Refugee Service

SCHN’s Children’s Refugee Service provides advocacy, research, training, and clinical services to children with a refugee background and their families and the health professionals caring for them. It combines the two well-established multidisciplinary pediatric refugee health clinics in the Network:

• The Health Assessment for Refugee Kids (HARK) clinic at The Children’s Hospital at Westmead
• The Refugee Child Health Clinic at Sydney Children’s Hospital.

Both clinics see children under 16 years of age from a refugee-like background for:

• Specialist assessment, treatment and referral for refugees and asylum seekers with specific health problems, and
• Health screening of asylum seekers in accordance with ASID guidelines.

Refugee research and education

Research

We support and conduct collaborative research in order to ensure our work is evidence-based and contributes to the knowledge base of this relatively new field.

Some of our current refugee research/policy projects include:

• systematic review of developmental delay and intellectual impairment in children who are refugees or seeking asylum
• documentation of the risk of Post-Traumatic Stress Disorder in children who are refugees or seeking asylum
• a randomized controlled trial of the benefits of providing periodic high doses of vitamin D vs more regular low doses to Vitamin D-deficient refugee children
• examination of the rate of TB (latent and active) by country of origin, which will help inform post-arrival screening practices, particularly in young children
• a longitudinal study to assess physical health, development and social-emotional wellbeing of newly arrived refugees over time
• exploration of the effectiveness of pre-departure MMR vaccine for refugee children
• investigation of the models of health care for newly arrived migrant and refugee students attending Intensive English Centres.

Education

The SCHN Children’s Refugee Service plays an active role in educating health professionals on critical elements of working with people from a refugee background. This includes:

• organisation of education forums on aspects of paediatric refugee health
• presentations at Grand Rounds and Ethics Forums at both children’s hospitals
• placements for medical students and paediatric trainees
• curriculum development of medical programs at UNSW and USyd
• training sessions and lectures on refugee health to early childhood nurses, health staff, medical students, registrars, and allied health forums.

We also contribute to community education by providing expert opinion to a variety of media, organisations and public forums on the health needs of displaced children. 

Policy development and advocacy

• We advocate for the health and wellbeing of refugee and asylum seeker children and their families at state, national and international levels.
• We provide leadership on refugee health policy. This includes the development of the Royal Australasian College of Physicians’ Health of Asylum Seekers and Refugees Position Statement, and involvement in their consultations for their NDIS Position Statement and its impact on refugees. 
• We assist in the development of clinical guidelines: contributing to the national screening guidelines for newly arrived refugees published by the Australasian Society for Infectious Diseases and Refugee Health Network of Australia.  
• Individuals of the refugee team have been involved in advocacy at various levels on behalf of the children held in detention by Australia. We have been consulted on several children with multiple health issues detained in Nauru, requiring extensive advocacy to facilitate interventions consistent with their health needs.

Our clinical team

Our staff include some of Australia’s leading experts in refugee child health. As well as expertise in refugee health, staff have experience in general paediatrics, community paediatrics, developmental paediatrics, emergency medicine, and infectious diseases. All work part-time, are supported by other departments or volunteer their time. They are supported by a Project Manager and Administration Officer.

Clinical Lead: Associate Professor Karen Zwi

Karen is the new Clinical Lead for Service, and leads the refugee clinic at Sydney Children’s Hospital. She has been centrally involved in service development for refugee children in South Eastern Sydney and the Illawarra. Karen represents SCHN on the Refugee Health Plan Implementation Group, led by the NSW Ministry of Health. She has represented the Royal Australasian College of Physicians on various forums addressing the health of refugee children, children in detention and asylum seekers. Karen is also Clinical Director of Priority Populations across the Network, and Head of the Department of Community Child Health, Sydney Children’s Hospital.

