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"Somalis Migrations."
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Diasporas, development and peacemaking in the Horn of Africa
Exiled populations, who increasingly refer to themselves as diaspora communities, hold a strong stake in the fate of their countries of origin. In a world becoming ever more interconnected, they engage in 'long-distance politics' towards, send financial remittances to and support social development in their homelands. Transnational diaspora networks have thus become global forces shaping the relationship between countries, regions and continents. This important intervention, written by scholars working at the cutting edge of diaspora and conflict, challenges the conventional wisdom that diaspora are all too often warmongers, their time abroad causing them to become more militant in their engagement with local affairs. Rather, they can and should be a force for good in bringing peace to their home countries. Featuring in-depth case studies from the Horn of Africa, including Somalia and Ethiopia, this volume presents an essential rethinking of a key issue in African politics and development.
eBook
Little White Houses
A rare exploration of the racial and class politics of architecture, Little White Houses examines how postwar media representations associated the ordinary single-family house with middle-class whites to the exclusion of others, creating a powerful and invidious cultural iconography that continues to resonate today. Drawing from popular and trade magazines, floor plans and architectural drawings, television programs, advertisements, and beyond, Dianne Harris shows how the depiction of houses and their interiors, furnishings, and landscapes shaped and reinforced the ways in which Americans perceived white, middle-class identities and helped support a housing market already defined by racial segregation and deep economic inequalities.After describing the ordinary postwar house and its orderly, prescribed layout, Harris analyzes how cultural iconography associated these houses with middle-class whites and an ideal of white domesticity. She traces how homeowners were urged to buy specific kinds of furniture and other domestic objects and how the appropriate storage and display of these possessions was linked to race and class by designers, tastemakers, and publishers. Harris also investigates lawns, fences, indoor-outdoor spaces, and other aspects of the postwar home and analyzes their contribution to the assumption that the rightful owners of ordinary houses were white.Richly detailed, Little White Houses adds a new dimension to our understanding of race in America and the inequalities that persist in the U.S. housing market.
eBook
Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden: a cross-sectional study
Background
Forced migrant populations have high rates of trauma-related ill health, including post-traumatic stress disorder (PTSD). Physical activity (PA) is well-established as an effective stress reliever, while insufficient PA is associated with adverse effects on both mental and physical health. The aim of this study was to examine the prevalence of different levels of PA and its association with PTSD symptom severity, controlled for exposure to torture, among asylum seekers in Sweden.
Methods
A cross-sectional survey study, with data from 455 asylum seekers, originating from Afghanistan, Eritrea, Iraq, Somalia, and Syria, residing at large housing facilities across Sweden. Level of PA was assessed by the Exercise Vital Sign and categorized as; Inactive, Insufficient PA, and Sufficient PA. Prevalence estimates for proportions of different levels of PA were calculated. Analysis of variance were conducted to determine the association between levels of PA and PTSD symptom severity, measured by the Harvard Trauma Questionnaire. Multivariable logistic regression analysis was performed to determine the contribution of PA on PTSD beyond sex, age, and exposure to torture.
Results
About half of the participants (53.3, 95% CI: 48.6–58.1) met the recommendations for Sufficient PA. One third of the participants (33.3, 95% CI: 28.7–37.8) were insufficiently engaged in PA, and 13.4% (95% CI: 10.1–16.7) were inactive. There was a significant difference in PTSD symptom severity between groups of asylum seekers with different levels of PA (
F
(2, 316)
= 23.15,
p
< .001). When controlling for sex, age, and exposure to torture, Sufficient PA was found to be associated with less PTSD symptom severity compared to both Insufficient PA (
B
= 0.297,
SE
= 0.086,
p
< .001) and Inactive (
B
= 0.789,
SE
= 0.104,
p
< .001).
Conclusions
Insufficient PA was common among the asylum seekers and our findings suggest that more PA is highly associated with lower PTSD symptom severity. An increased focus on assessment and promotion of PA is justified and discussed as particularly pertinent considering the much extended time of asylum-seeking processes. The results support previous evidence of PA as a potentially important factor in the context of PTSD and forced migrants’ health.
Journal Article
“Crazy person is crazy person. It doesn’t differentiate”: an exploration into Somali views of mental health and access to healthcare in an established UK Somali community
Background
Mental health conditions have been shown to disproportionately affect those from Black, Asian and Minority Ethnic (BAME) communities. Somali communities globally have relatively high levels of mental illness, but low levels of mental health service use, with numerous barriers to care identified.
