Skip to main content
Top
Published in: Conflict and Health 1/2011

Open Access 01-12-2011 | Research

Resilience of refugees displaced in the developing world: a qualitative analysis of strengths and struggles of urban refugees in Nepal

Authors: Fiona C Thomas, Bayard Roberts, Nagendra P Luitel, Nawaraj Upadhaya, Wietse A Tol

Published in: Conflict and Health | Issue 1/2011

Login to get access

Abstract

Background

Mental health and psychosocial wellbeing are key concerns in displaced populations. Despite urban refugees constituting more than half of the world's refugees, minimal attention has been paid to their psychosocial wellbeing. The purpose of this study was to assess coping behaviour and aspects of resilience amongst refugees in Kathmandu, Nepal.

Methods

This study examined the experiences of 16 Pakistani and 8 Somali urban refugees in Kathmandu, Nepal through in-depth individual interviews, focus groups, and Photovoice methodology. Such qualitative approaches enabled us to broadly discuss themes such as personal experiences of being a refugee in Kathmandu, perceived causes of psychosocial distress, and strategies and resources for coping. Thematic network analysis was used in this study to systematically interpret and code the data.

Results

Our findings highlight that urban refugees' active coping efforts, notwithstanding significant adversity and resulting distress, are most frequently through primary relationships. Informed by Axel Honneth's theory on the struggle for recognition, findings suggest that coping is a function beyond the individual and involves the ability to negotiate recognition. This negotiation involves not only primary relationships, but also the legal order and other social networks such as family and friends. Honneth's work was used because of its emphasis on the importance of legal recognition and larger structural factors in facilitating daily coping.