HARK Clinic Head: Professor David Isaacs

David leads the Health Assessment for Refugee Kids (HARK) Refugee Clinic, which he founded in 2005. He has published extensively on paediatric refugee health, particularly in relation to infectious diseases and asylum seeker health. In 2014 he was a consultant paediatrician for International Health and Medical Services at the detention centre at Nauru. David is also Clinical Professor in Paediatric Infectious Diseases at the Children’s Hospital at Westmead and the University of Sydney, and Editor-in-Chief of the Journal of Paediatrics and Child Health.

Clinical Nurse Consultant: Alanna Maycock

Alanna provides expert clinical support and leadership to the HARK clinic. She has worked with refugees and asylum seekers in both the governmental and voluntary sectors of Australia and the UK since 2004, and with the HARK clinic since 2011. She is regularly invited to speak on the health of children in detention and has spoken and written widely on the topic. In 2014, she was sent to assess and report on health processes at the Regional Processing Centre in Nauru on the Island. Alanna is a registered nurse immuniser and Tuberculin Skin Test (TST) administrator and reader, and has a Masters Degree in Health Science.

Clinical Academic: Dr Hasantha Gunasekera

Hasantha has worked with HARK since 2007. He is a Clinical Academic with the University of Sydney and a general paediatrician at The Children’s Hospital at Westmead. He has led research and spoken widely on refugee health, particularly on the impacts of detention on child health. He was a consultant paediatrician for International Health and Medical Services at the detention centre at Nauru in 2014 and for the Australian Human Rights Commission in 2015.  Hasantha is also Sub-Dean (Education) of The Children’s Hospital at Westmead Clinical School (University of Sydney), and Editor of the Journal of Paediatrics and Child Health.

Staff Specialist: Dr Merrran Mackenzie

Merran is a paediatrician at the HARK, where she has worked since 2014, initially as an Honorary Medical Officer, and now as a Staff Specialist. She is an experienced paediatrician, and is passionate about providing the best possible health care for refugee children and particularly those from asylum seeker families who face multiple barriers accessing health care.

Staff Specialist, Department of Infectious Diseases and Microbiology, CHW: Dr Philip Britton

Philip provides occasional clinical services at HARK as part of his role as Staff Specialist at the Department of Infectious Diseases and Microbiology. He is also an Early Career Researcher with Sydney Medical School and the Marie Bashir Institute for Infectious Diseases and Biosecurity. His interests lie in neurological infections, global child health, infectious disease epidemiology and prevention, and real world implementation of communicable disease control.

Honorary Medical Officer: Dr Helen Young

Helen is an experienced paediatrician and paediatric neurologist at CHW who works part time at the HARK clinic as an Honorary Medical Officer. She has particular expertise in the management of children who suffer from intellectual or physical disabilities, ensuring they get the best possible care and access to appropriate health care and services.

Honorary Medical Officer: Professor Wendy Hu

Wendy is a General Practitioner who has worked part time at HARK as an Honorary Medical Officer since 2012.  She has worked at the Children’s Hospital since 1989, as a clinician, researcher, educator and educational administrator. She is widely published and regularly invited to present at national and international conferences. Wendy is Professor of Medical Education, School of Medicine, Western Sydney University.

Clinical Academic: Professor Ben Marais

Ben provides occasional clinical services at HARK as part of his role in Paediatric Infectious Diseases at the Children’s Hospital at Westmead.  He is Deputy-Director of the Marie Bashir Institute for Infectious Diseases and Biosecurity (www.sydney.edu.au/mbi) and helps to lead the Centre for Research Excellence in Tuberculosis at the University of Sydney.    

Paediatric Refugee Health Fellows

SCHN has two part-time Paediatric Fellows which provide clinical services to both our clinics as well as support and advice to SCHN. This also provides the Fellows with an opportunity to develop their skills in refugee health under the supervision of highly experienced staff. Both positions are funded by the NSW Ministry of Health.

Social work staff

The role provides essential support to clinicians, by providing practical assistance with the myriad of issues that compound health issues including poor housing, poverty, and lack of social support. They provide links to school supports, psychosocial support programs, and other programs to support the whole family.