Afghanistan Updates

Afghanistan Updates and Services

Health Information for Afghan arrivals

Background

So far, over 4700 people have arrived into Australia from the evacuation carried out by Australia in Afghanistan in late August.   We can also expect more arrivals over the coming months. The following will provide helpful information for clinicians regarding Visa and Medicare status, COVID vaccination, Immigration Medical Examination (IME) and health assessment recommendations.

VISA type and Medicare

Some new arrivals have Australian citizenship/permanent residency, others have travelled under Australian refugee visas, many have arrived on Temporary Humanitarian Stay (449) visas – likely related to the speed of the uplift/evacuation.

VISA 449 holders are entitled to Medicare services from the date of arrival into Australia.  There have however been delays in enrolment in Medicare and access to Medicare numbers.  Most arrivals should now be enrolled and have a Medicare number.  If unable to access Medicare details for people, health providers can email: HARDSHIP.ASSISTANCE@servicesaustralia.gov.au  and contact the Humanitarian Settlement Provider: mailto:welcome@multiculturalaustralia.org.au

Immigration (Visa) Medical Assessment (IME)

Unlike other humanitarian arrivals, newly arrived Afghan refugees have not had an offshore Immigration Medical Examination (IME), instead this has been/ will be performed for each arrival granted a 449 Visa by BUPA onshore.  Most of the initial arrivals have already had this examination completed (Nov 21).

The BUPA assessment consists of:

    • age <2 years – medical exam (no blood tests)
    • age 2-10 years – medical exam, IGRA or Tuberculin Skin Test (TST)
    • age 11-15 years – medical exam (no blood tests), CXR
    • age 15 years and older – medical exam, HIV, HBsAg, HCV, HIV, syphilis screening, CXR
    • Unaccompanied minors – HIV, HBsAg (all ages), + age based as above.

Key points

    • Positive TB screening or blood-borne virus tests are disclosed to the client (who is called back for an appointment) and will be referred to local TB services/ public health service
    • Clients are not given a record of any negative screening results (including TB) but these can be requested from BUPA
  • BUPA DO NOT make medical referrals for other findings on the IME.  If a medical issue is identified the client is given a “Duty of Care” letter with limited clinical information and the HSP provider is notified to arrange medical follow up.

GPs / Health service providers can contact BUPA to request medical information with patient consent.  The pathology provider for BUPA IME in QLD is QML Pathology so results may be requested via QML.

  • BUPA contact email is BupaMedicalOfficerOnshore@bupamvs.com.au 

COVID Vaccination

  • Some arrivals have already received COVID vaccination overseas and will present with a vaccine record.  These include Covishield (AZ, India), Johnson and Johnson (Janssen Cilag), Sinopharm and AZD 1222 (UK, AZ) and some Sinovac.
  • All these vaccines are approved by the WHO and recognised by the TGA and are included on AIR

Comprehensive Health Assessment

The BUPA IME is not equivalent to a comprehensive refugee health assessment and does not cover all recommended refugee health screening pathology as recommended by the Australasian Society for Infectious Diseases:  ASID guidelines.

Therefore,   a Comprehensive Refugee Health Assessment should be offered to every child, adolescent and adult from a refugee background who is new to your care, preferably within one month of arrival.

This includes, migration history; a full medical history, including current concerns, developmental history in children and adolescents and psychosocial history; physical examination; investigations (including pathology); and development of a management plan. For children and adolescents, history may be taken from a parent or carer where appropriate.

Recommended-Pathology-for-Refugee-Arrivals-nov2021.pdf (refugeehealthnetworkqld.org.au)

  • Note:  We suggest routine screening for B12 deficiency in people from Afghanistan (in which case also check folate levels) and cases of Malaria have been seen in the recent arrivals.

Many of the arrivals have experienced significant trauma and remain distressed regarding loved ones remaining in Afghanistan.  To access further mental health support including The Qld Program of Assistance to survivors of torture and trauma refer to:

Mental Health – Refugee Health Network Queensland (refugeehealthnetworkqld.org.au)