Basic Psychological Needs Satisfaction and Psychological Wellbeing of Refugees in Africa.

Method

Qualitative data were collected first through focus group discussions (FGDs) to understand what factors contribute to the psychological well-being/frustration of both refugees and the host community. The qualitative study guide had the following questions; what frustrates or encourages your psychological well-being (subjective feelings of happiness, satisfaction or dissatisfaction with life)? How would you describe your current psychological well-being? Are there things that you have experienced as frustrations of your (subjective feelings of happiness, or dissatisfaction with life)? What have you done individually or as a group to achieve positive psychological well-being? Explain more about your response. How do you describe your current environment while you are staying with people from different nationalities, tribes as well as ethnic backgrounds? What does this mean to you? The rationale for having a sequential design was to allow both researcher and the respondents to understand what factors contribute to their psychological well-being. This may differ from person to person and from group to group.

Setting

The study took place in the Rhino camp refugee settlement in Arua District. The refugee settlement is over 72 km away from Arua City and approximately 449km from the capital city Kampala. Participants were recruited from the 7 zones that make up Rhino Camp (Omugo, Ofua, Tika, Eden, Ocea, Odobu and Eden) as well as the host community neighbouring this refugee settlement. Fully registered refugees and Ugandan Nationals were both recruited from the above locations for the study. Focus Group discussions were conducted in a quiet and safe environment in tents and some cases in classroom blocks for the youth in school. For the host community, the FGD took place in homes compounds and outside the dwelling for the FGD in Arua town.

Participants

To ensure all groups were well represented, the study involved refugees with 5 FGDs and the host community that had 4 FGDs, each FGD was comprised of 6 people hence a total number of N =54 participants. The refugees from different nationalities and different ethnic backgrounds took participated in the study (Southern Sudanese, Burundians, Congolese, Rwanda, and others). Then the host community was represented by both adults and youth, the same was for refugees.

Procedure and Ethical Considerations

The study was ethically approved by the Bremen International Graduate Institute of Social Sciences (BIGSSS) Research Ethics Committee (REC) and Uganda Christian University-REC. In addition, the Uganda National Council for Science and Technology (UNCST) and the Office of the Prime Minister (OPM) department of refugees in Uganda as representatives of the Ugandan Government authorized the study as well.

For this study, local research assistants/interpreters were recruited, and trained on relevant aspects to consider as well as the ethical guidelines which included but were not limited to confidentiality, and empathy among others. Before they could start the interpretation work where the researcher relied on them for translation/interpretations of the key terms into local languages was provided and their roles were explained throughout the entire process of data collection. Written consent from all the participants who took take part in the study was obtained, and the respondents had the opportunity to understand the consent form as it will be interpreted and translated into local languages used in the FGDs. Only participants aged 18 years and above took part in this study. To ensure confidentiality, no identifying information like the names of participants was recorded, but rather initials and signatures were used. During the FGDs a field tent was used to observe the confidentiality of the participants from the non-participants. The tent also shielded participants from the harsh sunshine and rain eventualities during the discussions. Each of the participants was compensated with UGX 28,000 to cater for meals and refreshments and transport refunds. The rationale for providing them transport was to ensure that the long distances within the camp from home to venue and venue to home as some had to cover more than 20 km twice and more. Respondents were informed that the compensation money “does not mean that they had to provide information which they not have but rather to cater for the expenses and time spent as explained above”.

The team of Uganda Christian University- REC, paid a visit to Rhino Camp to follow up with ethical compliance. They interacted with several participants and they later confirmed that all procedures were followed, and participants’ welfare was catered for. The REC has a mandate to do this and the participants were also aware of it as explained in the consent form.

Data Analysis

Thematic analysis was used according to procedures outlined by Braun and Clarke [5] to understand participants’ perspectives in response to the research question. Verbatim transcription of qualitative data was done, initial coding done, similar or related codes were grouped and this was followed by the creation of themes. The themes were later discussed with the interpreters who helped to track consistency. The narrative was prepared by addressing each theme and including participants’ quotes verbatim to support themes.

