PUBH6000 Public Health Program

PUBH6000 Assessment 2 Scenario: The Blockage in Life Ι Created on 25 October 2020 Page 1 of 4
Public Health Program
PUBH6000 Assessment 2: The blockages in life
Approximately, 272 million international migrants are living away from their homeland, accounting for 3.5% of
the world population. Migrants are prone to experience hardship in settling permanently into their new land,
including employment, culture, language, education, government policies and new healthcare systems
(Wechkunanukul, Grantham, & Clark, 2014). Interestingly, about two-third of migrants (over 90 million) are
working in skilled jobs and may not be adequately insured for healthcare (International Organization for
Migration, 2019). Uninsured migrants have to pay their medical bills which is likely to be an excessive cost
and lead to financial insecurity (World Health Organization, 2020). To address this health agenda, the World
Health Organization has released the Promoting the Health of Refugees and Migrants: the publish Global
Action Plan 2019-2023 with its Priority 2 to “Promote continuity and quality of essential health care, while
developing, reinforcing and implementing occupational health and safety measures” (World Health
Organization, 2019).
In 2019, more than 7.5 million migrants (30% of Australian population) reside in Australia and about 65% of
these migrants are holding temporary visas (Australian Bureau of Statistics, 2020).
The scenario:
In 2017, Jai a 59-year-old man, was working as a chef in a large Asian restaurant in a large city in Australia.
He was a qualified chef in his home country and had been offered a temporary working visa to work lawfully
in Australia with his boss Mr Tony since 2005. Jai has two daughters, 10 and 15 with his wife who were living
back in his home country. He decided to leave his homeland alone to work and send money back to support
his family. He had dreamed of a better future for his family in Australia. He thought if he was permanently
settled, he would be able to bring his family to live together.
Jai worked with Tony for 12 years on a temporary working visa. His salary met the Fair Work Australia Award
Rates (Hospitality); however his working hours were much more than a standard full-time working week. Jai
worked from 9.00 -21.30 from Tuesday to Saturday and 17.00 -23.00 on Sunday. The restaurant closed
every Monday and that was his day off. He never complained about long hours of work and never thought
about it as unfair. He did not mind working hard as it enabled him to keep supporting his family.
Jai was living in a shared house with three friends who came from the same hometown and worked as chefs
at the same restaurant. There were six chefs at his restaurant, another two were Asian from different
countries. They shared the same life routine, starting work at 9.00am until 10.30pm, smoking during the
breaks and drinking 1-2 bottles of beer at the end of the day. On his day off, Jai usually had a lazy day at
home to ease the stress and tiredness from his heavy workload throughout the week. He and his friends
would normally spend the day on the couch with cigarettes and snacks. Sometimes, they watched movies in
their language to entertain their life away from home. Jai rarely went out for shopping or socialised with the
community because he wanted to save money for his family, particularly for his daughters. Jai could only
afford a ticket to visit his family every two years. It made him feel lonely and he missed his family a lot.
After working in this restaurant for five years, Jai felt like his dream would never come true because his boss
renewed his temporary visa and did not discuss the permanent one. Jai and the other chefs talked about
their feelings, burned out and emotionally drained from long hours of work and an insecure future. However,
they had no choice but to keep working hard for the sake of their families and their dreams.
Jai did not seek professional medical advice or go to the doctor’s if he felt unwell since he moved to Australia
because his English was very limited, and he did not know how to communicate with health workers.
Additionally, he held only an essential health insurance policy which covered only basic services that made
Jai concerned about costs of care and medication. He smoked more often when he had headaches or when
he felt feverish because he believed something in cigarettes could help relax and reduce the fever. He
sometimes took his friend’s medications or traditional herbs.
PUBH6000 Assessment 2 Scenario: The Blockage in Life Ι Created on 25 October 2020 Page 2 of 4
Public Health Program
In 2017, his temporary working visa was expiring in March of that year and he could not apply for another
temporary visa due to the rules of the immigration department. However, his boss agreed to apply for a
permanent working visa for him. The decision made Jai feel over the moon as he could see his dream
coming true soon. His visa application was lodged in February 2017 and everything went well except for the
English language requirement. He was on a bridging visa after his temporary visa expired and he had to
pass the English test to get the permanent residence status. Jai felt completely stressed and hopeless with
his English as he had very limited English which was basic and got him through simple communication at
work He had no time to study or train to improve his English nor the means to afford paying for language
While he was fully stressed with visa and work issues, his wife called him to discuss their younger daughter’s
behavioural problems. Jai faced a heavy burden in his life , and it made him feel down, sad and hopeless.
He smoked more often and drank 4-5 beers each night to comfort himself.
It was in early April that Jai woke up and felt a little funny on his left arm and leg. He went to work as usual,
but he made many mistakes and could not focus well on his duties. His friends noticed Jai was a little slow
and looked unwell, and they suggested for him to go home. Although Jai felt something wrong in his body,
but he kept working to impress his boss that he was fit for work. Also, he was afraid to pay expensive
medical costs and thought it may be due to too much beer from the previous night. He finished work at
10.30pm and went home with his friends as usual. At 11.30pm before going to bed, Jai suddenly felt numb
on the left side of his body from head to toe, he was completely shocked with the sudden weakness of his
body. He could not see anything properly and tried to call his friends for help. He could not control his lips
and his voice was very soft and sounded strange. Luckily, his friends walked pass and grabbed him before
Jai reached the ground. His friends thought Jai had a serious condition and drove Jai to the hospital nearby.
