Unsettled

BackgroundDue to ongoing political and social conflicts, the number of international refugees has been increasing. Refugees are exposed to severe mental and physical strain, as well as traumatic experiences during their flight. Therefore, the risk of psychiatric disorders is markedly increased among international refugees. International organizations have criticized the lack of early interventions as a key problem, because untreated mental disorders are often difficult to cure at a later stage. Today, exercise and sport have been successfully employed to treat a wide range of psychiatric disorders. With patients with post-traumatic stress disorders (PTSD), very limited empirical evidence exists, and studies carried out with international refugees are nearly non-existent.MethodsWe intend to implement a pragmatic randomized controlled trial (RCT) with an exercise and sport intervention group (n = 68, 50% women) and a wait-list control group (n = 68, 50% women) in the Koutsochero refugee camp, located close to the city of Larissa (Greece). During the RCT, exercise and sport will be offered five times per week (60 min/session) for 10 weeks. Participants will be asked to participate in at least two sessions per week. The programme is developed according to the participants’ needs and preferences and they will be able to choose between a range of activities. PTSD symptoms will serve as primary outcome, and several secondary outcomes will be assessed. Qualitative data collection methods will be used to gain a more in-depth appraisal of the participants’ perception of the intervention programme. In the second year of study, the programme will be opened to all camp residents. A strategy will be developed how the programme can be continued after the end of the funding period, and how the programme can be scaled up beyond the borders of the Koutsochero camp.DiscussionBy moving towards the primary prevention of chronic physical conditions and psychiatric disorders, a relevant contribution can be done to enhance the quality and quantity of life of refugee camp residents in Greece. Our findings may also strengthen the evidence for exercise as medicine as a holistic care option in refugee camps, by helping camp residents to adopt and maintain a physically active lifestyle.Trial registrationThe study was registered prospectively on the 8 February 2021 with ISRCTN https://www.isrctn.com/ISRCTN16291983

"We use it a lot for everything": Antibioticalization and everyday life in a refugee camp in Lebanon.

The past half-century of urban studies has demonstrated that the design of human settlements is a potent tool of governance. Active involvement in place shaping has also been shown to be a key empowerment mechanism for citizens and a strong means of creating cohesion in communities. Internally displaced persons (IDPs) and refugee camps are a unique form of human habitation, temporary spaces created “between war and city.” Drawing from urban planning theory, camp management tools, and migrant narratives, this paper will explore the dynamics of the spatial relationship between camp residents and the international governance bodies who manage them. As we will demonstrate, this approach offers important insights into how the relationships between camp residents and aid agencies are negotiated, and the implications for governance in societies camp inhabitants later (re)settle in.

The camp and the question of community

Can class help understand refugee camp dynamics? We mobilise the concepts of exploitation, life chances, and cultural and social capital to analyse socio-economic stratification and inequality in Nyarugusu refugee camp in Tanzania. The research draws from a longitudinal survey with Congolese and Burundian refugee households and over 200 qualitative interviews carried out in 2017–2020. We show that camp residents, especially repeat Burundian refugees, are mostly from the poorest classes of their home countries. Inside the camp, however, we find socio-economic inequalities, partially driven by incentive aid workers and refugee ration traders who accumulate higher social and cultural capital and maintain their positions through exploitative terms of trade. The members of the camp ‘upper class’ have better life chances which affects their wealth, spatial mobilities, and migration possibilities. It emerges that the restrictive and often punishing encampment policy of Tanzania over time, which includes ration cuts and market shutdowns, erratically ‘flattens’ class. Zooming out to include social classes in the wider Kigoma region, we argue that the shared and distinctive experience of ‘refugeedom’ and access to humanitarian capital make the whole refugee camp a class of its own.

The paper considers the unique conditions that describe the National Museum of the Saharawi People, its relationship with visitors and its representation of the rights of residents of the refugee camp where it is located. In 1998, a National Museum of the Saharawi People was created in one of the several Saharawi refugee camps established in Eastern Algeria in the mid‐1970s. The museum was designed to provide knowledge about the cultures of the Western Sahara and to disseminate information about the challenges faced in the Saharawi territory. In 2006, a new curatorial investment was made and new exhibits mounted following a devastating flood that destroyed a substantial portion of the museum. In 2013 the Museum was remodelled. This case study undertaken after the 2013 reinstallation explored comments in the visitor books to understand how the museum contributed to cultural heritage, participated in the process of social cohesion, and supported the political struggle of a people demanding their right to self‐determination after decades of exclusion as residents in a refugee camp.