Results

The focus groups from both the refugee settlement and host community reported on several factors that contribute to their psychological well-being/frustration. The factors that were frequently discussed are presented below and will be contextualized in the already existing literature and reports and later will be linked to BPNS.

Availability of Food

In all focus discussion groups, food was the main factor that contributed significantly to their psychological well-being/frustration as it was talked about in each focus group discussion. For example, refugees reported feeling happy when food is always available, however, reported frustration onset in the event when food gets finished before the next distribution which leaves them with nothing to feed, and it was more problematic for those with children. However, food concern was never presented as a key concern in the host community. They appreciated the arrival of refugees whom they reported served as a market to whom they sell their garden produce. while food is categorized as a physical basic need, the issue of having limited influence on decision making concerning food can be fully related to the aspect of autonomy as major decisions are done by WFP.

….. “food reduction, some people are sleeping hungry. The little food given you cannot reach to the two months. It has really stressed people much”. (FGD, refugee in Rhino Camp-Omugo zone).

…… ‘I also want to add, food was reduced and the advice they give to the refugees is it that they should be tilling their land, it is now being a challenge. Some of the refugees most of them are finding their way back to South Sudan in the country, the place is not yet okay, war is still there. Unfortunately, others go and they are shot dead.” (FGD, refugee in Rhino Camp-Ofua zone).

….“I think when food is scarce, food at home is very scarce and that shortage makes me feel unhappy. Because of that shortage of food sometimes my children cry for food but I could not even provide for them. I myself I cannot even sustain myself.” (FGD, refugee in Rhino Camp-Ocea zone).

Family Separation and Deaths

Across the majority of focus groups from the refugee settlements, it emerged that separation from their family members negatively affects their psychological well-being on daily basis. This was coupled with the inability to attend burial ceremonies in case one lost their beloved one away from the camp. They stressed that they cannot have any chance to even travel to their respective countries due to fear for their lives, instead they live with the pain in the refugee camp. Some were unhappy with burying deceased loved ones in the camp noting that when they happen to go back to their countries they will leave their past loved ones in a foreign land. This is an example of frustration due to the need for relatedness as far as BPNS is concerned.

…..“You know, at this point, when we are in the settlement some other things were not in place, as usual as we had them before. And since we came here, you know we lost a lot of things, lost families” (FGD, Refugee in Rhino Camp- Tika zone).

…..“One of the things that made her unhappy is sickness, also if you lose a loved one those are the things which make them unhappy” (FGD, refugee in Rhino Camp-Ofua zone).

……“Losing my family my friends, people who died when I was here and not able to bury them, things like those cause frustration.” (FGD, refugee in Rhino Camp).”

Good Security in the Refugee Camp

Security emerged as a very positive factor for all the refugees and for Ugandans in the host community. A situation where the refugees have no worry about gunshots, and rebel attacks meant a lot of living described as happy and comfortable; they reported that this greatly contributes to their psychological well-being. This aspect can also be linked to competence, the focus groups viewed the Rhino camp as a peaceful environment compared to their previous countries that had daily attacks by rebels. Participants reported that children born in the Rhino camp have heard of or experienced war and they want them to be spared of this experience. Credit was given to the Ugandan Government for ensuring good and reliable security right from border entry and in the refugee camp.

……“to me what makes me happy in this settlement, I am just free just free not as I used to be in South Sudan you don't hear the sounds of bombs or people shooting themselves so I feel that I'm just safe here in the settlement”. (FGD, Refugee in Rhino Camp- Omugo zone)

……“I think I have an idea, what I've seen what makes me happy is my security, because here in the settlement I cannot see armed men carrying guns for killing people. But the arms they carry are just for protection for security and I can also see people carrying guns in the food distribution centre just for protecting my food from someone going to take it out from me and I cannot see someone dying because of insecurity. So that's what makes me happy in this settlement.” (FGD, refugee in rhino Camp- Odobu Zone)

……“When I wake up from here of course I feel glad because I'm alive and I am safe and the I have to be first of all happy for the life, in summary, I can say that security because I wake up and I'm safe nothing has happened to me there at least I have some reason to be happy” (FGD, a youth refugee in Rhino Camp)

Health Services

It was a relief that refugees have free access to medical health facilities in the refugee camps. The focus groups from the refugee camp mentioned this as another key factor towards their happy living in the camp, this can be linked to competence. To some extent, they reported feeling frustrated in circumstances when certain drugs were not at health centers and they had either to wait or be advised to buy from clinics which are not even within their reach.

