Refugee Center Research Articles

Understanding the ‘imposters’

AbstractAs teachers, we think that we understand the challenges of educating children and adults when addressing multiculturalism, immigration and racism. But are we getting it right if we do not know the experiences and challenges faced by international students or even know the perspectives of typically white British students learning in an increasingly multicultural education system? We have all at some point felt like an imposter, isolated and insecure but this is a very real, everyday experience for many people who happen to come from a different country or have different coloured skin. We need to challenge our perspectives by thinking outside of the protective box and seeking information from varied and contemporary sources who understand these challenges the most. This is a look at how a refugee centre has inspired a new way of teaching adult nursing students, and how utilising the enormous amount of knowledge in such centres can also be used to give valuable insight and a fresh perspective when it comes to teaching young people in schools, where the challenges of stamping out racism can be tackled early and head‐on.

Sharing Stories, Food and Passports: Forced Migration, Museum and Memory Activism in Contemporary Germany

ABSTRACT This article uses the online exhibition ‘Arriving: Life after Forced Migration’ by the Marienfelde Refugee Center Museum in Berlin as a case study to investigate how museum activism can contribute to creating and disseminating memories about contemporary forced migration. Employing a close visual and textual analysis of the online exhibition combined with insights from recent discourses on museum activism, migration and memory studies, the article explores which forms of memory the exhibition creates, how these memories emerge and to which end they are used. The analysis firstly illustrates how the exhibition creates a space for communicative memory to surface within the portrayed refugee families through the sharing of stories, objects and food from ‘home’. Secondly, it goes on to argue that the exhibition engages in memory activism by humanizing the portrayed individuals, exposing discriminatory state practices and challenging the audience through provocative questions. Thirdly, the article submits that this online exhibition contributes to a growing transnational archive of forced migration memories. Comprised of a multitude of online platforms dedicated to collecting, preserving and sharing forced migration stories, this archive stimulates multidirectional memory making and allows counter narratives to surface within an increasingly divided Europe.

Varied Prevalence of Antimalarial Drug Resistance Markers in Different Populations of Newly Arrived Refugees in Uganda.

Newly arrived refugees offer insights into malaria epidemiology in their countries of origin. We evaluated asymptomatic refugee children within 7 days of arrival in Uganda from South Sudan and the Democratic Republic of Congo (DRC) in 2022 for parasitemia, parasite species, and Plasmodium falciparum drug resistance markers. Asymptomatic P. falciparum infections were common in both populations. Coinfection with P. malariae was more common in DRC refugees. Prevalences of markers of aminoquinoline resistance (PfCRT K76T, PfMDR1 N86Y) were much higher in South Sudan refugees, of antifolate resistance (PfDHFR C59R and I164L, PfDHPS A437G, K540E, and A581G) much higher in DRC refugees, and of artemisinin partial resistance (ART-R; PfK13 C469Y and A675V) moderate in both populations. Prevalences of most mutations differed from those seen in Ugandans attending health centers near the refugee centers. Refugee evaluations yielded insights into varied malaria epidemiology and identified markers of ART-R in 2 previously little-studied countries.

Overcoming denominator problems in refugee settings with fragmented electronic records for health and immigration data: a prediction-based approach.

Epidemiological studies in refugee settings are often challenged by the denominator problem, i.e. lack of population at risk data. We develop an empirical approach to address this problem by assessing relationships between occupancy data in refugee centres, number of refugee patients in walk-in clinics, and diseases of the digestive system. Individual-level patient data from a primary care surveillance system (PriCarenet) was matched with occupancy data retrieved from immigration authorities. The three relationships were analysed using regression models, considering age, sex, and type of centre. Then predictions for the respective data category not available in each of the relationships were made. Twenty-one German on-site health care facilities in state-level registration and reception centres participated in the study, covering the time period from November 2017 to July 2021. 445 observations ("centre-months") for patient data from electronic health records (EHR, 230 mean walk-in clinics visiting refugee patients per month and centre; standard deviation sd: 202) of a total of 47.617 refugee patients were available, 215 for occupancy data (OCC, mean occupancy of 348 residents, sd: 287), 147 for both (matched), leaving 270 observations without occupancy (EHR-unmatched) and 40 without patient data (OCC-unmatched). The incidence of diseases of the digestive system, using patients as denominators in the different sub-data sets were 9.2% (sd: 5.9) in EHR, 8.8% (sd: 5.1) when matched, 9.6% (sd: 6.4) in EHR- and 12% (sd 2.9) in OCC-unmatched. Using the available or predicted occupancy as denominator yielded average incidence estimates (per centre and month) of 4.7% (sd: 3.2) in matched data, 4.8% (sd: 3.3) in EHR- and 7.4% (sd: 2.7) in OCC-unmatched. By modelling the ratio between patient and occupancy numbers in refugee centres depending on sex and age, as well as on the total number of patients or occupancy, the denominator problem in health monitoring systems could be mitigated. The approach helped to estimate the missing component of the denominator, and to compare disease frequency across time and refugee centres more accurately using an empirically grounded prediction of disease frequency based on demographic and centre typology. This avoided over-estimation of disease frequency as opposed to the use of patients as denominators.

