Burundian Refugees Research Articles

Erasing Our Humanity: Crisis, Social Emotional Learning, and Generational Fractures in the Nduta Refugee Camp

Ample scholarship thoroughly documents how modern humanitarian aid enacts legacies of colonialism and processes of Westernization through the imposition of foreign values and promotion of ‘universal’ norms. Extensive research has also explored processes of socio-cultural-moral transformation due to crisis and displacement. This paper extends this work by demonstrating an explicit connection between the two. Drawing on 10 months of ethnographic research that examined how Burundian refugees in Tanzania experience humanitarian social emotional learning (SEL), findings reveal various intersecting lines of crisis in the Nduta refugee camp. This research illuminates how SEL interacts with these lines of crisis to exacerbate intergenerational tensions. The self-centric values promoted through SEL and the pedagogies it employs conflict with the collectivist ethos of the Nduta community, thus breaking the Burundian generational contract of reciprocity, solidarity, and moral responsibility. In this context, SEL operates on conflicting narratives of crisis that clash with generational hopes for the prevention of future crisis in Burundi. These generational fractures are resulting in fears across the Nduta community that the decline of traditional Burundian values and communitarian ethos will not only perpetuate intergenerational experiences of crisis but has also initiated the perceived erasure of their culture and the essence of their humanity.

‘Ukijianika Utaanuliwa’: Urban Refugees’ Self-identity Formation and Interpersonal Communication during Dar es Salaam Acculturation

The research being reported here examined the self-identity formation and communication in the acculturation of urban-based refugees in Dar es Salaam, Tanzania. Because this refugees’ relationships with the host community are based on their principle of “Ukijianika Utaanuliwa” (If you show yourself, you will be exposed), urban refugees strive to hide their identities during the acculturation process. As they strive to survive in harsh living conditions outside the camps, individuals must work through their identities and develop positive interpersonal contact skills with the host to gain acceptance. Interviews with forty Congolese and Burundian refugees were conducted using targeted group discussions. The respondents acknowledge that establishing effective interpersonal communication mechanisms, individuals must negotiate their identities. The study found that urban refugees in Dar es Salaam grappled with issues of identity, including hiding their true identity, acculturation, social behaviour, and adaptability. Even media consumption helped inform the urban refugees, the present immigration policy does not assist their acculturation through personal communication, hence the need to revisit it and revise it accordingly.

THE MATCH/MISMATCH IN PERCEPTIONS OF SUCCESSFUL AGING AMONG OLDER BURUNDIAN REFUGEES IN THE US

Abstract Perceptions of successful aging may be impacted by unique lived experiences such as migration, adaptation, and traumatic life experiences. While there exist studies on successful aging among immigrant communities, research studies on successful aging among older refugees, who flee due to life threatening situations, are sparse. The present qualitative study aimed to shed light on the match or mismatch that may exist between older refugees’ perceptions of successful aging and their perceptions of their lived experiences, as well as sex variations in those perceptions. Twenty-one Burundian refugees, aged 50+, were recruited from an upper Midwest community to participate in in-depth interviews. The qualitative interviews were analyzed using thematic content analysis. Themes denoting a match in aging refugees’ perceptions of success aging and lived experience included: wisdom/ability to give advice (i.e., guidance especially to younger individuals), experiencing peace and security, and fostering family relationships. A mismatch was highlighted in themes related to work experiences (i.e., the challenge of engaging in jobs not related to their prior skills), lack of social connections, and communication difficulties. Gender differences were apparent in that women emphasized shifts in work-related gender roles while men emphasized shifts in dependency-related gender roles. In many ways, aging refugees’ unique backgrounds and experiences seemed influential for their match/mismatch in successful aging perceptions and experiences. These findings highlight the importance for host communities to better understanding how refugees perceive and experience successful aging to best inform the implementation of effective interventions for aging refugees.