BackgroundFrom 2015 to 2016 Germany faced an influx of 1.16 million asylum seekers. In the state of Hamburg Primary Care walk-in clinics (PCWC) were commissioned at refugee camps because the high number of residents (57,000 individuals) could not be provided with access to regular healthcare services. Our study aims were (1) to describe the utilization of a PCWC by camp residents, (2) to compare episodes of continuous care with shorter care episodes and (3) to analyse which diagnoses predict episodes of continuous care in this setting.MethodsA retrospective longitudinal observational study was conducted by reviewing all anonymized electronic medical records of a PCWC that operated from 4th November 2015 to 22nd July 2016 at a refugee camp in Hamburg. Episodes of care (EOC) were extracted based on the international classification of primary care-2nd edition (ICPC-2). Outcome parameters were episode duration, principal diagnoses, and medical procedures.ResultsWe analysed 5547 consultations of 1467 patients and extracted 4006 EOC. Mean patient age was 22.7 ± 14.8 years, 37.3% were female. Most common diagnoses were infections (44.7%), non-communicable diseases (22.2%), non-definitive diagnoses describing symptoms (22.0%), and injuries (5.7%). Most patients (52.4%) had only single encounters, whereas 19.8% had at least one EOC with a duration of ≥ 28 days (defined as continuous care). Several procedures were more prevalent in EOC with continuous care: Blood tests (5.2 times higher), administrative procedures (4.3), imaging (3.1) and referrals to secondary care providers (3.0). Twenty prevalent ICPC-2-diagnosis groups were associated with continuous care. The strongest associations were endocrine/metabolic system and nutritional disorders (hazard ratio 5.538, p < 0.001), dermatitis/atopic eczema (4.279, p < 0.001) and psychological disorders (4.056, p < 0.001).ConclusionA wide spectrum of acute and chronic health conditions could be treated at a GP-led PCWC with few referrals or use of medical resources. But we also observed episodes of continuous care with more use of medical resources and referrals. Therefore, we conclude that principles of primary care like continuity of care, coordination of care and management of symptomatic complaints could complement future healthcare concepts for refugee camps.

Humanitarian actors struggle to protect refugees from the violence of war, but critics argue that they often succeed in nothing more than segregating the displaced and turning their hardships into global public spectacles. This article narrows and refines these criticisms of contemporary humanitarian action by examining humanitarian spectacles at a local level in an ethnography of the Buduburam Refugee Camp, a predominantly Liberian refugee camp in Ghana, West Africa. It is clear from this vantage point that disenfranchisement and bureaucratic intransigence deeply constrained camp life. But the public spectacles we examine also highlight the unexpected persistence of civic life and the depth of social connections between camp residents themselves; between refugees and humanitarians; and between refugees and their hosts. By making the homogeneous, distant concept of humanitarian spectacle into a heterogeneous concept with local dimensions, we are able to capture more of the experiences of people who live in unsettled contexts. This argument contributes to research on refugees and humanitarianism by drawing attention to the interconnected social world of the refugee camp. It also contributes to research on public spectacles by casting these spectacles as neither a pure expression of distance nor empowerment, but rather an easily sullied form of civic life.

