Refugee Communities Research Articles

The Role of Muslim Rohingya Refugee Community-Based Organizations in Malaysia

The Rohingya refugee crisis has spurred the formation of community-based organizations (CBOs) among Muslim Rohingya refugees in Malaysia. This qualitative research explores the role and impact of these organizations within the refugee community. By employing a mixed-methods approach, including semi-structured interviews and content analysis, the study delves into the motivations, activities, challenges, and outcomes of Rohingya CBOs. The findings suggest that these CBOs play a critical role in bridging the gap between formal assistance and the unique needs of the Rohingya population in Malaysia. They offer vital services, foster a sense of belonging, and contribute to mental well-being. However, challenges related to resources and sustainability are apparent. This research contributes to a better understanding of refugee agencies and grassroots initiatives. It sheds light on the significance of CBOs as agents of change, amplifying the voices and actions of refugees themselves. The study's findings show that both policy and practice support and empower refugee communities.

Responding to health literacy of refugees in Australian primary health care settings: a qualitative study of barriers and potential solutions

BackgroundOrganisational health literacy is a promising area of research that enables a focus on how systems and services can be designed in ways that are responsive to populations with varying states and levels of health literacy, knowledge, and practices, including African refugees. The challenge is how organisations and professionals do this in practice, and research in this area is in its early stages. This qualitative study examined barriers to implementing health literacy responsive care practices in primary health care settings in Australia. It also offered suggestions to potentially address the barriers to improving organisational health literacy.MethodsRefugees (n = 19), primary health care professionals (n = 14), and other key stakeholders (n = 19) were recruited through convenience and snowball strategies from three states in Australia: New South Wales, Victoria, and Queensland. All but one participant was interviewed face-to-face via Zoom. Semi-structured interview guides were used to guide the conversations. Transcriptions from audio recordings were analysed using directed content analysis.ResultsThirteen themes were extracted from the data. Themes were organised into the following categories: structural and systemic, organisational context, individual professional level, individual patient level, and socio-community level. Major structural and system-level factors affecting organisational health literacy included rigid systems and structures and limited time. Key organisation-level factors included inflexible organisational processes and policies, institutionalised othering, discrimination and racism, and lack of interpreters. Individual professional factors were poor communication with patients and cultural knowledge gaps. Linguistic issues and service mistrust were key individual patient-level factors. Socio-community factors included limited community engagement. Participants identified potential solutions to help services navigate out of the barriers and improve their response to health literacy.ConclusionThe findings suggest that mainstream services and organisations could improve timely and appropriate health care access and utilisation for refugees through strategies such as designing services and health literacy programs with refugee communities, promoting health literacy champions in the workforce, integrating health literacy and culturally responsive care plans and strategies into organisational priorities.

Barriers and Facilitators to Co-Creating Interventions with Refugee and Migrant Youth: A Process Evaluation with Implementors

The rise in children experiencing forced displacement and the associated negative mental health effects have led to the proliferation of novel interventions targeting their educational development and mental health and psychosocial support (MHPSS) needs. To improve the acceptability and effectiveness of these interventions for refugee communities, co-creation is often used. However, there is a need to understand the mechanisms that support the co-creation process. This paper explores the process of co-creation within the REFUGE-ED project: an international consortium identifying, co-creating, and implementing educational and MHPSS interventions for refugee youth. The data are drawn from consortium members and site staff who participated in a range of meetings, focus groups, and interviews which occurred before, during, and after the implementation. A qualitative content analysis grounded in the (updated) Consolidated Framework for Implementation Research (CFIR) was then used to identify barriers to and facilitators of the co-creation process. Although numerous barriers and facilitators were identified only two traversed both categories and every stage of the co-creation process: namely, the quality of interpersonal relationships and the clarity of the implementation plan. We discuss relevance of these two factors to the field of co-creation as a means to adapt health interventions targeting youth refugee populations. Considerations, needs, and recommendations for future co-creation interventions are also outlined.

Health Needs and Priorities of an Underserved Karenni Refugee Community: A Community Needs Assessment.