……”Let me talk on behalf of health, as refugees when we were brought here we saw that they have provided us with health facilities where there are services of treatment when you're feeling sick, you come to the facility. They test you when you have malaria they give you drugs instead of you using small money got from causal work and go to the clinic and buy drugs but here since there is free facility, you just come freely, they test for malaria they give you drugs you go home you become fine. I am very happy with me myself because I've come as a refugee and I've seen that in this facility people are not dying because of malaria and other diseases. If at all you are sick you just come to the facility straight away. Then you are worked on. They give you drugs then you become fine.” (FGD, Refugee in Rhino Camp- Omugo zone)

…… “They might tell me these drugs are not there. You go home maybe come and check for these drugs after some days or one week or two weeks. But if you come back and find they're not there that they're out of stock. So that's another challenge. Well, we also see that it is also challenging and sometimes it is risky. You might end up dying because you have not got the director drug for your treatment.” (FGD, a female refugee in Rhino Camp- Ocea zone).

Education

Both focus group discussions in refugee and host community settings indicated the need for quality education at all levels as an important benefit for their children on the side of parents. Parents however get frustrated when asked to pay school fees for those in secondary schools because they have no source of income. The youth who took part in this study said continuing with education made their future seem bright. This was not the case with youth refugees who noted that they see no future ahead since they cannot proceed fully to the respective levels of education especially those joining tertiary institutions like universities which in end they report would affect their psychological well-being. The host community praised the support and empowerment of a girl child due to the provision of free education at the primary level (Universal Primary Education-UPE) they reported registering reduced school dropouts, early marriages and teenage pregnancies as opposed to the past before these free education services were implemented. More so the focus groups were questioning the scholarship criteria as it is so demanding and as a result most refugee students miss out on free tertiary sponsorship. This brings out a typical need of frustration related to competence in relation to BPNS.

……“Most, at first our children would go to school and at that moment they learn for free. But to some extent what I have seen as a challenge, is we have been told to pay money mostly the secondary school, so it is a challenge for some parents. It has made children go into the street to be exposed to drugs abuse and this causes rampant cases of criminalities in the community like teenage pregnancies this because they are unable to afford what they are supposed to do, because of the conditions that we are facing here.” (FGD, refugee in Rhino Camp- Eden zone).

……“In addition to what frustrated me much since I came into this settlement like most when the scholarship or sponsorship comes, the qualification that they can put it will not match the youths that we are having on the ground that's why it limits the youths to continue with an education that is the main thing that affects too much!” (FGD, a refugee youth in Rhino Camp- Eden zone).

……“Being in school makes me happy, it also prevents one from being spoilt and also not to fall into early marriages as one thinks so much about it when they are not in school, even the girls cannot have a teenage pregnancy.” (FGD, School going youth from Host community-Arua district

“My children cannot go to school, this is so frustrating for me” (FGD, a refugee parent at Rhino Camp).

The Role of Psychosocial Support

Refugees appreciated the initial and continuous support offered to them in the form of psychosocial support. In some focus group discussions, they say this helped them not to have delayed treatment for the traumatic and stressful events that they went through. Others looked at it as an ongoing activity that they always resort to whenever they feel overwhelmed by the hard-living conditions in the refugee camp. However, stigma was highlighted among those who seek psychosocial support as they are termed to be mentally sick and this has hindered many from utilizing the service offered by non-governmental international organizations, this aspect tallies well with the factor of competence in the BPNS.

……“When I came here to the camp, the first thing I received that helped me was the psychosocial support, it helped me much”. (FGD, refugee from Rhino Camp-Ofua zone)

…. “Concerning psychosocial support, I know the wellbeing of the person requires counselling. Me I know I am now Okay. When I came I was having that stress that is what made me not to be happy in the camp.” (FGD, a refugee from Rhino Camp-Eden zone).

