At zero and turning in circles: refugee experiences and coping in Durban, South Africa

Abstract

Millions of refugees are on the move globally, mostly settling in low- and middle-income (LMIC) "host" countries, where they often receive insufficient assistance and encounter a multitude of barriers. Despite a risk for developing mental illness, limited research exists on their struggles and coping strategies in these settings, especially outside of camps. Against this backdrop, our qualitative study aimed to gain a deeper understanding of refugee experiences in Durban, South Africa. We conducted semistructured individual interviews with 18 adult refugees from Zimbabwe and the Democratic Republic of Congo at a community-based support center in Durban. Participants described their problems, effects on mental health, and coping abilities. Interviews were recorded and analyzed for themes. Major problems were reported with work, xenophobia/racism, mental health, physical safety, housing, healthcare, and quality of life. Participants discussed feelings of worry, fear, emotional pain, anger, powerlessness, hopelessness, worthlessness, and passive suicidal ideation. Coping mechanisms consisted of friendships, church, praying, work, physical activities, family, learning the local language, and avoidance of thoughts. Many interviewees expressed a strong desire to either return to their homeland or move elsewhere. Refugees in South Africa face considerable hardships including xenophobia, physical abuse, and work/legal obstructions. More research is needed in LMICs to identify the challenges, psychological effects, and coping in such populations so that appropriate and accessible mental health services can be created for those who require them.

Enablers of psychological well‐being for refugees and asylum seekers living in transitional countries: A systematic review

“…Studies were published between 2002 and 2018. Four were quantitative cross sectional designs (Chase, Welton‐Mitchell, & Bhattarai, ; Emmelkamp, Komproe, Van Ommeren, & Schagen, ; Nakash, Nagar, Shoshani, & Lurie, ; Segal, Khoury, Salah, & Ghannam, ), 10 were qualitative studies (Akinyemi, Owoaje, & Cadmus, ; Chase & Sapkota, ; Cohen & Asgary, ; Elsass & Phuntsok, ; Hussain & Bhushan, ; Khawaja et al, ; Labys, Dreyer, & Burns, ; Lavie‐Ajayi & Slonim‐Nevo, ; Pavlish, ; Tippens, ) and two were mixed methods studies. From the mixed methods studies only the qualitative data were extracted for this review due to the quantitative components focusing solely on barriers (Chemali, Borba, Johnson, Khair, & Fricchione, ; Muhwezi & Sam, ).…”

“…Studies were conducted in various ( n = 11) host countries including three studies in Nepal (Chase & Sapkota, ; Chase et al, ; Emmelkamp et al, ) (Chase & Sapkota, ; Chase et al, ; Emmelkamp et al, ), two in Lebanon (Chemali et al, ; Segal et al, ), two in India (Elsass & Phuntsok, ; Hussain & Bhushan, ), and two in Israel (Lavie‐Ajayi & Slonim‐Nevo, ; Nakash et al, ). Studies were also conducted in Nigeria (Akinyemi et al, ), Thailand (Cohen & Asgary, ), Australia (retrospectively focused on coping during transit period in other host countries) (Khawaja et al, ), South Africa (Labys et al, ), Uganda (Muhwezi & Sam, ), Rwanda (Pavlish, ), and Kenya (Tippens, ).…”

“…The qualitative studies used a variety of participant sampling methods. Four studies used purposive sampling (Akinyemi et al, ; Lavie‐Ajayi & Slonim‐Nevo, ; Muhwezi & Sam, ; Pavlish, ); one study used random sampling of refugees attending a clinic (Labys et al, ); three used convenience sampling (Chemali et al, ; Cohen & Asgary, ; Elsass & Phuntsok, ); three used snowball sampling (Hussain & Bhushan, ; Khawaja et al, ; Tippens, ); and one study used a combination of both random and purposive sampling (Chase & Sapkota, ).…”

“…One study did not report on age but it is clear from the outcomes that participants were adults (Elsass & Phuntsok, ), whereas one study reported a median age only (Chase & Sapkota, ). Four studies reported an average age, ranging from 31 to 65.88 years (Chemali et al, ; Emmelkamp et al, ; Labys et al, ; Muhwezi & Sam, ). Chemali et al () specifically recruited elders aged 65 years and older.…”

“…Participants came from various cultural backgrounds or countries of origin ( n = 15). Countries of origin included Bhutan (Chase & Sapkota, ; Chase et al, ; Emmelkamp et al, ); Eritrea (Nakash et al, ); Palestine (Segal et al, ), Syria (Chemali et al, ; Segal et al, ); Liberia (Akinyemi et al, ), Sierra Leone (Akinyemi et al, ); Myanmar/Burma (Cohen & Asgary, ); Tibet (Elsass & Phuntsok, ; Hussain & Bhushan, ); Sudan (Khawaja et al, ; Lavie‐Ajayi & Slonim‐Nevo, ; Muhwezi & Sam, ; Nakash et al, ); Zimbabwe (Labys et al, ), Somalia, Rwanda, Ethiopia, and Kenya (Muhwezi & Sam, ); and the Democratic Republic of Congo (Labys et al, ; Muhwezi & Sam, ; Pavlish, ; Tippens, ).…”