Book Review
Health care and immigrants: A guide for the helping professions
Barbara Ferguson and Elspeth Brown
ISBN: 978-0803697775; 1991; 261 pages; MacLennon and Petty;
Lee-Ann Walding
Nursing Studies, Flinders University, Adelaide SA
Health Care and Immigrants, A Guide for the Helping Professions, is an integrated collection of chapters by authors from a wide variety of backgrounds: social work, nursing, psychiatry, education, psychology, policy and health promotion. The book is intended for use as an introductory text for students and as a reference manual for practitioners. The ultimate goal of the text is to improve health care for all Australians and particularly for the overseas-born and their children. Ideas about the migration experience, response to illness, access to and use of health services and other public health issues have changed considerably in recent years and take account of structural inequalities within Australia. This book provides a social health perspective and is supported by a growing and wide-ranging literature concerned with a social understanding and cultural history of health issues.
There are three parts to the book. Part One, Chapters 2 to 4, introduces the framework in which health care for immigrants and refugees takes place. Chapter 2 by Ferguson, defines concepts essential to the cross-cultural interaction and introduces a model for cross-cultural practice. In Chapter 3, Browne summarises the Australian context and the history of migration to this country. Chapter 4 by Barker, deals with the barriers to effective intercultural communication.
Part Two, Chapters 5 to 9, follows the lifespan, emphasising health and mental health issues which may arise at each stage and the special consequences for immigrants and refugees. Johnson, Johnson and Browne look at the implications for work with immigrant mothers and babies based on experiences at the North Richmond Community Health Centre in Victoria. In Chapter 6, Fernandez presents an Indian perspective on child-rearing. Hepperlin is concerned with adolescent development in Chapter 7 and particularly with the mental health of traumatised adolescent refugees. The author describes the model of services the Rivendell program in Sydney provides for youth from Vietnam, Laos and Cambodia. Schappe, in Chapter 8, addresses the needs of the increasing numbers of aging immigrants in Australia. In Chapter 9, Tsang looks at the significance of culture and the migration experience of bereavement counselling for immigrants.
Part three, Chapters 10 to 14 is devoted to special areas of health care. In Chapter 10 Williams provides an introduction and a review of research in the area of mental health. In Chapter 11 Tarn discusses mental health services for refugees and torture survivors. Hatty, in Chapter 12 examines the needs of people from non-English-speaking backgrounds related to drug and alcohol rehabilitation services. Malay and Mulas describe a model of health promotion and disease prevention implemented for AIDS education among immigrants in Chapter 13. Iskander in Chapter 14 reports on her research into the experiences of immigrant women disabled by industrial injury. Finally, in Chapter 15, the principles and themes common to work with immigrants are presented as a guide for work in the field of health and social care.
Overall, there is a logical sequencing of chapters and themes. As the material is presented at an introductory level it does not pretend to be a definitive or comprehensive work and provides instead relatively easy reading. Although the book is intended to inform in the field it may also be used in professional nursing education as self directed learning or for classroom activities. Each chapter includes a set of objectives, case material, exercises, a summary, review questions and references.
From a nursing perspective, the book supports a holistic model of health care. The authors stress the need for a 'high touch' approach to health care which acknowledges the cultural differences. Moreover, by examining the Australian health care system from the perspective of the immigrant, nurses may identify and remedy deficiencies in nursing practice. Although the text provides an overview of social justice issues, there is a need for nursing educators, students and practitioners to place the contents of this text within the wider context of primary health care. Any discussion related to immigrant health from a nursing perspective should also include client advocacy.
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