Describes ways to assess the varied medical conditions associated with immigrants and refugees as well as ways that family physicians can effectively provide medical care to these patients. Unlike economic immigrants, refugees do not make a voluntary choice to leave their homeland, and the physical and psychological effects of transition on the refugee can be both profound and long lasting. Specific screening recommendations depend on the refugee’s immigration status and point of origin, but include screening to determine nutritional status as well as for such mental health effects as depression and post-traumatic stress disorder (PSTD), infectious diseases, and preventable conditions. Challenges for health service delivery systems include: communication barriers, concerns about confidentiality, different cultural understandings of health and health care, and the persistent effects of PSTD, some of which are the result of torture. A traditional healer can understand patients within their own cultural context. Moreover, traditional healers and community leaders often are able to restore links with the past as an antidote to cultural bereavement. Taken together, traditional therapies, including herbal remedies and spiritual ceremonies, as well as Western modalities can be effective in treating refugee patients.
