was offered free in Nakivale Refugee Settlement at the GIZ Clinic, and people no longer had to travel outside the settle- ment to access this service, many people were tested for HIV. A refugee explained, “It is easy since we have the clinic within [Nakivale], not like if it would be in [nearby town]. Above all, we have the free treatment for the virus and we do not suffer the transportation problem going to [nearby town]. So testing is done free of charge, and we thank God for that.” Testing became even more accessible when mo- bile testing units came to the neighborhoods within the refugee settlement. One participant recalled, "It was the first days they started testing from here and people were very many and some of them could come back without being tested. After that, they started meeting people in their different zones and it is when I was tested." By minimizing barriers to HIV testing, more refugees were able to utilize testing services.
We identified differences comparing home-based HIV testers to clinic-based testers living in Nakivale, some of which are potentially explained by the structure of the refugee settlement. Home-based testers were older, with a difference in median age of 2 years. It may be that younger individuals move from the village to live closer to “basecamp”, the social and economic center of Nakivale. In basecamp there are informal stores based out of windows of homes (including electronic stores for charging cellular phones), small motels providing room and board for travelers, merchants with tarps spread on the ground selling goods (i.e. jerrycans, washing bowls, shoes, and maize), and a small selection of restaurants and bars. Similarly, Ugandan nationals living in Nakivale likely choose to live closer to the center of the settle- ment where commerce is most active and where Nakivale Health Center is located. It is likely for this reason that home-based testing had a higher proportion of refugee vs. Ugandan national participants compared to clinic-based testers (93% vs. 79% respectively). It may also be that refu- gees are less willing to access clinic-based services such as HIV testing, which are provided mostly by Uganda na- tional staff who are often not facile in their native lan- guage. Not surprisingly, home-based testers were more likely to live further from a health clinic. This may be be- cause of the remote location of the 3 villages where we conducted the pilot, though there are 4 health clinics dis- tributed around Nakivale. More likely, given the scarcity and cost of transportation in Nakivale, clinic-based HIV testers simply lived closer to and more often accessed clinic.
10 Read more
Results: During the HIV screening intervention period, 330 (4%) of 7766 individuals tested were identified as HIV-infected. Refugees were one quarter as likely as Ugandan nationals to be HIV-infected (aRR 0.27 [0.21, 0.34], p < 0.0001). Additionally, being female (aRR 1.43 [1.14, 1.80], p = 0.002) and traveling more than 1 h to the clinic (aRR 1.39 [1.11, 1.74], p = 0.003) increased the likelihood of being HIV-infected. Compared to individuals who were married or in a stable relationship, being divorced/separated/widowed increased the risk of being HIV-infected (aRR 2.41 [1.88, 3.08], p < 0.0001), while being single reduced the risk (aRR 0.60 [0.41, 0.86], p < 0.0001). Having been previously tested for HIV (aRR 0.59 [0.47, 0.74], p < 0.0001) also lowered the likelihood of being HIV-infected. Conclusions: In an HIV screening program in a refugee settlement in Uganda, Ugandan nationals are at higher risk of having HIV than refugees. The high HIV prevalence among clients seeking outpatient care, including Ugandan nationals and refugees, warrants enhanced HIV screening services in Nakivale and in the surrounding region. Findings from this research may be relevant for other refugee settlements in Sub-Saharan Africa hosting populations with similar demographics, including the 9 other refugee settlements in Uganda.
In Uganda generally, and in some settlements in Sudan, however, the opposite trend is observed. In these special cases, host community members account for more visits to refugee settlement outpatient services than refugees. This may reflect the attention to inte- grated services for refugees and host nationals in Uganda, especially among settlements near the Sudanese border, that appears in the literature [4,12-14]. In Uganda, for example, refugee settlements are no longer refugee camps. Refugees were integrated into existing villages and health services, some of which already existed and others which were newly created and are available to all. The Ugandan Ministry of Health is now a direct implementing partner of UNHCR in some refu- gee settlements, and UNHCR entirely handed back ser- vices to local districts. No refugee-specific services exist anymore in these places, and therefore it is expected that refugee and host access will be more equitable.