They did not call an ambulance because they believed using their car was the fastest option and they were
also concerned about the high cost of ambulance services.
Jai arrived at the Emergency Department of a large public hospital where full health services and specialist
care are available. Jai was diagnosed with a stroke because he had a blockage of blood flow in his brain. He
was sent to the operating theatre for urgent brain surgery to save his life. Nurses and staff were unable to
acquire the necessary health and social information from his housemates nor gain all the required consent to
offer health services. Unfortunately, there was a language barrier and differing attitudes to health care
between two cultures created ineffective communication. Special treatment and appropriate health services
were provided nonetheless based on the ethical principle of health care.
While Jai was in the operating room, his friends and colleagues were gathering in the waiting area with many
concerns and high levels of stress. They discussed how much the treatment costs would be and how Jai
could afford it. They wanted to share his burden, but they were also migrants with small amounts of savings.
Even if they collated all their savings, it would not be enough for the costs. They knew that Jai was uninsured
because he was in the gap between visa processes. They felt deeply sorry for Jai and also for themselves.
As migrants they felt like they had less value, less power and were living below the locals.
They were worried about the outcome of the brain surgery and whether Jai would survive. If he became
permanently disabled, how would he pay for living costs and who would look after him. In the worst case, if
he did not survive the operation, how would they organise a funeral for Jai and how would they send him
(Ashes) home and how much would it cost? They felt deeply for Jai but were also thinking about themselves
if something should happen to their life.
Tony (the restaurant manager/owner) was contacted by the hospital to consult about costs of care, but he
said the cost was too high for him to support. Jai’s situation would not be covered by his work as it happened
outside the workplace and work hours and was due to a non-work-related health issue.
Jai was facing the situation where he did not have health insurance, and he was not covered by the
Medicare system because of his visa status. His access to his superannuation (retirement fund) was
restricted due to his age.
There are multiple blockages in life faced by skilled migrants who are living away from home.
PUBH6000 Assessment 2 Scenario: The Blockage in Life Ι Created on 25 October 2020 Page 3 of 4
Public Health Program
Australian Bureau of Statistics. (2020). Migration, Australia, April 2020. Retrieved from
International Organization for Migration. (2019). World Migration Report 2020. UN, New York.
Wechkunanukul, K., Grantham, H., & Clark, R. A. (2014). Cultural competence in emergency department.
Australian Nursing and Midwifery Journal, 22(4), 35.
World Health Organization. (2019). Promoting the health of refugees and migrants, April 2019. Retrieved
World Health Organization. (2020). Refugee and migrant health. Retrieved from
Read the scenario and develop a report drawn from your critical analysis and applying theory into practice. .
1. Seek further information to provide a brief context of the population in the scenario and assess the
potential health problems among the population based on the given scenario and context.
2. Use the Ecological Model to analyse factors relevant to the scenario that influences health behaviours
and health outcomes of the population based on the following perspectives:
• Intrapersonal level
• Interpersonal level
• Community level
3. Critically recommend a health intervention(s) that would be appropriate to address those key social
determinants and scenario context. Please specify the approach and level of health intervention.
Please see the template below for more details and guidance on how to address this assessment.
Key Focus:
• Culturally and Linguistically Diverse Population
• SDH and social gradient – behaviour, attitude, culture, policy
• Accessibility and inequity
• Public and private health insurance
• Cultural competence
PUBH6000 Assessment 2 Scenario: The Blockage in Life Ι Created on 25 October 2020 Page 4 of 4
Public Health Program
Assessment 2 Template
Please use this template to develop your assignment 2
(Title of your assignment)
Assessment 2: PUBH6000: Student name , Student ID
Provide a short introduction which gives the reader an overview of the whole assignment
Briefly introduce the population and potential public health issues in the scenario (general information
only, you will provide details in the main body not in the introduction). Explain that your report will
propose an intervention to address a social determinant of health for this population group.
(Introduction should not longer than half a page)
Context of potential health issue for population
Provide an overview of the population and the potential health issue in the scenario: referring to brief
general information of the population followed by identified health issues in the scenario. You should
summarise and appropriately reference information you have found from academic sources.
Social determinants of health and its influence on health behaviours
Analyse the social determinants of the health issue in the given scenario and evaluate the influence of
those factors on health behaviours which lead to the health outcomes/health issue for the population.
Use the Ecological Model to assist critical analysis and evaluation based on three different
perspectives: Intrapersonal level, Interpersonal level and Community level
Make sure you support all your points with evidence from appropriate sources.
Recommendation for Public health interventions
Propose your recommendation for public health practice. The recommendation should be relevant to
the scenario i.e. context and health issues for the population andpotential social determinants. You
should develop recommendations from the scenario combined with your ideas and existing evidence
such as research or implemented programs.
Make sure you support all your points with evidence from appropriate sources.
In a short paragraph, provide a useful overall summary of your assignment for the reader. Do not
introduce any new information/ideas.

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