Darfur Crisis; Associated mental health Problems among Internally Displaced Women


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Darfur Crisis; Associated mental health Problems among Internally Displaced Women

  1. 1. 1. Saif A. MUSA(PhD)- United Arab Emirates University 2. AbdAllah Hamid(PhD)- United Arab Emirates University [email_address] International Disaster and Risk Conference Davos May 30 _ June 3 . 2010 Davos-Switzerland Darfur Crisis: Associated Mental Health Problems among Internally Displaced Women
  2. 2. Contents <ul><li>Purpose </li></ul><ul><li>Overview </li></ul><ul><li>Method </li></ul><ul><li>Findings </li></ul><ul><li>Conclusion and implications </li></ul>
  3. 3. Purpose <ul><li>To investigate the Darfur crisis impact on the mental health of internally displaced women. </li></ul><ul><li>This impact was investigated in terms of: </li></ul><ul><li>1- living conditions inside the camps </li></ul><ul><li>2- traumatic events </li></ul>
  4. 4. Overview <ul><li>Location: Northeast Africa within latitude 4 N  -22 N  and longitude 22 E  -38 E  . </li></ul><ul><li>Area: the largest country in Africa, with an area of 2.6 million square kilometers </li></ul><ul><li>Population: 32 millions, Darfur population is 6 millions </li></ul>
  5. 5. Armed Conflict and Displacement <ul><li>March 2003 start point of the Armed conflict in Darfur. </li></ul><ul><li>1.97 million internally displaced persons (IDPs), and 200000 refugees to neighboring Chad. </li></ul>
  6. 6. Relief and shelter
  7. 7. Health and nutrition
  8. 8. Child protection
  9. 9. Method-participants <ul><li>212 internally displaced women were interviewed. </li></ul><ul><li>Their ages ranged between 15 and 80 years (mean age= 34.1). 75% were married, 15.6% single, and 6.7% were widowed. </li></ul><ul><li>Women who displaced in early 2003 through, to mid 2005, were 31.3%, 65.1%, and 3.3% respectively. </li></ul><ul><li>About 44 % of them belonged to the Fur tribe, 21.7% to the Zaghawa tribe, and the rest belong to other tribes. </li></ul>
  10. 10. Method: Procedures <ul><li>Participants were selected from three camps around the towns of Fashir (52.4%) and Nyala (47.6%). </li></ul><ul><li>Camps in Fashir is much larger than camps in Nyala. </li></ul><ul><li>Participants were selected according to their availability from each tent. </li></ul><ul><li>Sampling technique most likely to be described as a stratified sampling. </li></ul><ul><li>Mixed methods research design was used . </li></ul>
  11. 11. Method: Materials /Measures <ul><li>Two sets of questionnaires were used in this study: </li></ul><ul><li>First questionnaire was especially designed to assess living conditions inside the camps. It has three parts; demographic information(7Q); living conditions(21Q); and displacement history (3Q). </li></ul><ul><li>2. The General Health Questionnaire (GHQ-28 items) comprises four subscales; anxiety, depression, somatic symptoms, and social dysfunction. </li></ul>
  12. 12. Method: Materials /Measures <ul><li>GHQ measures non-psychotic psychiatric disorder in both clinical and community settings (Goldberg &Williams,1991). </li></ul><ul><li>(0,0,1,1) Method was used for GHQ scoring in order to differentiate psychiatric from non-psychiatric cases with cutoff point of 4 or more. </li></ul><ul><li>The GHQ-28 was factored analyzed and yielded 4 subscales that gauge somatic symptoms, depression, anxiety, and social dysfunction. </li></ul><ul><li>The mean score on GHQ-28 scale is 14.9 (SD=8.4, Alpha reliability=0.94). </li></ul><ul><li>This study used cutoff point 9 to differentiate psychiatric from non-psychiatric cases. </li></ul>
  13. 13. Findings/Results <ul><li>1. Living conditions: </li></ul><ul><li>80% of internally displaced women reported that living conditions inside the camps were not satisfactory. </li></ul><ul><li>More than 74% stated that camps are located in unsecured areas. </li></ul><ul><li>About 65% were jobless. </li></ul><ul><li>Participants reported the lack and gap in relief services as follow: </li></ul><ul><li>i) 19% reported lacking of clean water and 45%sanitation </li></ul><ul><li>ii) compatible shelter </li></ul><ul><li>iii) 27% firewood and 8% schools </li></ul>