Southeast Asian refugee communities are frequently underserved by social and medical systems and experience profound health and health care inequities. The purpose of this study was to detail the health needs, priorities, and health care utilization of the Karenni, a Southeast Asian refugee community, in Forsyth County, North Carolina. A mixed-mode survey (i.e., online and in-person) was distributed in Kayah, Burmese, and English to Karenni adults in Forsyth County. Quantitative and qualitative questions focused on community health needs, health and public health service utilization, and social determinants of health. 101 Karenni adults completed the survey, with a total of 91 participants completing the quantitative portion (N = 91). Utilization of health care and public health services was low and impacted by individual- and contextual-level barriers, such as limited English profi-ciency and social determinants of health (e.g., lower levels of education and employment compared to state and national averages). Mental health, chronic pain, and health care access were highlighted as prominent community concerns while theh plaw theh jie (togetherness) and community organizations were described as community strengths. Data were collected using convenience sampling, and limited knowledge from the Karenni community regarding research served as a barrier to recruitment. Some sensitive questions (e.g., income) also experienced higher levels of missingness. This assessment highlights the need to increase engagement with and lower barriers to care for the Karenni community in Forsyth County, North Carolina. To produce culturally congruent and acceptable care, public health and health care systems should partner with the community to identify and address community needs and priorities, harness assets, and mitigate health and health care inequities.

"Nobody does checkups back there": A qualitative study of refugees' healthcare needs in the United States from stakeholders' perspectives.

The number of refugees globally grew to 35.3 million in 2022, and many refugees are exposed to various health risks along their migration journey. As a result, they may arrive in host communities with numerous health issues, including communicable diseases and chronic and mental health conditions. Navigating the healthcare system in a host country proves to be a significant challenge for them, leading to delayed care. This qualitative study explored the convolute healthcare needs of refugees in the United States by soliciting insights from stakeholders involved in refugee resettlement and healthcare. In-depth interviews were conducted with fifteen stakeholders who work closely with refugees, including healthcare providers, cultural/clinical health navigators supporting refugees, staff from refugee resettlement agencies and governmental entities, and researchers studying refugee health. Following informed consent, interviews were audio-recorded, transcribed verbatim, and imported into MAXQDA 2022 (VERBI Software) for thematic analysis. The results revealed key themes, including the heterogeneity of refugee populations, limited awareness of preventive healthcare, high prevalence and suboptimal management of chronic conditions, complexity of the healthcare system, lack of follow-up, and language barriers. Further research is warranted concerning the long-term health of refugee populations in the United States. Additionally, more tailored programs involving peer educators are recommended to support refugee communities in navigating the complex healthcare system in the host country.

THE MODERATING EFFECT OF RESILIENCE AND SOCIAL SUPPORT ON THE RELATIONSHIP BETWEEN POST-MIGRATION STRESS AND PSYCHOLOGICAL WELL-BEING AMONG UKRAINIAN REFUGEES IN ROMANIA

This study explores the connection between Post-migration Stress and Psychological Well-Being among Ukrainian refugees in Romania, with a focus on the moderating roles of Resilience and Social Support. Using scales for stress, well-being, resilience, and social support, data was collected from Ukrainian refugees (N = 84), mostly women aged 18 to 68. The analysis, conducted before significant changes in government support, revealed a negative correlation between post-migration stress and psychological well-being. Both resilience and social support showed moderating effects in the relationship between post-migration stress and environmental mastery (a facet of psychological well-being construct). The study also examined demographic variations within the refugee community in relation to stress, well-being, social support, and resilience, highlighting potential impacts of subsequent changes in refugees’ circumstances on research outcomes.

Integrating Syrian refugees into Lebanon’s healthcare system 2011–2022: a mixed-method study

