Women from refugee backgrounds and their experiences of attending a specialist antenatal clinic : narratives from an Australian setting

Problem: In response to an identified need, a specialist antenatal clinic for women from refugee backgrounds was introduced in 2008, with an evaluation planned and completed in 2010. Question: Can maternity care experiences for women from refugee backgrounds, attending a specialist antenatal clinic in a tertiary Australian public hospital, be improved? Methods: The evaluation employed mixed methods, generating qualitative and quantitative data from two hospital databases, a chart audit, surveys and interviews with service users, providers and stakeholders. Contributions were received from 202 participants. Findings: The clinic was highly regarded by all participants. Continuity of care throughout the antenatal period was particularly valued by newly arrived women as it afforded them security and support to negotiate an unfamiliar Western maternity system. Positive experiences decreased however; as women transitioned from the clinic to labour and postnatal wards where they reported that their traditional birthing and recuperative practices were often interrupted by the imposition of Western biomedical notions of appropriate care. The centrally located clinic was problematic, frequently requiring complex travel arrangements. Appointment schedules often impacted negatively on traditional spousal and family obligations. Conclusions: Providing comprehensive and culturally responsive maternity care for women from refugee backgrounds is achievable, however it is also resource intensive. The production of translated information which is high quality in terms of production and content, whilst also taking account of languages which are only rarely encountered, is problematic. Cultural competency programmes for staff, ideally online, require regular updating in light of new knowledge and changing political sensitivities.

Giving voice to service providers who work with survivors of torture and trauma

Clinicians who support people from refugee and asylum seeking backgrounds are routinely exposed to stories of trauma as part of their work. Hearing these stories can be highly distressing for clinicians, but simultaneously provide opportunities for positive personal growth. Adopting a longitudinal qualitative design, we interviewed twelve service providers at two time points a year apart. We used a semistructured interview protocol and analyzed the data according to interpretative phenomenological analysis. Five superordinate and 19 constituent themes emerged from the analysis at Time 1 and Time 2. We found that participants were both positively and negatively affected by their work, and their experiences remained relatively stable across time. The participants highlighted the use of organizational and personal coping strategies to help minimize distress and maximize wellbeing. Adopting a broad repertoire of such strategies is not only advantageous for the service providers, but ultimately for those people they seek to assist.

The Responsibility to Protect and International Law

The Responsibility to Protect (R2P) is a major new international principle, adopted unanimously in 2005 by Heads of State and Government. Whilst it is broadly acknowledged that the principle has an important and intimate relationship with international law, especially the law relating to sovereignty, peace and security, human rights and armed conflict, there has yet to be a volume dedicated to this question. The Responsibility to Protect and International Law fills that gap by bringing together leading scholars from North America, Europe and Australia to examine R2P’s legal content. The Responsibility to Protect and International Law focuses on questions relating to R2P’s legal quality, its relationship with sovereignty, and the question of whether the norm establishes legal obligations. It also aims to introduce readers to different legal perspectives, including feminism, and pressing practical questions such as how the law might be used to prevent genocide and mass atrocities, and punish the perpetrators.

Born in another country : women's experience of labour and birth in Queensland, Australia

Background Women born outside Australia make up more than a fifth of the Queensland birthing population and like migrants in other parts of the world face the challenges of cultural dislocation and possible language barriers. Recognising that labour and birth are major life events the aim was to investigate the experiences of these women in comparison to native-born English speaking women. Methods Secondary analysis of data from a population based survey of women who had recently birthed in Queensland. Self-reported clinical outcomes and quality of interpersonal care of 481 women born outside Australia who spoke a language other than English at home were compared with those of 5569 Australian born women speaking only English. Results After adjustment for demographic factors and type of birthing facility, women born in another country were less likely to be induced, but more likely to have constant electronic fetal monitoring (EFM), to give birth lying on their back or side, and to have an episiotomy. Most women felt that they were treated as an individual and with kindness and respect. However, women born outside Australia were less likely to report being looked after ‘very well’ during labour and birth and to be more critical of some aspects of care. Conclusion In comparing the labour and birth experiences of women born outside the country who spoke another language with native-born English speaking women, the present study presents a largely positive picture. However, there were some marked differences in both clinical and interpersonal aspects of care.