Prevalence of alcohol use disorder in migrants from a Portuguese Center for Refugees: a study protocol

Introduction According to the 2023 statistical report from the Portuguese Migration Observatory, Portugal has received over 72,000 refugees since 2015, with a significant number (56,041) being displaced citizens from Ukraine. This influx includes spontaneous asylum requests. The major countries of origin for refugees in Portugal are Afghanistan, India, Gambia, Pakistan, and Morocco. Notably, refugee populations exhibit elevated incidence rates of specific psychiatric disorders, including post-traumatic stress disorder and depressive disorders. These conditions are independent risk factors for substance use disorders. Furthermore, refugees face unique risks related to their migration journey, increasing their vulnerability to substance use disorders. The prevalence of substance use disorders, especially Alcohol Use Disorder, can reach up to 36% in this population. CAR 1 (Reception Center for Refugees) is a vital social facility in Portugal dedicated to enhancing the reception and integration of asylum seekers and refugees.ObjectivesOur primary objective is to determine the prevalence of potential alcohol problems and unhealthy alcohol use within the Portuguese Refugee Center in Lisbon. Our secondary aim is to comprehensively characterize the migrant population. This includes gathering data regarding demographic information, legal status, country of origin, pre-migration alcohol-related issues, psychiatric diagnoses, history of psychiatric evaluations, self-initiated help-seeking behavior, and self-perceived alcohol-related problems.Methods All individuals currently residing in our refugee center (approximately 70 people) will be invited to participate in a comprehensive survey and screening process. Exclusion criteria will apply to individuals with acute psychiatric conditions unable to provide reliable responses. The survey includes the Alcohol Use Disorders Identification Test (AUDIT) and the CAGE questionnaire. Quantitative data obtained from the questionnaires will be analyzed using Microsoft Excel and IBM SPSS 29 software.ResultsWe anticipate a high prevalence of positive responses to the AUDIT due to potential alcohol-related issues but expect low responses to the CAGE questionnaire due to limited awareness of alcohol use disorder and a reduced perception of the need for help.ConclusionsThis study could help identify and validate the prevalence of alcohol use disorders among migrants, emphasizing the need for appropriate responses. By shedding light on these challenges, we hope to promote effective responses to alcohol use disorder and encourage the utilization of alcohol screening tests in refugee centers, emphasizing the importance of seeking consultation when needed.Disclosure of InterestNone Declared

Citizenship and Political Identities of Children in Transnational Migration

Abstract This article expounds on the relationship between children's rights and asylum discourse as pertaining to the figure of the non-citizen child. Key for the understanding of the political identity of the asylum-seeking child, who is depicted as trapped between paternalistic concepts of childhood and restrictive asylum law on the one hand, and empowering children's rights discourse on the other, is an antagonism in the logic underlying human rights and citizenship discourse. Ethnographic findings with accompanied asylum-seeking children in Germany substantiate the argument, from the perspective of ‘new’ childhood sociology. The concept of citizenship is elucidated as practice lived in the everyday in children's action against exclusionary effects in refugee centres.

시리아 난민 대상 글로벌 서비스-러닝 참여 대학생들의 학습경험 탐색 연구

Objectives The purpose of this study is to explore the learning experiences and changes of universty students who participated in Global Service-Learning during vacation for Syrian refugees at the refugee center in Turkiye.
 Methods The research participants were seven students who participated in global service-learning. For the study, data were collected from students' reflective journals, reflection logs, and minutes of reflection meetings. The analysis of students' learning experiences and changes involved six stages of thematic analysis: ⑴ Familiarizing with the data, ⑵ Generating codes, ⑶ Identifying themes, ⑷ Reviewing themes, ⑸ Defining themes, and ⑹ Writing the report.
 Results The purposes of this study were to specify variables related to convergence competency, and to analyze the structural relationships among them. The purposes of this study were to specify variables related to convergence competency, and to analyze the structural relationships among them.
 Conclusions This study is meaningful as an example of continuous cooperation by connecting online Service-Learning, which began with the COVID-19 pandemic, to face-to-face Global service-learning, and will be a useful basis for designing Global Service-Learning for refugees.