No association between war-related trauma or PTSD symptom severity and epigenome-wide DNA methylation in Burundian refugees

ABSTRACT Background: War-related trauma is associated with varying posttraumatic stress disorder (PTSD) prevalence rates in refugees. In PTSD development, differential DNA methylation (DNAm) levels associated with trauma exposure might be involved in risk versus resilience processes. Studies investigating DNAm profiles related to trauma exposure and PTSD among refugees remain sparse. Objective: The present epigenome-wide association study investigated associations between war-related trauma, PTSD, and altered DNAm patterns in Burundian refugee families with 110 children and their 207 female and male caregivers. Method: War-related trauma load and PTSD symptom severity were assessed in structured clinical interviews with standardised instruments. Epigenome-wide DNAm levels were quantified from buccal epithelia using the Illumina EPIC beadchip. Results: Controlling for biological confounders, no significant epigenome-wide DNAm alterations associated with trauma exposure or PTSD were identified in children or caregivers (FDRs > .05). Co-methylated positions derived as modules from weighted gene correlation network analyses were not significantly associated with either war-related trauma experience in children or caregivers or with PTSD. Conclusions: These results do not provide evidence for altered DNAm patterns associated with exposure to war-related trauma or PTSD.

Prevalence of suicidality and associated factors of suicide risk in a representative community sample of families in three East African refugee camps

PurposeTo assess the prevalence of suicidality and associated factors of suicide risk in a sample of Burundian refugee families living in three refugee camps in Tanzania.MethodsChildren (n = 230) and their parents (n = 460) were randomly selected and interviewed about suicidality (suicidal ideation, plans, and attempts) and a range of sociodemographic, psychological, and environmental factors. Multinomial logistic regression analyses were conducted to examine factors associated with children and parents’ lower and moderate or high current suicide risk.ResultsPast-month prevalence of suicidal ideation, plans, and attempts were 11.3%, 0.9% and 0.9%, respectively, among children; 37.4%, 7.4% and 5.2%, respectively, among mothers; and 29.6%, 4.8% and 1.7%, respectively, among fathers. Older age in years (aORlower = 2.20, 95% CI 1.38–3.51; aORmoderate/high = 3.03, 95% CI 1.15–7.99) and higher levels of posttraumatic stress disorder symptoms (aORlower = 1.64, 95% CI 1.05–2.57; aORmoderate/high = 2.30, 95% CI: 1.02–5.16), internalizing (aORmoderate/high = 2.88, 95% CI 1.33–6.26) and externalizing problems (aORlower = 1.56, 95% CI: 1.06–2.31; aORmoderate/high = 3.03, 95% CI 1.42–6.49) were significantly positively associated with children’s current suicide risk. For mothers, higher perceived instrumental social support (aORmoderate/high = 0.05, 95% CI < 0.01–0.58) was significantly negatively related to suicide risk, whereas exposure to community violence (aORlower = 1.97, 95% CI 1.30–2.99; aORmoderate/high = 1.59, 95% CI 1.00–2.52), living in larger households (aORlower = 1.74, 95% CI 1.17–2.57), and higher psychological distress (aORmoderate/high = 1.67, 95% CI 1.05–2.67) were significantly positively associated with suicide risk. For fathers, higher perceived instrumental social support (aORmoderate/high = 0.04, 95% CI < 0.01–0.44) and having more years of formal education (aORmoderate/high = 0.58, 95% CI 0.34–0.98) were significantly negatively and exposure to war-related trauma (aORmoderate/high = 1.81, 95% CI 1.03–3.19) was significantly positively associated with suicide risk.ConclusionPrevention programs should target psychopathology, community violence and social support to mitigate children and parents’ current suicide risk.

Aging Out-of-Place: Perceptions of Successful Aging Among Aging Burundian Refugees in the United States.