  14. 14. Findings/Results <ul><li>Regarding the food services: </li></ul><ul><li>About 85% women reported that food amount was insufficient. </li></ul><ul><li>68% stated that food type was not suitable with their culture. </li></ul><ul><li>In their response to open-ended questions about lack of food supplies, women reported that: services were lacking vital items such as meat (67.3%), milk & tea 941%), and sorghum (42%). </li></ul><ul><li>Participants identified the unfamiliar ingredients in food supplies as follow: </li></ul>
  15. 15. Findings/Results <ul><li>1. soya cooking oil(57%0 </li></ul><ul><li>2. lentils (8.1) </li></ul><ul><li>3. wheat (9.9) </li></ul><ul><li>About 26% of participants reported that some of their relatives died due to malnutrition. </li></ul><ul><li>40.6% reported having malnourished relatives. </li></ul>
  16. 16. Findings/Results <ul><li>The General health Questionnaire </li></ul><ul><li>GHQ-28 results showed that 72% scored more than cutoff point 9. And accordingly were classified as non-psychotic psychiatric cases. </li></ul><ul><li>Age was significantly associated with social dysfunction, the older the age the more social dysfunction was reported. </li></ul><ul><li>Family size was significantly related with general distress, depression, and social dysfunction. That is, the larger family size the less score on above scales. </li></ul><ul><li>Two-tailed independent sample t -test results showed significant difference between employed and unemployed in general distress, somatic symptoms, depression, anxiety,& social dysfunction The unemployed scored higher in these dimensions. . </li></ul>
  17. 17. Findings/Results <ul><li>T-test results also showed significant difference based on date of displacement in general distress, somatic symptoms, depression, anxiety, and social dysfunction. Women who displaced in 2003 consistently had showed higher scores on all these dimensions compared to those who displaced in 2004. </li></ul><ul><li>One-way analysis of variance (ANOVA) resulted in significant differences related to marital status in general distress, somatic symptoms, and social dysfuction. Married participants scored higher on distress and social dysfunction compared to unmarried women and widows, while widows scored higher on somatic symptoms compared to married and single women. </li></ul>
  18. 18. Findings/Results <ul><li>T-test results have showed significant mean differences between internally displaced women in the Nyala camps and Fasher camp for the general distress, somatic symptoms, anxiety, and social dysfunction. IDPs in the Nyala camps (Seraif and Utash camps) reported more on these dimensions compared to their counterparts in the Fasher camp (Abu Shoak camp). </li></ul>
  19. 19. Conclusion & Implications <ul><li>This study was conducted in three camps located around towns of Nyala and Fasher to highlight the mental health problems facing IDPs. </li></ul><ul><li>Lack of security was the sole reason for internally displacement in Darfur. Since the IDPs were victims. </li></ul><ul><li>Four factors could have led to the dissatisfaction of internally displaced women: i)lack of employment ;ii) unsuitability of shelter and food items; iii) lack of sanitation and social services; and iv) lack of security around camps. </li></ul>
  20. 20. Conclusion & Implications <ul><li>Non-psychotic psychiatric disorder symptoms were highly prevalent amongst displaced women, in particular those who displaced in 2003. displaced women in camps by Nyala town seemed to experience more mental health problems than those in the camp by Fasher town. </li></ul><ul><li>Displacement and experiences of armed conflict have a significant impact on mental health of victims. </li></ul><ul><li>Findings of this study imply that attention should be directed toward provision of psychosocial support and psychological rehabilitation services to internally displaced women in Darfur. </li></ul>
  21. 21. Thank you 