Intended for healthcare professionals

Practice Clinical Updates

The health of forced migrants

BMJ 2018; 363 doi: (Published 24 October 2018) Cite this as: BMJ 2018;363:k4200
  1. Angela Burnett, lead doctor1,
  2. Tracy Ndovi, advocate2
  1. 1Freedom from Torture, London, UK
  2. 2Survivors Speak OUT, London, UK
  1. Correspondence to A Burnett aburnett{at}

What you need to know

  • Conflict, torture, trafficking, and environmental disasters are common reasons for forced migration

  • When discussing health, consider using a trained interpreter to avoid placing responsibilities on friends, family, or children

  • Purposeful activity can help tackle concerns about the past, a pending asylum case, and/or the future

  • Distinguish mental illness from a natural emotional response to trauma

  • Offer screening for sexually transmitted infection to people who have experienced sexual violence

“If you have never been tortured, been forced to make a dangerous journey, or leave your child, you may not fully understand what it does to a human being.”

The “cultural bereavement of exile”1 is the loss of social structures, cultural values, community rituals, relationships, and material features experienced by forced migrants. Meeting the healthcare needs of those affected can help achieve safety and rehabilitation.

Globally, the number of forced migrants is estimated at 68.5 million.2 Most of these people remain close to their home country; those with access to resources may travel further. Countries hosting the greatest numbers of migrants are Turkey (3.5 million), Pakistan (1.4 million), Uganda (1.4 million), Lebanon (998 900), Iran (979 400), Germany (970 400), Bangladesh (932 200), and Sudan (906 600).3

Forced migrants include asylum seekers, refugees, and people who have experienced torture, armed conflict, and human trafficking (for slavery or sexual exploitation). They are at risk of several physical and mental illnesses. Management often requires approaches that are different from those used for the rest of the population.

This article provides an overview of the healthcare needs of migrants who have been forced to leave their home countries. It aims to offer guidance to, and raise awareness among, health workers caring for them.

Sources and selection criteria

Most of the information in this article is based on our own personal and clinical experience, supported by references, which are listed.

Additional educational …

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