Refugees flee their home countries due to life-threatening situations and are resettled in countries such as the United States. For older refugees, their cultural background and forced migration experience may affect how they perceive successful aging in their host countries. As such, it is important to understand how aging refugees perceive aging well to enhance their well-being in the host communities. Thus, the present study explores perceptions of successful aging among refugees in the United States. Twenty-one Burundian refugees, aged 50-67, were recruited from an upper Midwest community to participate in interviews on their perceptions of successful aging. The qualitative interviews were analyzed using thematic content analysis. Emergent themes showed that aging refugees' perceptions of successful aging were in some ways consistent with perceptions among other nonrefugee aging populations, such as perceptions related to physical functioning and health. Yet, in many ways, refugees' unique background and experiences seemed to lead to unique aging perceptions, such as perceiving an earlier onset of aging and expressing surprise and appreciation to experience old age. Study findings suggest important future directions and potential implications for refugee host regions and communities on how they can better support aging refugees as well as develop effective interventions to promote well-being.

Localisation frontalière des camps des réfugiés burundais à l’Est de la RDC : analyse critique

"Since the beginning in March 2015 of the political crisis that shook Burundi, with the focus on the re-election of President Pierre Nkurunziza to a third term deemed unconstitutional by the opposition, the UNHCR had estimated that 14,300 Burundians had entered Congolese territory as political refugees. They arrived in the region fleeing the killings and abuses allegedly committed by the ""Imbonerakure"" militia, presumed to belong to the party in power in Burundi. As a result, a refugee camp was established in Lusenda to accommodate Burundian refugees, and a second one in Mulongwe after the first one was saturated and exceeded the expected number of refugees, reaching over 40,000. These two Burundian refugee camps are located in villages with the same names, less than fifteen kilometers from Lake Tanganyika, the baseline of the DRC's eastern border with the Republic of Burundi. According to our analysis, these sites do not offer the best conditions for refugee camps for reasons that we will outline in the following lines. Our analysis in this article is to alert to the great danger that threatens the DRC because of its hospitality by repeating for the second time the mistake of placing refugee camps on its borders. Keywords: Democratic Republic of Congo (DRC), Burundi, United Nations High Commissioner for Refugees (UNHCR), National Commission for Refugees (CNR), Imbonerakure, refugees."

Reasons for referral and referral compliance among Congolese and Burundian refugees living in Tanzania: a community-based, cross-sectional survey

ObjectivesIn order to prevent overburdening of higher levels of care, national healthcare systems rely on processes of referral, including for refugee populations which number 26 million globally. The goal of...

Class in camps or the camped class? The making and reshaping of socio-economic inequalities in the refugee camps of north-western Tanzania

ABSTRACT 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.

Access to Health Services Among Forced Migrants in Tanzania: A Cluster Randomized Cross Sectional Study of 3560 Congolese and Burundian Refugees.

Despite significant advances in the understanding of the global burden of surgical disease, limited research focuses on access to health and surgical services among refugees, especially in east Africa. The goal of this study was to describe patterns of access to transportation to health services among Congolese and Burundian refugees in Tanzania. We utilized cluster random sampling to perform a large, cross-sectional study in Nyarugusu refugee camp, Tanzania using an adapted version of the Surgeon Overseas Assessment Tool (SOSAS). We randomly selected 132 clusters out of 1472 clusters, randomly selected two people from all households in those clusters. Data analysis was performed in STATA (Stata Version 16, College Station, TX). A total of 3560 participants were included in the study including 1863 Congolese refugees and 1697 Burundian refugees. The majority of refugees reported they were generally healthy (n = 2792, 79.3%). The most common period of waiting to be seen at the health center was between three and 5 h (n = 1502, 45.8%), and over half of all refugees waited between 3 and 12 h to be seen. There was heterogeneity in other intra-camp referral networks (e.g. to and from traditional healer and hospital). Finally, a low percentage (3%) of participants reported leaving the refugee camp to seek health care elsewhere, and Congolese refugees were more likely to pursue self-referral in this manner. To our knowledge, this is the largest study focused on access to transportation among refugees in Tanzania and sub-Saharan Africa. Most participants reported financial difficulty always affording transportation costs with significant wait times occurring once arrived at the hospital. Our study does suggest that some independent health care seeking did occur outside of the camp-based services. Future research may focus more specifically on barriers to timely servicing of patients and patterns of self-referral.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Zachary Obinna] Last Name [Enumah] and Author 2 Given name: [Mohamed Yunus] Last Name [Rafiq]. Also, kindly confirm the details in the metadata are correct.Confirmed.

