This document summarizes the experiences of Somali refugee women living in the United Kingdom. It describes their difficult migration journeys, which often involved fleeing violence and instability in Somalia. The women faced challenges in refugee camps and then navigating new systems in the UK. They struggle with isolation, mental health issues, and lack of communication from healthcare services. The document recommends that services provide culturally-appropriate care, ensure safe interpreters, clearly explain options, and invest more time in building trust with refugees. It also stresses the need for research that considers non-Western perspectives and supports researchers' emotional well-being.

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When the Stories Break your Heart
Forced Migration
the Experiences of Somali Refugee Women
Living in the United Kingdom
Dr Barbara Howard‐Hunt
Senior Lecturer / Researcher
 Provide an overview of the women’s migration
journey’s .
 To outline some of the challenges faced by the
women in terms of accessing health care services.
 Discuss why the traditional homogenising discourse
which informs policy and practice is at best a
compromise.
 Outline some of the recommendations made that
could improve the uptake of services.
Design: Giving the women a voice
 Qualitative
 Descriptive Phenomenology
 Feminist Principles
 Focus Groups
 Individual Interviews
 Observations

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 Total population 10.4 million
 Life Expectancy
male: 50.9 years
female: 49.4 years
 Worst infant, child and maternal
mortality rates in the word
86 deaths per 1000 live births
 73% living below the poverty line
 31.8% adult literacy
 49% of the population have no
access to sanitation services
 (World Bank 2014 est.)
The Somali Community in the UK
 1.3 million Somalis reside in the
UK.
 High percentage of female headed
families.
 Depression, PTSD, and anxiety are
common as well as chronic long
term conditions such as diabetes,
hypertension and COPD.
 There is very poor uptake for all
health services.
 Somali community experience
multiple forms of disadvantage i.e.
housing, education, employment

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Spiral of Loss and Trauma
Living in a War Zone
… things were getting worse. The
roads blocked by militia … , had to
pay bribe.
The soldiers would weigh us right
there on the road ….
Some women were taken …
[and raped]
Leaving Somalia
... we didn’t care where we were going
cos it was safe
just knew we was getting out of the country
… knew we weren’t gonna die ...

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Running to Safety
More than 80,000 refugees and
asylum-seekers reside in
Kakuma camp.
“I was very frightened, it was not
safe … in the camps we were
threatened every day, there was no
security at all”
.
Food is limited
Shortages of water
Safe and Secure?
“the very ones who were meant
to be
protecting us those
are the ones who are
raping us”
“ ... you can imagine three, four,
five men
raping the mothers and
the daughters”
Moving On
the mukhalis [smuggler] was in the town … I was wary
but I had no choice if I wanted to leave … I needed
papers, tickets [he] said it would be arranged … I gave
money for tickets but after that I never saw that man
again and nobody knew what had happened [to him]
… when you are in such a desperate situation you take
risks that before you would not do

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“He did everything, even the passports ...
… he say they heard that the Government [in
Germany] don’t allow anybody to have transit
ticket to Germany… It’s 50/50 to go or send you
back … that time my husband was very sick so I
say go whatever happen we will stand for it”
Arriving in the UK
It was very hard and you
know, you feel no one is
believing what you are
saying … my dialect, I am
from minority tribe, it was a
little difficult and I was so
scared he wasn’t understand
me [the interpreter]…
so I am telling my story …
I’m praying that I was saying
a good story … so I just told
my story and praying that
they would believe it.
he [the immigration officer] said you are free to stay
in this country and I ask him are you serious, he said
yes and then I still ask him, are you serious …
he asked the interpreter tell this lady to stop
following me and tell her she’s free to stay in this
country …
I was a bit confusion [confused]
freedom means everything.

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“When you are a refugee you are suffering a lot,
thinking about your family who are still in [Somalia]
we left our problem but some of our families are still in
that problem …
they are not with you and you cannot
help them or they you. …
[it makes us] feel bad inside and out”
Contrasting views
We see women not turning up
and not answering our questions
___________________________________________
They see memories they cannot discuss
“You see a lot of people dying in front
of you … bodies blown apart,
bits missing in the street”.
We see … They see
“Its confusing, there are so
many services,
I don’t know how to keep
track [of them all] …
so many [health
professionals]
involved
in one family.
Its hard to know what they
are all doing”

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They want We provide
“ For Somali it’s oral,
I don’t want leaflet,
I want to talk,
I want someone to explain to
me so I can hear it … “
“…there is no communication
… nobody talks to you; in
Somalia we don’t go crazy
but here all ladies crazy
because of the isolation”
We are perplexed when
they don’t tell their stories
and we are met with a
wall of silence
They remember not being
believed
“before they were coming to
steal and then they are
raping …, the woman she
will not say only to keep it
to herself”.
“no one listened …
no one to believe us …
We provide interpreters
and are confused when
these are not readily
accessed or women seem
suspicious or nervous,
We may think they don’t
really want our help.
They fear
“I am from minority tribe,
she the one who was the
interpreter was from that
other tribe
and so you cannot say to
them everything … what
will they say to that
person… the one who
needs the information”

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Spiral of Loss and Trauma
Cycle 2:
Running to
safety
Cycle 3:
Moving on
Running Differently
RecoveryAnomie
One size does not fit all

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Recommendations
I. Staff have access to resources and training so that they
can work within an appropriate cultural frame,
acknowledging differences as well as similarities.
II. Extreme care is taken when using interpreters, in not only
matching language and dialect, but also recognition of the
fact that inter‐clan conflicts may mean some interpreters
are not acceptable
III. A register of trained interpreters, who understand medical
terminology and are trained to work with those who may have
experienced rape and torture be available
I. All newly arrived asylum seekers and refugees be
assessed in accordance with current DH guidelines.
II. Clear information about health service provision,
for example accessing a dentist or optician and
health service policies on issues such as
confidentiality, be provided.
III. All information provided should be in a accessible
format i.e audio recordings rather than written.
Research
I. Researchers working with refugee women are made
aware of (and are able to commit to) the considerable
time investment needed to facilitate access and
develop trust with the women.
II. Research studies are designed which recognise non‐
westernised perspectives of concepts such as consent.
Where necessary this should include cross cultural
communication training for researchers.
III. All those working with working with emotive data sets
are made aware of how this may impact on their own
emotional well‐being. It is essential that researchers
have the professional expertise to work with refugee
groups and have access to counselling services.

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Points for reflection
 What do you consider to be the main issues many
refugee women face now that they are living in the
UK.
 What are the potential challenges for refugee
women when trying to access health services and
what could be done to minimise them?
 What challenges may you face when working with
refugee women and what practically could you do to
try to overcome them?
Questions
Dr Barbara Howard‐Hunt
Birmingham City University