Conclusions

Understanding how urban refugees cope by negotiating access to various forms of recognition in the absence of legal-recognition will enable organisations working with them to leverage such strengths and develop relevant programmes. In particular, building on these existing resources will lead to culturally compelling and sustainable care for these populations.
Appendix
Available only for authorised users
Literature
2.
go back to reference Spiegel PB: Health-care needs of people affected by conflict: future trends and changing frameworks. Lancet. 2010, 375 (9711): 341-345. 10.1016/S0140-6736(09)61873-0.CrossRefPubMed Spiegel PB: Health-care needs of people affected by conflict: future trends and changing frameworks. Lancet. 2010, 375 (9711): 341-345. 10.1016/S0140-6736(09)61873-0.CrossRefPubMed
3.
go back to reference Campbell EH: Urban refugees in Nairobi: Problems of protection, mechanisms of survival, and possibilities for integration. Journal of Refugee Studies. 2006, 19 (3): 396-413. 10.1093/jrs/fel011.CrossRef Campbell EH: Urban refugees in Nairobi: Problems of protection, mechanisms of survival, and possibilities for integration. Journal of Refugee Studies. 2006, 19 (3): 396-413. 10.1093/jrs/fel011.CrossRef
4.
go back to reference Coker EM: Travelling pains: embodied metaphors of suffering among Southern Sudanese refugees in Cairo. Cult Med Psychiatry. 2004, 28 (1): 15-39.CrossRefPubMed Coker EM: Travelling pains: embodied metaphors of suffering among Southern Sudanese refugees in Cairo. Cult Med Psychiatry. 2004, 28 (1): 15-39.CrossRefPubMed
5.
go back to reference Matheson K, Jorden S, Anisman H: Relations between trauma experiences and psychological, physical and neuroendocrine functioning among Somali refugees: Mediating role of coping with acculturation stressors. Journal of Immigrant and Minority Health. 2008, 10 (4): 291-304. 10.1007/s10903-007-9086-2.CrossRefPubMed Matheson K, Jorden S, Anisman H: Relations between trauma experiences and psychological, physical and neuroendocrine functioning among Somali refugees: Mediating role of coping with acculturation stressors. Journal of Immigrant and Minority Health. 2008, 10 (4): 291-304. 10.1007/s10903-007-9086-2.CrossRefPubMed
6.
go back to reference Ndege , Kagwanja , Odiyo : Refugees in law and fact: A review of the literature and research agenda in Kenya. Occasional Paper Series. 2002, 1 (1). Ndege , Kagwanja , Odiyo : Refugees in law and fact: A review of the literature and research agenda in Kenya. Occasional Paper Series. 2002, 1 (1).
7.
go back to reference Shrestha NM, Sharma B, Van Ommeren M, Regmi S, Makaju R, Komproe I: Impact of torture on refugees displaced within the developing world: Symptomatology among Bhutanese refugees in Nepal. Jama. 1998, 280 (5): 443-448. 10.1001/jama.280.5.443.CrossRefPubMed Shrestha NM, Sharma B, Van Ommeren M, Regmi S, Makaju R, Komproe I: Impact of torture on refugees displaced within the developing world: Symptomatology among Bhutanese refugees in Nepal. Jama. 1998, 280 (5): 443-448. 10.1001/jama.280.5.443.CrossRefPubMed
8.
go back to reference Van Ommeren M, de Jong JTVM, Sharma B, Komproe I, Thapa SB, Cardena E: Psychiatric disorders among tortured Bhutanese refugees in Nepal. Archives of General Psychiatry. 2001, 58 (5): 475-482. 10.1001/archpsyc.58.5.475.CrossRefPubMed Van Ommeren M, de Jong JTVM, Sharma B, Komproe I, Thapa SB, Cardena E: Psychiatric disorders among tortured Bhutanese refugees in Nepal. Archives of General Psychiatry. 2001, 58 (5): 475-482. 10.1001/archpsyc.58.5.475.CrossRefPubMed
9.
go back to reference Neuner F, Schauer M, Klaschik C, Karunakara U, Elbert T: A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Journal of Consulting and Clinical Psychology. 2004, 72 (4): 579-587.CrossRefPubMed Neuner F, Schauer M, Klaschik C, Karunakara U, Elbert T: A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Journal of Consulting and Clinical Psychology. 2004, 72 (4): 579-587.CrossRefPubMed
10.
go back to reference Emmelkamp J, Komproe IH, Van Ommeren M, Schagen S: The relation between coping, social support and psychological and somatic symptoms among torture survivors in Nepal. Psychological Medicine. 2002, 32 (8): 1465-1470.CrossRefPubMed Emmelkamp J, Komproe IH, Van Ommeren M, Schagen S: The relation between coping, social support and psychological and somatic symptoms among torture survivors in Nepal. Psychological Medicine. 2002, 32 (8): 1465-1470.CrossRefPubMed
11.
go back to reference Inter-Agency Standing Committee: IASC guidelines on mental health and psychosocial support in emergency settings. 2007, Geneva: Inter-Agency Standing Committee Inter-Agency Standing Committee: IASC guidelines on mental health and psychosocial support in emergency settings. 2007, Geneva: Inter-Agency Standing Committee
12.
go back to reference Schweitzer R, Greenslade J, Kagee A: Coping and resilience in refugees from the Sudan: A narrative account. Australian and New Zealand Journal of Psychiatry. 2007, 41 (3): 282-288. 10.1080/00048670601172780.CrossRefPubMed Schweitzer R, Greenslade J, Kagee A: Coping and resilience in refugees from the Sudan: A narrative account. Australian and New Zealand Journal of Psychiatry. 2007, 41 (3): 282-288. 10.1080/00048670601172780.CrossRefPubMed
