Syrian Refugees in a Container City in Turkey: Retrospective Evaluation of Primary Care Admissions

Year 2019, Volume: 13 Issue: 4, 508 - 513, 20.12.2019

Pınar Döner , Rabia Kahveci İrfan Şencan , Duygu Ayhan Adem Özkara

https://doi.org/10.21763/tjfmpc.651567

Abstract

Objective: The aim of this study was to collect and share information about primary care (PC) services provided to the Syrian refugees in Kilis container city and to evaluate their situation excluding preventive services. We also tried to determine further needs.
Methods: This is a retrospective type descriptive study. Data about PC services provided to Syrian refugees in Öncüpınar was collected by personal contacts and observation besides summarizing our own experience. The container cities have a manual system. For the take of the analysis, information from the paper files was transferred to an electronic database. The study covered the period between April 2012- where settling of Syrians started- and 20th December 2012 when admissions were recorded. Total number of admissions to the PC center was 17399 during this period.
Results: Health care services are provided through a PC center, 112 medical emergency service stations and a tent hospital. Most of the admissions were in 12-59 month age group (20.2%), followed by 20-29 years age group (16.6%),46% of all admissions were acute problems including respiratory tract infections, gastrointestinal system problems, soft tissue infections and pain. Hypertension was the most common diagnosis among chronic conditions. Of all admissions, 10.8 % ended up with referral, 17.5 % of the patients were referred to the emergency service where the remaining were referred to different specialty services.
Conclusion: This is the first study of the PC services provided to the Syrian refugees in Turkey and identifies main causes of admissions and referrals. Day by day living in the host country, all requirements are increasing and changing occasionally. Therefore the situation should be reviewed constantly and plan should be done for the current and future needs.

Amaç: Bu çalışmanın amacı, Suriyeli mültecilere sunulan önleyici hizmetler hariç olmak üzere birinci basamak sağlık hizmetleri hakkında Kilis konteyner kentindeki mültecilerin durumunu paylaşmak, bilgi toplamak ve durumu değerlendirmektir. Ayrıca gelecekteki ihtiyaçları belirlemeye çalıştık.
Yöntem: Çalışma retrospektif tipte tanımlayıcı bir çalışmadır. Öncüpınar'daki Suriyeli mültecilere birinci basamak hizmetleri hakkındaki kendi tecrübelerimizi özetlemenin yanı sıra kişisel görüşmeler ve gözlemler yaparak veri toplandı. Konteyner şehirlerin manuel bir sistemi bulunmaktadır. Analizler için, kâğıt dosyalardan gelen bilgiler elektronik bir veri-tabanına aktarıldı. Çalışma Suriyelilerin yerleşiminin başladığı Nisan 2012’den itibaren 20 Aralık 2012 tarihine kadar kayıtların kaydedildiği süreyi kapsamaktadır. Bu dönemde birinci basamak sağlık merkezine başvuruların toplam sayısı 17399 idi.
Bulgular: Sağlık hizmetleri birinci basamak hizmetleri, 112 acil tıbbi servis istasyonu ve bir çadır hastane aracılığıyla sağlanmaktadır. Başvuruların çoğu 12-59 aylık grupta (% 20,2), 20-29 yaş grubunda (% 16,6) yapılmıştı. Başvuruların büyük çoğunluğu solunum yolu enfeksiyonları, gastrointestinal sistem sorunları, yumuşak doku enfeksiyonları ve ağrı gibi akut problemlerdi. Kronik durumlar arasında hipertansiyon en sık görülen tanıydı. Tüm başvuruların % 10,8'i sevk ile sonuçlandı. Hastaların% 17,5'i acil servise, geri kalan hastalar ise farklı uzmanlık servislerine sevk edildi.
Sonuç: Bu çalışma, Türkiye'deki Suriyeli mültecilere sunulan birinci basamak hizmetleriyle ilgili ilk çalışma olup, başvuruların temel nedenleri belirlenmiştir. Günden güne mültecilerin gereksinimleri artmakta ve değişmektedir. Bu nedenle durum sürekli gözden geçirilmeli ve mevcut ve gelecekteki ihtiyaçlar için planlamalar yapılmalıdır.