'You don't compare horrors, you just don't do that': Examining assumptions and extending the scope of comparative victim beliefs.

Social psychological research on collective victimhood has often focused on comparisons between the ingroup's and outgroups' collective victimization (i.e. comparative victim beliefs such as competitive victimhood or inclusive victim beliefs). This qualitative study examines how people in different contexts of collective victimization and its aftermath make sense of items commonly used to assess comparative victim beliefs, and how they extend or challenge these constructs and their underlying assumptions. We used thematic analysis to analyse eight focus group discussions among four minority groups in the United States with historical or more recent experiences of collective victimization (Armenian Americans, Burundian refugees, Jewish Americans and Nepali-speaking Bhutanese refugees). Findings extend commonly assessed comparative victim beliefs and reveal participants' critical perspectives on these constructs. The findings also highlight the dialectical structure of collective victim beliefs: Participants not only endorsed but also rejected comparative victim beliefs, and relatedly described both ingroup power and outgroup power in the context of their group's victimization. These findings extend existing social psychological literature on comparative victim beliefs and intergroup relations.

Correction to: Making ‘The Process’: Sexual Vulnerability and Burundian Refugee Boys and Young Men’s Strategies for Onward Migration from Nakivale Refugee Settlement in Uganda

Correction to: Making ‘The Process’: Sexual Vulnerability and Burundian Refugee Boys and Young Men’s Strategies for Onward Migration from Nakivale Refugee Settlement in Uganda

Implementation of Refugees' Inclusion in National Viral Hepatitis B and Hepatitis C Screening Campaign in Mahama Refugee Camp, Rwanda.

The World Health Organization has called for the elimination of hepatitis B virus (HBV) and hepatitis C virus (HCV) as public health threats by 2030. In response to the United Nations High Commissioner for Refugees requests, Rwanda became the first country to include refugees in its national viral hepatitis prevention and management program in 2019. We used secondary data to describe the implementation of the first HBV and HCV screening program among refugees in Rwanda. Rapid diagnostic tests were used to screen for HBV surface antigen (HBsAg) and HCV antibody (anti-HCV). We used routine data collected during the HBV and HCV mass screening campaign among Burundian refugees living in Mahama camp and program records to estimate the screening coverage, the prevalence of HBV and HCV, and the cost of the campaign. Over 28 days in February and March 2020, 26,498 unique individuals were screened for HBV and HCV, reflecting a screening coverage of 77.9% (95% confidence interval [CI]=76.5%, 78.4%). Coverage was greater than 90% among women aged 30-64 years, but younger age groups and men were less likely to be screened. On average, 946 clients were screened per day. The prevalence of anti-HCV was 1.1% (95% CI=1.0%, 1.3%), and the prevalence of HBsAg was 3.8% (95% CI=3.6%, 4.0%). We estimate that the total cost of the campaign was US$177,336.60, reflecting a per-person-screened cost of US$6.69. Conducting a mass screening was a feasible and effective strategy to achieve high screening coverage and identify refugees who were eligible for HBV and HCV treatment. This screening program in the Mahama refugee camp can serve as a reference for other refugee camps in Rwanda and elsewhere.

Making ‘The Process’: Sexual Vulnerability and Burundian Refugee Boys and Young Men’s Strategies for Onward Migration from Nakivale Refugee Settlement in Uganda

Abstract Based on ethnographic research among Burundian refugee boys and young men in Nakivale refugee settlement in Uganda, we explore how boys and young men in the camp, guided by the longing for a better life, aspire for onward migration and develop strategies based on their knowledge of relevant legal frameworks. Given that onward migration under the UNHCR framework is possible for only the most ‘vulnerable’, we highlight the negotiation strategies adopted by some boys and young men to support their ‘process’, based on sexual vulnerability related to being in same-sex relationships. Notwithstanding the deprivation and bleak prospects, we thus propose to look at the refugee settlement also as a space opening chance for vital transformation. At the same time, we point out that the restricting frameworks seeking to foster protection of refugees, may, in an environment hostile to same-sex relations, unintentionally render refugee boys and young men more vulnerable to gendered exploitation.

