The World Health Organisation in 2014 reported that there were around 1 billion refugees and asylum seekers spread around the world.

Life in a typical refugee camp
  • They also stated that 214 million are international (not in their home country) migrants and 740 million are internal migrants (in their home country) with these numbers forecast to increase.

In 2015/16 Europe experienced its most significant influx of migrants and refugees since World War 2.

  • This has parallels with migrating in the past including, for example, the Scottish Highland clearances of the 18th century when those seeking refuge were travelling by overland on foot or embarking on dangerous sea journeys lasting weeks, months or sometimes years.

  • The UK operates a system of asylum for those in need of protection which centres on the provision of refugee status to those meeting the 1951 UN Convention definition (see below).

It is important to be on the lookout for asylum seekers, refugees or others who have been victims of human trafficking and exploitation


'Refugees' and 'Asylum Seekers' are legal terms, describing the stage of the process of asylum that a person has reached. It is important that healthcare professionals ensure that each person is treated as an individual.

A refugee is someone who ‘owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country'.

An asylum seeker is someone who has applied for asylum and is waiting for a decision as to whether or not they are a refugee. In the UK an asylum seeker is someone who has asked the Government for refugee status and is waiting to hear the outcome of their application.

Internally displaced persons (IDP’s), in contrast, are those who have not crossed an international border to find sanctuary but remained within their own country. They are among the world's most vulnerable people.

  • An example of this group was, in 2010 following the Haiti earthquake, people were fleeing from the devastation and dangers. UNHCR estimated 38 million highly vulnerable people were still displaced within their own country in 2014.

Health needs related to migration

Healthcare professionals are involved in the collective health needs of this sizeable and often transient population either as volunteers in refugee camps or as health workers in the receiving countries.

  • Traffickers (those making money from charging the refugees for moving them around) frequently have little concern for their health and safety and commonly break local laws and ignore immigration procedures
A poignant drawing by a child refugee fleeing from violence in her home village

Their health needs are many and varied. Many are similar to those living in the receiving countries but there may be infections, for example, contracted abroad which need to be considered.

Many problems refugees encounter result directly from having left behind a familiar environment in their home countries, leaving family and possessions behind and having constant stress due to moving around day by day in unfamiliar and often dangerous situations.

  • Psychological support is essential since displaced persons may have completely lost their homes and family contacts who may have remained in their home country because they were unable or unwilling to travel.

The illustration on the right was drawn by a refugee child who had experience in a war-torn situation in Africa.

Some other points to consider when providing care for refugees

Refugees frequently meet lack of understanding and compassion when the traumas they have endured are not recognised, understood or they are ignored.

  • Relatives and friends may have been killed or seriously injured.

  • Assault and rape are common risks for those on the move and away from the protection of a secure home and familiar surroundings. The psychological impact is severe and often prolonged.

This WHO website contains a lot of information about migration and migrants' health needs