Over 43 million persons are currently living under conditions of forced displacement.  These persons are among the world’s most vulnerable, with high rates of communicable and non-communicable disease, reproductive mortality, nutritional deficits, and psychological illness. This course provides an overview of the health needs of refugees, critically analysing from social, cultural and political perspectives the reasons for, and potential solutions, to poor health among displaced and resettled populations. Key areas to be addressed include the resources and capabilities of refugees, models of health service provision in temporary settlements and after resettlement, patterns of illness, and the debates about post-traumatic stress disorder. The course will consider case studies of refugees resettled from Sudan, Burma, Iran and Afghanistan, and will incorporate seminars from community leaders and resettlement workers. 

Learning Outcomes

Upon successful completion, students will have the knowledge and skills to:

On satisfying the requirements of this course, students will have the knowledge and skills to:

• Articulate the impacts of forced displacement on the epidemiology and experiences of illnesses among refugees along the life-course. (LO 1)
• Identify the sociocultural, biological and political determinants of  refugee health and illness in resettlement countries and countries of first refuge (LO 2)
• Critically evaluate health systems to promote refugee health in temporary and permanent settlements (LO 3)

Field Trips

This course includes a field trip to a settlement service. For distance students, the field trip will involve a settlement service in your region.

Additional Course Costs

There are no additional class costs.

Examination Material or equipment

None required

Required Resources

There are no required resources

Recommended Resources

Recommended reading/viewing will be available to students on Wattle

Staff Feedback

Students will be given feedback in the following forms in this course:

• Written comments
• Verbal comments
• Feedback to the whole class, to groups, to individuals, focus groups

Student Feedback

ANU is committed to the demonstration of educational excellence and regularly seeks feedback from students. Students are encouraged to offer feedback directly to their Course Convener or through their College and Course representatives (if applicable). The feedback given in these surveys is anonymous and provides the Colleges, University Education Committee and Academic Board with opportunities to recognise excellent teaching, and opportunities for improvement. The Surveys and Evaluation website provides more information on student surveys at ANU and reports on the feedback provided on ANU courses.