This study was conducted in an established UK Somali community in the South West of England and aimed to explore community beliefs and views about the causes of mental illness, treatment for mental illness, and access to medical services in general. Participants were asked about how mental health and illness are understood and conceptualised, along with the cultural meaning of mental illness and its manifestations in relation to men, women and young people.
Design
Using a community-based participatory research design, in partnership with local Somali community organisations, the research team conducted four focus groups with a total of 23 participants aged over 18. Open-ended questions were used to facilitate discussion. Transcripts were analysed thematically.
Results
The participants discussed the role of migration and associated stress from the civil war and how that could contribute to mental illness.
Participants tended to view the symptoms of mental illness as physical manifestations such as headaches and to describe a strong community stigma where those with mental health conditions were viewed as “crazy” by others. Barriers to accessing healthcare included language barriers, waiting times and a mistrust of doctors. Various ideas for improvements were discussed, including ideas to reduce stigma and ideas for community initiatives.
Conclusion
Cultural considerations and reducing stigma are vital in improving understanding of mental illness and improving access to mental health services, along with building relationships and trust between the Somali community and health care workers.
Journal Article
Elusive Jannah
As a Somali working since high school in the United Arab Emirates, Osman considers himself \"blessed\" to be in a Muslim country, though citizenship, with the security it offers, remains elusive. For Ardo, smuggled out of Somalia to join her husband in South Africa, insecurities are of a more immediate, physical kind, and her economic prospects and legal status are more uncertain. Adam, in the United States-a destination often imagined as an earthly Eden, orjannah, by so many of his compatriots-now sees heaven in a return to Somalia.
The stories of these three people are among the many that emerge from mass migration triggered by the political turmoil and civil war plaguing Somalia since 1988. And they are among the diverse collection presented in eloquent detail inElusive Jannah, a remarkable portrait of the very different experiences of Somali migrants in the UAE, South Africa, and the United States. Somalis in the UAE, a relatively closed Muslim nation, are a minority within a large South Asian population of labor migrants. In South Africa, they are part of a highly racialized and segregated postapartheid society. In the United States they find themselves in a welfare state with its own racial, socioeconomic, and political tensions. A comparison of Somali settlements in these three locations clearly reveals the importance of immigration policies in the migrant experience.
Cawo M. Abdi's nuanced analysis demonstrates that a full understanding of successful migration and integration must go beyond legal, economic, and physical security to encompass a sense of religious, cultural, and social belonging. Her timely book underscores the sociopolitical forces shaping the Somali diaspora, as well as the roles of the nation-state, the war on terror, and globalization in both constraining and enabling their search for citizenship and security.
eBook
Gender-related mental health differences between refugees and non-refugee immigrants - a cross-sectional register-based study
Background
Being an immigrant in a high-income country is a risk factor for severe mental ill health. Studies on mental ill health among immigrants have found significant differences in mental health outcome between immigrants from high income countries and low-income countries. Being an asylum seeker or a refugee is also associated with mental ill health. This study aimed to assess if there is a difference in mental ill health problems between male and female refugee and non-refugee immigrants from six low-income countries in Sweden.
Methods
A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Outcome: Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders.
Results
The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5%) were women and 24,403 (56.5%) were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15 - 1.40).
Conclusions
Female refugees from low-income countries seem to be a risk group among immigrant women from low-income countries, whereas male refugees had the same risk patterns as non-refugee immigrants from low-income countries. This underlines the need for training of clinicians in order to focus on pre-migration stress and the asylum process, among female newcomers.
Journal Article
Coping with Trauma and Symptoms of Post-Traumatic Stress Disorder: Exploring Intentions and Lay Beliefs about Appropriate Strategies among Asylum-Seeking Migrants from Sub-Saharan Africa in Germany
Asylum-seekers are at high risk of developing post-traumatic stress disorder (PTSD) due to frequent exposure to trauma. We investigated the coping intentions and lay beliefs about appropriate coping strategies among asylum-seekers from Sub-Saharan Africa in Germany. The study applied a methodological triangulation strategy with a vignette describing symptoms of PTSD. In a quantitative part, asylum-seekers (n = 119) that were predominantly from Eritrea (n = 41), Somalia (n = 36), and Cameroon (n = 25), and a native comparison sample (n = 120) responded to questionnaires assessing coping, traumatic events, and post-traumatic symptoms. In a qualitative part, asylum-seekers (n = 26) discussed coping strategies in focus groups. In the quantitative part, asylum-seekers displayed higher intentions for religious coping, emotional support, and denial compared to the native participants. Asylum-seekers with a higher symptom load expressed lower intentions to seek instrumental support. Asylum-seekers with a lower educational level and those with a higher symptom load expressed higher intentions for substance use. In the qualitative part, we identified three superordinate themes: (a) religion, (b) social support systems, and (c) cognitive strategies. Asylum-seekers expressed coping intentions that are associated with an adaptive response to trauma. Less-educated asylum-seekers with a higher symptom load might constitute a particularly vulnerable group.
