Many problems persist in refugee health care

Up to half a million refugees have been hosted in the Czech Republic since the outbreak of the war in Ukraine. Of these, 42 per cent have already sought some form of medical assistance. Even a year and a half after the outbreak of the war, a number of problems persist in the provision of health care. These include intercultural differences or negative attitudes towards vaccinations on the part of refugees. This also applies to common diseases such as tetanus or hepatitis. This is based on a survey conducted by SYRI National Institute among Czech health professionals.

"Health care delivery habits in the Ukraine and the Czech Republic are different. Among other things, in Ukraine the patient manages his/her own treatment more due to the limited functioning of the local healthcare system," points out Karolína Dobiášová from the National Institute SYRI and Charles University. This is why Ukrainians come to Czech surgeries with their own ideas about diagnosis and treatment and expect doctors to treat them according to their instructions.

"Of course, this is not customary here. That is why it is important to continue to inform Ukrainian refugees about how our medical system works. For example, we should also support the interpretation and involvement of Ukrainian health professionals, including the teaching of medical Czech, or prevent prejudices and negative attitudes by providing factual information and intercultural education," Dobiášová said.

One of the problems is the refugees' great distrust of vaccines, which also applies to common vaccinations such as tetanus and hepatitis. "In the Ukraine, the anti-vaccination movement and disinformation campaigns are much more widespread. In addition, the low trust in vaccination in the Ukrainian population is partly due to a series of incidents related to vaccines, for example, in 2010 and 2013, when a number of people experienced adverse reactions due to improper storage and administration of vaccines," Dobiášová points out.

Many Ukrainian refugees still do not have a general practitioner. This is linked to problems with pre-operative examinations, preventive examinations, administrative certificates, overuse of emergency rooms, and so on. "By not having a paediatrician, things that can be solved by a GP sometimes end up in the emergency room. For adults, the greater use of alternative treatments and self-medication in Ukraine also plays a role. This is also why Ukrainian patients sometimes come to the doctor at a later stage of their illness than Czech patients," the scientist said.

Researchers have identified five intercultural barriers that need to be worked on. The first one is language barrier, the other is the different health care system in the Czech Republic and the Ukraine, the different approach to health and illness, cultural differences and socio-economic conditions of refugees. "A big problem is the lack of documentation. In some cases, Ukrainian patients bring only a discharge report in Cyrillic. Misunderstandings and poor quality communication can lead to lower patient satisfaction and adherence, and as a result to poorer healthcare outcomes," Dobiášová added.

The Czech Republic has registered around half a million refugees since the start of the Russian invasion, two-thirds of whom are women. A total of 68 percent of the refugees are people of working age, 28 percent are children and only four percent are seniors. More than half of the refugees, namely 58 per cent, have not received any health care.