7
Health
Support Groups
30. We have to stress that the progress which has been made in various parts of the country is recent, is fragile and still relies heavily on the work of the agency field workers and advisers to sustain. Particularly where the Vietnamese are now employed in local projects, a great deal is expected of them by their own community and by the services with whom they deal. They need to be sustained by experienced agency workers over this critical period.
31. In describing the progress made, we have so far ignored the areas where there has been very little development. Perhaps 50% of the Vietnamese are scattered in areas like this, often in very small groups. In these areas in particular the problems caused by their isolation and the language barrier are severe and the capacity of local services to respond is particularly restricted. The local authorities, doctors, hospitals and other agencies, the local support groups, where they exist, and the Vietnamese themselves rely heavily on the refugee agency staff to advise them on particular problems. The issues may be straightforward but without knowledge of language the services cannot help and the agencies provide so far the only source of advice. This is not to say that what is on offer from the agencies is in any way a feather bedded service. The fieldworkers are spread thin and it is their policy always to make the local services and the refugees themselves face up to their own responsibilities. Where they do get involved is when the situation has reached something of a crisis as there is just no one else with understanding of language, culture or refugee experience.
32.
The refugees from Vietnam bring with them their own cultural attitudes to illness and its treatment. As refugees some of them will also suffer the mental stresses which have been shown to follow from the refugee experience. In part because of dispersal, however, there is still considerable ignorance within the health service on how to treat illness among the Vietnamese and a lack of understanding of the refugees' mental stress. There is then the problem of language.
33. The refugee agencies have tried to help at local level through their field workers and by participating in projects and seminars on health care and ethnic minorities. Nationally they have also co-operated in the production by the Health Education Council/National Extension College of an admirable book on the Vietnamese "The Vietnamese in Britain" for use by health workers. The BRC have also recently published a report of an International Conference on the Psychosocial Problems of Refugees which draws together much of the evidence of the particular health problems which refugees experience. Further articles on the Vietnamese are proposed for the various medical journals but the agencies believe that more needs to be done at regional and national level to improve the level of response given by the health service to the Vietnamese. In the longer term it is suggested that it may become necessary to establish a hospital unit to treat severe problems among the Vietnamese much as Mabledon hospital has done for Polish refugees.
340 At present Ockenden Venture offers specialist residential care for mentally or physically handicapped refugees, including those temporarily under stress, under the supervision of consultant psychiatrists. A number of Vietnamese refugees have benefited from this. The difficulty in many cases, however, is to persuade the health authorities that there is a problem which needs specialist knowledge and that Ockenden offers a national resource for which it should be paid.
35. We recognise that agency workers and local authority employed staff are not the only resource on which we can call. We have already referred to
7.