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Orcutt M. Meeting the health needs of forcibly displaced populations: translating evidence into implementation via the WHO global research agenda on migration and health. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
In this presentation, Dr Orcutt, will outline the health system responses needed to respond effectively to the health needs of forcibly displaced populations - from initial health assessments to the longer term - and the role that research can play in ensuring evidence-informed policies and practice. She will present the main areas of the WHO's new global research agenda on migration and health and outline how translating evidence into implementation is essential to improve the health of migrants.
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Affiliation(s)
- M Orcutt
- Health and Migration Programme, WHO , Geneva, Switzerland
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Hargreaves S, Kondilis E, Papamichail D, McCann S, Orcutt M, Carruthers E, Veizis A. The impact of COVID-19 on migrants in Greece: a retrospective analysis of national data. Eur J Public Health 2021. [PMCID: PMC8574628 DOI: 10.1093/eurpub/ckab164.589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background For 56,000 refugees and asylum seekers in Reception and Identification Centres (RICs) and Reception Sites (RS) in Greece, living in severely substandard living conditions, prevention measures have been severely limited. We assessed the impact of COVID-19 on migrants in these settings. Methods We did a retrospective analysis of policy documents and national surveillance data to identify COVID-19 outbreaks and estimate incidence among migrants residing in these camps (26th Feb - 15th Nov 2020). Incidence proportion (IP) of COVID-19 confirmed cases was calculated for three population groups (migrant populations in RICs, migrant populations in RSs, and the general population in Greece) during three time periods (first wave, second wave, and overall across the 9-month period). Results 25 outbreaks were identified in migrant reception facilities, with 6 (85.7%) of 7 RICs and 18 (56.3%) of 32 RSs reporting at least one outbreak during the study period. The overall 9-month COVID-19 IP among refugee and asylum seeker populations residing in RSs on the Greek mainland was 1,758 cases per 100,000 population; in RICs the incidence was 2,052 cases per 100,000 population. Compared to the general population the risk of COVID-19 infection among migrants in reception facilities was 2.5 to 3 times higher; the risk of acquiring COVID-19 infection was higher among migrant populations in RSs on the Greek mainland (IP ratio: 2.45; 95% CI: 2.25-2.68) but higher still among migrant populations in RICs in the Greek islands and the land border with Turkey (IP ratio: 2.86; 95% CI: 2.64-3.10), where living conditions are particularly poor. Conclusions We identified high levels of COVID-19 transmission among migrants in reception facilities in Greece, with immediate implications for policy and practice to ensure refugee and asylum seeker populations are included in national response plans to reduce transmission, alongside ensuring their inclusion in plans for COVID-19 vaccine roll out. Key messages Thousands of migrants in Greece live in severely substandard conditions and largely excluded from the COVID-19 response. We identified high levels of COVID-19 transmission among migrants in reception facilities in Greece, with immediate implications for policy and practice.
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Affiliation(s)
- S Hargreaves
- Migrant Health Research Group, St George's University of London, London, UK
| | - E Kondilis
- Laboratory of Primary Health Care, General Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Papamichail
- Department of Public Health Policy, University of West Attica, Attica, Greece
| | - S McCann
- Institute for Global Health, University College London, London, UK
| | - M Orcutt
- Institute for Global Health, University College London, London, UK
| | - E Carruthers
- Institute for Global Health, University College London, London, UK
| | - A Veizis
- INTERSOS Hellas, Thessaloniki, Greece
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Hayward SE, Deal A, Cheng C, Orcutt M, Norredam M, Veizis A, Campos-Matos I, McKee M, Kumar B, Hargreaves S. Impact of COVID-19 on migrant populations in high-income countries: a systematic review. Eur J Public Health 2021. [PMCID: PMC8574658 DOI: 10.1093/eurpub/ckab164.882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Migrants in high-income countries (HICs) may have been disproportionately affected by the COVID-19 pandemic, yet the extent to which they are impacted, and their predisposing risk factors, are not clearly understood. We did a systematic review to assess clinical outcomes, indirect health and social impacts, and key risk factors in migrants. Methods Our systematic review following PRISMA guidelines (PROSPERO CRD42020222135) identified peer-reviewed and grey literature relating to migrants (foreign-born) and COVID-19 in 82 HICs. Primary outcomes were cases, hospitalisations and deaths from COVID-19 involving migrants; secondary outcomes were indirect health and social impacts and risk factors. Results 3016 data sources were screened with 158 from 15 countries included in the analysis. We found migrants are at increased risk of SARS-CoV-2 infection and are over-represented among cases (e.g. constituting 42% of cases in Norway [to 27/4/2020], 26% in Denmark [to 7/9/2020], and 32% in Sweden [to 7/5/2020]); some datasets from Europe show migrants may be over-represented in deaths with increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected, with certain nationality groups disproportionately impacted. Migrants experience a range of risk factors for COVID-19, including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement. Conclusions Migrants in HICs are at high risk of COVID-19, with a range of specific risk factors that have not been well-considered in the public health response to date. These data are of immediate relevance to the policy response to the pandemic, with strategies urgently needed to reduce transmission. Migrant populations must also be better considered in national plans for COVID-19 vaccination roll-out. On behalf of ESGITM Key messages Migrants in high-income countries may be disproportionately represented in COVID-19 infections and deaths, with higher levels of many vulnerabilities and risk factors. Migrants must be better included in all aspects of the pandemic response, including vaccination roll-out.
