Monday, June 24, 2019

Trauma and mental health among forcibly displaced and conflict-affected refugee populations in Uganda



Hazar H. Khidir, M.D. 
Resident in PHS Emergency Medicine Residency 
PGY 2

June 18, 2019

What makes one want to leave their home? For refugees, it is the feeling of needing to flee from violence, poverty, and/or persecution. This impetus  is what fundamentally distinguishes refugees from other migrants.  Refugees flee whereas migrants immigrate. Thus, the pre-migration, perimigration, and post-migration experiences of refugees are uniquely marked by higher incidents of trauma. I understood this from by background research on incidents of trauma and prevalence of mental health illnesses (depression, anxiety, post-traumatic stress disorder) among refugee populations globally. My aim in traveling to Nakivale in person was to try to understand the forces of flight, migration experience, and the mental health outcomes of refugees on a more individual, human level. 

Nakivale Refugee Settlement was opened in 1958 and officially established as a settlement in 1960. Officially, based on UNHCR (the UN Refugee Agency) figures, Nakivale hosts > 100,000 refugees from Burundi, the Democratic Republic of Congo, Eritrea, Ethiopia, Rwanda, Somalia, Sudan, and South Sudan. During the Burundi crisis in 2015, the population of the settlement greatly increased and has since remained this high.

The settlement span across 185 km. It is at times both sparsely populated with small clusters of modest homes scattered across a large area of land and densely populated, informal shopping markets. The markets are impressive in scope, with hundreds of stalls. Stalls sell food, offer salon services, and locally manufactured goods such as metal gates, wooden bed frames, and cultural garb.

There are several individual communities within the settlement that are largely separated based on country of origin (i.e. Burundi Camp, Somali camp, Ethiopian camp, “New congo”). There are one or two camps that host an integrated community of refugees. Religion appears to be a factor that has resulted in self-segregation of the Somali refugee community from refugees of other nationalities.

There is also noticeable variation in socioeconomic status. There are those who have established successful shops and are relatively thriving and those who can’t afford enough food and are dependent on World Food Program distributions. All residents of Nakivale Settlement receive care from three clinics. These clinics off very basic medical testing but no imaging (including chest x-rays) or other diagnostics. The nearest referral center for the clinics is Mbarara’s University Hospital, the second largest referral hospital in Uganda.

27 comments:

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      If you have any problem like
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      *HIV/Aids,
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    1. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
      (Dr.idowuherbalhome@gmail.com)
      If you have any problem like
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      *Penis enlargament/ass,
      WhatsApp him via (+2348052789941)
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  3. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
    (Dr.idowuherbalhome@gmail.com)
    If you have any problem like
    *Herpes 1/2,
    *HIV/Aids,
    *Hepatitis a,b,c,
    *Breast cancer/cancer,
    *Marriage,
    *Pregnancy problem,
    *Ex back, 
    *Penis enlargament/ass,
    WhatsApp him via (+2348052789941)
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    ReplyDelete
    Replies
    1. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
      (Dr.idowuherbalhome@gmail.com)
      If you have any problem like
      *Herpes 1/2,
      *HIV/Aids,
      *Hepatitis a,b,c,
      *Breast cancer/cancer,
      *Marriage,
      *Pregnancy problem,
      *Ex back, 
      *Penis enlargament/ass,
      WhatsApp him via (+2348052789941)
      Please give him a try ,no harm in trying ok....   

      Delete
  4. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
    (Dr.idowuherbalhome@gmail.com)
    If you have any problem like
    *Herpes 1/2,
    *HIV/Aids,
    *Hepatitis a,b,c,
    *Breast cancer/cancer,
    *Marriage,
    *Pregnancy problem,
    *Ex back, 
    *Penis enlargament/ass,
    WhatsApp him via (+2348052789941)
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    ReplyDelete


  5. God bless Dr.MACAULAY for his marvelous work in my life, I was diagnosed of HERPES since 2018 and I was taking my medications, I wasn't satisfied i needed to get the HERPES out of my system, I searched out some possible cure for HERPES i saw a comment about Dr.MACAULAY, how he cured HERPES,DIABETES,HIV,and CANCER with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine I took the medicine as prescribed by him and 14 days later i was cured from HERPES, Dr. MACAULAY truly you are great, do you need his help also? Why don’t you contact him through his EMAIL: DR.MACAULAYHERALHOME@YAHOO.COM,WHATSAPP +258876173604 for any help......