IntroductionThe Lebanese government estimates the number of Syrian refugees to be 1.5 million, representing 25% of the population. Refugee healthcare services have been integrated into the existing Lebanese health system. This study aims to describe the integration of Syrian refugee health services into the Lebanese national health system from 2011 to 2022, amid an ongoing economic crisis since 2019 and the COVID-19 pandemic.MethodsThis paper employs a mixed-methods approach drawing upon different data sources including: 1- document review (policies, legislation, laws, etc.); 2- semi-structured interviews with policymakers, stakeholders, and health workers; 3- focus group discussions with patients from both host and refugee populations; and 4- health systems and care seeking indicators.ResultsAlthough the demand for primary health care increased due to the Syrian refugee crisis, the provision of primary health care services was maintained. The infusion of international funding over time allowed primary health care centers to expand their resources to accommodate increased demand. The oversupply of physicians in Lebanon allowed the system to maintain a relatively high density of physicians even after the massive influx of refugees. The highly privatized, fragmented and expensive healthcare system has impeded Syrian refugees’ access to secondary and tertiary healthcare services. The economic crisis further exacerbated limits on access for both the host and refugee populations and caused tension between the two populations. Our findings showed that the funds are not channeled through the government, fragmentation across multiple financing sources and reliance on international funding. Common medications and vaccines were available in the public system for both refugee and host communities and were reported to be affordable. The economic crisis hindered both communities’ access to medications due to shortages and dramatic price increases.ConclusionIntegrating refugees in national health systems is essential to achieve sustainable development goals, in particular universal health coverage. Although it can strengthen the capacity of national health systems, the integration of refugees in low-resource settings can be challenging due to existing health system arrangements (e.g., heavily privatized care, curative-oriented, high out-of-pocket, fragmentation across multiple financing sources, and system vulnerability to economic shocks).

Ukrainian–Russian bilingualism in the war-affected migrant and refugee communities in Austria and Germany: a survey-based study on language attitudes

IntroductionThis paper provides an initial exploration of Ukrainian–Russian bilingualism in the context of the war-affected migration from Ukraine to Austria and Germany. While extensive research exists on various aspects of Ukrainian– Russian bilingualism in relation to Ukraine itself, thus far no studies have been conducted on this bilingualism in the diasporic context, i.e., as a language of the first and subsequential generations with a migrant background in Austria and Germany.MethodsTo address this research gap, our paper examines the language attitudes of two respondent groups with a Ukrainian background in the two countries: migrants and refugees who left Ukraine after 2014 and those who left after Russia’s invasion in February 2022. In the framework of a sociolinguistic survey, we describe their current attitudes regarding the use of Ukrainian and Russian, among others, in relation to the actual and intended use of the language(s) in the multilingual context of migration. The survey eliciting information on demographic information, language proficiency, language attitudes and language use was conducted on 406 Ukrainians in two host countries (Austria: n = 103; Germany: n = 306). First, we compared self-rated proficiency in Ukrainian and Russian as well as attitudes and use of these languages. Second, we applied a network modelling analysis to determine the nature of relationships between these variables.Results and discussionThe results indicated that proficiency in Ukrainian and in Russian were the strongest nodes in the model affecting language use and language attitudes toward the respective languages. Our data analysis focused on the pragmatic and symbolic value of Russian and Ukrainian playing a crucial role in the language vitality in multilingual settings. The paper discusses the imbalanced correlation of the symbolic and pragmatic value of Ukrainian and Russian in the diasporic Ukrainian communities. While Ukrainian has gained a higher symbolic status, Russian maintains a better pragmatic one, despite its negative symbolic status. However, we anticipate that the increasing symbolic value of Ukrainian and the diminishing value of Russian will lead to an increase in the use of Ukrainian also in Russian-dominant bilingual groups of Ukrainian migrants and refugees, even as an insider-code in hermetic minority groups.

Capacity building and community of practice for women community health workers in low-resource settings: long-term evaluation of the Mobile University For Health (MUH).

Lebanon has been facing a series of crises, significantly increasing health challenges, and straining its healthcare infrastructure. This caused deficiencies in the system's ability to attend to population health needs, and it profoundly impacted vulnerable and refugee communities who face additional challenges accessing healthcare services. In response, the Global Health Institute at the American University of Beirut designed and implemented the Mobile University for Health (MUH), which promotes task-shifting through capacity building complemented by communities of practice (CoP). The program aimed to prepare vulnerable women to assume the role of community health workers (CHW) within their communities, and to promote positive health knowledge and behaviours. A mixed-methods approach was used to evaluate MUHs' three certificates (women's health, mental health and psychosocial support, and non-communicable diseases). Implementation took place between 2019 and 2022, with 83 CHWs graduating from the program. Short-term data including knowledge assessments, course evaluations, and community member feedback surveys were collected. 93 semi-structured interviews with CHWs and 14 focus group discussions with community members were conducted to evaluate the long-term impact of the capacity building and CoP components. Data revealed multiple strengths of the initiative, including increased access to education for the community, effectiveness of blended learning modality, successful planning and delivery of CoP sessions, and improved knowledge, skills, and health behaviours over time. The supplementary CoP sessions fostered trust in CHWs, increased community empowerment, and increased leadership skills among CHWs. However, some challenges persisted, including limited access to healthcare services, implementation logistical issues, difficulties with some aspects of the learning modality, and some resistance within the communities. MUH promoted and improved positive health knowledge and behaviours within targeted vulnerable populations in Lebanon. The supplementary CoP component proved instrumental in empowering CHWs and enhancing their impact within their communities. The study highlights the need for ongoing training and support for CHWs and underscores the importance of continued investment and adaptation of such initiatives through a gendered lens. This evaluation provides evidence on the successes of a capacity building model that has strong potential for scale and replication across health topics in conflict-affected contexts.

