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“It’s my life, not theirs!” Therapeutic itineraries and refugee reflections on referral health care in western Tanzania

Globally, refugees number over 25 million. Yet, little attention has been paid to how refugees access referral health care in host countries. By referral, I mean the process by which a patient deemed too sick to be managed at a lower-level health facility is transferred to a higher-level facility wi...

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Autor principal: Enumah, Zachary Obinna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249889/
https://www.ncbi.nlm.nih.gov/pubmed/37289748
http://dx.doi.org/10.1371/journal.pgph.0001655
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author Enumah, Zachary Obinna
author_facet Enumah, Zachary Obinna
author_sort Enumah, Zachary Obinna
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description Globally, refugees number over 25 million. Yet, little attention has been paid to how refugees access referral health care in host countries. By referral, I mean the process by which a patient deemed too sick to be managed at a lower-level health facility is transferred to a higher-level facility with more resources to provide care. In this article, I provide reflections on referral health care from the perspective of refugees living in exile in Tanzania. Through qualitative methods of interviews, participant observation, and clinical record review, I trace how global refugee policy on referral health care manifests itself in the lives of refugees locally in a country like Tanzania that has strict policies and limitations on freedom of movement. In this space, refugees experience complex medical problems, many of which began prior to or during their flight to Tanzania. Many refugees indeed are approved to be referred to a Tanzanian hospital for further treatment. Others are denied care or pursue other therapeutic itineraries outside the formal system. But, all are subject to policies of Tanzania that restrict freedom of movement and almost all experience delays on several levels (e.g., waiting for a referral, waiting at the referral hospital, waiting for follow-up appointments). In the end, refugees in this context emerge not simply as passive beings upon which biopower is enacted, but also as active agents, sometimes circumventing a system of power in their pursuit of their right to health, all in the context of strict policy that seeks to enforce state security over one’s right to health. In the process, refugee experiences with referral health care become a window into the larger politics of refugee hosting in Tanzania in the present day.
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spelling pubmed-102498892023-06-09 “It’s my life, not theirs!” Therapeutic itineraries and refugee reflections on referral health care in western Tanzania Enumah, Zachary Obinna PLOS Glob Public Health Research Article Globally, refugees number over 25 million. Yet, little attention has been paid to how refugees access referral health care in host countries. By referral, I mean the process by which a patient deemed too sick to be managed at a lower-level health facility is transferred to a higher-level facility with more resources to provide care. In this article, I provide reflections on referral health care from the perspective of refugees living in exile in Tanzania. Through qualitative methods of interviews, participant observation, and clinical record review, I trace how global refugee policy on referral health care manifests itself in the lives of refugees locally in a country like Tanzania that has strict policies and limitations on freedom of movement. In this space, refugees experience complex medical problems, many of which began prior to or during their flight to Tanzania. Many refugees indeed are approved to be referred to a Tanzanian hospital for further treatment. Others are denied care or pursue other therapeutic itineraries outside the formal system. But, all are subject to policies of Tanzania that restrict freedom of movement and almost all experience delays on several levels (e.g., waiting for a referral, waiting at the referral hospital, waiting for follow-up appointments). In the end, refugees in this context emerge not simply as passive beings upon which biopower is enacted, but also as active agents, sometimes circumventing a system of power in their pursuit of their right to health, all in the context of strict policy that seeks to enforce state security over one’s right to health. In the process, refugee experiences with referral health care become a window into the larger politics of refugee hosting in Tanzania in the present day. Public Library of Science 2023-06-08 /pmc/articles/PMC10249889/ /pubmed/37289748 http://dx.doi.org/10.1371/journal.pgph.0001655 Text en © 2023 Zachary Obinna Enumah https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Enumah, Zachary Obinna
“It’s my life, not theirs!” Therapeutic itineraries and refugee reflections on referral health care in western Tanzania
title “It’s my life, not theirs!” Therapeutic itineraries and refugee reflections on referral health care in western Tanzania
title_full “It’s my life, not theirs!” Therapeutic itineraries and refugee reflections on referral health care in western Tanzania
title_fullStr “It’s my life, not theirs!” Therapeutic itineraries and refugee reflections on referral health care in western Tanzania
title_full_unstemmed “It’s my life, not theirs!” Therapeutic itineraries and refugee reflections on referral health care in western Tanzania
title_short “It’s my life, not theirs!” Therapeutic itineraries and refugee reflections on referral health care in western Tanzania
title_sort “it’s my life, not theirs!” therapeutic itineraries and refugee reflections on referral health care in western tanzania
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249889/
https://www.ncbi.nlm.nih.gov/pubmed/37289748
http://dx.doi.org/10.1371/journal.pgph.0001655
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