    ReplyDelete
    Replies
    1. Hello everyone here, Am Lady bar Patricia Covenupa. from Bronx,New York United States.I want everyone to know how grateful i am after the restoration of my marriage with the help of a spell caster called Dr CHUKWU MADU. He is great and unique,i saw people testifying about Doc.Chukwu and i told him my problems and he cast a love spell that brought my husband back to me after he has cheated and wanted a divorce after 3 years of our marriage. Dr CHUKWU MADU is there to respond to your relationship problems and other human activities like, email him at dr.chukwumaduherbalhome@gmail.com
      Whatsapp Number +2347030936239
      1.Bringing back your ex lover to you. (penis Enrlargment)

      2.Spell to win Lottery ( Herpes CURE Cure all types of disease) 

      3.He cure all types of human diseases. HEPATITIS B

      4.He cast a spell to get a good job with high income.

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      Delete


  6. God bless Dr.MACAULAY for his marvelous work in my life, I was diagnosed of HERPES since 2018 and I was taking my medications, I wasn't satisfied i needed to get the HERPES out of my system, I searched out some possible cure for HERPES i saw a comment about Dr.MACAULAY, how he cured HERPES,DIABETES,HIV,and CANCER with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine I took the medicine as prescribed by him and 14 days later i was cured from HERPES, Dr. MACAULAY truly you are great, do you need his help also? Why don’t you contact him through his EMAIL: DR.MACAULAYHERALHOME@YAHOO.COM,WHATSAPP +258876173604 for any help........

    ReplyDelete


  7. God bless Dr.MACAULAY for his marvelous work in my life, I was diagnosed of HERPES since 2018 and I was taking my medications, I wasn't satisfied i needed to get the HERPES out of my system, I searched out some possible cure for HERPES i saw a comment about Dr.MACAULAY, how he cured HERPES,DIABETES,HIV,and CANCER with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine I took the medicine as prescribed by him and 14 days later i was cured from HERPES, Dr. MACAULAY truly you are great, do you need his help also? Why don’t you contact him through his EMAIL: DR.MACAULAYHERALHOME@YAHOO.COM,WHATSAPP +258876173604 for any help...............

    ReplyDelete
  8. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
    (Dr.idowuherbalhome@gmail.com)
    If you have any problem like
    *Herpes 1/2,
    *HIV/Aids,
    *Hepatitis a,b,c,
    *Breast cancer/cancer,
    *Marriage,
    *Pregnancy problem,
    *Ex back, 
    *Penis enlargament/ass,
    WhatsApp him via (+2348052789941)
    Please give him a try ,no harm in trying ok....   

    ReplyDelete
  9. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
    (Dr.idowuherbalhome@gmail.com)
    If you have any problem like
    *Herpes 1/2,
    *HIV/Aids,
    *Hepatitis a,b,c,
    *Breast cancer/cancer,
    *Marriage,
    *Pregnancy problem,
    *Ex back, 
    *Penis enlargament/ass,
    WhatsApp him via (+2348052789941)
    Please give him a try ,no harm in trying ok....   

    ReplyDelete
  10. I already gave up on ever getting cured of HSV2 because i have tried many treatment none of them worked out for me i have gone to different hospital they always tell me same thing there is no cure for herpes when i came across a post about Dr RAZOR on the internet from a lady called Angela[USA] i contacted him and he reassured me of the effectiveness of his herbal medicine and he sent me thy medication after he promised to guide me, i took the medication according to the way he instructed, within 18 days i started having some changes in me and i went to the medical hospital for check up and i was confirmed herpes negative. I doubted at first because i have been to a whole lot of reputable doctors, tried a lot of medicines but none was able to cure me. so i decided to listen to him and he commenced treatment, and under 18 days i was totally freed from #Herpes. i want to say a very big thank you to DR RAZOR for what he has done in my life. You can leave him a message on email drrazorherbalhome@gmail.com and also WhatsApp him +2349065420442..
    He might as well be able to get rid of
    1...ALS CURE/DIABETES CURE/EPILESY/HPV CURE/LUPUS/HEPATITIS/CANCER/GOUT

