A lost tribe in the city: health status and needs of African asylum seekers and refugees in Hong Kong

Abstract

BackgroundHong Kong’s resistance to be a signatory of the 1951 Geneva Convention and lack of domestic policies in this area has resulted in restrictions on access to healthcare amongst asylum seekers and refugees (ASRs). Using social determinants of health framework this study sought to identify health practices, problems and needs of African ASRs in Hong Kong.MethodsA cross-sectional survey comprising of six domains including health status, health-seeking behaviour and social experience targeted at adult African ASRs in Hong Kong was conducted through three local non-governmental organisations between February and April 2013. Outpatient care and inpatient care in the past 12 months were used as proxy measures of general and severe ill health respectively. Associations between the determinants of health factors with general or severe health was explored through logistic regressions.ResultsMajority of 374 participants were young, single, educated males having been in Hong Kong for over 5 years. A third of ARS (36.1 %) screened positive for depression. Most reported problems related to basic necessities (64.7–78.6 %) and access to health services (72.2 %). ASRs with relatively less education, health awareness or higher risk behaviours were less likely to have obtained outpatient or inpatient services. African ASRs reporting problems with case officers (aOR = 2.80; 95 % CI = 1.35-5.79) or illness in the past 30 days (aOR = 6.00; 95 % CI = 2.94-12.25) were more likely to report general ill health. Similarly, problems with the case officers (aOR = 3.76; 95 % CI = 1.97-7.18) and self-reported illness in the past 30 days (a​OR = 3.32; 95 % CI= 1.68-6.57) were also significantly associated with severe ill health. At the health system level, those who reported experiencing difficulties accessing the medical services in Hong Kong are 3.29 (95 % CI = 1.48-7.31) and 4.12 (95 % CI = 1.73-9.79) times as likely to report general and severe ill health respectively.ConclusionThe host government should have moral and ethical obligations to attend to the health needs of ASRs. Evidently a number of structural and health system factors have significantly impacted the health of African ASRs in Hong Kong. Changes to current policies regarding how African ASRs are handled whilst in Hong Kong but, more immediately, improvements in healthcare access are needed.

Refugees and Sustainable Health Development in Iran

“…28 Another study showed that host governments should have a moral obligation to the health needs of migrants and refugees. 29 Others have called for a strong and coordinated support at the global, national and subnational levels to ensure that refugees remain a priority in societal plans. 30 According to the Asylum Law in Germany, newly arrived refugees must receive a health insurance card that provides them with screening services for some communicable diseases.…”

Conceptualizing religious asylum: Security, religiosity, and subjective well-being of Christian asylum-seekers in Hong Kong

“…This article builds upon recent works on refugee studies that examined the impact of policies and asylum-seeking arrangements on asylum-seekers’ mental health (Ahearn, 2000; Chuah et al, 2018; Coffey et al, 2010; Wong et al, 2016, 2017). Aligned with most of these studies, this research explores the relationship between the social determinants of health and the subjective well-being of asylum-seekers.…”

Self-perceived mental health and factors associated with the mental health of Hong Kong's asylum-seekers and refugees – A mixed methods study

“…Like any forcibly displaced migrants, the constant pressure facing the asylum-seekers and refugees in Hong Kong from the threats of deportation, poverty and discrimination may associate with their health and mental well-being. Wong et al [ 7 , 8 ] have published two articles on African asylum-seekers in Hong Kong which highlight discrimination as one of the social determinants of access to health services. Using quantitative survey methods, the two papers provide interesting and invaluable insights on the African ASRs in Hong Kong.…”

“…Voluminous research has been conducted on refugees' mental health and factors associated with their psychological well-being in South America, Europe, the USA and Asia, including asylum-seekers and refugees in different situations [ 7 , 8 , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] ]. Some focus on specific circumstances such as detention [ 19 , 21 ] or on refugee housing facilities [ 17 ]; some focus on particular issues like access to health services [ 7 , 8 ], the relationship between trauma and post-migration experiences [ 22 ], and the long years living in a host country [ 12 , 20 ]; others focus on pre-migration and/or post-migration experiences [ 15 , 23 ]. In Hong Kong, however, asylum-seekers and refugees are in a particularly transient position, expecting either to be deported back to their home countries should their cases fail, or to be accepted by third countries should their cases be upheld.…”