Refugee women in the informal health sector in Lebanon: Gendered experiences of close to community healthcare providers during the COVID-19 response

IntroductionDuring the COVID-19 pandemic, Close-to-Community (CTC) healthcare providers emerged to compensate for the lack of healthcare workers in areas with high concentrations of Syrian refugees. Gender norms and power relations shaped the experiences of those CTC providers. MethodologyA qualitative study explored the lived experiences of men and women CTC providers in Beqaa - Lebanon. It examined their gendered experiences during the COVID-19 response using in-depth interviews with informal CTC providers who are members of the Syrian refugee community themselves, and key informant interviews with their managers. Thematic data analysis and synthesis were guided by gender analysis frameworks and supported by NVivo 12. ResultsCTC providers faced many challenges in their work including illegal work, absence of benefits, high workload, insufficient income, transportation challenges, disturbances in family life, and social isolation. Working illegally as refugees led to underpayment and absence of benefits. Gender norms and power dynamics significantly influenced the experiences of these CTC providers. Women CTC providers faced increased workload, lower payment, limited opportunities for extra hours, the pressure of juggling work and family life, transport challenges, psychological distress and lack of support from their organizations. ConclusionThe COVID-19 pandemic has shed light on how gender shapes vulnerabilities within the healthcare response. Women and men informal CTC providers experienced different challenges providing healthcare services for their communities during the COVID-19 response. There is a need to address the vulnerabilities for women CTC providers and develop and implement practical interventions to address them.

Resilience and Positive Wellbeing Experienced by 5-12-Year-Old Children with Refugee Backgrounds in Australia: The Childhood Resilience Study.

Refugee research tends to be deficit based and focused on the risks threatening positive adaptation and wellbeing. High rates of mental (and physical) health issues have been reported for refugee adults and children, including intergenerational trauma. This study uses the new Child Resilience Questionnaire (CRQ), co-designed with refugee background communities, to describe resilience and positive wellbeing experienced by children of refugee-background. The Childhood Resilience Study (CRS) recruited 1132 families with children aged 5-12 years in Victoria and South Australia, Australia. This included the recruitment of 109 families from 4 refugee background communities: Assyrian Chaldean (Iraq, Syria), Hazara (Afghanistan), Karen (Burma, Thailand) and Sierra Leonean families. CRQ-parent/caregiver report (CRQ-P/C) scores were categorised into 'low', 'moderate' and 'high'. The child's emotional and behavioural wellbeing was assessed with the Strengths and Difficulties Questionnaire, with positive wellbeing defined as <17 on the total difficulties score. Tobit regression models adjusted for a child's age. The CRQ-P/C scores were not different for boys and girls of refugee background. Children of refugee-background (n = 109) had higher average CRQ-P/C scores than other CRS children (n = 1023) in the personal, school and community domains, but were lower in the family domain. Most children with 'high' resilience scores had positive wellbeing for both children of refugee-background (94.6%) and other CRS children (96.5%). Contrary to common stereotypes, children of refugee-background show specific individual, family, school and cultural strengths that can help them navigate cumulative and complex risks to sustain or develop their positive wellbeing. A better understanding as to how to build strengths at personal, family, peer, school and community levels where children are vulnerable is an important next step. Working in close collaboration with refugee communities, schools, policy makers and key service providers will ensure the optimal translation of these findings into sustainable practice and impactful public policy.