Class Schedule

Week/Session	Summary of Activities	Assessment
1	SESSION 1: REFUGEES AND INTERNATIONAL FRAMEWORKS Seminar:This session introduces the international framework and bodies that oversight the protection of refugees. We will explore the escalations in refugee numbers over the last fifty years, and the international frameworks that govern and support the response of signatories to the challenge of large populations of people rendered stateless. At the end of this session you should be able to: * Explain the definitions of refugee in the Convention, and identify the parts of the Convention that are regarded as non-negotiable * Describe UN's three durable solutions to refugee flows * Critically review arguments on the relevance or irrelevance of the Convention for contemporary flows of asylum seekers * Describe the push factors that have driven the escalation in refugee flows over the last fifty years	Includes pop quiz on geographic borders
2	SESSION 2: INTERNAL DISPLACEMENT Seminar:50.8 million people (more than half of the world’s refugees) are internally displaced because of war and conflict. In 2020, Syria, Colombia and the Democratic Republic of Congo have the largest populations of people internally displaced due to war and conflict. Climate change disasters also intersect with and compound with internal displacement due to conflict, with 2020 being the first year in many decades where more people were displaced by climate change disasters than war, reflecting the global impacts of climate change across all nation states. In this seminar we will consider historical accounts of internal displacement, ways in which people are displaced in the contemporary world, and implications for health and health care. By the end of this session you should be able to * Identify where the largest internally displaced populations in the world are * Describe and explain the health risks associated with being internally displaced * Critically trace changing patterns of torture and violence against civilians * Use the Internal Displacement Index to compare regions’ responses to internal displacement	Includes class exercise using the Internal Displacement Index
3	SESSION 3: LOCAL INTEGRATION There is an increasing focus by UNHCR on local integration – that is integration into the host country of first refuge. Since many of these host countries are poor, local integration is challenging, marked sometimes by disenfranchisement of the refugee, and disenchantment by host communities. In this session we’ll examine models of local integration, potential impacts on health and ways of safety-netting. By the end of this session you should be able to * Describe what is meant by local integration in a host country * Identify key elements that support, or undermine, local integration * Identify potential risks for health associated with local integration * Describe system approaches to mitigate the risks to health in local integration models	Includes worked interactive exercise Where do you run? exploring health and human security consequences of fleeing from one refugee source to any one of its eight near countries.
4	SESSION 4: INSIDE REFUGEE CAMPS Refugee camps are not durable solutions, but they are such a fixture in the management of displaced persons, that some have morphed into permanent cities. This session looks at the structures, systems and everyday life in a refugee camp. We conclude with an introduction to Agamben and his concept of bare life. The reading material is Agamben’s commentary on Hannah Arendt’s We Refugees. At the end of this session you should be able to: * Describe different types of camps, giving an example of each * Identify key challenges associated with living in camps	Includes exercise on categorising refugee camps indicating safety, security, supports of different camp models under different international and national regulatory systems
5	SESSION 5: HEALTH AND REFUGEE CAMPS This session looks at pressing health issues of refugees in camps. Some of these are specific to specific regions, and some are common issues across all refugee camps. The readings focus on reproductive health and public health. From what you know about the experiences of refugees and their health systems, what other areas of health care delivery might be of concern? At the end of this seminar you should be able to: * Identify the major health issues associated with prolonged stay in a refugee camp * Identify health issues that may differ between different contexts * Describe, and provide a rationale for, critical health infrastructure for health care delivery in refugee camps.	Includes interactive class exercise: From sick chickens to public health emergency on the Thai/Burma border
6	SESSION 6: PRESENTATION OF SITREPS Student-run session, with presentations and Sitreps on different refugee camps.	Assessment: SEMINAR PRESENTATION: SitReps 15% 30 March
7	SESSION 7: FORMAL RESETTLEMENT PROGRAMS The third durable solution of the UNHCR is resettlement in a third country. We will explore the number of countries engaged in formal resettlement, and the variations between their approach to resettlement and the services that are provided. Specific attention will be paid to Australia’s humanitarian resettlement program. At the end of this seminar you should be able to: * Describe the resettlement program as practised in Australia * Identify the top six resettlement countries, and identify key differences, and similarities between their resettlement programs. * Critically evaluate determinants of successful re-settlement, and whether or not these reflect the program or the population group. * Describe the health checks undertaken before arriving in Australia	Class exercise: Leaving Kakuma
8	SESSION 8: CLAIMING ASYLUM, IMMIGRATION DETENTION One of the most contentious areas in the refugee policies of signatory countries is how they respond to asylum seekers. Mandatory detention for asylum seekers was introduced in 1992 in Australia. In this session we explore the current policies around asylum seekers, and the experience of immigration detention. At the end of this session you should be able to: * Compare the policies for asylum seekers in first world countries * Articulate the effects of prolonged immigration detention on asylum seekers * Use a life course perspective to describe the health impacts on being a community based asylum seeker (in community detention or on bridging visa E)	Includes materials by writers and film-makers who have lived through long term immigration detention.
9	SESSION 9: HEALTH SYSTEMS AND CARE How should we delivery health care to newly resettled refugees? Is there an argument for a permanent parallel health care system? And how is the Australian health system perceived by those who are newly resettled? At the end of this session, you should be able to: * Critically compare different models of health care delivery for resettled refugees * Describe the focus of on arrival resettlement health care * Identify some of the gaps where people are likely to have difficulty accessing health care. * Analyse current policies in relation to COVID for newly resettled refugees	Minor essay components must be submitted 6 May
10	SESSION 10: TRAUMA AND PAIN This session explores trauma, and the express of distress by refugees. There is a counter argument now being raised about whether or not PTSD is a useful category for refugees. As you read the resource material think about your own views of the medicalisation of pain and trauma. At the end of this session, you should be able to: * Outline the latest formal definition of PTSD * Critically evaluate the arguments for and against the medicalisation of trauma * Articulate strategies used by refugees to describe and manage pain and distress	Includes guest presentations from clinicians working in refugee health
11	SESSION 11: INFECTIOUS DISEASES In this session, we’ll explore three communicable diseases of public health importance: HIV, hepatitis B, and tuberculosis. We will look at the attitudes, occasionally stigma, that people from refugee backgrounds bring to these subjects. Paradoxically, the fact that Australia performs a medical examination to access a visa can result in driving underground people who have, or are concerned that they have, various infectious diseases. At the end of this session, you should be able to: *Describe prevalence and incidence of these communicable diseases in people from refugee backgrounds * Compare access and attitudes to testing for HIV for refugees and immigrants from high-prevalence countries in Australia and New Zealand * Analyse risks, barriers and enhancers to tuberculosis screening and monitoring in this population group * Analyse risks, barriers and enhancers to hepatitis B screening and monitoring in resettled refugees from a range of backgrounds	Includes exercise exploring cultural and political aspects of health promotion materials for complex public health interventions (DOTS for TB; monitoring and long-term treatment for hepatitis B; PEPP and PrEPP for HIV)
12	SESSION 12A: REPRODUCTIVE HEALTH CARE The so-called “forgotten area” of refugee health became the subject of a great deal of research and practice effort in the early 21st century. In this session we focus on reproductive health care in the resettlement period. At the end of this session, you should be able to * Describe the range of conditions included under the banner “Reproductive Health” * Apply a gender perspective to reproductive health to explain why it was overlooked in the past, and the determinants of good reproductive health * Analyse some approaches that improve maternal health outcomes for resettled refugees using the patient journey framework SESSION 12B: CELEBRATING REFUGEES This final component celebrates the achievements and resilience of refugees in our community	Major essay is due 27 May