Reviewed by: Unsettled: Refugee camps and the making of multicultural Britain by Jordana Bailkin Lucy Mayblin Unsettled: Refugee camps and the making of multicultural Britain By Jordana Bailkin. Oxford: Oxford University Press, 2018. Contemporary studies of migration have increasingly been criticised for their lack of attention to history. Equally, in the British public sphere, there has tended to be a highly selective orientation to history, with only those which paint the country in a favourable light being popularly remembered. Unsettled contributes both to the scholarly agenda of re-historicising our understandings of migration histories, in this case the vast historical architecture of refugee encampment across the British Isles, and has the potential to also shift popular imaginaries of encampments past and present. As Bailkin explains: "This book is about camps in Britain, but also about their erasure from public memory. This amnesia is selective" (12). In this way, through putting refugees at the centre of the national narrative, this fabulous work of painstakingly detailed archival research is also deeply, though quietly, political. Empirically, Bailkin has drawn on a range of sources including documents from the (British) National Archives, the archives of camps in East Sussex, West Sussex, Hampshire and Surrey, a range of oral histories (including from the British Library's Sound Archive, the North West Sound Archive in Lancashire, and the BBC Asian Network's Millennium Memory Bank Interviews), as well as her own interviews with people who lived or worked in refugee camps. Memoirs, photographs and poems are also woven through the book to add "fuller expression to refugees themselves" (13). While Bailkin does discuss the early life of British camps, starting from concentration camps in South Africa, and the troubled categories of the encamped, such as the blurred line between British citizen, subject and refugee, the focus of the book is on camps in the British Isles. This is sensible considering the vast scale of encampment within Britain; Bailkin identifies 96 camps across England, Wales, Scotland and the Isle of Man. This impressive body of data would be hard for anyone to discipline into a singular narrative for the purposes of a book, and one of the joys of this text is that it sits with the inevitable complexity and only loosely disciplines it for the purposes of discussion. What are presented, then are a complex set of stories which often unsettle what we thought we knew about refugee camps in the past. Structuring chapters thematically into "Making Camp" (everything you ever needed to know about Nissen huts in one place), "Feeding and Hungering" (on the vital role—symbolic, cultural, religious, nutritional—of food and eating in camps), "In Need" (on refugee care and the kinds of subjects produced by it), "Happy Families?" (on the definition of a family and how encamped families related to contemporaneous ideas about families), "Mixing Up" (on how the encamped interacted with and were responded to by local communities) and "Hard Core" (on those refugees that were deemed difficult to settle after encampment) offers just enough of a scaffold around which to organise this vast body of historical data. The title Unsettled, then, is multi layered in that it refers to more than the unsettling of peoples across borders. Many aspects of the book unsettle easy narratives which seek to simplify experiences of encampment. For example, the camps that Bailkin discusses housed both British nationals and refugees, often mixed together. Many "refugees" were, furthermore, British subjects—citizens of the British Empire. The idea that camps represent the division of citizens and non-citizens therefore does not stand up to historical inspection, even if it is the case today. Bailkin writes "at different moments, camps could signal either the unity of citizens and refugees or their segregation" (1), and rather than taking citizen/non-citizen as her key distinction, it is the settled/unsettled distinction that she focusses her analysis upon. While Bailkin is a historian, and therefore less concerned than a social scientist might be with theorising and generalising from the historical materials that she has found through her research, she explains that "'unsettled' became a way to make sense of—and bring together—the variety of people whose mobility was perceived...

For many refugees, going home is not possible because of continued instability and local integration is unavailable due to host country policies, so resettlement becomes the only possible “durable solution” to displacement. In Kenya, despite long-standing resettlement programmes, there remain over 588,000 refugees and asylum seekers living in the country. While most studies of resettlement focus on those who resettle, this paper sheds light on the perspectives of those who are still waiting in Kenyan camps for resettlement: those who have “not yet” and perhaps will “never” be resettled. Through focus groups and interviews with 75 refugees in the Dadaab refugee camps, Kakuma Refugee Camp, and Kalobeyei settlement, we find that camp residents experience waiting for resettlement individually and communally. Individually, camp residents assess options, place life plans on hold, and face the mental health consequences of prolonged uncertainty. Communally, camp residents interpret policy changes, share information, and exchange remittances.