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Affiliation(s)
- SE Hayward
- Institute for Infection and Immunity, St George's, University of London, London, UK
- Faculty of Public Health and Policy, LSHTM, London, UK
| | - A Deal
- Institute for Infection and Immunity, St George's, University of London, London, UK
- Faculty of Public Health and Policy, LSHTM, London, UK
| | - C Cheng
- Institute for Infection and Immunity, St George's, University of London, London, UK
| | - M Orcutt
- Institute for Global Health, University College London, London, UK
| | - M Norredam
- Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Amager and Hvidovre, Denmark
| | - A Veizis
- Médecins Sans Frontières Greece, Athens, Greece
| | - I Campos-Matos
- Public Health England, London, UK
- UCL Collaborative Centre for Inclusion Health, University College London, London, UK
| | - M McKee
- Faculty of Public Health and Policy, LSHTM, London, UK
| | - B Kumar
- Norwegian Institute of Public Health, Oslo, Norway
| | - S Hargreaves
- Institute for Infection and Immunity, St George's, University of London, London, UK
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Nagi Y, Sender H, Orcutt M, Fouad F, Burgess RA, Devakumar D. Resilience as a communal concept: Understanding adolescent resilience in the context of the Syrian refugee crisis in Bar Elias, Lebanon. J Migr Health 2021; 3:100046. [PMID: 34405191 PMCID: PMC8352196 DOI: 10.1016/j.jmh.2021.100046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/28/2022] Open
Abstract
Background The conflict in Syria has led to the displacement of 1.5 million refugees into the neighboring country of Lebanon, with a majority that have yet to return to their homeland. Syrian adolescents in the town of Bar Elias in the Bekaa Valley, Lebanon have lived and grown in the face of resource-limited environments, restricted movement, and a longing for return. Resilience is manifested in the adaptation to such circumstances through close supportive relationships, social engagement, employment, and religion. There is a communal aspect to resilience that is important to the adolescent refugee experience and to the efforts supporting these communities. Methods Fifteen one-to-one interviews and two focus groups, with a total of eighteen Syrian adolescents, were analyzed using an inductive thematic analysis informed by grounded theory principles. Participants were recruited through partnering non-governmental organizations (NGOs) in the area, and ethical approval was granted through UCL and the American University in Beirut (AUB). Results Syrian adolescents highlighted supportive relationships, communal activities and spaces, memories of home, employment, and shared environments as integral elements to their personal adaptation. Methods of resilience involved social cohesion and establishing stability for one's family and close community. Adaptation to the present is intertwined with facing the consequences of displacement in this new context and maintaining aspirations for a bright future. Engaging with the environments they share and help create is an important facet of resilience and occurs through group gatherings , hobbies, and online communication. Additionally, inner strength can be derived from religious activities and empowers individual processing. Conclusion This study illuminates the elements and mechanisms embodied in these adolescents' communities and relationships that allow for adaptation to life in Bar Elias. These factors strengthen their approach to overcome social barriers and practice resilience. These communal aspects of the adolescents' lives also connect to their memories of home, current environment, and future aspirations.
