2.2 Who is a Refugee?
2.3.3 Experiences in the Host Country (Post-Migration)
2.3.3.2 Post Traumatic Stress Disorders
39 country, but may decide not to as a result of negative experiences such as xenophobia, discrimination and violence. As a result, refugee children will not have any culture that they would be following. According to Berry (1997) marginalization occurs when refugees do not maintain their culture or follow the culture of the host country when they settle.
Berry’s model was criticised for not explaining whose culture refugees would be following when they adopt a marginalization strategy. It is important to note that Berry’s model of acculturation has been challenged and continues to be a subject of critical debate (MacLachlan & McGee, 2007). Perez-Escamilla and Putnik (2007) acknowledged the four acculturation strategies in Berry’s model, but also reported that many more phases (other than the four) exist on acculturation. Regardless of the acculturation strategy that a refugee child adopts, the process is strenuous and stressful. Kelly (2010) postulates that the need to negotiate a new culture results in some refugees experiencing discrimination, depression, and PTSD.
40 Kinzie (2006) avers that it is highly probable that refugees who experience trauma will have PTSD and depression. When children are traumatised, they may experience psychological disturbance which can manifest itself as PTSD when they settle in a country of refuge (Björn, Bodén, Sydsjö & Gustafsson, 2011). Post-migration problems are significantly associated with PTSD symptoms (Carswell, Blackburn & Barker, 2011). PTSD is an illness that refugees have as a result of trauma. Muneghina and Papadopoulos (2010) contend that due to trauma, some refugee children develop diagnosable psychiatric disorders and the most common one is PTSD, which requires professional intervention. When refugees suffer from mental health problems, it can also be linked to PTSD because it manifests in different ways.
Refugee children encounter trauma in different ways. They can be traumatised in all stages of refugee experiences (Birman et al., 2008; Papadopoulos, 2007). Hollander et al. (2011) contend that stress caused by children’s experiences (such as torture and losing homes and family members) in their home countries can lead to depression and PTSD. PTSD involves intense fear, helplessness, or terror. PTSD occurs in children when they re-experience a certain traumatic event (Flouri, 2005). Durio and Schneider (2007) listed the symptoms of PTSD which include:
• Flashbacks to the original traumatic event
• Sleep disruptions (nightmares, sleep disturbances)
• Depression
• Irritability or anger, sometimes to the point of violence
• Withdrawal from family, friends, and previously enjoyed activities
• Emotional numbness
• Loss of attention and ability to focus on work or family (p. 63)
Flashback is when children remember and visualise painful memories that they had. This is prominent among children because they tend to meditate about their losses and find it difficult to put those memories aside in order to move on (Papadopoulos, 2007). Sleep disruptions and depression are also common among refugee children. They will find it difficult to sleep at night which explains why some sleeps at school during the day. As children would be sleeping, the elements of isolation and depression come into play. Thus PTSD occurs in a series of ways to young children.
41 According to the American Psychiatric Association [APA] (2000) PTSD can be grouped into three categories:
i) Re-experiencing of the traumatic event. Hart (2009) argues that re-experiencing of traumatic events can happen through nightmares, flashbacks and intrusive thoughts;
ii) Avoidance, whereby children will be evading discussing their previous experiences or keep away from situations that might make them remember their traumatic experiences (Durio & Schneider, 2007); and
iii) Numbing, which entails increased arousal. Children may be feeling very numb and have no sensation as a result of the experienced PTSD.
Finding ways to cope with children’s traumatic experiences and protecting themselves from re- experiencing injuries of the past is another major challenge that refugees encounter which can exacerbate PTSD (Lin, Suyemoto & Kiang, 2009). This is because they may be living under harsh circumstances which will not permit them to forget the past. Some refugee children may potentially experience trauma in both their home countries and in hosting nations and will require some form of therapy. Without professional help to get rid of PTSD, some refugee children end up isolating themselves (Lin et al., 2009). According to Lin et al. (2009) high rates of PTSD among Cambodian refugees were manifested through avoidance, accompanied by silence as a coping strategy. Some refugee children may develop symptoms such as feeling sad and getting bored all the time.
As a result of severe traumatic experiences, some Darfur refugees developed symptoms of PTSD that include severe headaches, forgetting things, thinking deeply about some things, fear of demons, feeling very miserable and hopelessness (Rasmussen et al., 2011). PTSD negatively affects children’s education because of forgetfulness and general sickness of the child which results from constant recurrence of trauma.
42 2.4 Challenges Faced by Refugees
When persons are forced to flee from their homes and move to a new country to seek refuge, they understandably experience a variety of challenges which affect almost every single aspect of their lives (Muneghina & Papadopoulos, 2010). The frustrations which refugee children and asylum seekers face in their entire lives are very complex and demotivating. The barriers they encounter can be financial and accessibility challenges (Elwyn et al., 2012). They may face barriers and challenges such as hardships in accessing health care, becoming victims of xenophobia, being placed into large groups regardless of their educational backgrounds and having language difficulties.