Background: Rape is the most common form of violence in conflict and refugee situations but because of the associated stigma few cases are reported. This study assessed the outcome of an intervention targeted at women groups on the utilization of medical services by rape survivors in refugee camps in Zambia. Methods: A prospective quasi-experimental community-based intervention study was carried out in two refugee camps allocated into intervention and comparison areas. The intervention was participatory education sessions for women groups. Data was collected using the clinic records and the main outcome was the number of rape survivors who utilized and completed medical services provided at the camp clinics. Univariate, bivariate and multivariate analyses were carried out with level of significance set at 5%. Results: The proportion of the rape survivors who accessed medical care within 72 hours increased significantly from 41.2% to 84.8% in the intervention area but from 31.1% to 38.9% in the comparison area, (p=0.005). Those who completed their medical treatment and the follow-up visits increased significantly from 42.8% to 94.8% in intervention area but reduced from 38.5% to 21.4% in the comparison area, (p=0.002). Being resident in the intervention area predicted the utilization of medical services, [OR: 3.15; 95%CI: 1.955-5.681], p=0.002. Conclusion: Community-based intervention using participatory women’s group discussion had a significant impact on increasing the utilization of medical services by rape survivors and should be considered for scaling up as a key intervention for increasing utilization of medical services for rape survivors especially in refugee situations. Keywords: Rape survivors, Participatory group discussion, Medical services, Zambia

Reviewed by: Rightlessness in an Age of Rights: Hannah Arendt and the Contemporary Struggles of Migrants by Ayten Gündoğdu Rhoda E. Howard-Hassmann (bio) Ayten Gündoğdu, Rightlessness in an Age of Rights: Hannah Arendt and the Contemporary Struggles of Migrants (New York: Oxford University Press, 2015), ISBN 9780199370412, 298 pages. In The Origins of Totalitarianism, Hannah Arendt famously called for the "right to have rights." Reflecting on her own status as a stateless refugee from Germany, Arendt broadened her analysis to include the problem of statelessness as a whole. Ayten Gündoğdu engages with the entirety of Arendt's opus, especially with The Human Condition and On Revolution as well as with The Origins, to unpack the various meanings and implications of this call. Gündoğdu starts with what Arendt called the "perplexity" of the contradiction between state sovereignty and the universal enjoyment of human rights. Then and now, rights are protected—or not—by sovereign states that normally extend their protection only to their citizens, and perhaps non-citizens legally in their territory. The naked human being, unmoored from the state-people-territory framework, has no rights. Gündoğdu extends Arendt's argument to cover all migrants, not only stateless people, focusing on their powerlessness and dehumanization. She grounds her analysis empirically in the dehumanization experienced by residents of camps for refugees and displaced people. She also refers to the appalling detention camps now dotting the world's island geography, where potential refugee claimants live in endless limbo. Gündoğdu discusses the ways in which human beings actually manufacture, claim, and win human rights. She notes that Arendt criticized the "urge to approach social issues with a moralistic framework centered on compassion," positioning those who faced injustice as "victims…erasing their singularity and denying them equal standing."1 Gündoğdu analyzes the limits of compassion in the treatment of camp-dwellers, people without political agency who are mere objects to be administered. She is [End Page 755] correct that compassion is not the best basis for solidarity. Camp dwellers cannot rely on compassion if they are to be treated as equal human beings enjoying liberty. Compassion and charity leave the human being at the mercy of others, mostly those of higher status who cannot help but look down upon those who are their administrative objects. Nevertheless, the real problem here is not that residents of refugee camps must rely on the compassion of those who administer them. Such administrators are probably well aware of the problems of subjecting residents to charity, but they are limited in what they can do by financial constraints and the state system. The UNHCR, other agencies of the UN system such as UNICEF, and nongovernmental organizations (NGOs) such as Médecins sans Frontières are dependent upon voluntary financial contributions from states and compassionate private citizens. These voluntary contributions rarely, if ever, reach the amount needed merely to ensure that residents are not riddled by disease or suffering from malnutrition. Gündoğdu defends Arendt against charges of elitism made by other philosophers with whose work she engages. Arendt is criticized for denigrating manual and other kinds of labor, but Gündoğdu argues that she views both labor and work as crucial to human dignity. According to Gündoğdu, Arendt defined labor as dayto-day bodily maintenance and maintenance of one's home and surroundings. This labor grounds the individual in the material world and provides her with a sense of routine, permanence, and community with others. By work, Arendt apparently meant creativity, the ability to make or build something new and worthwhile. Both labor and work are denied to residents of camps. Dependent for their every need on the compassion of others, they endure lives of complete boredom without social roles or responsibilities. This is a degraded form of "life," without meaning or substance. Gündoğdu argues that Arendt did not rely on what philosophers call foundational principles of human rights. Rather, Arendt used an approach that Gündoğdu calls "founding." Rights, she argues along with Arendt, are founded in political action, including "inaugural speech acts that bring forth new...

