According to The World Health Organisation in the year 2000 there were 750 million migrants. Often they did not have skin disease on leaving their country but acquired conditions such scabies or fungus infections from poor housing conditions and overcrowding during migration.
Warning Strife affects many nations and many countries are host to internally displaced persons. Such mobile populations have common skin infections and lack of acceptance in the community and malnourishment. The health facilities available may not have the drugs to treat the condition and consequently visits to local traditional health practitioners are common. Nomadic people such as the Massai tend to have close contact with animals and so cattle ringworm is prevalent. There are frequent changes of sexual partners in remote areas and no access to condoms. The migrant often is also often poorly adapted to food that is foreign and malnourishment is common.
Action No one person or group can be lawfully prevented from receiving primary health care services and in most countries the laws support the right to emergency care. Guidelines to management, assessment of cultural differences, cultural competence, identification of torture, dealing with immigration control have been published in The International Journal of Dermatology and are on the website.
The most helpful skill for managing migrants is to be able to communicate, to speak their language and get a full history. If, as is sadly common, you find yourself assessing skin conditions due to torture, be sure to record a full history and using photography ensure thorough documentation.
Migration from rural to urban areas and sedentary lifestyles, transition from a Mediterranean to a Western diet, control of infectious diseases and consequent longer life expectancy especially in urban areas, have all contributed to the rising prevalence of hypertension and diabetes. To get help from carers that are culturally competent and able to deal with these issues, there must be adaptation to the complexities of living which the immigrant has to deal with.