15 Read more
Learning from our qualitative data and drawing from research outside of refugee populations, there are a number of potential avenues to promote ART adherence in the refugee settlement environment. Peer support has led to improvements in low- and middle-income coun- tries . To provide peer support and to help overcome the barrier of distance to clinic, small groups of ART pa- tients could take turns collecting medications at the health facility and distributing among group members . As identified in a study of conflict-affected in- ternally displaced people in Northern Uganda, ways to improve ART adherence in this humanitarian setting might include mobile health teams, increased security, and restocking of drugs with regularity . Pertinent lessons from a Médecins Sans Frontiéres (MSF) HIV program in the Democratic Republic of the Congo included educating on the importance of ART adherence, decentralizing care, establishing treat- ment information cards and duplicate medical re- cords, and cooperating with HIV treatment facilities in neighboring regions .
prolonged forced migration process. However, it is also conceivable that Somali war survivors in general have had an unusually high exposure to conflict-related events dur- ing the long periods of repeated unrest. The Somali popu- lation was also more vulnerable to recent traumatic events that took place within the refugee settlement (in the past year). That such events continue to take place shows that such refuges do not offer absolute safety for refugees. The researchers did not set out to establish construct valid- ity of the PTSD construct within these cultural groups. However, the significant correlations between various health measures such as posttraumatic stress disorder symptom sum score, depression and anxiety scores and subsequent functioning deficits may indicate the validity of the PTSD construct in these populations (see Table 4). The researchers did seek to establish criterion validity and, as mentioned before, the results are reported fully in . Notably, the HSCL-25 in both languages had a low Kappa score (0.31 when taken together). This indicates a defi- ciency in the accuracy of the rendition of the HSCL-25 into the local languages Kinyarwanda and Somali, thus limiting the reliability of the depression and anxiety meas- ures.
16 Read more
The chapter examines how different refugee settlement policies in Italy and the Netherlands affect the process of formation of social networks within and outside a group of compatriots. I explore the social condition of exile communities from the former Yugoslavia and examine how different policy interventions, intentionally and unintentionally, affect micro-level social interactions in these specific settlement contexts. Data for this study were collected during several months of ethnographic fieldwork in Rome (1999-2000) and Amsterdam (2000-2001). The discussion aims to emphasise the connection between specific policy contexts, structural constraints they embody, and the type of human agency they engender. Special emphasis is placed on the examination of the role of ‘bridging social networks’ established outside the refugee group, which seem to facilitate considerably the successful integration of refugees. I suggest that although governments cannot directly affect the formation of bridging social capital, it is possible to develop policies that facilitate it. Without such policies, integration remains plagued by relative social isolation, even when there are employment opportunities and relaxed naturalisation policies.
22 Read more
There was a significant association between parity of teenage mothers and current use of contraceptives [X 2 =7.749, p=0.005, 95% CI). Teenage mothers with a birth order of two and below were more likely to be currently using family planning [OR=1.227 (1.072-1.405) 95% CI] than those with a birth order of three and above. This is contravenes studies elsewhere (Sharma et al., 2012; Jabeen et al., 2011) that have associated increased uptake of contraceptives with a high parity, although these studied women of the reproductive age group in general other than teens. Based on the present study however, and given the economic and social implication of a teenage pregnancy moreover in refugee settings, emancipated minors who need contraceptives should access them freely with or without spousal approval so that every pregnancy is wanted. This necessary especially in conflict and post conflict settings; where adolescents are commonly reported to be survivors of sexual violence (UNICEF, 2005) amidst increasing HIV epidemic and other STIs (UNAIDS, 2004; Uganda AIDS Indicator Survey, 2011; UBOS, 2010). This however would need change of health provider’s attitude through continued engagement and training workshops. The high birth orders amongst teenage mothers in the present study can be explained by the high level of sexual and gender based violence (rape) reported in this refugee setting, amidst the fear of side effects, miss perceived infertility and promiscuity linked to use of contraceptives. However contemporary literature reveals that oral contraceptives are generally safe for adolescents and beliefs like promiscuity have been shown to be associated with low contraceptive uptake (Ikechebelu et al., 2005).The current use and choice of contraceptives differed by country of origin [X 2 =10.321, p=0.016; 95% C.I)] possibly due to cultural differences and beliefs. The most preferred method of contraception was Injectaplans. Indeed no woman cited vasectomy as a measure of contraception. This is explained by the patriarchal nature of African families with the general concept of contraception as being a “woman’s burden” alongside the stigma associated with combined oral contraceptives; particularly without spousal or parental endorsement.
