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

Abstract

Background According 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 findings Between 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. Conclusions In 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 PLOS MEDICINE

Navigating new lives: A scoping review and thematic synthesis of forced migrant women's perinatal experiences

“…Across contexts, these everyday insecurities were frequently expressed by many women as powerlessness and loss of control, preventing them from participating in host country life ( Hufton and Raven, 2016 ; Korukcu et al., 2018 ; Gewalt et al., 2018 ; Lalla et al., 2020 ). For some, religious beliefs provided hope and comfort in adversity ( Riggs et al., 2017 ; Chulach et al., 2016 ; Niner et al., 2013 ).…”

“…In one study, the ongoing trauma experienced by a woman who was forced to give birth in the open after her refugee camp was destroyed was described ( Niner et al., 2013 ). Other participants spoke of trauma caused by witnessing or being victims of rape ( Tobin et al., 2014 ; Briscoe and Lavender, 2009 ; Lalla et al., 2020 ), or labouring during bombing and shootings ( Henry et al., 2020 ). “Even during that time people were raped things like that.…”

“…Entitlement to state-provided maternity care ( Lephard and Haith-Cooper, 2016 ) and methods of referral to maternity services ( McLeish, 2005 ; Nabb, 2006 ; Murray et al., 2010 ) could be a source of confusion. In a refugee camp, study participants identified financial barriers in the form of maternity care costs or bribery: “They [nurses and refugee nursing assistants] asked me, ‘Are you Ethiopian or Somali?’ then I had to give them ‘kitu kidogo’ [translated from Swahili as ‘a little something’].” ( Lalla et al., 2020 ). …”

“…“They [nurses and refugee nursing assistants] asked me, ‘Are you Ethiopian or Somali?’ then I had to give them ‘kitu kidogo’ [translated from Swahili as ‘a little something’].” ( Lalla et al., 2020 ).…”

Migrant and refugee health: Complex health associations among diverse contexts call for tailored and rights-based solutions

“…In conflict-affected settings, migration may coincide with weakened protections from family and social networks that leave people, particularly women and girls, vulnerable to exploitation. In a study by Amber Lalla and colleagues, Oromo and Somali refugee women in the Kakuma Refugee camp in Kenya were found to experience multiple sources of insecurity, including violence and neglect, in all spaces of the refugee camp [6]. Health services, including sexual and reproductive health services, are also often limited.…”