Exploring sources of insecurity for Ethiopian Oromo and Somali women who have given birth in Kakuma Refugee Camp: A Qualitative Study

BackgroundAccording to the United Nations High Commissioner for Refugees, 44,000 people are forced to flee their homes every day due to conflict or persecution. Although refugee camps are designed to provide a safe temporary location for displaced persons, increasing evidence demonstrates that the camps themselves have become stressful and dangerous long-term places—especially for women. However, there is limited literature focused on refugee women’s perspectives on their insecurity. This qualitative study sought to better understand the ways in which women experienced insecurity at a refugee camp in Kenya.Methods and findingsBetween May 2017 and June 2017, ethnographic semi-structured interviews accompanied by observation were conducted with a snowball sampling of 20 Somali (n = 10) and Ethiopian Oromo (n = 10) women, 18 years and older, who had had at least 1 pregnancy while living in Kakuma Refugee Camp. The interviews were orally translated, transcribed, entered into Dedoose software for coding, and analyzed utilizing an ethnographic approach. Four sources of insecurity became evident: tension between refugees and the host community, intra- or intercultural conflicts, direct abuse and/or neglect by camp staff and security personnel, and unsafe situations in accessing healthcare–both in traveling to healthcare facilities and in the facilities themselves. Potential limitations include nonrandom sampling, the focus on a specific population, the inability to record interviews, and possible subtle errors in translation.ConclusionsIn this study, we observed that women felt insecure in almost every area of the camp, with there being no place in the camp where the women felt safe. As it is well documented that insecure and stressful settings may have deleterious effects on health, understanding the sources of insecurity for women in refugee camps can help to guide services for healthcare in displaced settings. By creating a safer environment for these women in private, in public, and in the process of accessing care in refugee camps, we can improve health for them and their babies.

背景：根据联合国难民事务高级专员公署的数据，每天都有4.4万人因冲突或迫害而被迫逃离家园。尽管难民营旨在为流离失所者提供一个安全的临时居所，但越来越多的证据表明，难民营本身已经变成了充满压力和危险的长期场所——尤其是对女性而言。然而，关于难民女性对其不安全感的看法的文献研究却相当有限。本研究采用定性研究方法，旨在更深入地理解女性在肯尼亚难民营中体验不安全感的方式。方法与发现：在2017年5月至2017年6月期间，对20名年龄在18岁及以上、在卡库马难民营生活期间至少有过一次怀孕的索马里（n = 10）和埃塞俄比亚奥罗莫（n = 10）女性进行了民族志半结构化访谈，并伴随观察。访谈内容经过口头翻译、转录，并录入Dedoose软件进行编码，采用民族志方法进行分析。研究发现四个不安全来源：难民与东道主社区之间的紧张关系、文化内或跨文化冲突、难民营工作人员和安全人员对女性的直接虐待或忽视，以及获取医疗保健时的不安全状况——包括前往医疗设施以及设施本身。潜在局限性包括非随机抽样、对特定人群的聚焦、无法记录访谈，以及翻译过程中可能出现的细微错误。结论：在本研究中，我们观察到女性在难民营的几乎所有领域都感到不安全，难民营中没有任何地方让女性感到安全。鉴于不安全和压力环境可能会对健康产生有害影响，了解难民营中女性不安全感的来源，有助于指导在流离失所环境中的医疗保健服务。通过在私人空间、公共空间以及难民营中获取保健的过程中为这些女性创造一个更安全的环境，我们可以改善她们及其婴儿的健康状况。