13.
go back to reference Muhwezi WW, Sam DL: Adaptation of urban refugees in Uganda: A study of their socio-cultural and psychological well being in Kampala city. Journal of Psychology in Africa. 2004, 14 (1): 37-46.CrossRef Muhwezi WW, Sam DL: Adaptation of urban refugees in Uganda: A study of their socio-cultural and psychological well being in Kampala city. Journal of Psychology in Africa. 2004, 14 (1): 37-46.CrossRef
14.
go back to reference Willems R: Coping with displacement: Social networking among urban refugees in an east African context. Displacement risks in Africa: Refugees, resettlers and their host populations. Edited by: Ohta I, Gebre YD. 2005, Australia: Trans Pacific Press, 53-77. Willems R: Coping with displacement: Social networking among urban refugees in an east African context. Displacement risks in Africa: Refugees, resettlers and their host populations. Edited by: Ohta I, Gebre YD. 2005, Australia: Trans Pacific Press, 53-77.
15.
go back to reference Muecke MA: New paradigms for refugee health problems. Social Science & Medicine. 1992, 35 (4): 515-523. 10.1016/0277-9536(92)90344-P.CrossRef Muecke MA: New paradigms for refugee health problems. Social Science & Medicine. 1992, 35 (4): 515-523. 10.1016/0277-9536(92)90344-P.CrossRef
16.
go back to reference Dryden-Peterson S: 'I find myself as someone who is in the forest': Urban refugees as agents of social change in kampala, uganda. Journal of Refugee Studies. 2006, 19 (3): 381-395. 10.1093/jrs/fel010.CrossRef Dryden-Peterson S: 'I find myself as someone who is in the forest': Urban refugees as agents of social change in kampala, uganda. Journal of Refugee Studies. 2006, 19 (3): 381-395. 10.1093/jrs/fel010.CrossRef
17.
go back to reference Jacobsen K: Just enough for the city: Urban refugees make their own way. World Refugee Survey. 2004, 57-65. Jacobsen K: Just enough for the city: Urban refugees make their own way. World Refugee Survey. 2004, 57-65.
18.
go back to reference Grabska K: Marginalization in urban spaces of the global south: Urban refugees in Cairo. Journal of Refugee Studies. 2006, 19 (3): 287-307. 10.1093/jrs/fel014.CrossRef Grabska K: Marginalization in urban spaces of the global south: Urban refugees in Cairo. Journal of Refugee Studies. 2006, 19 (3): 287-307. 10.1093/jrs/fel014.CrossRef
19.
go back to reference Keller A, Lhewa D, Rosenfeld B, Sachs E, Aladjem A, Cohen I: Traumatic experiences and psychological distress in an urban refugee population seeking treatment services. The Journal of Nervous and Mental Disease. 2006, 194 (3): 188-194. 10.1097/01.nmd.0000202494.75723.83.CrossRefPubMed Keller A, Lhewa D, Rosenfeld B, Sachs E, Aladjem A, Cohen I: Traumatic experiences and psychological distress in an urban refugee population seeking treatment services. The Journal of Nervous and Mental Disease. 2006, 194 (3): 188-194. 10.1097/01.nmd.0000202494.75723.83.CrossRefPubMed
20.
go back to reference Almedom AM, Tumwine JK: Resilience to disasters: a paradigm shift from vulnerability to strength. African Health Sciences. 2008, 8 (S): 1-4. Almedom AM, Tumwine JK: Resilience to disasters: a paradigm shift from vulnerability to strength. African Health Sciences. 2008, 8 (S): 1-4.
21.
go back to reference Skovdal M, Ogutu VO, Aoro C, Campbell C: Young carers as social actors: Coping strategies of children caring for ailing or ageing guardians in western Kenya. Social Science & Medicine. 2009, 69 (4): 587-595. 10.1016/j.socscimed.2009.06.016.CrossRef Skovdal M, Ogutu VO, Aoro C, Campbell C: Young carers as social actors: Coping strategies of children caring for ailing or ageing guardians in western Kenya. Social Science & Medicine. 2009, 69 (4): 587-595. 10.1016/j.socscimed.2009.06.016.CrossRef
23.
go back to reference Miller KE, Rasco LM: The Mental Health of Refugees: ecological approaches to healing and adaptation. 2004, New Jersey: Lawrence Erlbaum Associates Inc. Publishers Miller KE, Rasco LM: The Mental Health of Refugees: ecological approaches to healing and adaptation. 2004, New Jersey: Lawrence Erlbaum Associates Inc. Publishers
24.
go back to reference Tol WA, Kohrt BA, Jordans MJD, Thapa SB, Pettigrew J, Upadhaya N: Political violence and mental health: A multi-disciplinary review of the literature on Nepal. Social Science & Medicine. 2010, 70 (1): 35-44. 10.1016/j.socscimed.2009.09.037.CrossRef Tol WA, Kohrt BA, Jordans MJD, Thapa SB, Pettigrew J, Upadhaya N: Political violence and mental health: A multi-disciplinary review of the literature on Nepal. Social Science & Medicine. 2010, 70 (1): 35-44. 10.1016/j.socscimed.2009.09.037.CrossRef
26.
go back to reference Khan N: Trespasses of the State: Ministering the Copyright to Theological Dilemmas. Bare Acts, Sarai Reader. 2005, 5: 178-188. Khan N: Trespasses of the State: Ministering the Copyright to Theological Dilemmas. Bare Acts, Sarai Reader. 2005, 5: 178-188.
27.
go back to reference Honneth A: The Struggle for Recognition: The Moral Grammar of Social Conflicts. 1995, Boston: MIT Press Honneth A: The Struggle for Recognition: The Moral Grammar of Social Conflicts. 1995, Boston: MIT Press
