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