Listening deeply to refugee background women to understand experiences of domestic and family violence in their communities to foster engagement with global support systems

ABSTRACT As trauma survivors, women and girls from refugee backgrounds face significant challenges when settling in host countries; the risk of domestic and family violence (DFV) accentuates these difficulties. Reflecting on findings from a seven-year university and industry research partnership, this article explores the etiology of DFV in women from refugee backgrounds living in non-metropolitan Australia. Drawing on action research principles and intersectional and social ecological theoretical frameworks, this study captured diverse women’s views about experiences and strategies for addressing DFV in refugee communities. Having developed trusting relationships with participants over the different study phases, the first author conducted in-depth interviews with women of refugee backgrounds, listening deeply and confirming findings with participants as they emerged. Interviews were also conducted with staff from settlement, health and specialist domestic violence services to offer a broad perspective on how best to support refugee women experiencing DFV. Key findings revealed stressors and support that impact violence, such as employment status and acculturation, and identification of who the women would trust if experiencing violence. By understanding the interweaving factors influencing women’s risk of DFV and strategies to address it, global healthcare providers will be better positioned to collaborate with refugee communities and specialist services.

Dismantling racism through partnership with resettled refugee communities.

The enormous and ever-increasing problem of forced displacement warrants the attention of psychological science to play a role in leading efforts to address the needs of refugee communities. As a nation of immigrants, the United States has a long and complicated history of refugee admissions, including both generous and racist policies and sentiments. Examining the past can increase our capacity to transform the future. Taking conscious action to dismantle racism is of central importance to begin to make reparations and find pathways toward healing. Recognizing the instrumental role of systemic forces, three guideposts to support an antiracist foundation for research and practice in psychology are drawn from existing frameworks and applied to the case of refugees. These include (a) remembrance as an act of historical and sociopolitical analysis, (b) truth-telling to engage in critical self-reflection within the field of psychology, and (c) accompaniment alongside refugee communities to develop partnerships that reinforce their strengths and agency and directly benefit them. These guideposts underscore the importance of upholding community priorities and empowering refugee communities to reclaim their own cultural knowledge and strengths and to create effective and sustainable programs, with the potential for significant public health impact. As such, psychologists can play a critical role in transforming social systems over time and actively working to dismantle racism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

From Hongkew Ghetto to Shanghai Ark: Rethinking representation in the (re)making of affective atmosphere during cultural regeneration

The “Shanghai Ark” is an urban regeneration project in Shanghai’s Hongkou (Hongkew) District, aiming to transform the built environment and cultural legacy of the former Jewish refugee community, Hongkew Ghetto, into the present Shanghai Ark neighbourhood, showcasing the city’s and the nation’s cosmopolitanism and generosity. This article re-evaluates the notion of representation and explores the interplay among top-down representations, emotional resonances, and atmospheric practices in urban spaces. By employing discourse analysis and ethnographic data, we examine perceptions and practices of various stakeholders, including officials, citywalk leaders, museum curators, residents, local visitors, and foreign visitors. The findings reveal that affective atmospheres emerge from the interweaving of top-down narratives, personal experiences and memories, and emotional resonances between bodies and material environment, as well as the emotional interactions among people. By reconsidering representations in shaping affective atmospheres, this study sheds light on the fluid and dynamic nature of cultural regeneration, offering a deeper understand of the multifaceted experiences and emotions that underlie urban development.

Rohingya Refugees in Indonesia: Risk Evaluation to National Security and Resilience

This study aims to evaluate the risks to Indonesia's national security and resilience due to the arrival of Rohingya refugees. The focus of this research is on the impact of Rohingya refugees in Indonesia. This study uses a qualitative approach and combines primary data from interviews with relevant stakeholders and secondary data from official sources. The results identified several potential threats to national security and resilience, including instability in refugee camps, violent practices within camps, and impacts on local communities. Research also highlights the importance of effective conflict integration and management in preventing a potential escalation of conflict among Rohingya refugees and local communities. The conclusion of the study provides recommendations to strengthen risk management strategies for the Indonesian government, the Rohingya refugee community, and the international parties involved. By considering this context, the study contributes to a better understanding of how the presence of Rohingya refugees can affect Indonesia's national security and resilience.

