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< SH3‎ | ITPs
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  • Forced arrival, rushed, no planning (didn't bring money/documents), dangerous
  • Refugee camps are dangerous, sometimes as dangerous as the place where people came from
  • CXR - TB; treated in country, and your application is deferred
  • HIV+ - you and your entire extended family have your migration status rejected
  • Health waivers can get around these rules
  • Common for those people to get anaemia (bleeding due to parasites)
  • Schistosomiasis = worm in mud etc that comes up through feet, lymph nodes, and sits in the bladder, gastric veins
  • In jar: round worm (schirus aneuploides ???). Can vomit them up, come out nose
  • Hep B: chronic infection, cancer, cirrhosis
    • Globally, most infection is vertical transmission
    • sAg, sAb, cAb are the three indicators of Hep B
    • tells you if they've been vaccinated, every had it in past, or have it now.
  • Australia: HepB is transmitted sexually, IDU, tattoo
    • Hep C: IDUs, tattoo. Only sexually in men with HIV sometimes
  • Mass vaccination for schistosomiasis spread Hep B everywhere --> high prevalence.
  • 1000 cases of TB in Australia each year (500 in NSW). 80% of cases occur in migrants (dormant infection brought from other countries).
    • Pulmonary TB and laryngeal TB are the only infectious forms
    • Tests for TB: sputum (to lab for acid fast stains + culture and PCR; check if they're infectious), CXR. Mantoux is useful for overall knowledge. IFNg (PPD) of blood is good too. Neither Mantoux nor CXR are diagnostic
  • Vitamin D deficiency: sunlight, nutrition (oily fish, margarine), kidney & liver
    • sunlight is the main thing; people who cover up need supplementation
  • FGM: illegal. Important to not stitch up episiotomy too far
  • Health care card needed for refugees to access dental
  • Water boarding: water in lungs causes chronic bronchitis
  • TIS National services have phone interpreters specifically for medical practitioners
  • Interpreter notes
    1. Always talk to the patient (never use the third person)
    2. Short sentences - pause with translation
    3. Don't use jargon
    4. Ask them if they have any more questions before the interpreter goes

Interpreter is free