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Quality of life after postconflict displacement in Ethiopia: comparing placement in a community setting with that in shelters

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Abstract

Background

The resilience of post-war displaced persons is not only influenced partly by the nature of premigration trauma, but also by postmigration psychosocial circumstances and living conditions. A lengthy civil war leading to Eritrea separating from Ethiopia and becoming an independent state in 1991 resulted in many displaced persons.

Method

A random sample of 749 displaced women living in the shelters in the Ethiopian capital Addis Ababa was compared with a random sample of 110 displaced women living in the community setting of Debre Zeit, 50 km away from Addis Ababa, regarding their quality of life, mental distress, sociodemographics, living conditions, perceived social support, and coping strategies, 6 years after displacement.

Results

Subjects from Debre Zeit reported significantly higher quality of life and better living conditions. However, mental distress did not differ significantly between the groups. Also, Debre Zeit subjects contained a higher proportion born in Ethiopia, a higher proportion married, reported higher traumatic life events, employed more task-oriented coping, and perceived higher social support. Factors that accounted for the difference in quality of life between the shelters and Debre Zeit groups in three of the four quality of life domains of WHOQOL-BREF (physical health, psychological, environment), included protection from insects/rodents and other living conditions. However, to account for the difference in the fourth domain (social relationships), psychosocial factors also contributed significantly.

Conclusion

Placement and rehabilitation in a community setting seems better than in the shelters. If this possibility is not available, measures to improve specific living conditions in the shelters are likely to lead to a considerable increase in quality of life.

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References

  1. Aptekar L, Giel R (2002) Walks in Kaliti, life in a destitute shelter for the displaced. In: de Jong J (ed) Trauma, war, and violence: public mental health in socio-cultural context. Kluwer Academic/Plenum Publishers, New York, pp 337–366

    Chapter  Google Scholar 

  2. Araya M, Chotai J, Komproe IH, de Joop JTVM (2007) Gender differences in traumatic life events, coping strategies, perceived social support and sociodemographics among postconflict displaced persons in Ethiopia. Soc Psychiatry Psychiatr Epidemiol 42:307–315

    Article  PubMed  Google Scholar 

  3. Araya M, Chotai J, Komproe IH, de Joop JTVM (2007) Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians. Qual Life Res 16:915–927

    Article  PubMed  Google Scholar 

  4. Ashmore J, Babister E, Corsellis T, Fowler J, Kelman I, McRobie A, Manfield P, Spence R, Vitale A, Battilana R, Crawford K (2003) Diversity and adaptation of shelters in transitional settlements for IDPs in Afghanistan. Disasters 27:273–287

    Article  PubMed  Google Scholar 

  5. Birman D, Tran N (2008) Psychological distress and adjustment of Vietnamese refugees in the United States: association with pre- and postmigration factors. Am J Orthopsychiatry 78:109–120

    Article  PubMed  Google Scholar 

  6. Birman D, Beehler S, Harris EM, Everson ML, Batia K, Liautaud J, Frazier S, Atkins M, Blanton S, Buwalda J, Fogg L, Cappella E (2008) International family, adult, and child enhancement services (FACES): a community-based comprehensive services model for refugee children in resettlement. Am J Orthopsychiatry 78:121–132

    Article  PubMed  Google Scholar 

  7. Bonner PC, Schmidt WP, Belmain SR, Oshin B, Baglole D, Borchert M (2007) Poor housing quality increases risk of rodent infestation and Lassa fever in refugee camps of Sierra Leone. Am J Trop Med Hyg 77:169–175

    PubMed  Google Scholar 

  8. Cutrona CE, Russell D (1987) The provisions of social relationships and adaptation to stress. In: Jones WH, Perlman D (eds) Advances in personal relationships, vol 1. JAI Press, Greenwich, CT, pp 37–68

    Google Scholar 

  9. de Jong JTVM (2002) Public mental health, traumatic stress and human rights violations in low-income countries: a culturally appropriate model in times of conflict, disaster and peace. In: de Jong J (ed) Trauma, war, and violence: public mental health in socio-cultural context. Kluwer Academic/Plenum Publishers, New York, pp 1–91

    Chapter  Google Scholar 

  10. de Jong JT, Komproe IH, van Ommeren M, el Masri M, Araya M, Khaled N, van de Put W, Somasundaram D (2001) Lifetime events and posttraumatic stress disorder in 4 postconflict settings. JAMA 286:555–562

    Article  PubMed  Google Scholar 

  11. de Jong JT, Komproe IH, van Ommeren M (2003) Common mental disorders in postconflict settings. Lancet 361:2128–2130

    Article  PubMed  Google Scholar 

  12. Derogatis LR (1994) SCL-90-R: symptom checklist-90-R. Administration, scoring and procedures manual. National Computer Systems, Minneapolis, MN

  13. Dobricki M, Komproe IH, de Jong JTVM, Maercker A (2010) Adjustment disorders after severe life-events in four postconflict settings. Soc Psychiatry Psychiatr Epidemiol 45:39–46

    Article  PubMed  Google Scholar 

  14. Endler NS, Parker JDA (1990) Multidimensional assessment of coping: a critical evaluation. J Pers Soc Psychol 58:844–854

    Article  PubMed  CAS  Google Scholar 

  15. Endler NS, Parker JDA (1994) Assessment of multidimensional coping: task, emotion, and avoidance strategies. Psychol Assess 6:50–60

    Article  Google Scholar 

  16. Graham K, Rehman H, Ahmad M, Kamal M, Khan I, Rowland M (2004) Tents pre-treated with insecticide for malaria control in refugee camps: an entomological evaluation. Malar J 3:25

