Across the globe, persecution and conflict are forcing more people than ever before to flee in search of sanctuary. Global numbers of refugees are now over 100 million – equivalent to the fifteenth-largest nation on earth, or the combined size of Germany and the Netherlands.
Although individual circumstances and national responses differ, one thing is certain: integration is key to ensuring that refugees’ needs are met, and that host countries can cope with increasing demands on infrastructure, above all for health care. Innovative solutions, such as integrating qualified refugees in the health workforce, can help, yielding benefits for both refugees and their host communities.
“Countries in the WHO European Region are responding to large-scale displacement that they have not faced in decades,” explains Gerald Rockenschaub, Regional Emergency Director for WHO/Europe. “We know that more and more people may be forced to flee their homes in the future due to the consequences of crises such as climate change, to cite just one factor, so it is vital that health systems are able to adapt and innovate if they are to effectively meet the needs of both refugees and host communities.”
Here we meet different health professionals who are drawing on their experience as refugees to help others. They recount how this has helped them to integrate in their host communities.
The cultural mediator
When refugees first arrive in a new country, they urgently need access to information and assistance to address their basic needs, including accommodation, food and health care. Cultural mediators offer assistance and advice on how to navigate unfamiliar systems in host countries, including the health system.
Dian fled his native Guinea at aged 15 after a violent military coup in 2008. He initially intended to travel to France, thinking that it would be easier to integrate because he spoke the language. However, when he ended up travelling to Greece from Türkiye, he eventually decided to stay in the country and learn the language, earning his Greek high school diploma.
Now working as a cultural mediator and interpreter, Dian travels to the Schisto refugee camp on his motorbike each morning. “I work in a refugee camp with many vulnerable people, people who use wheelchairs, blind people, those with chronic diseases, children, pregnant women and others. My colleagues are providing personalized medical services as well as psychosocial support and mental health services,” he explains.
“I feel that my work has a great impact on the lives of refugees coming to Greece. They know my experience, so they feel safe with me. They know that I care and that I want to make a difference in their lives.”
Dian underscores the crucial role of trust: “People trust me, they know that we have similar experiences. I understand what they feel, what they need, and they can sense that. Also, the fact that I am a black African helps – the beneficiaries I work with feel safe to talk and I can fully interpret their needs since I know their culture. Cultural mediators have a crucial role in developing trust in their services. I am trusted by both the beneficiaries and the health personnel.”
Dian also knows that his situation inspires other people: “My experience has made me stronger, fitter to adapt to challenges, more independent. Now I give people courage. I have learned the language, I have integrated and I now have a respected job which allows me a certain standard of living. Through me, they can see how far it is possible to go in this country. I think that my example gives people hope, especially young people and children.”
The psychologist
Maryna Riabenko was forced to flee her home in Kharkiv, Ukraine, when it was struck by a rocket in spring 2022. Arriving in Czechia, she quickly found an apartment and began learning the Czech language with the help of a local family, which enabled her to look for work. Once her academic qualifications in child psychology were recognized, Maryna began working at a support centre for refugees fleeing Ukraine.
“Initially, I suggested that we introduce art therapy and relaxation in addition to individual consultations. Several of the children had been receiving psychiatric care or psychological counselling in Ukraine, so the stress of the war and becoming refugees meant that their psychological state deteriorated rapidly. Those children needed medication and psychological support,” explains Maryna.
“There are other children who have behavioural problems because they have experienced really distressing events – in some cases they have been split up from their parents or their homes have been destroyed. We work with the schools to try to help these children, developing strategies to help them improve conditions so that the children feel better adapted.”
Maryna emphasizes her affinity with the young people she works with: “I immediately realized that I was able to connect with the Ukrainian children on a deeper level. It’s not just that we speak the same language – I have also become a refugee, so I understand how they feel and I can relate to it. I already know what support they need because I’ve been there myself.”
The doctor
Svitlana Borysenko arrived in Poland with her daughter and grandson in March 2022. The family home in Kramatorsk, a city in the Donbas region of Ukraine, was close to the fighting, and her husband and son-in-law, who are medics, stayed to treat the wounded on the frontline.
“Originally, I thought we would be in Poland for a month or two, no longer. So, when we realized that we would not be going home soon, my daughter and I knew that we had to work somehow, live somehow. We needed to survive,” she recounts.
“We are both doctors, so we completed our applications to practise medicine in Poland, which was not easy. The procedure was quite intensive – once my documents had been approved by the Ministry of Health, I had to pass an exam and be interviewed, then work under supervision. Because it is a different country, the system and customs are slightly different. But the diseases and health problems that the patients have are the same no matter what background or nationality they have.”
In Ukraine, Svitlana had 4 specializations: physiotherapy, rehabilitation, nephrology and family medicine. Now in Poland, she works in the lung department of the internal medicine department at the hospital in Lubartów, and at a clinic. At the hospital she mainly sees Polish patients, but at the clinic her patients are primarily Ukrainian.
“When the Ukrainian patients meet me and realize that their doctor is a fellow refugee, they are very happy – it is simply easier for them to explain their problems, both in our shared language and with our shared experience. I see a lot of Ukrainian patients with mental disorders, depression, anxiety. Every second or third person has experienced difficult times during the war.”
Svitlana explains, “I come from the east of Ukraine, and I don’t know what I will find when I return. It’s really difficult not knowing how long this war will go on. But I am proud of what I’ve achieved since I arrived here. I’m not a young woman anymore, and gaining the right to practise my profession in another country is a huge success for me.”
When asked what practical advice she would give to other refugee doctors, she says that starting to learn the language is the most important thing. She did not speak any Polish when she arrived in the country, but through study she obtained an A1 level of language proficiency, and is now working towards B1.
She adds, “On a personal level, the advice I’d give other refugee medics is that if you want something very much, sooner or later, you’ll achieve it. Anything can be done, but you have to want it enough. You can’t put your hands down and give up, you can’t stop believing in yourself.”
The clear benefits of integration
Gundo Weiler, Director of Country Support Systems at WHO/Europe, highlights, “As these stories show, integration benefits refugees and host communities alike, on multiple fronts. WHO/Europe, along with the wider United Nations family, thanks Member States who have gone out of their way to host refugees and facilitate their integration, professionally and personally, into the wider community. The beneficial impacts of this – with an emphasis on health and well-being – are clear to see.”