Refugees get frustrated when they are unable to get psychosocial support services in their respective places at any time when they are needed. They have always relied on the mental health and psychosocial service providers at all times for the management of mental illnesses like Acute Stress Disorder, post-traumatic stress disorder (PTSD), depression, separation anxiety disorder, among others.

…… “Now unfortunately nowadays the services of psychosocial support, are meagre it has rarely made so many issues arising is a talk now we have a lot of the things in the community, people are traumatized”. (FGD, refugee from Rhino Camp-Tika zone).

……“She first of all appreciates that the time she was coming up the border side she had a mental illness. She was happy they told her to come and meet if she did she reached at Omugo she will come up the health center she will get somebody called Juma who works with TPO with issue of mental health she will be helped actually she came she found your mental assistance helped her. But also, what made her not be happy sometimes is that TPO was not always there in the settlement. That is what made her unhappy.” (FGD, a female refugee from Rhino Camp-Omugo zone).

Unfavorable Farmland

The focus group discussions from the refugee camp reported frustration due to poor land topography and the dryness of the area which does not favor crop growing. Having no opportunity to cultivate their own food and supplement what they are provided by the World Food Program (WFP) leaves many vulnerable by only relying on food aid by WFP yet they would be digging just like how some refugees in other camps do. This frustration from the BPNS cannot be separated from autonomy whereby refugees limited say as well as choice and yet this is not the case with the host community as they have full control and options to choose.

……”We are trying to cook up for the farming but the pattern of the rain here cannot really make us to produce what we want to produce, it has really stressed me much.” (FGD, a refugee from Rhino Camp-Ofua zone.

“The topography of the place is not okay where you can gain some livelihood project that can sustain your life that is the main challenge.” (FGD, a refugee from Rhino Camp-Omugo zone)

… “We are in this place where one is not able to make some cultivations and it's actually making us just remain poor from time to time. So that is why I am not happy also being here.”

In addition, they talked about difficulties in relating with host communities as they cannot be offered some additional land to grow some vegetables and other faster-growing crops instead, in some cases the host community is accused of illegally harvesting the refugees’ food without permission which leaves them disgruntled and frustrated.

…” and also to the native side, they would be friendly with the nationals sometimes we are going to have issues of land and then after cultivating some of them turn negative at harvesting you find your things are harvested which is causing most of the problems to people.”

Employment and Income-Generating Activities

Focus group discussions from both settings were happy when engaged in income-generating activities or employment. This created more avenues of having sufficient family support hence reducing aspects of dependency on NGO support but rather self-reliance. It was however presented that most refugees are unable to get jobs that correspond with their educational qualifications. They felt unhappy since they are mostly given volunteer jobs and other lower-paying jobs. This was not the case with focus groups in the host community who viewed the presence of the camp as a means of reliable job opportunities. When individuals strive for financial freedom in form of employment and involvement in income-generating activities, this can be reflected in BPNS inform if fulfilling their competence at the same time autonomy. All these two aspects of BPNS will see them able to support themselves and also free from dependence.

……“I feel okay because I've gained stability. By the time when I came in, I was just stranded. But later when I got employed, I could manage the children whom I came with, which I so, I was like a father I was like a mother behind the children.”

……“Yeah, I can I can also add on what makes me unhappy. In most cases, we lack opportunities, things like employment opportunities which are very scarce in the settlement.”

……“If there is no work to do, it makes you feel stressed in the community even if there is electricity for you to benefit you have to have a job to do something to do so that you can get some little money manage to enjoy whatever you want to do that's where the happiness will come. You have some petty works to do like Boda Boda riding, then one can be happy.”

Collaboration and Peer Support

In almost all youth Focus group discussions included a focus on how they enjoy interacting with colleagues from other countries especially in the case of refugees. For the Ugandan youths, they reported good moments when they have peaceful interactions with refugees which was also the case with refugees. It was later pointed out that things like sports, sharing of cultural related practices, sharing past experiences and how one dealt with painful or distressing situations are some of the key things the youths enjoy engaging in and this has seen peaceful co-existence among youths in all settings as they are eager to learn from each other and offer peer support. Ugandan youth hope to be treated well if they happen to go to Sudan as long as they also treated their peers well while in the refugee camp. This is a typical example of relatedness in the aspect of BPNS. This applies to both refugees and the host community.