"I don´t put people into boxes, but…" A free-listing exercise exploring social categorisation of asylum seekers by professionals in two German reception centres.

Newly arriving asylum seekers in Germany mostly live in large reception centres, depending on professionals in most aspects of their daily lives. The legal basis for the provision of goods and services allows for discretionary decisions. Given the potential impact of social categorisation on professionals' decisions, and ultimately access to health and social services, we explore the categories used by professionals. We ask of what nature these categorisations are, and weather they align with the public discourse on forced migration. Within an ethnographic study in outpatient clinics of two refugee accommodation centres in Germany, we conducted a modified free-listing with 40 professionals (physicians, nurses, security-personnel, social workers, translators) to explore their categorisation of asylum seekers. Data were qualitatively analysed, and categories were quantitatively mapped using Excel and the Macro "Flame" to show frequencies, ranks, and salience. The four most relevant social categorisations of asylum seekers referred to "demanding and expectant," "polite and friendly" behaviour, "economic refugees," and "integration efforts". In general, sociodemographic variables like gender, age, family status, including countries and regions of origin, were the most significant basis for categorisations (31%), those were often presented combined with other categories. Observations of behaviour and attitudes also influenced categorisations (24%). Professional considerations, e.g., on health, education, adaption or status ranked third (20%). Social categorisation was influenced by public discourses, with evaluations of flight motives, prospects of staying in Germany, and integration potential being thematised in 12% of the categorisations. Professionals therefore might be in danger of being instrumentalised for internal border work. Identifying social categories is important since they structure perception, along their lines deservingness is negotiated, so they potentially influence interaction and decision-making, can trigger empathy and support as well as rejection and discrimination. Larger studies should investigate this further. Free-listing provides a suitable tool for such investigations.

Afghan Women Refugees Enduring Domestic Violence Despite Finding Sanctuary in the UK

This article examines the settlement experiences of Afghan women refugees following their migration into the UK. The findings highlight how violence and oppression depicted many of the women’s experiences prior to seeking asylum. This was found to persist when the women gained asylum in the UK, as many continued to face severe and enduring violence within their family, from both men and other women, as traditional patriarchal values involving physical and psychological violence remained. However, the findings indicated that violence within the home was less prevalent among women from the Hazara ethnic group who held a higher educational background. The research was designed within an interpretivist paradigm of inquiry, and qualitative semi-structured interviews were conducted in Dari and English languages, with 15 Afghan refugee women, based at a London refugee centre. The resulting data was analysed using thematic analysis. Reflecting the findings of a number of international reports on women’s status in Afghanistan, the findings highlighted their experiences of violence and oppression in their home country prior to seeking asylum. The article concludes with an emphasis on practitioners recognising the potential risks of violence and abuse female Afghan refugees face within their own homes.

Migrants’ mental health recovery in Italian reception facilities

BackgroundForced migration leaves deep marks on the psychological well-being of migrants, with post-traumatic stress disorder (PTSD) and other psychological conditions being prevalent among them. While research has clarified the extent to which pre-migration trauma is a predictor of mental health outcomes, the role of post-migration stressors in the settlement environment are yet to be fully characterized.MethodsWe monitored mental health of a cohort of 100 asylum-seekers during their 14-day COVID-19-related quarantine in reception facilities in Rome, Italy, through the administration of six questionnaires (a demographic survey, the WHO-5 well-being index, the Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), the Harvard Trauma Questionnaire, the Trauma and Loss Spectrum—Self Report, and the LiMEs—Italian version). Through the combination of statistical analysis and supervised learning, we studied the impact of the first contact with the reception system on asylum-seekers’ mental health and sought for possible risk and shielding factors for PTSD.ResultsWe find that sheltering in refugee centers has a positive impact on migrants’ mental health; asylum-seekers with PTSD reported more traumatic events and personality characteristics related to loss and trauma; life events are predictors of PTSD in asylum-seekers.ConclusionsWe identify past traumatic experiences as predictors of PTSD, and establish the positive role the immediate post-migration environment can play on migrants’ psychological well-being. We recommend for host countries to implement reception models that provide effective protection and integration of asylum-seekers, similar to those in the Italian system.