The role of the ethnic enclave in facilitating immigrant business performance and social integration

Chinese immigrant entrepreneurs, known the world over for their successful business practices (Kee, 1994), tend to start businesses within their ethnic enclave. But in a move away from multiculturalism, host countries increasingly fear that immigration and asylum pose a threat to social integration resulting in a lack of social cohesion and a plethora of government programs (Cheong, Edwards, Goulbourne & Solomos, 2007). For many immigrant entrepreneurs, the EE is an integral part of their social and cultural context and the location where ethnic resources reside (Logan, Alba & Stults, 2003). Immigrant entrepreneurs can harness the networks for labor and customers through various ties in their EE (Portes and Zhou, 1996). Yang, Ho and Chang (2010) illustrate in their paper that the Chinese immigrant entrepreneurs (IE) were able to utilize ethnic network resources as their social capital in order to reduce transaction costs and thus enhance business performance. Tilly (1990) explains that immigrants’ reliance on such networks for business or other information minimizes the socioeconomic hardships they would experience in host countries (Raijman & Tienda, 2000). Acquiring jobs in ethnic businesses and establishing businesses within an EE may facilitate migrants’ social integration into the host country (Tian & Shan, 1999). Although an EE has distinct economic advantages for immigrant entrepreneurs, Sequeira and Rasheed (2006: 367) argue that ‘Exclusive reliance on strong ties within the immigrant enclave has a negative effect on growth outside the enclave community.’ Similarly, Drori, Honig and Ginsberg (2010: 20) also propose that ‘The greater the reliance of transnational entrepreneurs on ethnic (versus societal) embedded resources and network structure, the narrower their possibilities of expanding the scope of their business.’ This research asks, ‘What is the role of the ethnic enclave in facilitating immigrant business growth and social integration? This project has the following important aims: A1 To better understand the role of IE, in particular Chinese IE in the Australian economy A2 To investigate the role of the EE in facilitating or inhibiting immigrant business performance A3 To understand how locating their firm inside or outside of the EE will affect the IE’s embeddedness in co-ethnic and nonco-ethnic networks and social integration A4 To understand how an IE’s social network affects business performance and social integration

Globalising the body : globalisation and reproductive rights

Globalisation is a phenomenon of the contemporary world. Everywhere around us there seem to be signs of the power of the forces of globalisation: in our media and popular culture; in our international linkages across continents through international travel and telecommunications; in our globalised trade; and with the global movement of people, a process which itself ranges from the movement of international tourists to the international movement of refugees and other displaced persons. The processes of globalisation seem to simultaneously unify and divide us. There is no doubt that we live in a globalised world and that we are connected to others in previously unimaginable ways by transportation, telecommunications and economics. Yet, while this global context increasingly links us to others, there is also a very real sense in which separation, difference and the local have also gained a new significance; we are locked in a tension between the universal and the particular that has come to typify contemporary society. This article explores the meanings of globalisation and this dynamic – or tension – between the universal and the particular in terms of its implications for the body and, in particular, its significance for women and their reproductive rights.

Bound to the borders: Representing refugees in the Australian space

This project consists of a novel and an exegesis that explore the use of fiction to counter negative hegemonic representations of refugees in Australia. The possibilities of using Australian spaces, including border spaces, to reveal tensions surrounding refugee belonging and to highlight the reconfiguration of border sites in the Australian imaginary, is a particular focus of this work.

Legitimising Rejection : International Refugee Law in Southeast Asia

The 1951 Convention Relating to the Status of Refugees and the 1967 Protocol Relating to the Status of Refugees are the two primary international legal instruments that states use to process asylum seekers' claim to refugee status. However, in Southeast Asia only two states have acceded to these instruments. This is seemingly paradoxical for a region that has been host to a large number of asylum seekers who, as a result, are forced to live as ‘illegal migrants’. This book examines the region's continued rejection of international refugee law through extensive archival analysis and argues that this rejection was shaped by the region’s response to its largest refugee crisis in the post-1945 era: the Indochinese refugee crisis from 1975 to 1996. The result is a seminal study into Southeast Asian's relationship with international refugee law and the impact that this has had on states surrounding the region, the UNHCR and the asylum seekers themselves.

The 1989 Comprehensive Plan of Action (CPA) and refugee policy in Southeast Asia : twenty years forward what has changed?

In 2012, the only South East Asian countries that have ratified the 1951 Convention relating to the Status of Refugees and the 1967 Protocol Relating to the Status of Refugees (hereafter referred to as the 1951 Convention and 1967 Protocol) is Philippines (signed 1954), Cambodia (signed 1995) and Timor Leste (signed 2001). Countries such as Indonesia, Malaysia and Thailand have annual asylum seeking populations from Myanmar, South Asia and Middle East, that are estimated to be at 15 000-20 000 per country (UNHCR 2012). The lack of a permanent and formal asylum processing process in these countries means that that asylum-seeking populations in the region are reliant on the local offices of the United Nations High Commission for Refugees based in the region to process their claims. These offices rely upon the good will of these governments to have a presence near detection camps and in capital cities to process claims of those who manage to reach the UNHCR representative office. The only burden sharing mechanism within the region primarily exists under the Bali Process on People Smuggling, Trafficking in Persons and Related Transnational Crime (the Bali Process), introduced in 2002. The Bali Process refers to an informal cooperative agreement amongst the states from the Asia-Pacific region, with Australia and Indonesia as the co-chairs, which discusses its namesake: primarily anti-people smuggling activities and migration protocols. There is no provision within this process to discuss the development of national asylum seeking legislation, processes for domestic processing of asylum claims or burden sharing in contrast to other regions such as Africa and South America (i.e. 2009 African Union Convention for the Protection and Assistance of the Internally Displaced, 1969 African Union Convention Governing the Specific Aspects of Refugee Problems in Africa and 1984 Cartagena Declaration on Refugees [Americas]) (PEF 2010: 19).