Assessment Summary

Assessment task	Value	Due Date	Learning Outcomes
PRESENTATION SitRep 30 March 2022	15 %	30/03/2022	1
MINOR ESSAY Settlement portfolio	35 %	06/05/2022	2
Essay	45 %	30/05/2022	1,2,3
Class participation	5 %	*	1,2,3

* If the Due Date and Return of Assessment date are blank, see the Assessment Tab for specific Assessment Task details

Policies

ANU has educational policies, procedures and guidelines, which are designed to ensure that staff and students are aware of the University’s academic standards, and implement them. Students are expected to have read the Academic Misconduct Rule before the commencement of their course. Other key policies and guidelines include:

• Student Assessment (Coursework) Policy and Procedure
• Special Assessment Consideration Policy and General Information
• Student Surveys and Evaluations
• Deferred Examinations
• Student Complaint Resolution Policy and Procedure

Assessment Requirements

The ANU is using Turnitin to enhance student citation and referencing techniques, and to assess assignment submissions as a component of the University's approach to managing Academic Integrity. For additional information regarding Turnitin please visit the ANU Online website Students may choose not to submit assessment items through Turnitin. In this instance you will be required to submit, alongside the assessment item itself, hard copies of all references included in the assessment item.

Moderation of Assessment

Marks that are allocated during Semester are to be considered provisional until formalised by the College examiners meeting at the end of each Semester. If appropriate, some moderation of marks might be applied prior to final results being released.

Examination(s)

There is no examination in this course

Assessment Task 1

PRESENTATION SitRep 30 March 2022

This task requires you to present a SitRep about a refugee camp, focusing on health.

A SitRep is a structured report that is: 

*Up to date

* Structured, and easily digested

* Describes situation to date

* Describes actions to date

* Describes what needs to be done

 

We are modifying this a little for this assignment, as you are not really officials who can engineer change. Instead of identifying changes, you will instead prepare an up-to-date SitRep as if you were briefing a new colleague. Choose a refugee camp. The largest, or most relevant for Australia, are: Kakuma (Kenya), Daadab (Kenya), Mae Lae (Thailand), el-Zaatari (Jordan), Jabalia (Gaza Strip), Dolo Ado (Ethiopia), Bredjing (Chad), Philippines Refugee Processing Centre (Indochina), Lampedusa (Italy), Niatak (Iran), Moraa (Greece) Camps for Tamils in India, Camps for Rohingya in Bangladesh. You may choose another camp if you wish as camps are fluid entities which change size and composition. 

Your SitRep should address all the elements in the SitRep template. You will also to develop a 10-15 minute powerpoint presentation, and respond to questions. Your SitRep will be distributed to other students. It can be no more than one double-sided page. Use dot-points, rather than prose.  Distance students will prepare their SitRep online and also prepare a powerpoint + respond to questions posed by nominated student.

Assessment Task 2

MINOR ESSAY Settlement portfolio

This task involves you compiling a portfolio of items related to settlement:

Your written SitRep prepared for Task 1. You may amend the draft version submitted to your peers at the seminar presentation

Your Australian settlement service report after visit to a settlement service

A country dasboard for Internally Displaced Persons using publicly available data

1. SItRep written report - max 1000 words

2.Settlement service report. This task requires you to prepare a structured report about the activities of the settlement agency that you visited. This document is confidential.

The report will include the following headings:

1. Service name and settlement focus

2. Funding source(s) and longevity

3. Staffing numbers, hours of operation.

4. Nature of volunteer support

5. Key challenges as identified by the organisation

6. Your own views of service function (include teamwork, relationship with community, resilience, and whether or not their service mission is sustainable)

Length 1000-1500 words.

3.IDP Country dashboard

A country dashboard is an even more briefer summary of data than that a SitRep. Using the IDMC Indicators and publicly available data , prepare a country dashboard using the format on p 22-23 https://www.internal-displacement.org/sites/default/files/211213_IDI_CountryGuidelines.pdf. Your dashboard should exist on one page and be readily digestible for the reader. Then write a summary max 750 words outlining key challenges with data for your country dashboard.