Journal Article
Population based cohort study of fetal deaths, and neonatal and perinatal mortality at term within a Somali diaspora
Background
Somali women deliver at greater gestational age with limited information on the associated perinatal mortality. Our objective is to compare perinatal mortality among Somali women with the population rates.
Methods
This is a retrospective cohort study from all births that occurred in Minnesota between 2011 and 2017. Information was obtained from certificates of birth, and neonatal and fetal death. Data was abstracted from 470,550 non-anomalous births ≥37 and ≤ 42 weeks of gestation. The study population included U.S. born White, U.S. born Black, women born in Somalia or self-identified as Somali, and women who identified as Hispanic regardless of place of birth (377,426). We excluded births < 37 weeks and > 42 weeks, > 1 fetus, age < 18 or > 45 years, or women of other ethnicities. The exposure was documented ethnicity or place of birth, and the outcomes were live birth, fetal death, neonatal death prior to 28 days, and perinatal mortality rates. These were calculated using binomial proportions with 95% confidence intervals and compared using odds ratios adjusted (aOR) for diabetes, hypertension and maternal body mass index.
Results
The aOR [95%CI] for stillbirth rate in the Somali cohort was greater than for U.S. born White (2.05 [1.49–2.83]) and Hispanic women (1.90 [1.30–2.79]), but similar to U.S. born Black women (0.88 [0.57–1.34]). Neonatal death rates were greater than for U.S. born White (1.84 [1.36–2.48], U.S. born Black women (1.47 [1.04–2.06]) and Hispanic women (1.47 [1.05–2.06]). This did not change after analysis was restricted to those with spontaneous onset of labor. When analyzed by week, at 42 weeks Somali aOR for neonatal death was the same as for U.S. born White women, but compared against U.S. born Black and Hispanic women, was significantly lower.
Conclusions
The later mean gestational age at delivery among women of Somali ethnicity is associated with greater overall risk for stillbirth and neonatal death rates at term, except compared against U.S. born Black women with whom stillbirth rates were not different. At 42 weeks, Somali neonatal mortality decreased and was comparable to that of the U.S. born White population and was lower than that of the other minorities.
Journal Article
Baseline data from a planned RCT on attitudes to female genital cutting after migration: when are interventions justified?
ObjectivesTo present the primary outcomes from a baseline study on attitudes towards female genital cutting (FGC) after migration.DesignBaseline data from a planned cluster randomised, controlled trial. Face-to-face interviews were used to collect questionnaire data in 2015. Based on our hypothesis that established Somalis could be used as facilitators of change among those newly arrived, data were stratified into years of residency in Sweden.SettingSweden.Participants372 Somali men and women, 206 newly arrived (0–4 years), 166 established (>4 years).Primary outcome measuresWhether FGC is acceptable, preferred for daughter and should continue, specified on anatomical extent.ResultsThe support for anatomical change of girls and women’s genitals ranged from 0% to 2% among established and from 4% to 8% among newly arrived. Among those supporting no anatomical change, 75%–83% among established and 53%–67% among newly arrived opposed all forms of FGC, with the remaining supporting pricking of the skin with no removal of tissue. Among newly arrived, 37% stated that pricking was acceptable, 39% said they wanted their daughter to be pricked and 26% reported they wanted pricking to continue being practised. Those who had lived in Sweden ≤ 2 years had highest odds of supporting FGC; thereafter, the opposition towards FGC increased over time after migration.ConclusionA majority of Somali immigrants, including those newly arrived, opposed all forms of FGC with increased opposition over time after migration. The majority of proponents of FGC supported pricking. We argue that it would have been unethical to proceed with the intervention as it, with this baseline, would have been difficult to detect a change in attitudes given that a majority opposed all forms of FGC together with the evidence that a strong attitude change is already happening. Therefore, we decided not to implement the planned intervention.Trial registration numberTrial registration number NCT02335697;Pre-results.
Journal Article