Rosenfield, Maya. COMFORTING THE OCCUPATION. WORK, EDUCATION, AND POLITICAL ACTIVISM OF PALESTINIAN FAMILIES IN A REFUGEE CAMP. Stanford University Press, Stanford, CA 2004. Soft cover, ISBN 0-8047-4987-6.Confronting the Occupation is a thoughtful and interesting volume. The author, anthropologist Maya Rosenfeld, describes and analyses the lives and world of Palestinian families in the Dheisheh refugee camp located near Bethlehem. Based on field observations and the close relationships she developed with members of this community, her work covers the period from 1992 well into the present Sharon Government. Rosenfeld owns her own political perspectives, and while clearly sympathetic to the people of Dheisheh, she examines the development and meaning of political and social action without trying to sway her readers.The contested terrain described by Rosenfeld is rich in history of all kinds. Any point of entry is sure to raise criticisms that some important set (or interpretation) of antecedent events has been left out. The author does provide readers a good sense of context which is further expanded through reference notes and the availability of an extensive bibliography. She begins by sketching out the pre 1948 period to establish certain social, economic, and educational, features of Palestinian life.If Palestinian family and village life were modest in their economic manifestations, families often owned their own land, livestock, and homes, and were part of a social structure characterized by the usual economic and social distinctions between segments of the community. Freedom to travel to buy and sell agricultural products, engage in trade, and work away from one's own village, were rights taken for granted. Social structure was traditional and intergenerational, with families arranging marriages and strongly influencing the occupational direction of their children. Advanced formal education was reserved for a few young men and was not considered essential for those whose lives appeared reasonably secure in controlling the means of their livelihoods.Israel's successful war of independence (1948) and subsequent victories (1967,1973), have changed Palestinian life dramatically, as have Palestinian response - political organizing and a First and second Intifada. The claims of the State have manifest themselves in the displacement of Palestinians from their property, villages, economic livelihoods, offering instead a new twilight status as permanent residents of temporary refugee camps. …

Although refugee camps are established to accommodate, protect, and assist those fleeing from violent conflict and persecution, life often remains difficult there. Building on empirical research with refugees in a Ugandan camp, Ulrike Krause offers nuanced insights into violence, humanitarian protection, gender relations, and coping of refugees who mainly escaped the conflicts in the Democratic Republic of Congo. This book explores how risks of gender-based violence against women, in particular, but also against men, persist despite and partly due to their settlement in the camp and the system established there. It reflects on modes and shortcomings of humanitarian protection, changes in gender relations, as well as strategies that the women and men use to cope with insecurities, everyday struggles, and structural problems occurring across different levels and temporalities.

Between 1944 and 1958, the western zones of Germany had to absorb over nine million refugees who had fled or been expelled from their homes east of the Oder-Neise rivers or had left the Soviet zone. Owing to these large numbers and the catastrophic housing conditions, many had to spend varying periods of time in camps. This article looks at refugee camps for German refugees in three West German Lander to examine the extent to which community-building can be seen to have taken place between 1945 and 1960. The development of the refugee camp phenomenon is traced, from the initial policies to ensure a quick turn-around, to the transformation of many camps into Wohnlager, providing facilities for everyday living, social events and employment. Perceptions of outsiders are analysed and found to show that they were rarely able to recognize instances of community growth. This may be largely explained by political considerations and concern over the social effects of living in a refugee camp environment. Finally, the article turns to Camp Poxdorf/Hagenau in Mid-Franconia to demonstrate how a refugee settlement with a thriving social life was able to emerge from an unremarkable hut camp. The conclusion places the refugee camps in the wider context of the postwar history of the FRG, arguing that fears surrounding ‘asocials’ in camps reflected wider fears about society, but, like the rest of the population, refugee camp residents were working towards achieving a state of normality. Camp communities can be seen to have aided integration by providing an environment where the residents could get used to their situation and look to the future.