TOTAL MINOR ESSAY word count 2500 wds PORTFOLIO IS DUE 6 May but subcomponents can be submitted earlier

Assessment Task 3

Essay

Choose a condition and consider it in relation to its distribution among refugee populations after resettlement, management approaches, whether there are any specific cultural issues, and critically analyse health policy in relation to this. Your essay must consider epidemiology and if relevant, the broader literature about constructions of health.

                                               OR

Choose a health intervention or service, and consider its uptake or ease of access among resettled refugee populations. Your essay should critically review its uptake or ease of access for refugee populations (or a specific subpopulation) and discuss policy implications. Your essay must incorporate a critical review of the literature on this topic.  

                                               OR

Choose a life stage (eg menopause, aging, death, birth). Analyse the literature on cultural approaches within a refugee subpopulation, and the response of the health sector to refugees going through this life stage. Your essay should incorporate a discussion of implications for health policy at the service or national level.

Assessment Task 4

Class participation

Specific tasks will be designed for distance students

Academic Integrity

Academic integrity is a core part of our culture as a community of scholars. At its heart, academic integrity is about behaving ethically. This means that all members of the community commit to honest and responsible scholarly practice and to upholding these values with respect and fairness. The Australian National University commits to embedding the values of academic integrity in our teaching and learning. We ensure that all members of our community understand how to engage in academic work in ways that are consistent with, and actively support academic integrity. The ANU expects staff and students to uphold high standards of academic integrity and act ethically and honestly, to ensure the quality and value of the qualification that you will graduate with. The University has policies and procedures in place to promote academic integrity and manage academic misconduct. Visit the following Academic honesty & plagiarism website for more information about academic integrity and what the ANU considers academic misconduct. The ANU offers a number of services to assist students with their assignments, examinations, and other learning activities. The Academic Skills and Learning Centre offers a number of workshops and seminars that you may find useful for your studies.

Online Submission

The ANU uses Turnitin to enhance student citation and referencing techniques, and to assess assignment submissions as a component of the University's approach to managing Academic Integrity. While the use of Turnitin is not mandatory, the ANU highly recommends Turnitin is used by both teaching staff and students. For additional information regarding Turnitin please visit the ANU Online website.

Hardcopy Submission

For some forms of assessment (hand written assignments, art works, laboratory notes, etc.) hard copy submission is appropriate when approved by the Associate Dean (Education). Hard copy submissions must utilise the Assignment Cover Sheet. Please keep a copy of tasks completed for your records.

Late Submission

No submission of assessment tasks without an extension after the due date will be permitted. If an assessment task is not submitted by the due date, a mark of 0 will be awarded.

Referencing Requirements

Accepted academic practice for referencing sources that you use in presentations can be found via the links on the Wattle site, under the file named “ANU and College Policies, Program Information, Student Support Services and Assessment”. Alternatively, you can seek help through the Students Learning Development website.

Returning Assignments

Assignments will be returned via email

Extensions and Penalties

Extensions and late submission of assessment pieces are covered by the Student Assessment (Coursework) Policy and Procedure The Course Convener may grant extensions for assessment pieces that are not examinations or take-home examinations. If you need an extension, you must request an extension in writing on or before the due date. If you have documented and appropriate medical evidence that demonstrates you were not able to request an extension on or before the due date, you may be able to request it after the due date.

Resubmission of Assignments

Resubmission is permitted

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Distribution of grades policy

Academic Quality Assurance Committee monitors the performance of students, including attrition, further study and employment rates and grade distribution, and College reports on quality assurance processes for assessment activities, including alignment with national and international disciplinary and interdisciplinary standards, as well as qualification type learning outcomes. Since first semester 1994, ANU uses a grading scale for all courses. This grading scale is used by all academic areas of the University.

Support for students

The University offers students support through several different services. You may contact the services listed below directly or seek advice from your Course Convener, Student Administrators, or your College and Course representatives (if applicable).

• ANU Health, safety & wellbeing for medical services, counselling, mental health and spiritual support
• ANU Diversity and inclusion for students with a disability or ongoing or chronic illness
• ANU Dean of Students for confidential, impartial advice and help to resolve problems between students and the academic or administrative areas of the University
• ANU Academic Skills and Learning Centre supports you make your own decisions about how you learn and manage your workload.
• ANU Counselling Centre promotes, supports and enhances mental health and wellbeing within the University student community.
• ANUSA supports and represents undergraduate and ANU College students
• PARSA supports and represents postgraduate and research students