Immigration is the movement of an individual or group of peoples to a foreign country to live permanently. Since 1788, when the first British settlers arrived in Botany Bay, immigrants have travelled from across the world to establish a life in Australia. The reason for people or groups of peoples moving to Australia varies. Such reasons can be due to seeking work or even refuge from third world countries. The health of immigrants entering Australia varies depending on the individual's country of origin and the circumstance of which they came, as well as their state of travel to Australia. Immigrants are known to enter Australia both regularly and irregularly, and this can affect one's health immensely. Once in Australia, immigrants are given the opportunity to access a high quality of healthcare services, however, the usage of these services can differ dependent on the culture and place of birth of the individual. Australia has strict health regulations that have to be met before one is allowed access into Australia and can determine if one is granted or denied such access. The quarantine process of immigrants into Australia has been in place since 1830, starting at the North Head Quarantine Station and continues all over Australia.
Australia's immigrants
Europeans
In 1788, the first fleet of British immigrants established a colony in Australia. The arrival of the Europeans in the 1800s, saw those from Italy, Greece, Poland, Malta, Russia and France land on the shores of Australia. Upon embarking, it is expected that the European immigrants would have carried infectious diseases aboard the ships, and given the nature of the vessels, any disease would have spread quickly among the passengers. Reports by Mark Stainforth suggest that many forms of bacteria and viruses caused high levels of illness and on-board deaths among those European immigrants travelling to Australia.
Diagnosis of immigrant morbidity on board ship (1837–39)
Source:
DiseaseModern EquivalentCasesDiarrhoeaDiarrhoea350ObstipatioConstipation160CattarhusInfluenza147Continuae SynochusTyphoid143ScareltinaScarlett fever133Ophthalmiavarious81Colicavarious67DysentariaDysentery68Cyanchie Tonsilonsvarious59Tabesvarious49
Because of these viruses and infections that spread among European immigrants before reaching Australia, upon arrival, a majority of immigrants were of ill health. The immigration of European settlers introduced such bacteria and viruses to Australia.
1789: Smallpox
1850: Measles were reported in Australia brought over by the European immigrants.
1900: Bubonic plague found among European immigrants.
1982: HIV was detected in a European man.
Chinese
According to the 1861 Colonial Census, Chinese-born persons made up 3.4% of the Australian population,Services, Q., H., M. (2011) Chinese Australians. Retrieved from equating to approximately 38,258 Chinese in Australia after 1842 when the Chinese first settled in Australia. Some arrived in Australia hoping to escape civil disorder in China, although the majority of Chinese migrated to Australia after hearing about the gold rush.
Within Australia, the average life expectancy is 81.7 years, while China-born individuals have an average of 74.7 years. The Queensland Health Multicultural Services suggests that Ischaemic heart disease, cancer and cerebrovascular disease are the major causes of death of China-born persons in Australia. Such cancers that have been identified include nasopharynx, lung, intestine, rectum, stomach and liver cancer, all of which are prominent among Chinese immigrants.
Afghans From the 1860s, "Afghan" cameleers, who came mainly from Afghanistan, but also British India and other countries, settled in Australia, establishing work helping to open up outback Australia.
Afghans who have migrated to Australia more recently face several disadvantages when accessing health services. Disadvantages include language barriers, a lack of translators in Australian health services, and the incompatibility of some Australian healthcare services and procedures with Islamic beliefs.Services, Q., H., M. (2011) Afghan Australians. The migrants may experience a sense of alienation and lack of belonging as they are put in a situation that makes them feel like outcasts compared to the rest of Australia. However, the Queensland Health Multicultural Services have suggested that Afghan migrants use the health services just as much as Australian-born individuals.
Children The Royal Children's Hospital in Melbourne have conducted a study that identifies the following among children who have immigrated to Australia. InfectionPercentage of childrenAnaemia10–30%Hepatitis B2–7%Pathogenic faecal parasites14–42%Tuberculosis25–55%
Quarantine and health requirements
Early years
In the 1830s, the immigrants that arrived by boat on the shores of Sydney were suspected to be carrying contagious diseases. During this period, influenza, typhoid, scarlet fever and whooping cough were all found on European ships arriving in Australia. To contain such diseases, the ships were stopped at North Head Quarantine Station where the authority would place the passengers and crew into quarantine. The Australian Government (2015) suspects that each passenger would have spent on average, 40 days in quarantine before being released into Australia, as Australian residents. Each experience within North Head varied and was dependent on class. Some immigrants were exposed to further disease, disempowerment and in some cases death. In the beginning, North Head Quarantine Station provided tents for those immigrants who came to Australia. However, in 1837, those who appeared to be healthy were those who were granted accommodation in the tents, while those who were sick were required to stay on the ship. The Australian government suggests that in the year of 1837, 295 healthy immigrants were kept ashore while those who were contagious or otherwise were kept on the ship. The North Head Quarantine Station's facilities continued to grow. However, between 1860 and 1870, the quarantine station took a turn for the worse when the world economy decelerated along with immigration. As a result, an outbreak of smallpox occurred due to insufficient maintenance of the North Head Quarantine Station. It was only in 1909, when the Commonwealth government took over North Head Quarantine, that the station attained a maximum volume of 1200 people.