Studying refugee settlement through longitudinal research : methodological and ethical insights from the Good Starts study

Research involving resettled refugees raises methodological and ethical complexities. These complexities typically emerge within cross-sectional research that focuses on refugee experiences at a specific point in time. Given the long term and dynamic nature of refugee settlement, longitudinal research is valuable, yet it raises distinct complexities within the research process. This article focuses on the methodological and ethical insights that emerged in a longitudinal study of settlement and wellbeing with a cohort of young people from refugee backgrounds in Australia. It considers: engagement and retention of a cohort over time; the need to adapt research tools to changing settlement contexts and life stages; participants’ experiences of long-term involvement in the study; and the challenge of timely translation of findings into evidence for policy and practice. The article contributes to a growing understanding of the practical, ethical and epistemological challenges and opportunities presented by longitudinal research, in this case, with resettled refugee background youth.

The healthy immigrant effect: Patterns and evidence from four countries

The existence of a healthy immigrant effect—where immigrants are on average healthier than the native born—is a widely cited phenomenon across a multitude of literatures including epidemiology and the social sciences. There are many competing explanations. The goals of this paper are twofold: first, to provide further evidence on the presence of the healthy immigrant effect across source and destination country using a set of consistently defined measures of health; and second, to evaluate the role of selectivity as a potential explanation for the existence of the phenomenon. Utilizing data from four major immigrant recipient countries, USA, Canada, UK, and Australia allows us to compare the health of migrants from each with the respective native born who choose not to migrate. This represents a much more appropriate counterfactual than the native born of the immigrant recipient country and yields new insights into the importance of observable selection effects. The analysis finds strong support for the healthy immigrant effect across all four destination countries and that selectivity plays an important role in the observed better health of migrants vis a vis those who stay behind in their country of origin.

Donald Ezekiel AM : passionate and innovative contact lens practitioner and manufacturer

Donald Ezekiel (known to all as ‘Don’) was born in Singapore on September 12, 1936, to a German mother and Iraqi father. His parents were Jewish refugees, who met in Batavia,1 married and alternately lived in Batavia and Singapore. The family established their primary residence in Singapore after Don’s older brother Eric (later to become a haematologist) was born in 1934. The Ezekiel family was forced to flee in 1941 when the Japanese bombed Singapore and were fortunate to obtain passage on a hospital ship to Perth. They returned to Singapore after the war but left again on their own accord in 1951 due to race riots. The Ezekiels sold up everything in Singapore and decided to settle in Perth...

Never at Home? Migrants Between Societies

This chapter explores the dialectic meaning of ‘home’, and movement away from home. Movement away from home – migration – is characterized as a dynamic, dialectic, and developmental experience. We emphasize the sense of being at home and the intertwined sense of identity as interlinked and mutually defining anchors of our existence that become inevitably shaken and ruptured in the experience of migration. But when looking at how this rupture is experienced and managed, we highlight the inherently complex and dialectic nature of migration, instead of seeing it as a unidirectional sequence of rupture → shock → coping → new stable being. We discuss the complexities of migration experiences as entailing dialectics of home and non-home, rupture and continuity, novelty and everydayness, changing and remaining. The sense of being at home is simultaneously enabling and constraining, helping us to build self-continuity in a new environment, yet also holding us back and distancing us from novelty. Similarly, migration is a threat, yet also a promise; it is a painful, yet possibly exhilarating experience that makes us lose our centre of security and familiarity, yet also opens up opportunities for transformation and re-invention.

Second language social networks and communication-related acculturative stress: The role of interconnectedness

Although a substantial amount of cross-cultural psychology research has investigated acculturative stress in general, little attention has been devoted specifically to communication-related acculturative stress (CRAS). In line with the view that cross-cultural adaptation and second language (L2) learning are social and interpersonal phenomena, the present study examines the hypothesis that migrants’ L2 social network size and interconnectedness predict CRAS. The main idea underlying this hypothesis is that L2 social networks play an important role in fostering social and cultural aspects of communicative competence. Specifically, higher interconnectedness may reflect greater access to unmodified natural cultural representations and L2 communication practices, thus fostering communicative competence through observational learning. As such, structural aspects of migrants’ L2 social networks may be protective against acculturative stress arising from chronic communication difficulties. Results from a study of first generation migrant students (N = 100) support this idea by showing that both inclusiveness and density of the participants’ L2 network account for unique variance in CRAS but not in general acculturative stress. These results support the idea that research on cross-cultural adaptation would benefit from disentangling the various facets of acculturative stress and that the structure of migrants’ L2 network matters for language related outcomes. Finally, this study contributes to an emerging body of work that attempts to integrate cultural/cross-cultural research on acculturation and research on intercultural communication and second language learning.