Quiz: How Much Do You Know About Refugees’ Health?

Humanity recently passed a sobering milestone: For the first time, 100 million people are now forcibly displaced worldwide, including refugees, asylum seekers, and internally displaced populations. That’s larger than the entire populations of Vietnam, Turkey, Iran, and Germany. It’s more than double the population of California, triple the population of Texas, and five times the population of New York.

There are numerous hurdles that prevent refugees from accessing health care, from income and documentation to language barriers and stigmas. But with 1% of the world’s population now displaced, ensuring everyone’s access to quality care has never been more crucial.

How well do you know the health issues refugees face? Test your knowledge with these true-or-false questions below.

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How Did You Do?

1. More than half of refugees who seek health care end up receiving treatment for mental health conditions.

False. The number of refugees who are able to receive mental health treatment vastly underrepresents the need: In 2018, mental health consultations accounted for less than 2% of refugee health consultations.

Because most refugees live in low- or middle-income regions, health care infrastructure on its own can be lacking. Treatment for mental health is often completely out of reach. Yet, displacement brings a number of traumas that can lead to severe mental health issues, particularly in children. The most common issues among refugees are depression and anxiety, but more serious issues can also be found due to the conflict, violence, and persecution these populations face.

Mental health is health, regardless of who you are or where you live. But the trauma that refugees experience means that mental health care for displaced populations must be prioritized.

2. Relocation allows most refugees to access improved health care services in the places they resettle.

False. The vast majority of refugees (86%) are hosted in developing regions where basic services are already strained.

Most refugees go to neighboring countries or stay close to home, which is why the 10-year Syrian war has led to Turkey hosting the most refugees on earth. In Colombia, where health care services near the border have been strained by the Venezuela crisis, the government recently announced that Venezuelans can now live and work legally in the country for 10 years, a move which will greatly improve access to health care for the 1.8 million Venezuelans who live there.

Project HOPE has supported health care systems near the Colombia-Venezuela border since the start of the crisis. In addition to COVID-19 support, we’re also helping improve access to health care for pregnant women and mothers who have had to go without essential prenatal or antenatal care.

3. All refugees in the United States receive a comprehensive health exam and mental health evaluation.

True. Since 1997, states are required to provide a comprehensive health screening for all newly arrived refugees in the United States, which includes a mental health evaluation and a physical examination. Refugees also receive eight months of health care coverage.

4. Refugees’ greatest health needs have increasingly shifted to transmissible and infectious diseases.

False. Most refugees live in non-camp settings and the most common health needs are shifting to noncommunicable diseases like cancer and diabetes.

Infectious diseases like cholera are still a major issue in many refugee settings, and COVID-19 has spread through refugee populations in crowded areas like camps and borders. NCDs, however, are the world’s number one killer, and the burden of NCDs in the top refugee countries of origin tells the story: NCDs account for 63% of the health burden in Myanmar, 51% in Sudan, and 43% in Afghanistan.

The majority of Syrian refugees live in Jordan, Lebanon, and Turkey, where NCDs account for more than three-quarters of total deaths. A 2019 study of Syrian refugees in Jordan found that more than 1 in 10 refugees experienced hypertension, with other issues including cardiovascular disease and diabetes.

Managing chronic health conditions can be a long, costly road. The more refugees have to delay care, the worse these health conditions can become, making the need for immediate, equitable access to health care more important than ever.

5. Studies have found that the stress of displacement largely ends once a refugee is relocated in a new community.

False. Post-migration stress is a major health issue among refugees, contributing to further mental trauma even after refugees arrive in a new location.

The intense stress of displacement doesn’t end when you find a place to resettle: refugees can live for years in limbo without documentation, work, or any idea of whether they might be able to return home. Language and cultural barriers can add to the stress, which can be compounded by the traumatic experience of displacement.

Finding health care can be a major stressor for refugees, including in the United States. It all adds up to a major burden on refugees’ mental health that can last for years — especially in children. Researchers have found that young refugees are at a high risk of psychosocial and mental health issues, including anxiety, depression, and post-traumatic stress disorder.

6. Nearly all major countries that host refugees have said they will include refugees in their COVID-19 vaccination plans.

True. According to the United Nations Refugee Agency, 150 of the 157 countries it is monitoring have pledged to vaccinate refugees. But whether that happens is yet to be seen.

The vast majority of vaccinations to date have happened in wealthy countries, with low-income countries only able to purchase 2% of the available vaccine doses so far. COVAX, the global initiative to ensure equitable access to the vaccines, has delivered 190 million fewer doses than anticipated.

The issue has been compounded by the deadly wave of COVID-19 in India, the world’s largest vaccine producer. In Cox’s Bazar, Bangladesh, where more than 900,000 Rohingya refugees live, not a single vaccine had been administered as of June 1.