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Affiliation(s)
- Y Nagi
- New York Medical College, Valhalla, NY, USA
| | - H Sender
- UCL Development Planning Unit/Institute for Global Prosperity, London, UK
| | - M Orcutt
- Institute for Global Health, University College London, London, UK
| | - F Fouad
- American University of Beirut, Beirut, Lebanon
| | - R A Burgess
- Institute for Global Health, University College London, London, UK
| | - D Devakumar
- Institute for Global Health, University College London, London, UK
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Gunst M, Jarman K, Yarwood V, Rokadiya S, Capsaskis L, Orcutt M, Abbara A. Healthcare access for refugees in Greece: Challenges and opportunities. Health Policy 2019; 123:818-824. [PMID: 31229274 DOI: 10.1016/j.healthpol.2019.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 06/01/2019] [Accepted: 06/07/2019] [Indexed: 12/27/2022]
Abstract
The arrival of more than one million refugees and migrants in Europe in 2015, most of whom transited through Greece, has placed significant strains on local health systems and demonstrated the need for preparedness to meet the immediate and longer-term health needs of arrivals in EU countries. Population movements will continue to occur and the need for cost effective, appropriate provision of both primary and secondary health services to meet these needs is key. The Global Compact on Migration was ratified in 2018 and forms an overarching, international agreement to address safe, orderly and regular migration which benefits refugees and migrants as well as host communities; however, it did not give due emphasis to health. In this manuscript, we explore the evolution of the health response for refugees in Greece over the last three years, the challenges faced at different times of the response and the efforts to integrate refugees into Greece's health system.
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Affiliation(s)
- M Gunst
- Sydney Children's Hospital Network, Sydney, Australia
| | | | - V Yarwood
- MSF 6 GP Trainee, St George's University Hospitals, NHS Foundation Trust, London, UK
| | - S Rokadiya
- Infectious Diseases and General Medicine Registrar, Barts Health NHS Trust, UK
| | - L Capsaskis
- Academy Stavros Niarchos Foundation Fellow (2017), Chatham House, London, UK
| | - M Orcutt
- Institute of Global Health, University College, London, UK
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Abstract
A number of vibrios obtained from the small intestines of calves fed feces from spontaneous diarrhea in cows, natural intestinal disorders of calves, experimentally induced infections of calves, and cultures obtained from Dr. Theobald Smith have been studied. From the close morphological resemblance, similarities in motility, position and number of flagella, tinctorial properties, and the tendency to fragmentation in older cultures, as well as the narrow nutritive requirements, we are led to regard them as a closely allied group and we propose the name Vibrio jejuni. Immunologically as judged by agglutination the organisms have been divided into two groups, the smaller representing two strains originating from diarrhea in cows and the larger comprising one from this source and many from the calf disease. The larger group can be subdivided by means of agglutination absorption into cultures which do not contain the complete antigenic complex and others which do so. Certain freshly isolated vibrios when injected into rabbits incite definite reactions terminating in a localization in the small intestine accompanied by catarrhal inflammation.
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Affiliation(s)
- F S Jones
- Department of Animal Pathology of The Rockefeller Institute for Medical Research, Princeton, N. J
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Affiliation(s)
- F S Jones
- Department of Animal Pathology of The Rockefeller Institute for Medical Research, Princeton, New Jersey
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Lerman MI, Glenn GM, Latif F, Daniel L, Hosoe S, Brauch H, Hampsch K, Delisio J, Orcutt M, Zbar B. A new polymorphic probe on chromosome 3p: lambda LIB49-63 (D3S192E). Nucleic Acids Res 1990; 18:206. [PMID: 1689819 PMCID: PMC330244 DOI: 10.1093/nar/18.1.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- M I Lerman
- Laboratory of Immunobiology, National Cancer Institute-Frederick Cancer Research Facility, MD 21701
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Lerman MI, Glenn GM, Daniel L, Latif F, Hosoe S, Brauch H, Hampsch K, Delisio J, Orcutt M, Zbar B. A new polymorphic probe on chromosome 3p: lambda LIB28-77 (D3S169E). Nucleic Acids Res 1990; 18:205. [PMID: 1968621 PMCID: PMC330243 DOI: 10.1093/nar/18.1.205-a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- M I Lerman
- Laboratory of Immunobiology, National Cancer Institute-Frederick Cancer Research Facility, MD 21701
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Young RB, Orcutt M, Blauwiekel PB. Quantitative measurement of protein mass and radioactivity in N,N'-diallyltartardiamide crosslinked polyacrylamide slab gels. Anal Biochem 1980; 108:202-6. [PMID: 6450545 DOI: 10.1016/0003-2697(80)90713-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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