    ReplyDelete
  11. I already gave up on ever getting cured of HSV2 because i have tried many treatment none of them worked out for me i have gone to different hospital they always tell me same thing there is no cure for herpes when i came across a post about Dr RAZOR on the internet from a lady called Angela[USA] i contacted him and he reassured me of the effectiveness of his herbal medicine and he sent me thy medication after he promised to guide me, i took the medication according to the way he instructed, within 18 days i started having some changes in me and i went to the medical hospital for check up and i was confirmed herpes negative. I doubted at first because i have been to a whole lot of reputable doctors, tried a lot of medicines but none was able to cure me. so i decided to listen to him and he commenced treatment, and under 18 days i was totally freed from #Herpes. i want to say a very big thank you to DR RAZOR for what he has done in my life. You can leave him a message on email drrazorherbalhome@gmail.com and also WhatsApp him +2349065420442..
    He might as well be able to get rid of
    1...ALS CURE/DIABETES CURE/EPILESY/HPV CURE/LUPUS/HEPATITIS/CANCER/GOUT

    ReplyDelete
  12. Hello everyone i am very delighted that i recently got cured of herpes virus. I have been battling with this disease for over 4 years now, ever since i got diagnosed of the virus i have been using medical pills and therapies to suppress the virus. But inside of me i needed the Virus gone cause my health was deteriorating, So  i went on to the internet to search on how one could get cured from this virus, when i came across some testimonies on how herbalist razor has helped them get rid of Herpes virus, Hiv/aids, Cancer. I copied out his details (email ; drrazorherbalhome@gmail.com) and Whatsapp number +2349065420442) as provided by the testifiers on a blog site. But before that i was so skeptical, i knew there are so many herbal doctors on the internet,i needed the one who can help me get through this Herpes Virus completely with his herbal Remedy. I got in contact with doctor Razor,and i explained my problem to him and he promised to help me, which he actually did. I got my medication in the US sent by doctor razor and he instructed me on how i was to take it for 18 days. After the said 18 days i went for medical check up and the doctors ran some test on me and told me i was Herpes Negative, i was amazed and dumb-folded, so i had to go back home, i noticed my health for some months, i didn't have any outbreaks nor symptoms of the virus, but i went to another hospital after 2 months to conduct another test and the same result. I will be forever grateful to you doctor Razor and I will make sure the world gets to know about your herbal exploits sir. Reach doctor razor on his email : drrazorherbalhome@gmail.com or whatsapp/call his cell on +2349065420442

    ReplyDelete
  13. Good day viewer, I am Nurse Sonia kuffin from Austria . It has happened the way you said it will sir. Daddy am very happy today for your help in my life, doctor Chukwu Madu herbal home you cured me finally from Herpes virus, I was infected with this deadly virus in the year 2012 and i was
    taking my medications, I wasn't satisfied i needed to get the HERPES out of my system, I searched about some possible cure for HERPES i saw a comment about Dr CHUKWU MADU HERBALHOME how he cured HERPES with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine through UPS delivery company. I took the medicine as prescribed by him and 11 days later i tested negative for HERPES, Dr.CHUKWU MADU truly you are great,It's Good for herpes patient to please read my testimony becuase People think herpes is really a minor skin irritation,herpes has a long term effects on health and The stigma attached to this virus by ignorant people is ridiculous. do you need his help also? Why don't you contact him through his email (dr.chukwumaduherbalhome@gmail.com) .
    or call him on +2347030936239.
    DOCTOR CHUKWU MADU CAN AS WELL CURE THE FOLLOWING VIRUS:-
    1. HIV/AIDS .
    2. HERPES .
    3. CANCER .
    4. Hepatitis B AND C.
    5. Diabetes.
    6. Athrux,
    7. hydrophobia
    8.hpv .
    9 pregnancy spell and bring back your ex back .
    10 scabies .
    He cures any kind if viruses and diseases.