…… “Another thing which I can say which is positive to this place is that to come people expected to meet. Amm,… especially here we are 3 nationalities and even there is another nationality you find that you meet new people share idea in Norman about them where they come from about their culture, you found that now that issue that thing for having for nature, different people from a different area that is one advantage.” (FGD protection).

… “Having a good friend, like we have neighbors around us refugees, specifically a good friend from them, you can at least share some things which are not even aware of, which will help you never know you may reach also to Sudan, which will guide you to stay confident in public like that.” like how to stay with people in the communities you know, each country has its own rules and the way to stay with some cultures is different like here being a Lugbara by tribe, we have our behaviors. But when you reach that side people also have their different ways of behaving. You find it easier to relate. (FGD youth from host community).

Youths also say it is easier for them to mobilize themselves towards advocating for peace because they view themselves as the agents of peace in their respective countries where tribal disputes resulted in war. Good relations among them has made it easier for them to talk to each other as they create more awareness and advocacy for peace. They hope this will be the same way they can practice the same when they return to their respective countries in the event repatriation occurs.

……“So, I am like what should I do by the way? My own country is misbehaving like that they certainly do a misunderstanding themselves, they don't want to come to a common talk. So, with all that, I met one of peacemakers, they call themselves peacemakers we formed a group, they were counselling people how to at least have that …that heart where you can be patient any time the country can be fine, they told me today the country might not be fine but you never know tomorrow the country will be okay. So that word has encouraged me, I am at least happy. So I am hoping that by tomorrow next time, the country will announce that there's already peace, people have to go back.” (FGD a refugee youth from Rhino camp –Ofua zone).

Delayed Resettlement

Specific Focus Group Discussions pointed out that staying in one place greatly affected them since they had hoped to stay for less time in Rhino camp and then they would be resettled to other parts of the country or even outside Uganda. They felt fed up with staying in one place with their main interest being leaving Rhino Camp. This is one aspect that causes distress to those in favor of living outside Rhino Camp as they never view it as a second safe and happy home to them.

……“I personally am living with my parents most of the thing which makes me sad is the time I had some expectation which I have but cannot get in this place one of expectation which I had it's an issue related to…., the first was security second was resettlement. But the expectation which I had it was that maybe too short time as they promised they can give promise that may be after six months one year the issue to be solved. But you found that he stayed five years now going to six years. Those have affected me much in many ways, it has affected me psychologically as you're thinking just future now I am 26 years.” (FGD, refugee from Rhino Camp-Ocea zone).

Discussion

Food security remains a key concern among refugees in Rhino camp refugee settlement since they mainly rely on aid from the World Food Program (WFP). It is with no doubt that any delay or reduction in food ration will place them in a vulnerable situation because they have no other way out of accessing food. This issue is further escalated by the family size of respective refugee homes as they tend to be big. Surviving on little food ratio may result in having to skip some meals in a day or even go without food for a day in some circumstances. This has also seen cases of food theft increase in and out of the refugee settlements by refugees about a recent study done in Kyaka II refugee settlement, is also seen as a risk factor for conflicts between refugees and Ugandan nationals as reported by UNHCR [6]. The UNHCR has always prioritized the aspect of food distribution to refugees as they have always provided this to refugees through their implementing partners like AFI, and World Vision among others to enable refugees to meet their immediate food and nutrition needs [7]. The question remains, is the food supply sufficient for the refugees to survive on until the next shipment? More so are the refugees engaged in discussions before food rations are increased or reduced since this appears to be one of the key concerns for the refugees who seem to be decided for and they only have to obey. It should be noted that in some cases even those who receive cash for food complained that it was not sufficient according to the assessment report results by [6] who found out that the (31,000 UGX) given to refugees per individual was inadequate to sustain them for the whole month.