Refugee Women’s Entrepreneurship: A Concept Analysis

Purpose: This paper aims to conceptually define refugee women's entrepreneurship in host countries, filling a literature gap on its gendered aspects and effects on well-being and integration. It seeks to clarify this concept and its impact on refugee women's empowerment, autonomy, and community contribution. Design/methodology/approach: Employing the Walker and Avant (2011) method, this analysis methodically reviews literature on refugee women's entrepreneurship, identifying key attributes, antecedents and consequences of refugee women’s entrepreneurship. The study grounds these findings in real-world cases and theory. Findings: The analysis shows that refugee women pursue entrepreneurship to overcome employment obstacles, using their resilience and creativity. It provides a route to empowerment, independence, and integration, improving well-being and challenging gender norms, while positively impacting the host society's economy and social structure. Conclusion and implications: This concept analysis uniquely deepens our insight into refugee women's entrepreneurship, offering an intricate conceptualization that bridges economic, social, cultural, and psychological facets. It positions entrepreneurship as a strategic response to displacement with profound implications for policy and practice. This concept analysis emphasizes the need for policies and programs that support refugee women's entrepreneurship, aiding their integration and enhancing host economies. It also underscores entrepreneurship's role in advancing gender equality, social inclusion, and community resilience, advocating for wider recognition of these entrepreneurs' societal contributions. Keywords: Refugee women; entrepreneurship; concept analysis; Walker and Avant

Study of mental health perceptions among Central African refugee populations and host communities in the East Cameroon region

IntroductionCameroon’s eastern region faces numerous security challenges linked to successive crises in the Central African Republic, particularly with the massive influx of refugees especially since 2013. Official UNHCR figures speak of 349,409 Central African refugees present on Cameroonian soil. These are both refugees already well established in their host communities, and new arrivals. Since the post-electoral crisis in CAR at the end of 2020, the situation has gradually stabilized in the Kadey department, but remains volatile due to daily insecurity in the northern regions of the Central African Republic.ObjectivesWith a view to meeting the mental health and psychosocial support needs of the region’s population and better integrating refugees into their host communities, it was necessary to obtain a more exhaustive picture of the population’s perception of mental health, to understand the mechanisms of psychosocial support at community level and any differences between refugees and the indigenous population.MethodsA mixed methodology with quantitative and qualitative data was chosen for a more detailed analysis. The survey was carried out in two communes in the Kadey department: Kentzou and Kette. The sample was disaggregated to take account of the socio-demographic characteristics and to enable to make comparisons between the situations of host communities, living in refugee sites and outside sites. For quantitative data, 205 the individuals responded to a questionnaire. 12 individual interviews and 12 Focus Group Discussions (involving 60 participants ) guided by semi-structured questions were used to collect qualitative data from key members of the community.ResultsAnalysis of quantitative and qualitative data has confirmed the successful integration of Central African refugees into the host community. Nevertheless, there is a difference between these two groups in terms of their perception and understanding of the definition of mental health, mental health disorders and treatment options. Thus, there was a clear difference in training and awareness needs between the host and refugee communities.ConclusionsBased on the qualitative and quantitative results of our assessment, a number of recommendations have been drawn up. It would be interesting to find a balance in the definition, attribution of causes and treatment of mental disorders between the traditional, mystical and cultural vision and the psychological and psychiatric one. It would be important to encourage refugee communities to return to some of their traditional practices, and to allow several visions of the human being to coexist between a traditional and a more medical vision.To address the lack of resources for mental health care in the Kadey area, more training in mental health and psychosocial support is needed for health and social workers in the area.Disclosure of InterestNone Declared

Beyond refugeeness: complex subjectivities in Palestinian refugee camps

ABSTRACT This article explores Palestinian refugeeness to argue for a more complex understanding of refugee subjectivity. The subjectivities of Palestinian refugees – and especially of those from the refugee camps – have been informed by their participation in national politics. Therefore, Palestinian refugees, while embodying experiences of violence, displacement and exclusion much like other refugee communities, have also been emphatically seen through their political agencies. In this article, I aim to complicate the emphasis on political subjectivity and explore Palestinian refugee subjectivity as complex, multidimensional, and contradictory. By narrating ethnographic encounters with two of my interlocutors, I demonstrate that subjectivities emerge not only from their politicized position as Palestinian refugees nor from the camp spaces they dwell in but from their complex and mundane relationalities that are neither static nor coherent. By emphasizing this fluid complexity, the aim is to acknowledge refugee subjectivities as multidimensional and fragile formations imbued with internal tensions that emerge from multiple and contradictory desires and from a sense of self that is not reducible to refugeeness.