15 Read more
Rwamwanja settlement scheme covers an area of about 108.5 km 2 divided into 15 zones and 45 villages. By the end of 2015, the population of the scheme was estimated to be 40,000 people. However, the population was expected to increase to a maximum capacity of be- tween 55,000 and 60,000 due to escalating violence in neighboring countries. SGBV is a challenge in the settle- ment area. In a community baseline survey carried out in the study site in 2015, a large proportion of female household heads reported experiencing physical IPV (69%) and sexual IPV (63%) since moving into the settle- ment area—the majority (68%) had lived in the area for more than 2 years . Furthermore, many female heads of household indicated that they had experienced non- partner physical violence (47%) and non-partner sexual violence (46%) since they started residing in the settle- ment. Data from two health facilities in the scheme showed that 837 (10%) out of 8462 female clients (aged 15 and above) screened by health providers from Sep- tember 2015 to January 2016, had been exposed to some form of SGBV including intimate partner violence (IPV) and/or non-partner sexual violence .
12 Read more
While fleeing, I joined strangers in the street. So many people were trying to flee. I simply ran with them. When these people reached their destination, they branched off from the road. It was night time by then. I was alone. I hated my life. I followed the road and finally fell asleep under a bush. I had given up about life by then. I felt like I had died as well. I knew about the danger of wild animals and lions, but I did not care... This is how I came to Uganda. When we reached Kampala I saw a group of Somalis and went to greet them. They took me in and I lived with them for a few weeks. They also showed me how to register as a refugee with UNHCR. I remember the day I came to Nakivale Refugee Camp. I was so surprised how peo- ple can live in a place like this. I stayed with the Somali family that found me in Kampala for about two years in the camp. Finally, Red Cross helped me to build my own house in 2000, I was about 14 years then. Since then I live alone. I started going to school when I came to Nakivale. I will graduate from P7 at the end of this year. I have learnt how to live by myself; I can do everything by myself. I never ask for help. No one can help me anyway. I have never heard about my brother and sister again. Whether they are still alive and if so, where I could find them. But now I am ready to look for them.
trend is acknowledged and the impact of that resentment is not felt by the individuals who are receiving the necessary, timely and quite specialised support at a time of high transition. There also needs to be attention paid to rural racism (Chakraborti & Garland 2004) where communities hold a strong and fixed ideal about their area. This is a phenomenon that makes the act of ‘othering’ (Riggins 1997) outsiders more likely to occur and less likely to be acknowledged (Chakraborti & Garland 2004; Garland & Chakraborti 2006). This also requires the acceptance of realistic timescales in refugee settlement and the recognition of negative community attitudes as an active barrier to successful settlement (Samarasinghe & Arvidsson 2002).The processes by which refugees enter Australia and are allocated a primary place of residence, create issues related to the unpredictability of arrival and the concentration of communities. This arrival process creates difficult timelines for the transfer of knowledge and
488 Read more
sometimes refers to this type of work as ‘modern day slavery’ or ‘contracted slavery’ (e.g. Ehrenreich & Hochschild, 2002). Although there is no doubt that this type of work entails structural inequality as well as very often a lived, day-to-day, experience of exploitation, subordination, and victimisation, my research demonstrates that women mostly approached their work in domestic service as an important stepping stone for a future, more meaningful life in exile. In pursuit of their longer and long- term goals, they made the system work for them. From this perspective, the live-in phase of their life in Rome, may be viewed as a ‘refuge’ or ‘shelter job’, to borrow the terms from Cole et al. (2006) and Colombo (2007), which was helpful in their initial adjustment and functional settlement in the country.
27 Read more
Although Australian police were not the perpetrators of the profound violation of trust that characterises the refugee experience, they have the potential to be one of the key agencies in settlement to assist in the restoration of trust. This research explores the perspectives of police and refugees concerning police-refugee and refugee-police relations. The research was conducted in Tasmania, Australia, as a regional location settling refugees. The qualitative research involved 160 participants including police and members of seven of the African newly arrived refugee communities. The data was collected from 2006 to 2008, a time that was characterised by periods of negative media attention focusing on African refugees and debate about settlement in regional Australia.
15 Read more
This approach to settlement moves beyond a narrow focus on policies and services facilitating integration, to one that makes visible diverse ways of navigating unstable, multi-faceted, and precarious settlement terrains. Social navigation offers a powerful alternative to conventional linear conceptualizations of refugee settlement, highlighting temporal dimensions, via the dual focus on the “immediate” (the realities of the present and proximate needs) and the “imagined” (aspirations and visions of the future). It draws attention to the Australian settlement environment as not necessarily stable, safe, or supportive; indeed, we argue that settlement is often precarious and fraught with risk. Social navigation allows us to understand settlement as a process by which people develop (or fail to develop) the skills and knowledge to successfully navigate their new host environ- ment in their project of attaining viable futures. The concept of social navigation is a powerful way of understanding how refugee young people move through settlement—a terrain that is also in motion—as agents in making their lives and their futures, providing a powerful metaphor for describing the lived experiences of settlement in Australia.