Exit is the answer: The political nature of Central American migration

AbstractThis article provides evidence that many Central Americans who have joined the migrant caravans to the north manifest a profound discontent with the political institutions of their home countries. It is based on surveys with migrants in refugee centres, compared with similar data from the AmericasBarometer survey, and complemented with contextual qualitative data on the experience of immigrants passing through Mexico. The article shows that several Central Americans in route to the north do not trust their political institutions and express little support for their political system. It demonstrates that in contexts where economic instability, rampant crime, and environmental uncertainty prevail, many citizens keep exiting their countries under the conviction that government institutions have lost the capability to protect them from existential threats.

Refugee and Migrant Behavioral Health Technical Assistance Center (SAMHSA)

Refugee and Migrant Behavioral Health Technical Assistance Center (SAMHSA)

Fast EMR: An Online and Offline Mobile Electronic Medical Record for Disaster Settings

Introduction:The absence of clinical information in the aftermath of disasters in resource-constrained environments costs lives. fEMR– fast Electronic Medical Records–is a medical records system designed for mobile clinics and has proven useful in post-disaster settings. While the original version of the system was developed for areas without access to the Internet, a new version of this system was developed in 2019 to accommodate regions with connectivity.Method:We reviewed the design, implementation, and usage of fEMR from June 2014 to October 2022. We used logged data of the number of users, patient encounters, and the circumstances of each deployment. We compared usage between the original fEMR system and fEMR-on-chain.Results:The original fEMR system was created in an iterative process by students in Computer Science classes at three different American universities. The system creates a closed intranet signal to which clinicians connect their own device to access the software. The hardware is transported to the medical team in a carry-on suitcase prior to deployment. All data are stored on a laptop that acts as a server. The online version, fEMR On-Chain, was developed under a grant, but is sustained in development through academic partnerships. Both versions are designed so that the provider can complete an encounter with as few clicks as possible and with as little input as necessary to identify patients.The original fEMR system has been deployed to mobile clinics worldwide since 2014. The system has about 14,181 patients and 16,021 clinical encounters from 12 different countries. fEMR On-Chain has been deployed to refugee and migrant settings since 2019, containing about 18,000 patients and 22,000 encounters in two different countries.Conclusion:Successive versions of the fEMR system have been used in a variety of conditions and settings, with usage accelerating since 2019 in refugee and migrant health centers.

IMPROVING THE HEALTH LITERACY OF THE ELDERLY: SLOVAK EXPERIENCE

The article presents the generalised results of the study conducted under the VEGA project of the Ministry of Education, Science, Research and Sport of the Slovak Republic № 1/0293/21 «Education for the Health of the Adult Population» (2022-2023) («Edukácia k zdraviu dospelej populácie») in Slovakia. The survey was conducted in the largest humanitarian centre for refugees using a special questionnaire HLS19-Q12 to measure general health literacy). The survey revealed a low level of health literacy among the majority of older people. In the course of the study, the elderly were provided with psychological first aid techniques and educational activities to improve their health literacy.

Exstrophic bladder duplication in the sagittal plane: Surgical management of a rare case

The bladder-Exstrophy-Epispadias complex (BEEC) contains a wide spectrum of congenital malformations. A treatment naïve refugee was referred to our center with what was identified as BEEC. A 27-year-old female patient was referred for total incontinence since birth by the general practitioner from the refugee center. An exstrophic bladder with blind ending ureteral orifices and a second non-exstrophic bladder with two orthotopic ureters was identified, demonstrating the bladder duplication in the sagittal plane. Laparotomy was performed, dissecting the exstrophic bladder plate caudally and using it as a ventral onlay to augment the non-exstrophic bladder. A Mitchell-type bladder neck reconstruction was performed with an autologous fascia sling around the bladder neck to obtain continence. As the patient had never voluntarily voided, chances of spontaneous voiding after surgery were low. Therefore creation of a continent Mitrofanoff-type vesicostomy was additionally realized and genital reconstruction was achieved. 12 months post operatively, the patient was completely continent, had a bladder capacity of 250 ml, and performed self-catheterization 5 times a day. No post-operative complications were observed. Admission of political refugees can implicate challenging surgeries for congenital malformations in adults, such as BEEC. This demonstrates the importance of multidisciplinary transitional care.

Refugee reception, extreme-right voting, and compositional amenities: Evidence from Italian municipalities

We use data from Italy to study the political and social impact of a refugee reception policy (SPRAR) directly managed by local governments, whose features recall the conditions of the contact theory (Allport, 1954). Instrumental variables estimates indicate that municipalities that opened a refugee center between the 2013 and 2018 national elections experienced a change in the vote shares of extreme-right parties that is approximately 7 percentage points lower compared to municipalities that did not open a refugee center. We document that the positive impact of SPRARs on “compositional amenities” (i.e., local schools) and population growth allows explaining the negative impact on anti-immigrant prejudice. Finally, we provide evidence of spillovers in prejudice reduction in neighboring municipalities without a SPRAR.