The executive functioning of Burundian refugee youth: Associations with individual, family and community factors

Executive functioning (EF) may be important for refugee youth's long-term adjustment. The current study examined associations between factors on different ecological levels (individual, family, community) and inhibitory control (IC), working memory (WM), cognitive flexibility (CF), and selective attention (SA) among 226 Burundian youth aged between 7 and 15 in three refugee camps. Multiple regression models revealed positive associations between trauma exposure and CF and between posttraumatic stress symptoms and SA and WM. Having more siblings, fathers' socioeconomic status and a better father-child relationship were related to better EF including higher SA and WM. Higher levels of maltreatment by mothers were related to lower IC. Higher peer support was related to higher WM. Being orphaned, children's emotional and behavioral problems, mothers' education, community violence and the type of camp (established vs. new) were not significantly related to children's EF. The findings underscore the importance of proximal social factors for children's EF.

Ethically (un)bounding camp research: Life histories within and beyond camp boundaries

AbstractThe changing enforcement and porosity of camp boundaries have implications for research in camps and their environs. Camp research is increasingly blurring their locational and categorical boundaries. However, in contexts where camp boundaries are being actively “hardened,” researchers must be attentive to possible effects of research across boundaries for those who are targeted by encampment. Research has an ethical imperative to challenge exclusionary boundaries and categories, recognising the many ways these constructed boundaries are already crossed and contested. It must also conscientiously negotiate and even defer to boundaries in research when participants may otherwise be at risk because of the underlying violence that maintains camps as discrete spatial technologies of power. In conducting life‐history research with Burundian refugees in Tanzania, I chose to “bound” my research with Burundian refugees to within camp boundaries, to reduce the risk to research participants. I argue that although research in camps may risk reifying camp boundaries, it can nevertheless conscientiously reach beyond and challenge camp boundaries through attentive methods. The stories recounted in this research reach far beyond camp boundaries, and include experiences of Burundian border‐crossers seeking liveable lives in diverse places and situations, not always of their own choosing. Life histories thus weave an imperfect, inchoate “minor cartography” of often‐invisibilised, diverse sites of refugee lives, bound up with the changing power and policing of camp boundaries shaping refugees' trajectories in the broader “campscape” over time.

Humanitarian surgical service utilization by a host country population: comparing surgery patterns between refugees and Tanzanians using an interrupted time-series analysis

BackgroundWhile current estimates suggest that up to three million additional surgical procedures are needed to meet the needs of forcibly displaced populations, literature on surgical care for refugee or forced migrant populations has often focused on acute phase and war-related trauma or violence with insufficient attention to non-war related pathologies. To our knowledge, no study has compared refugee versus host population utilization of surgical services in a refugee camp-based hospital over such an extended period of twenty years. The aim of this paper is to first describe the patterns of surgical care by comparing refugee and host population utilization of surgical services in Nyarugusu refugee camp between 2000 and 2020, then evaluate the impact of a large influx of refugees in 2015 on refugee and host population utilization.MethodsThe study was based on a retrospective review of surgical logbooks in Nyarugusu refugee camp (Kigoma, Tanzania) between 2000 and 2020. We utilized descriptive statistics and multiple group, interrupted time series methodology to assess baseline utilization of surgical services by a host population (Tanzanians) compared to refugees and trends in utilization before and after a large influx of Burundian refugees in 2015.ResultsA total of 10,489 operations were performed in Nyarugusu refugee camp between 2000 and 2020. Refugees underwent the majority of procedures in this dataset (n = 7,767, 74.0%) versus Tanzanians (n = 2,722, 26.0%). The number of surgeries increased over time for both groups. The top five procedures for both groups included caesarean section, bilateral tubal ligation, herniorrhaphy, exploratory laparotomy and hysterectomy. In our time series model, refugees had 3.21 times the number of surgeries per quarter at baseline when compared to Tanzanians. The large influx of Burundian refugees in 2015 impacted surgical output significantly with a 38% decrease (IRR = 0.62, 95% CI 0.46–0.84) in surgeries in the Tanzanian group and a non-significant 20% increase in the refugee group (IRR = 1.20, 95% CI 0.99–1.46). The IRR for the difference-in-difference (ratio of ratios of post versus pre-intervention slopes between refugees and Tanzanians) was 1.04 (95% CI 1.00–1.07), and this result was significant (p=0.028).ConclusionsSurgical care in conflict and post-conflict settings is not limited to war or violence related trauma but instead includes a large burden of obstetrical and general surgical pathology. Host population utilization of surgical services in Nyarugusu camp accounted for over 25% of all surgeries performed, suggesting some host population benefit of the protracted refugee situation in western Tanzania. Host population utilization of surgical services was apparently different after a large influx of refugees from Burundi in 2015.