11 Read more
Sarah Ansari's recent study is a continuation of her early work which focused on Sindh from its annexation by British India in 1843 to its inclusion in the state of Pakistan in 1947. In Life after Partition, she leaves her Sufis and Pirs aside and tries to come to grips with the state functionaries and policies dealing with the people, especially those who had been displaced or were voluntarily on the move in the wake of Partition. She finds interesting parallels with Punjab, where such moves led to greater dislocation amidst more bloodshed, yet the demographic transformation of Sindh following the outflow of Hindus and the influx of Muslim refugees, and the resulting, often less-regulated settlements, have left their lasting imprints on all sides. Here, an interesting and not-so-dissimilar interface between the new states can be detected as they faced similar issues. The reader also acquires in-depth knowledge of the immense speed and volume of demographic diversification within Sindh; a new province since its separation from Bombay Presidency in 1936. Ansari's research pieces together the details of refugee settlement in urban and rural Sindh under the auspices of the newly-independent government of Pakistan, which, like the provincial government, was based in Karachi.
unemployment and greater barriers to employment than the general population, causing social and economic stresses among community groups and families. Youth are likely to become disengaged and feel disenfranchised when faced with structural unemployment, while family relationships often deteriorate as a result of financial pressures (Ethnic Communities’ Council of Victoria, 2008). More specifically, a recent Australian Survey Research (2011) report found that humanitarian entrants are the most likely to be unemployed, with only around 40 per cent of humanitarian entrants securing a job of some type within four years of arriving in Australia (Australian Survey Research, 2011). The report further shows that non-participation in education was one of the main causes of humanitarian entrants’ sustained unemployment due to their relatively low educational attainment. However, the report failed to recognise that many humanitarian entrants ideally want to work or study to support their families in Australia as well as overseas. The issue of employment was identified as one of the many areas of refugee settlement that need further investigation (Australian Survey Research, 2011).
22 Read more
The first of the three main sections frames refugee law as a regime in crisis (13). Catherine Dauvergne in “Refugee law as perpetual crisis” uses the vernacular of crisis to describe the paradigm from within which refugees are viewed, both in terms of how their plights are represented (fleeing from crisis)(14) as well as what she terms ‘crisis bias’, or the centrality of the crises of the urgent escape or the noteworthy drama of regime change within successful refugee claims (15–16). This contribution provides a timely echo of the work of Hilary Charlesworth, who described international law as a ‘discipline in crisis’. While Charlesworth argues the disadvantages of such a crisis model, Dauvergne departs from this sentiment and suggests that the crisis paradigm when applied to refugee law, unlike human rights law more generally, serves the important purpose of maintaining the value of refugee law—and that while the crisis embodied by refugees and the system of international refugee law must be resisted, to ‘resolve’ the crisis would ‘make refugees disappear’ and eliminate the critical potential of the constant tension and resistance caused by the ill-fit of refugee law within international law and international human rights law (28–31).
historically, produced by the combustion of coal. A by product of the process are fine ashes collected by electrostatic precipitation from the flue gases (known as pulverised fuel ashes or pfa) and coarser furnace bottom ashes. Some pfa is used as a cement replacement but a large percentage is disposed of by producing a water-based slurry and pumping it into lagoons where settlement occurs. The result is a site that may have a considerable depth of potentially loose, fine-grained material. These areas have potential for development but there are
30 Read more
Most refugees studied had lower-than-desirable vitamin D levels when categorized based on IOM and Osteoporosis Canada guidelines. When compared with the Canadian population, refugees had lower levels across all age and sex categories. Women and children from the Middle East had the lowest mean 25(OH)D levels compared with all other regions. These findings suggest that refugee women of childbearing age and children newly arrived to Calgary are at high risk of being vitamin D deficient, and therefore are at risk of the health concerns associated with vitamin D deficiency.
The Researcher is a new initiative of the Refugee Documentation Centre. It is an electronic newsletter distributed by e-mail and published quarterly. The purpose of The Researcher is to provide our clients and interested parties with up to date information on developments in the RDC. The newsletter will cover topics related to Country of Origin Information and legal research. We hope to feature a specialist article on a particular theme in each issue. We will also let you know of recent library acquisitions, new resources and relevant RDC statistics. We welcome your feedback on any of these matters.