Eating, showering and getting dressed. Most of us do these basic activities every day. Many of us also use a phone or some other form of technology on a daily basis and housework and grocery shopping are part of our weekly chores. Performing these and other daily activities come natural to the majority of us, yet for some, even a simple task like brushing your teeth is a daily struggle.
A recent study in Denmark has established a link between exposure to torture, trauma and post-migration stress in newly arrived asylum seekers and a decreased ability to perform activities of daily living. The researchers behind the report Activity of Daily Living Performance amongst Danish Asylum Seekers: A cross-sectional study used a number of different measures to first determine the health of 43 asylum seekers and then look at their ability to perform basic everyday tasks. The result showed an overwhelming 62% struggled with completing some of their daily tasks.
Across the world, health professionals often refer to activities of daily living (ADLs) when measuring the functional status of a person. While there is much information on how well individual groups such as the elderly or people with disabilities perform ADLs, no larger studies have addressed ADL issues encountered by traumatised asylum seekers and refugees. Although relatively small, the Danish study is a good indicator of what to expect from future studies addressing this issue.
When it comes to measuring a person’s ability to perform ADLs, it is impossible to ignore their health and well-being. Pain in particular, is an important factor when discussing ADL ability, as it is well documented that persistent pain interferes with a person’s ADL performance and social participation.
In the Danish study, which involved asylum seekers from Syria, Iran and Afghanistan, a staggering 72% of the participants reported that they suffered from a pain problem. Alarmingly, most of them had been exposed to torture and many of them showed signs of stress and depression, both of which can contribute to a low ADL score.
Most people arriving in a new country after fleeing war and mass conflict need urgent treatment and rehabilitation to help tackle the trauma and other physical and mental after-effects. Yet, unlike other groups in Denmark that struggle with completing everyday tasks, asylum seekers, tortured or not, do not instantly have access to treatment or rehabilitation.
Many of the specialised rehabilitation centres simply do not offer rehabilitation before the asylum seeker has been granted asylum just as health care and social subsidies remain a privilege for the resident population. Until their pending case is decided and they receive refugee status, asylum seekers only have access to acute medical needs, unless they apply to the Danish Immigration Service for further medical attention.
As the study points out, the right to rehabilitation should in principle be regarded as an obligation to rehabilitate those who are in need. Failing to do so can have far-reaching consequences for traumatised asylum seekers, including social isolation, dependency on others and deteriorating health.
According to the Danish researchers, one way of preventing further loss of ADL ability among traumatised asylum seekers is to provide them with the appropriate rehabilitation upon arrival, and not wait until they have been granted asylum. An argument that is difficult to disagree with when reality is that most asylum seekers have complex health and social care needs that require our immediate attention.
In other words, health impediments that reduce someone’s quality of life must be addressed as soon as possible. After all, something as simple as brushing your teeth should not be a struggle for anyone.
To read the latest issue of Torture Journal click here.