Forced Migration, Older Refugees and Displacement : Implications for Social Work as a Human Rights Profession

This article explores the conditions of globally displaced older refugees and outlines the implications for social work as a human rights profession. The study is based on a literature review and two current case examples of globally displaced older refugees facing long-term structural discrimination and human rights violation: older Rohingyas at the Bangladesh-Myanmar border and older Palestinians at the Israel-Gaza and Lebanon borders. The authors suggest that social workers as ‘front-line human rights workers’ are uniquely placed to identify needs, take actionable steps to support and advocate for the human rights of older displaced refugees. It is argued that global social work ethics and principles of social justice and human rights should underpin social work practices that engage people and structures in order to address life challenges and enhance the well-being of displaced older refugees in war zones, at borders and in refugee camps. Future research and welfare projects that aim to analyze the political context that forms the living conditions of forcibly displaced older refugees, whilst enhancing the importance of social workers in interprofessional collaborations in these areas, are discussed.

The Relaxation Exercise and Social Support Trial (RESST): a community-based randomized controlled trial to alleviate medically unexplained vaginal discharge symptoms

<p>Abstract</p> <p>Background</p> <p>Symptoms such as medically unexplained vaginal discharge (MUVD) are common and bothersome, leading to potentially unnecessary use of resources.</p> <p>Methods</p> <p>A community-based individually randomized controlled trial to assess the effectiveness of a relatively simple, culturally appropriate multi-component intervention on reducing reported MUVD, among women suffering from low-moderate levels of common mental distress. The setting was a socio-economically deprived, informal settlement in the southern suburbs of Beirut, Lebanon. The intervention comprised up to 12 group sessions implemented over a six-week period, each divided into a psychosocial and a relaxation exercise component. The primary outcome was self-reported MUVD, which was defined as a complaint of vaginal discharge upon ruling out reproductive tract infections (RTIs), through lab analysis. Anxiety and/or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25). Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Blinding on the intervention status was not possible for both logistic and ethical reasons, especially as knowledge of involvement in the intervention was integral to its delivery. Intent to treat analysis was used.</p> <p>Results</p> <p>Of 75 women randomized to the intervention, 48% reported MUVD at 6 months compared with 63% of 73 in the control group (difference of -15%, 95% confidence interval (CI) -31%, 0%, p=0.067). Adjustments for baseline imbalances and any factors relating to consent had no appreciable effect on these results. The risk of MUVD was reduced in absolute terms by 2.4% for each intervention session attended (95% CI -4.9%, 0.0%, p=0.049). While there was also marginal evidence of a beneficial effect on anxiety, there was no evidence of mediation of the effect on MUVD through measures of common mental disorders.</p> <p>Conclusion</p> <p>This study confirms that MUVD is an important public health problem. While the benefits of this intervention may appear modest, the intervention offers an opportunity for women to enhance their problem-solving skills as well as use physical relaxation techniques that can help them deal with stressful in their lives. Further research is needed in a variety of contexts, for different populations and preferably involving larger randomized trials of such an intervention.</p> <p>Trial registration</p> <p>* Title of trial: The Relaxation Exercise and Social Support Trial</p> <p>ISRCTN assigned: ISRCTN98441241</p> <p>Date of assignation: 10/09/2010</p> <p>Link: <url>http://www.controlled-trials.com/ISRCTN98441241</url></p> <p>* Also registered at the Wellcome Trust register:</p> <p><url>http://www.controlled-trials.com/mrct/trial/469943/98441241</url></p