arrived refugees, suffering from physical and mental problems

Professional and societal pitfalls, possibilities and threats