Government health requirements In order to ensure Australia's health and safety, the Government is required to examine all immigrants prior to entering Australia. Those who seek either a permanent or temporary visa are part of this application. All candidates are checked for Tuberculosis, HIV and Hepatitis, Yellow fever, Polio and the Ebola virus disease (EVD). In order to be allowed access into Australia, you must be cleared of all of these diseases and deemed to be no threat to Australian communities.
Australian health services
Current health care system The Medicare system in Australia is a publicly funded system that is designed to provide heavily subsidised costs for all Australians, including those foreign born immigrants who either have a citizenship, a working visa, a permanent visa, or one who is married to an Australian citizen.
Health care difficulties for immigrants
For those who migrate to Australia, there are many disadvantages in the way of healthcare. The Australian government provides well supported healthcare for immigrants, however, those immigrants who arrive in Australia are struck by culture and communication barriers as well as a lack of knowledge regarding the cost of health services and knowing their rights.
Cultural barriers Cultural barriers felt by immigrants include the Australians perceptions of health as well as their behaviour when sick. Such differences are determined by ones cultural heritage. It is also prominent that some immigrants are concerned that doctors will not recognise or understand their specific cultural needs. An example of this includes the religious and cultural needs of women from the Middle East or Islamic faith, who may be fearful of male doctors examining them. The ABC (2003) stated that "different cultural groups have specific expectations. For example, Jehovah's Witness followers will refuse to have blood transfusions, believing it is polluting."
Communication barriers For those immigrants coming to Australia from non-English speaking backgrounds, communication barriers can influence one's health experience, whether it be negative or positive. The ABC (2003) stated that non-English speaking immigrants may say 'yes' in stressful situation in order to avoid further need for communication with healthcare services. This can have great impacts on the individual as they may not receive the help they need as a result, or they will choose not to contact health services as they are wary of the communication barriers and believe it is easier to avoid the situation. This could result in the individual's health deteriorating as a result of lack of attention.
Cost of healthcare When immigrants arrive in Australia, it is evident that a lack of money and understanding of the healthcare system can lead to immigrants avoiding the services. Therefore, it is vital for immigrants, upon arrival, are noted of their rights in regards to free healthcare. Those immigrants who have access to Medicare are: Permanent residents Those who await the final process of their permanent residency claim. Countries such as Finland, Great Britain, the Netherlands, Italy, Malta, Ireland and New Zealand have an agreement with the Australian healthcare system that grants immigrants from the above countries with access to Medicare.
Patient rights It has been identified that immigrants from non-English speaking backgrounds, tend to feel less empowered, resulting in the patients becoming reticent. Non-English speak immigrants tend not to ask questions. As a result, many individuals are discouraged from visiting the services again, which can lead to the ill health of immigrants that are new to Australia.
These factors can be reduced if new arrivals to Australia are aware of their rights. All patients have the right to: Ask for a doctor of a particular sex. What privacy they wish for. An interpreter. Complain if they feel necessary. Between 2007 and 2008, an Australian Charter of Healthcare Rights was established by the commission. This charter provides a clear outline of the rights of those seeking healthcare, and is directed at patients, consumers, families, carers and service providers. This charter can be applied in all health settings in Australia. These include, public hospitals,. general practices and other environments.
See the Australian Charter of Healthcare Rights below:
Expectations of the Australian health system Patient rightsWhat this meansAccessPatients have the right to health carePatients can access services to address their healthcare needs.SafetyPatients have a right to receive safe and high quality carePatients have a right to receive safe and high quality service, provided with professional care, skill and competence.RespectPatients have the right to be shown respect, dignity and considerationThe care provided shows respect to a patient, their culture, beliefs, values and personal characteristics.CommunicationPatients have a right to be informed about services, treatment, options and costs in a clear and open way.Patients should receive open, timely and appropriate communication about their health care in a way they can understand.ParticipationPatients have a right to be included in decisions and choices about their care.Patients may join in making decisions and choices about their care and about health service planning.PrivacyPatients have a right to privacy and confidentiality of their