The provision of psychosocial support by refugees has seen more positive results among refugees and the host community which has a significant impact on their psychological well-being. Whereas the services of psychosocial support are vital, it is still a challenge that not all those who need this service utilize it much as it is available in the respective settings[8]. In instances where psychosocial support is offered and utilized, few problems are a result of psychological distress of substantiation as opposed to situations where this service is not offered. According to Williams and Thompson[9] community-based interventions are emphasized where non-specialized individuals are trained to offer psychosocial support to fellow refugees or host community members as this is more efficient and sustainable due to the high demand for mental health support. In this case for instance the self-help plus has been found to promote refugees’ psychological well-being, this does not require highly specialized individuals to deliver it, besides participants gather in smaller groups. Fellow refugees can be trained to deliver this very intervention for fellow refugees.

The findings revealed that concerns about access to education were raised primarily by students and their parents in Focus Group Discussions. Specifically cited was that youth are more hopeful when they have learnt or are in school acquiring specific skills. This is a key tool they can start with to live and survive when they return to their respective countries. Whereas schools are constructed in the refugee settlement, this study documented that most of them concentrated on lower levels with very few secondary schools as well as technical schools being set up. As a result, some youths miss out on school, joining poor peer groups that come with negative consequences. Very few refugee students manage to go to university when offered scholarships, this leaves the majority with no continuation after their secondary school education. For learners this not only limits career opportunities it also affected their psychological well-being. Provision of Education to refugees remains a major services by the UNHCR through its implementing partners, several schools have been set up in various refugee settings, this has not only benefited the refugees alone but also the host community where learners are not charged fees to access these free services [10]. In most cases, it is the concern of long distances that have to be covered by learners to reach school, from home as they sometimes tend to be far away from home or even have like one secondary school in the entire sub-county. This continues to show the concern of few education infrastructures with increased demand in refugee-hosting communities. Sometimes the numbers in refugees’ schools are said to be high as compared to the target number or expected number to be in a particular class.

Health services in refugee settlements are in place and can easily be accessed as implementing partners also offer mobile clinics to reach out to refugees and host community areas that may seem far from the health centers, this has seen timely detection and treatment of illnesses among patients. The provision of mobile clinics has as well supported the PSN who sometimes are unable to walk long distances. Making these services readily available, free of charge has built more trust in health implementing partners, more host community members walk into refugee set up health centers to access health services an act which has also created good relations between refugees and the host communities who see the coming of refugees as a benefit, some have got jobs of working in the same health centers to work as medics or even language interpreters o doing any other causal job which is offered to both refugees and Ugandan nationals hence enabling them to earn a living besides health improvement. These health centers, are often overwhelmed with many patients who out way the staff or even the facilities available and this is in agreement with a study by Andrew [11] who found out that the number of refugees seeking health services often overwhelm the services providers. On the other hand, refugees are more likely to miss out on timely referrals which are more than 40 miles away from the refugee settlement in instances of referral to regional referral hospitals. Transport logistics can be unreliable due to the high demand for the few hospital ambulances on the ground.

Inability to do home gardening/farming has contributed to a shortage in food supplementary supply among refugees in Rhino Camp refugee settlement, a study conducted by Njenga and colleagues [12] also observed the same problem and advocated for irrigation, use of compost and biochar for soil improvement in the Rhino cam refugee settlement. Since they have no other assured sources of accessing food, this leaves refugees frustrated when they delay or fail to get food on time and in desired quantities. From this study, it was also found out that the refugees were not concerned about the variety of food given to them but rather the quantity they receive per month. It has been realized that in refugee camps where the land is fertile with a favorable climate, refugees have fully participated in serious commercial farming, sold food to WFP and then kept the rest for their home consumption. This has left them happy in earning and with settled peace of mind that resulted in balanced psychological well-being. It is also impossible that all refugees can be hosted in fertile places within the country, the case of the Rhino camp is different as the settlement is located in the West Nile region which is mostly dry and cannot be compared to Kiryandogo and Kyangwali refugee settlements in the western region which are more fertile with good rain patterns that favor farming among the refugees. Some have also gone out of the camp to rent land for farming, this has greatly improved refugees’ engagement in income-generating activities, good relations with the host community and most importantly reducing aspects of dependence on food aid.