Mental health and addiction in young refugees-Research on prevalence of alcohol and substance use, PTSD and psychological difficulties experienced by young migrants and refugees placed in two refugee centers in Serbia in the time of COVID-19 pandemic

Abstract: IntroductionAs the global resettlement needs are further increasing, the questions on refugee youths’ wellbeing arise. The experience of migration during childhood might interfere with the developmental trajectories in different ways. Refugee youths might be at higher risk of violence, abuse and mental health problems.ObjectivesThis study aimed to explore the prevalence of alcohol and substance use among young refugees, along with the indicators of experienced psychological difficulties.MethodsData collection was followed by numerous difficulties–C-19 pandemic, linguistic diversity and high respondents’ illiteracy rate.ResultsThe sample consisted of 184 participants aged 11–18 years. More than a half of them displayed symptoms of PTSD - more frequently females, those who resided in a greater number of refugee centers and those who were exposed to abuse and domestic violence. Half of the respondents consumed energy drinks, slightly less than a third of them used tobacco, 13% consumed alcohol, 4.6% marijuana, whereby the frequency of other substance use was significantly lower. The significant indicators of individual propensity to use alcohol and substances were shown to be older age (14-18 years), male gender, lower education, being unaccompanied child and exposure to emotional abuse.ConclusionsOur research confirmed that young refugees, especially unaccompanied, might be at higher risk for mental health difficulties. Research on this topic should aim to link scientific data to sustainable practices, applicable in everyday life.Disclosure of InterestNone Declared

Art Tables at refugee drop-in centres: From exclusion to belonging

This article describes the Art Table at a drop-in centre for asylum seekers and refugees. It shows how a non-verbal approach can offer an opportunity for members to experience self-expression, companionship and healing in a safe space. This is illustrated by four stories of members and their artwork. The structure, approach and materials are described, followed by a discussion as to whether this work should be defined as art therapy or art and well-being. Issues specific to refugees are highlighted. The article concludes by highlighting the importance of community building and relational social justice.

Complete bladder duplication presenting in adulthood: A case report on reconstructive technique and reflections on translational urology in refugees

Introduction and aim of studyThe bladder-Exstrophy-Epispadias (BEEC) complex is a spectrum of congenital malformations with many variations. A never operated political refugee with BEEC was referred to our center for management upon arrival in Europe. Our aim is to report the technique and outcomes on a never operated on BEEC adult, highlighting the importance of transitional urologic care for congenital malformations in adult patients.Materials and methodsA 27-year old female patient was referred to our center for complete incontinence since birth by the General practitioner from the refugee center who suspected BEEC. Upon further investigation, an exstrophic bladder with blind ending ureteral orifices and a urethral meatus caudal to the exstrophic bladder plate were highlighted. A second non-exstrophic bladder with two orthotopic ureters was demonstrated, thereby a bladder duplication in the sagittal plane was diagnosed, presenting a wide-open bladder neck and a 7 cm pubic diastasis, causing the incontinence she was initially referred for. With the patient in a supine position, laparotomy incision was done with excision of the umbilical scar. The exstrophic bladder plate is dissected caudally. As it presents good detrusor quality, decision is taken to use it as a ventral inlay to augment the non-exstrophic bladder. A Mitchell-type bladder neck reconstruction is performed with a classical fascia sling wrapped around the bladder neck to increase the continence mechanism given the very wide pubic diastasis. Given the risk for hyper-continence, interposition of a continent Mitrofanoff-type vesicostomy is additionally realized. Genital reconstruction is achieved.ResultsOver 1 year post operatively, the patient is completely dry, can holp up to 250ml between catheterization she performs five times per day and once at night. No post-operative complications were observed.ConclusionThe case of one adult patient with a rare urological condition like bladder exstrophy with duplication is presented, illustrating challenges political refugees referred to Europe implicates in terms of surgery regarding congenital malformations in adult patients. A multidisciplinary approach is highly important, demonstrating the importance of transitional care.

Not welcome anymore: the effect of electoral incentives on the reception of refugees

Abstract Do electoral incentives affect immigration policies? Exploiting the Italian system for refugees’ reception and data from Italian municipalities, we show that proximity to elections reduces the probability that a municipality applies to host a refugee center by 26%, despite the economic benefits arising from these centers. Low electoral competition and high shares of extreme-right voters drive the effect. Our results are rationalized by a theoretical model and can explain the unequal distribution of refugees across and within countries.