Keywords

Container City, Primary Care Services, Syrian Refugees

References

• 1. AFAD.https://www.afad.gov.tr/EN/ (accessed Sept 26, 2018).
• 2. UNHCR. Syria Regional Refugee Response.http://data.unhcr.org/syrianrefugees/country (accessed December 16, 2018).
• 3.AA News Agency. Dec 01,2018. Foreign Minister Cavusoglu. (accessed March 03, 2019)
• 4. AFAD. Director General of AFAD, Dr. Fuat OKTAY informed European Union-Turkey Joint Parliamentary Committee about Syria, June 28, 2013. https://www.afad.gov.tr/EN/
• 5. Döner P, Ozkara A, Kahveci R. Syrian refugees in Turkey: numbers and emotions.Lancet. 2013; 382(9894):764. doi: 10.1016/S0140-6736(13)61823-1. PMID: 23993181
• 6. Refaat MM, Mohanna K. Syrian refugees in Lebanon: facts and solutions. Lancet. 2013;382(9894):763-4. doi: 10.1016/S0140-6736(13)61461-0.
• 7.Murshidi MM, Hijjawi MQ, Jeriesat S, Eltom A..Syrian refugees and Jordan's health sector. Lancet. 2013;382(9888):206-7. doi: 10.1016/S0140-6736(13)61506-8. Epub 2013 Jul 3. PMID: 23830357
• 8. Burki TK. The right to health for Syrian refugees.Lancet Respir Med. 2013;1(6):439-40. doi: 10.1016/S2213-2600(13)70129-2.
• 9. Turner C, Turner P, Hoogenboom G, Aye Mya Thein N, McGready R, et al. A three year descriptive study of early onset neonatal sepsis in a refugee population on the Thailand Myanmar border.BMC Infect Dis. 2013; 13:601. doi: 10.1186/1471-2334-13-601.
• 10. Turner C, Carrara V, Aye Mya Thein N, Chit Mo Mo Win N, Turner P, Bancone G, et al.Neonatal intensive care in a Karen refugee cAMP: a 4 year descriptive study.PLoS One. 2013; 8(8):e72721. doi: 10.1371/journal.pone.0072721
• 11. Rainey JJ, Sugerman D, Brennan M, Cadet JR, Ernsly J, Lacapère F, et al.Rapid monitoring in vaccination campaigns during emergencies: the post-earthquake campaign in Haiti.Bull World Health Organ. 2013; 91(12):957-62. doi: 10.2471/BLT.12.117044.
• 12. Razum O, Müller O. Polio eradication: where are we now? Lancet. 2013;382(9909):1979. doi: 10.1016/S0140-6736(13)62652-5.
• 13.Eichner M, Brockmann SO.Polio emergence in Syria and Israel endangers Europe.Lancet. 2013;382(9907):1777. doi: 10.1016/S0140-6736(13)62220-5.
• 14. Celentano LP, Lopalco PL, Huitric E, Coulombier D, Giesecke J.Polio and the risk for the European Union.Lancet. 2014;383(9913):216-7. doi: 10.1016/S0140-6736(13)62223-0.
• 15.Duncan G, Harding C, Gilmour A, Seal A. GP and registrar involvement in refugee health - a needs assessment.Aust Fam Physician. 2013;42(6):405-8.
• 16. Carta MG, Oumar FW, Moro MF, Moro D, Preti A, Mereu A,et al. Trauma- and stressor related disorders in the tuareg refugees of a cAMP in burkina faso.Clin Pract Epidemiol Ment Health. 2013;9:189-95. doi: 10.2174/1745017901309010189.
• 17. Wales J, Rashid M.No longer a place of refuge: health consequences of mandatory detention for refugees.Can Fam Physician. 2013;59(6):609-11.
• 18. Turner C. High rates of pneumonia in children under two years of age in a South East Asian refugee population.PLoS One. 2013;8(1):e54026. doi: 10.1371/journal.pone.0054026.
• 19. Polonsky JA, Ronsse A, Ciglenecki I, Rull M, Porten K. High levels of mortality, malnutrition, and measles, among recently-displaced Somali refugees in Dagahaley camp, Dadaab refugee camp complex.Confl Health. 2013;7(1):1. doi: 10.1186/1752-1505-7-1.
• 20. Hynes M, Sakani O, Spiegel P, Cornier N. A study of refugee maternal mortality in 10 countries, 2008-2010.Int Perspect Sex Reprod Health. 2012;38(4):205-13. doi: 10.1363/3820512.
• 21. Nyiri P, Eling J.A specialist clinic for destitute asylum seekers and refugees in London. Br J Gen Pract. 2012;62(604):599-600. doi: 10.3399/bjgp12X658386.
• 22. Rasmussen A, Crager M, Baser RE, Chu T, Gany F.Onset of posttraumatic stress disorder and major depression among refugees and voluntary migrants to the United States.J Trauma Stress. 2012;25(6):705-12. doi: 10.1002/jts.21763.
• 23. Warfa N, Curtis S, Watters C, Carswell K, Ingleby D, Bhui K.Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study.BMC Public Health. 2012;12:749. doi: 10.1186/1471-2458-12-749.
• 24.Das-Munshi J, Leavey G, Stansfeld SA, Prince MJ. Migration, social mobility and common mental disorders: critical review of the literature and meta-analysis.Ethn Health. 2012;17(1-2):17-53. doi: 10.1080/13557858.2011.632816.
• 25.Truppa C, Leresche E, Fuller AF, Marnicio AS, Abisaab J, El Hayek N. Utilization of primary health care services among Syrian refugee and Lebanese women targeted by the ICRC program in Lebanon: a cross-sectional study. Confl Health. 2019; 15;13:7
• 26. Ziad EK , Scales D, Vearey Jo, Forsberg BC.Letter to Editor Syrian refugees, between rocky crisis in Syria and hard inaccessibility to healthcare services in Lebanon and Jordan. Conflict and Health20137:18.
• 27.Otoukesh S, Mojtahedzadeh M, Sherzai D, Behazin A, Bazargan-Hejazi S, Bazargan M.A retrospective study of demographic parameters and major health referrals among Afghan refugees in Iran. Int J Equity Health. 2012;11:82. doi: 10.1186/1475-9276-11-82.
• 28. Mateen FJ, Carone M, Al-Saedy H, Nyce S, Ghosn J, Mutuerandu T, et al.Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System. Bull World Health Organ. 2012;90(6):444-51. doi: 10.2471/BLT.11.097048.