    Article  PubMed  Google Scholar 

  17. Lev-Wiesel R, Amir M (2000) Posttraumatic stress disorder symptoms, psychological distress, personal resources, and quality of life in four groups of Holocaust child survivors. Fam Process 39:445–459

    Article  PubMed  CAS  Google Scholar 

  18. Lindencrona F, Ekblad S, Hauff E (2008) Mental health of recently resettled refugees from the Middle East in Sweden: the impact of pre-resettlement trauma, resettlement stress and capacity to handle stress. Soc Psychiatry Psychiatr Epidemiol 43:121–131

    Article  PubMed  Google Scholar 

  19. Medlock JM, Aryemo M, Bean J (2007) Impact of mosquito proofing of night shelters in refugee camps in Kitgum, northern Uganda. Trop Med Int Health 12:370–376

    Article  PubMed  Google Scholar 

  20. Mollica RF, Caspi-Yavin Y, Bollini P et al (1992) The Harvard Trauma Questionnaire—validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis 180:111–116

    Article  PubMed  CAS  Google Scholar 

  21. Mollica RF, Cui X, McInnes K et al (2002) Science-based policy for psychosocial interventions in refugee camps: a Cambodian example. J Nerv Ment Dis 190:158–166

    Article  PubMed  Google Scholar 

  22. Mollica RF, Lopes Cardozo B, Osofsky HJ et al (2004) Mental health in complex emergencies. Lancet 364:2058–2067

    Article  PubMed  CAS  Google Scholar 

  23. Mollica F, McInnes K, Pham T et al (1998) The dose–effect relationships between torture and psychiatric symptoms in Vietnamese ex-political detainees and a comparison group. J Nerv Ment Dis 186:543–553

    Article  PubMed  CAS  Google Scholar 

  24. Olsen LR, Mortensen EL, Bech P (2006) Mental distress in the Danish general population. Acta Psychiatr Scand 113:477–484

    Article  PubMed  CAS  Google Scholar 

  25. Perez-Sales P, Cervellon P, Vazquez C et al (2005) Post-traumatic factors and resilience: the role of shelter management and survivors’ attitudes after the earthquakes in El Salvador (2001). J Community Appl Soc Psychol 15:368–382

    Article  Google Scholar 

  26. Porter M, Haslam N (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta- analysis. JAMA 294:602–612

    Article  PubMed  CAS  Google Scholar 

  27. Punamäki RL, Komproe I, Qouta S et al (2005) The deterioration and mobilization effects of trauma on social support: Childhood maltreatment and adulthood military violence in a Palestinian community sample. Child Abuse Negl 29:351–373

    Article  PubMed  Google Scholar 

  28. Rafnsson FD, Smari J, Windle M et al (2006) Factor structure and psychometric characteristics of the Icelandic version of the Coping Inventory for Stressful Situations (CISS). Personal Individ Differ 40:1247–1258

    Article  Google Scholar 

  29. Schmitz N, Hartkamp N, Kiuse J et al (2000) The Symptom Check-List-90-R (SCL-90-R): a German study. Qual Life Res 9:185–193

    Article  PubMed  CAS  Google Scholar 

  30. Skevington SM, Lotfy M, O’Connell O (2004) The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL Group. Qual Life Res 13:299–310

    Article  PubMed  CAS  Google Scholar 

  31. SPSS Inc (2005) SPSS Base 14.0 and AMOS 6.0 for Windows. Chicago, IL

  32. Thapa SB, Hauff E (2005) Psychological distress among displaced persons during an armed conflict in Nepal. Soc Psychiatry Psychiatr Epidemiol 40:672–679

    Article  PubMed  Google Scholar 

  33. Trompenaars FJ, Masthoff ED, Van Heck GL et al (2005) Content validity, construct validity, and reliability of the WHOQOL-BREF in a population of Dutch adult psychiatric outpatients. Qual Life Res 14:151–160

    Article  PubMed  Google Scholar 

  34. Turnip SS, Hauff E (2007) Household roles, poverty and psychological distress in internally displaced persons affected by violent conflicts in Indonesia. Soc Psychiatry Psychiatr Epidemiol 42:997–1004

    Article  PubMed  Google Scholar 

  35. UNHCR (2007) Internally displaced persons: questions and answers. Available at http://www.unhcr.org/basics/BASICS/405ef8c64.pdf. Retrieved January 2007

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Addis Ababa University, P.O. Box 9986, Addis Ababa, Ethiopia

    Mesfin Araya

  2. Division of Psychiatry, Department of Clinical Sciences, University of Umeå, 901 85, Umeå, Sweden

    Mesfin Araya & Jayanti Chotai

  3. Department of Research and Development, HealthNet TPO, Amsterdam, The Netherlands

    Ivan H. Komproe & Joop T. V. M. de Jong

  4. Department of Psychiatry, Boston University School of Medicine, Boston, USA

    Joop T. V. M. de Jong

  5. Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands

    Ivan H. Komproe

Authors
  1. Mesfin Araya
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  2. Jayanti Chotai
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  3. Ivan H. Komproe
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  4. Joop T. V. M. de Jong
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Corresponding author

Correspondence to Jayanti Chotai.

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Araya, M., Chotai, J., Komproe, I.H. et al. Quality of life after postconflict displacement in Ethiopia: comparing placement in a community setting with that in shelters. Soc Psychiatry Psychiatr Epidemiol 46, 585–593 (2011). https://doi.org/10.1007/s00127-010-0223-1

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  • DOI: https://doi.org/10.1007/s00127-010-0223-1

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