“Is it Commerce?”: Dehumanization in the Framing of Refugees as Resources

The idea that “refugees are resources” has been promoted as countering the dehumanization that frames refugees as burdens or security threats. But is framing people as resources truly humanizing? Resource theorists have highlighted how modern Western conceptions of what resources are depends on a distinction between the human and the non-human. This logic is similar to, and originates in the same epoch as, hierarchies of humanity. State appraisal and management of human and mobility continue to be shaped by race and perceptions of productive value in terms, just as the value of resources varies, and has always been social and political. This intervention highlights the perspective of a Burundian refugee in Tanzania who traces continuities between experiences and being called a resource—in that a resource can be sold or traded across borders with no input into its future. Refugees can and do meaningfully contribute to the communities and countries in which they live, but the “resources” lens curtails a truly humanizing perspective on refugees’ lives.

Prevalence and associated risk factors for hepatitis B and C viruses among refugee populations living in Mahama, Rwanda: A cross-sectional study.

As part of the integration of refugees into Rwanda's national hepatitis C elimination agenda, a mass screening campaign for hepatitis B (HBV) and hepatitis C (HCV) was conducted among Burundian refugees living in Mahama Camp, Eastern Rwanda. This cross-sectional survey used data from the screening campaign to report on the epidemiology of viral hepatitis in this setting. Rapid diagnostic tests (RDTs) were used to screen for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) among people of ≥15years old. We calculated seroprevalence for HBsAg and anti-HCV by age and sex and also calculated age-and-sex adjusted risk ratios (ARR) for other possible risk factors. Of the 26,498 screened refugees, 1,006 (3.8%) and 297 (1.1%) tested positive for HBsAg and Anti-HCV, respectively. HBsAg was more prevalent among men than women and most common among people 25-54 years old. Anti-HCV prevalence increased with age group with no difference between sexes. After adjusting for age and sex, having a household contact with HBsAg was associated with 1.59 times higher risk of having HBsAg (95% CI: 1.27, 1.99) and having a household contact with anti-HCV was associated with 3.66 times higher risk of Anti-HCV (95% CI: 2.26, 5.93). Self-reporting having HBV, HCV, liver disease, or previously screened for HBV and HCV were significantly associated with both HBsAg and anti-HCV, but RDT-confirmed HBsAg and anti-HCV statuses were not associated with each other. Other risk factors for HBsAg included diabetes (ARR = 1.97, 95% CI: 1.08, 3.59) and family history of hepatitis B (ARR = 1.32, 95% CI: 1.11, 1.56) and for anti-HCV included heart disease (ARR = 1.91, 95% CI: 1.30, 2.80) and history of surgery (ARR = 1.70, 95% CI: 1.24, 2.32). Sero-prevalence and risks factors for hepatitis B and C among Burundian were comparable to that in the Rwandan general population. Contact tracing among household members of identified HBsAg and anti-HCV infected case may be an effective approach to targeted hepatitis screening given the high risk among self-reported cases. Expanded access to voluntary testing may be needed to improve access to hepatitis treatment and care in other refugee settings.

A Study of Local Government in Africa through Participatory Action Research (PAR)

A Study of Local Government in Africa through Participatory Action Research (PAR)