Health problems of refugees in The Netherlands.

Research was carried out on the medical, i.e. somatic and mental, and social complaints of refugees in The Netherlands. This research consisted of a literature study and a retrospective and prospective, or cross-sectional patient study. The most important assumption which formed the base of the study was: refugees who underwent torture present the same medical and social complaints as refugees who were not tortured but underwent other forms of organized violence. For the cross-sectional study 156 refugees from the Middle East were interviewed. Not only was investigated whether the nature and extent of organized violence influenced the presentation of the refugees' medical and social complaints, but also whether other characteristics such as legal status and length of stay in The Netherlands were related with the refugees' medical and social complaints. The same data were sought for in literature. The results confirm the main assumption, as well as show that factors other than the traumatic experiences in the country of origin are related with the health problems of refugees. Although many studies in literature demonstrated that a relatively high percentage of refugees present a post traumatic stress disorder (DSM-III-R) these findings could not be confirmed. It is concluded that refugees undergo a sequence of traumatic experiences and stress before, during and after their flight into exile. Various pre- and post-migration factors are responsible for the presentation of aspecific physical and mental complaints and social problems of refugees.