Challenges Associated with the Implementation of an Exercise and Sport Intervention Program in a Greek Refugee Camp: A Report of Professional Practice.

Florian Knappe,Markus Gerber,Flora Colledge

doi:10.3390/ijerph16244926

Florian Knappe, Markus Gerber + Show 1 more

Open Access

https://doi.org/10.3390/ijerph16244926

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Abstract

Objective Refugees have a particularly high prevalence of psychopathological disorders. Despite this, little attention has been paid to the treatment of traumatized refugees, and research on the effects of exercise and sport among refugees is still in its infancy. Thus far, no randomized controlled trials have been carried out in a refugee camp setting, most likely because such trials are complicated by multiple organizational and methodological issues. We highlight some major challenges when carrying out experimental research in a refugee camp. Method This report of professional practice is based on systematic observations, individual and focus group interviews, and experiences made in a pre-experimental study, implemented in a refugee camp on the Greek mainland. Results The report provides background information about how refugees generally come to Greece, how transit camps are typically managed, which institutions are involved in the camp management, which rules need to be followed by people working in a camp, which countries refugees generally come from, and the conditions in which they live in the camp. We also identify general factors that complicate experimental research in such a setting, and highlight specific issues pertaining to sport and exercise-based intervention trials. Conclusions Currently, more people are fleeing their home regions than after the end of the Second World War. This situation calls for a change in the understanding of humanitarian aid. Pure material and technical support must be complemented by public health measures, including exercise and sport programs. Researchers who want to enter this field of research can learn important lessons from our observations.

Highlights

In addition to the physical toll that becoming a refugee can take, being forced to flee one’s country frequently engenders great psychological distress
Our study showed that a sport and exercise intervention is feasible in a refugee camp setting, we acknowledge that randomized controlled trial (RCT) are required to advance the empirical evidence base in this field of research
We address the issue of whether specific rules need to be followed by people working in a refugee camp, before we briefly report on which countries refugees generally come from, and conditions in which they live in the camp

Summary

Introduction

In addition to the physical toll that becoming a refugee can take, being forced to flee one’s country frequently engenders great psychological distress. Many refugees are faced with difficult living conditions, economic hardship, discrimination, social exclusion, and exploitation. Prior to their escape, this population has often been exposed to severe mental and physical strain due to war, violence, political and religious persecution, poverty, imprisonment, or torture [1]. It is well established that refugees have a considerably higher prevalence of psychopathological disorders such as post-traumatic stress disorder (PTSD), depression, or anxiety disorders [2]. As defined in the ICD-10 (International Classification of Diseases, 10th edition), PTSD is the result of a long-lasting or pervasive strain due to a devastating natural disaster, combat, severe accident, witnessing a violent death, torture, terrorism, or rape. The mental disorder is a direct result of the trauma experienced. Trauma is a perceived discrepancy between the life-threatening situation and

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