28.
go back to reference Blunden A: Chapter five: subjectivity, redistribution and recognition. Recognition in Politics: Theory, Policy and Practice. Edited by: Connolly I, Leach M, Walsh L. 2007, Cambridge Scholars Publishing Blunden A: Chapter five: subjectivity, redistribution and recognition. Recognition in Politics: Theory, Policy and Practice. Edited by: Connolly I, Leach M, Walsh L. 2007, Cambridge Scholars Publishing
30.
go back to reference Wang C, Yi W, Tao Z, Carovano K: Photovoice as a participatory health promotion strategy. Health Promotion International. 1998, 13 (1): 75-10.1093/heapro/13.1.75.30.CrossRef Wang C, Yi W, Tao Z, Carovano K: Photovoice as a participatory health promotion strategy. Health Promotion International. 1998, 13 (1): 75-10.1093/heapro/13.1.75.30.CrossRef
31.
go back to reference Skovdal M, Andreouli E: Using identity and recognition as a framework to understand and promote the resilience of caregiving children in western Kenya. Journal of Social Policy. 2010, 40 (4): 31. Skovdal M, Andreouli E: Using identity and recognition as a framework to understand and promote the resilience of caregiving children in western Kenya. Journal of Social Policy. 2010, 40 (4): 31.
32.
go back to reference Creswell JW: Qualitative inquiry & research design: Choosing among five approaches. 2007, Thousand Oaks, California: Sage Publications Creswell JW: Qualitative inquiry & research design: Choosing among five approaches. 2007, Thousand Oaks, California: Sage Publications
33.
go back to reference Attride-Stirling J: Thematic networks: An analytic tool for qualitative research. Qualitative Research. 2001, 1 (3): 385-405. 10.1177/146879410100100307.CrossRef Attride-Stirling J: Thematic networks: An analytic tool for qualitative research. Qualitative Research. 2001, 1 (3): 385-405. 10.1177/146879410100100307.CrossRef
34.
go back to reference Amisi B, Ballard R: In the absence of citizenship: Congolese refugee struggle and organisation in South Africa. A Case Study for the UKZN Project Entitled: Globalisation, Marginalisation and New Social Movements in Post-Apartheid South Africa, University of Kwazulu-Natal. 2005 Amisi B, Ballard R: In the absence of citizenship: Congolese refugee struggle and organisation in South Africa. A Case Study for the UKZN Project Entitled: Globalisation, Marginalisation and New Social Movements in Post-Apartheid South Africa, University of Kwazulu-Natal. 2005
35.
go back to reference Brune M, Haasen C, Krausz M, Yagdiran O, Bustos E, Eisenman D: Belief systems as coping factors for traumatized refugees: A pilot study. European Psychiatry. 2002, 17 (8): 451-458. 10.1016/S0924-9338(02)00708-3.CrossRefPubMed Brune M, Haasen C, Krausz M, Yagdiran O, Bustos E, Eisenman D: Belief systems as coping factors for traumatized refugees: A pilot study. European Psychiatry. 2002, 17 (8): 451-458. 10.1016/S0924-9338(02)00708-3.CrossRefPubMed
36.
go back to reference Tol WA, Reis R, Susanty D, De Jong JTVM: Communal violence and child psychosocial wellbeing: qualitative findings from Poso, Indonesia. Transcultural Psychiatry. 2010, 47 (1): 112-35. 10.1177/1363461510364573.CrossRefPubMed Tol WA, Reis R, Susanty D, De Jong JTVM: Communal violence and child psychosocial wellbeing: qualitative findings from Poso, Indonesia. Transcultural Psychiatry. 2010, 47 (1): 112-35. 10.1177/1363461510364573.CrossRefPubMed
37.
go back to reference Ager A, Strang A: Understanding integration: a conceptual framework. Journal of Refugee Studies. 2008, 21 (2): 166-191. 10.1093/jrs/fen016.CrossRef Ager A, Strang A: Understanding integration: a conceptual framework. Journal of Refugee Studies. 2008, 21 (2): 166-191. 10.1093/jrs/fen016.CrossRef
38.
go back to reference Ager A, Strang A: Refugee integration: emerging trends and remaining agendas. Journal of Refugee Studies. 2010, 23 (4): 589-607. 10.1093/jrs/feq046.CrossRef Ager A, Strang A: Refugee integration: emerging trends and remaining agendas. Journal of Refugee Studies. 2010, 23 (4): 589-607. 10.1093/jrs/feq046.CrossRef
39.
go back to reference Jacobsen K: Can refugees benefit the state? Refugee resources and African statebuilding. The Journal of Modern African Studies. 2002, 40 (04): 577-596.CrossRef Jacobsen K: Can refugees benefit the state? Refugee resources and African statebuilding. The Journal of Modern African Studies. 2002, 40 (04): 577-596.CrossRef
40.
go back to reference Miller KE, Rasmussen A: War Exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Social Science & Medicine. 2010, 70 (10): 7-16.CrossRef Miller KE, Rasmussen A: War Exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Social Science & Medicine. 2010, 70 (10): 7-16.CrossRef
Metadata
Title
Resilience of refugees displaced in the developing world: a qualitative analysis of strengths and struggles of urban refugees in Nepal
Authors
Fiona C Thomas
Bayard Roberts
Nagendra P Luitel
Nawaraj Upadhaya
Wietse A Tol
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Conflict and Health / Issue 1/2011
Electronic ISSN: 1752-1505
DOI
https://doi.org/10.1186/1752-1505-5-20

Other articles of this Issue 1/2011

Conflict and Health 1/2011 Go to the issue