    ReplyDelete
  14. Six weeks previously, I had attended my primary care doctor (PCD) with dysuria and was treated for a urinary tract infection, however, symptoms persisted. Several days later I noticed an acute onset of bilateral vulvar blisters. I was clinically diagnosed with genital herpes and commenced taking valacyclovir 500 mg bd for one week as instructed by my  PCD. The blisters resolved within five days, however, I developed burning and exquisite sensitivity to touch in both inner thighs and in my left buttock extending down my left leg and including the sole of my left foot and toes. I found that at times, I was unable to walk and sit. So returned to her PCD who told me to continue taking valacyclovir for another week, however, the burning persisted. And I knew this was never going to cure me. I sorted for Natural Herbs And Gos so good i came across doctor razor's Details,I contacted him and we spoke and he assured me everything is going to be permanently fine. Few days after I reached out to him he sent me herbal medicine to take for 18 days. after completing the dosage for 18 days. I started noticing some changes in my Genital Area. so i told the herbalist about it, he asked me to go for a medical test, which i did. Lo and behold, My PCD was surprised to see my result out Negative,. I was overwhelmed with joy, I waited for 2 weeks to make sure the Virus was not laying dormant in my Nerve Cells, So i went for another test After the two months, And it had the same Negative result. I am forever indebted to you Doctor Razor. If you are having hard times with this same virus or you do know of anyone with herpes virus, i kindly recommend you to him. Email drrazorherbalhome@gmail.com
    WhatsApp or Call his cell phone +2349065420442..,.

    ReplyDelete
  15. Hello everyone here, Am Lady bar Patricia Covenupa. from Bronx,New York United States.I want everyone to know how grateful i am after the restoration of my marriage with the help of a spell caster called Dr CHUKWU MADU. He is great and unique,i saw people testifying about Doc.Chukwu and i told him my problems and he cast a love spell that brought my husband back to me after he has cheated and wanted a divorce after 3 years of our marriage. Dr CHUKWU MADU is there to respond to your relationship problems and other human activities like, email him at dr.chukwumaduherbalhome@gmail.com
    Whatsapp Number +2347030936239
    1.Bringing back your ex lover to you. (penis Enrlargment)

    2.Spell to win Lottery ( Herpes CURE Cure all types of disease) 

    3.He cure all types of human diseases. HEPATITIS B

    4.He cast a spell to get a good job with high income.

    5.He cast a pregnacy spell(friutfulness of the worm)

    6.He cast a spell of promotion in your working place.

    7.He cast a spell of protection,
    etc.
    Contact him directly on his active Email address him at dr.chukwumaduherbalhome@gmail.com
    Whatsapp Number +2347030936239

    ReplyDelete
  16. TO EVERYONE BATTLING WITH HERPES INFECTION ,I want to quickly drop my life story on how a specialized healer called DR RAZOR cured me from HERPES virus, A good man who have used his herbal roots and herbs to cure all kind of deadly disease. I was infected with HERPES virus and I never thought HERPES virus could be cured,but with the medication DR RAZOR sent to me i was cured,I saw his email on web page by a patient he has cured from HERPES,who dropped the email and phone contact of the doctor.I really thank FLORENCE for sharing her testimony on how she was cured When I contacted him he prepared the herbal medication for my HERPES cure and send it to me via DHL And i got cured within 18 days of using the herbal medicine,Contact him through E-MAIL drrazorherbalhome@gmail.com or for easy communication you can WHATSAPP/CALL him via his mobile number +2349065420442. He can Also cure Infections like :HSV 1 & HSV 2ASTHMADIABETESEPILEPSYCANCERINFERTILITYSTAPHYLOCOCCUS.BARRENNESSHIV /AIDSHEPATITIS B Kidney?

