Abstract

Prolonged detention of refugees and asylum seekers is known to have negative effects on individual's physical and mental health. There is growing evidence that the management of health complaints and common health conditions is much poorer among detained and community-dwelling refugee populations. In the wider community, chronic pain is a common and debilitating condition that can impact on emotional well-being, physical functioning and overall quality of life. To date no formal research has been conducted examining the incidence, burden and management of persistent pain among those in detention. Throughout 2015–2017, voluntary humanitarian visits to an immigration detention centre in Sydney, Australia were conducted. Informal interviews were conducted verbally with detainees who wished to discuss medical issues, including pain and pain management. Interviews were conducted with 22 male detainees (aged 19–61). 19 reported to be suffering from persistent pain (86%), resulting from a variety of afflictions including gunshot wounds, trauma such as motor vehicle or boating accidents, assault, inflammatory arthropathies, dental problems and undiagnosed visceral pain. Described pain patterns largely mirrored those commonly seen in trauma settings including the military setting, with a high incidence of chest and pelvic pain. Of those with pain, 31% reported they had no access to any medication or treatment for their pain, including simple paracetamol. Many individuals reported associated psychiatric symptoms including depression, anxiety, post-traumatic stress disorder (PTSD) and sleep disturbances, which they believed were exacerbated by their ongoing pain. Anecdotal evidence uncovered a considerable and debilitating chronic pain burden among detainees that is currently being inadequately managed and is compounding the traumatic experience of being in detention. There is a notable social and moral imperative to further investigate and address this issue.

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