Real-time investigation of an influenza A(H3N2) virus outbreak in a refugee community, November 2022

ObjectivesTo report epidemiological and virological results of an outbreak investigation of influenza-like illness (ILI) among refugees in Northern Italy. Study designOutbreak investigation of ILI cases observed among nearly 100 refugees in Northern Italy unvaccinated for influenza. MethodsAn epidemiological investigation matched with a differential diagnosis was carried out for each sample collected from ILI cases to identify 10 viral pathogens (SARS-CoV-2, influenza virus type A and B, respiratory syncytial virus, metapneumovirus, parainfluenza viruses, rhinovirus, enterovirus, parechovirus, and adenovirus) by using specific real-time PCR assays according to the Centers for Disease Control and Prevention (CDC) protocols. In cases where the influenza virus type was identified, complete hemagglutinin (HA) gene sequencing and the related phylogenetic analysis were conducted. ResultsThe outbreak was caused by influenza A(H3N2): the attack rate was 83.3% in children aged 9–14 years, 84.6% in those aged 15–24 years, and 28.6% in adults ≥25 years. Phylogenetic analyses uncovered that A(H3N2) strains were closely related since they segregated in the same cluster, showing both a high mean nucleotide identity (100%), all belonging to the genetic sub-group 3C.2a1b.2a.2, as those mainly circulating into the general population in the same period. ConclusionsThe fact that influenza outbreak strains as well as the community strains were genetically related to the seasonal vaccine strain suggests that if an influenza prevention by vaccination strategy had been implemented, a lower attack rate of A(H3N2) and ILI cases might have been achieved.

OVERGROWING REFUGEE PROBLEM IN LEBANON

The growing issue of Syrian refugees in Lebanon weaves tightly with Lebanon's past. It's a country with a complex history surrounding refugees, especially Palestinian refugees, and a long past with Syria. This rising refugee concern started after the Syrian Civil War. It's also tied to political, social, and economic elements that shaped Lebanon's reaction to this human crisis. Lebanon serving as a sanctuary for refugees isn't a new thing. It started before the Syrian refugee wave that came after the 2011 Civil War. The long-standing Palestinian refugee community, who've lived in Lebanon's camps for about seven decades, remarkably impacted Lebanon's view on welcoming refugees. Lebanese-Palestinian history carries weight due to the Arab-Israeli conflicts and PLO's role in the Lebanese Civil War. This past creates a hesitant, suspicious attitude in Lebanon towards refugees. It impacts how they handle the crisis of Syrian refugees. Also, the lasting stay of Syrian soldiers in Lebanon following its Civil War added tension. This, combined with Syria's large political sway, has intensified the rift between the countries. The long-term effects of this situation have stirred negativity towards Syrians and refugees in Le Banon. It's impacted both societal views and politics. It's also determined how Lebanon's government handles the necessities of Syrian refugees. Lebanon has a special governance system. It gives roles to people based on their religion. It has really influenced how they treat the refugee situation. Why? Because they're scared. They're scared about their population changing. Scared about tension between religious groups. That worry makes them hesitant in giving legal status to the refugees. They're worried that this might make the refugees want to stay longer. The past vents highlight the complex reasons for Lebanon's approach to the increasing refugee situation. The Syrian Civil War started, and Lebanon became home to roughly 1.5 million Syrian refugees. That's a ton for a place with around only 6.8 million people. Lebanon faces a massive dilemma now. It tests their shaky economy and society greatly. Lebanon's challenge is dealing with a large number of refugees. Their old residency rules make it tough. Many Syrians don't have official status. They can't work, go to school, or get healthcare. They might be taken advantage of and can't do much legally about it. Additionally, tough management hurdles, like the twice-yearly complex registration for refugees over 15, carry on their unstable situation. Various refugees, scared off by the difficult renewal steps, choose not to renew their legal status. This worsens their risk and blocks their way to vital services. The refugee crisis has had a profound and far-reaching impact on the fundamental rights and well-being of those affected, particularly in the areas of education, healthcare, and basic living conditions. These dire circumstances permeate all aspects of their lives, potentially perpetuating long-term vulnerabilities and significantly affecting their daily existence. In this context, international aid has played a crucial role in addressing the immense humanitarian needs created by Lebanon's refugee crisis. However, the necessary funds to adequately support these individuals have fallen short, resulting in approximately 54% of the required 2014 funding remaining unmet. This financial strain has only added to the already daunting challenges of providing essential support and services to the refugees.