    ReplyDelete
  17. GOD BLESS DR KELECHUKWU HERBAL HOME FOR THE WONDERFUL WORK HE HAS DONE IN MY LIFE,INDEED YOU ARE GOD SENT.I have been suffering from Herpes virus for 6 years and i was told by my doctor that it has no cure.After years of believing that herpes has no cure i finally came across some comments on the Internet,about how Dr.kelechukwu has cured lots of people with his herbal medication, i gave him a trial at first but when I got the herbal medication, i used it as prescribed.after 3weeks i went to my doctor for check up,to my greatest surprise i tasted nagative.this is how i was cured permanently from herpes virus.God bless Dr kelechukwu herbal home for bringing back happiness in my life again.you the true Dr..feel free to reach him via his mail at drkelechukwu2@gmail.com or whatsApp him +2348077365216He also cureHIVCANCERHPVHERPES 1&2
    HEPATITIS e.t.c

    ReplyDelete
  18. My Sincere Gratitude to Dr Razor, I was infected with HERPES SIMPLEX VIRUS 2 November 13 2018, I went to many hospitals for cure but there was no solution, I was confused because the medical drugs has become my daily food, but i decided to sort after Natural Herbs. One day I sat beside the pool, Browsing and thinking where I could get a solution to end this my predicament. I saw a blog on how Dr Razor cured people with his herbal medicine, i did not believe but i just decided to give him a try, Visit Doctor's Razor's Website : https://drrazorherbalhome.wixsite.com/drrazorherbalhome .I contacted him and he prepare the herbs for me which i took, and he instructed me to go for check up, after the test i was confirmed herpes negative, i am so happy. If you have any problem or you are also infected with any disease, kindly contact him now with his Email: drrazorherbalhome@gmail.com or call +2349065420442This testimonial serves as an expression of my gratitude.
    He also have a herbal cure for COLD SORE,
    SHINGLES,
    CANCER(Cannabis Oil),
    HPV,
    ASTHMA,
    IMPOTENCE,
    BARENESS/INFERTILITY ..
    Contact him on this email: drrazorherbalhome@gmail.com , or call his cell phone number on +2349065420442

    ReplyDelete
  19. I want to use this medium to let everyone know that Herpes Simplex Virus has a complete and Permanent cure and that Dr Razor Herbal Medicine is the solution. I was Diagnosed with Herpes Virus type 1 in January 16, 2015, I have made several Research Hoping to see a true Cure or Healer, Fortunately for me i saw on a blog site how Dr Razor has been saving different lives and marriages with his herbal medicine, At first i did not believe but on a second thought, i decided to give him a try, I contacted him and he assured me of a cure, he prepared the herbal medication for me, which i took for 18 days, he told me to go for a medical check up, could you believe that i was confirm Herpes type 1 Negative after the test, and i went to a different hospital and it was also Negative, I became very happy and decided to write my appreciation article about this Good man. If you are battling with this same Infection or you know of a person who is infected with any disease like Herpes, HIV, Cancer, Syphilis, Hepatitis A,B,C, all types of Cancer, Gonorrhea, life's problems that you might have etc. kindly Reach out to Doctor Razor on Email : drrazorherbalhome@gmail.com. Whatsapp/Call him on +2349065420442. You can Also Visit His website : https://drrazorherbalhome.wixsite.com/drrazorherbalhome . My Sincere Gratitude to you Sir, God will surely Keep you safe from harms way. Please share so Other lives can be saved

    ReplyDelete
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  21. My ex-husband and I had always managed to stay friendly after our divorce in February 2017. But I always wanted to get back together with him, All it took was a visit to this spell casters website last December, because my dream was to start a new year with my husband, and live happily with him.. This spell caster requested a specific love spell for me and my husband, and I accepted it. And this powerful spell caster began to work his magic. And 48 hours after this spell caster worked for me, my husband called me back for us to be together again, and he was remorseful for all his wrong deeds. My spell is working because guess what: My “husband” is back and we are making preparations on how to go to court and withdraw our divorce papers ASAP. This is nothing short of a miracle. Thank you Dr Emu for your powerful spells. Words are not enough. here is his Email: emutemple@gmail.com or call/text him on his WhatsApp +2347012841542

    He is also able to cast spell like 1: Lottery 2: Conceive 3: Breakup 4: Divorce 5: Cure for all kinds of diseases and viruses.

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