Refugees with the capacity to get employed to better positions or even compete for jobs that tally with their level of education, skills or even working experience often tend to accept low paying jobs that are below their worth or qualification as observed in this study. This leaves these individuals unsatisfied and earning less than what they would get, this is also in agreement with findings by Loiacono and Vargas [13] who also adds that mostly refugee women were more less likely to look for jobs as compared to refugee men. It also found out during this study that some simply get reluctant to work since they have access to food and non-food items (NFIs) in the refugee camp. On the other hand, besides needing work, some refugees do not have any academic qualifications, no working experience but are demanding to be employed most especially for jobs within the refugee settlement. As recruiting agencies, organizations follow the standard procedures, some of these refugee applicants are left out, which leaves them unhappy and unemployed. Since the policies permit them to work those who can meet the criteria and work are grateful for the opportunities which help them to apply their skills and get a reward in form of salary. Uganda has given freedom for refugees to get engaged in work most especially in the areas next to their refugee camps or in the refugee settlement themselves, something which permits refugees to enjoy their rights to work as long as they meet the job requirements and provided there is job opportunity. It should also be noted that also Ugandans are battling with the issue of unemployment, so in cases where refugees may not be offered a job this in most cases is tied to the very many qualifying applicants competing for the same position. With more stability of Ugandan nationals to stay on the job hence some refugees tend to self-relocate from one refugee settlement o the other, this may reduce their chances of being employed first before the Ugandan nationals.

Besides paid employment, there is ongoing empowerment of refugee projects to generate income both at the individual and group levels. The aspect of this capital startup has also come with training refugees with skills in doing different things that can generate money like baking, weaving, winemaking among others for things that they can easily produce and get ready market within the refugee settlement. On the other hand, the refugees have been trained in financial management skills. All these developments have not left the host community out due to the government policy that requests all activities done within the refugee settlements, should have been taken to the host community (60–40%) refuge to host community share. This has promoted the development of host communities too alongside letting the host community enjoy the coming of refugees in their respective places. International labor organizations also find the Uganda model of permitting refugees to work, utilize land through cultivation as well as free movement within the country in addition to free access to health services and also education as key aspects that empowered refugees. Refugee settlements in Uganda usually host large markets where refugees sell the products harvested from their gardens and this is mostly done in southwest Uganda.

A particularly noteworthy and positive finding in this study was the good collaborations strategies exhibited mostly by the youth who frequently interact together amongst refugees from different nationalities or ethnic backgrounds in various aspects like sports, cultural activities. This study also found in the host community youths related well with the refugees in the refugee camps. Most importantly, they acknowledge learning new things like language and how to offer peer support since most of them rely on each other for support. Peer support on the other hand seems to be playing a key role in helping refugees get quick support before any other support comes in, these are new and vital milestones that should not be taken for granted since they create more healing among those who need help. In refugee settlement in Uganda where there has been a good collaboration among refugees themselves or even host community and refugees, there have been no cases of conflicts as compared to cases where refugees have more misunderstandings amongst themselves which in most cases is tribal. These incidents have cost the lives of refugees in cases of the West Nile region (Bidi Bidi, Rhino camp refugee settlements) and the Northern region of the country.

It is the wish of every refugee fleeing their country to find a safe and peaceful environment. However, this study has found out that while there are groups of refugees who feel safe and happy to stay in Rhino camp citing good security alongside other good things, other members in this study through the FGD indicated that they were to stay in Rhino camp for few months with hopes to be resettled in other places within the country or even be taken outside the country. To their frustration, the months have turned into years as some say they have stayed for 6 years with no hope or clear update about their resettlement. In interactions with the refugees, it is very clear that some would be safer when settled away from this refugee camp, this, therefore, can be subjected to the authorities in charge in line with the promises they make to the refugees as these set them to be more anxious hoping for the next home taking Rhino camp to be a transit. Globally resettling remains one of the major tasks as each country has specific laws and policies towards refugee support and acceptance. Amidst these logistical delays, the UNHCR has always provided the required protection to these refugees who may be at high risk if not fully protected, something which has seen them live a happy life even when they still have resettlement expectations. Some refugees have countries of their preferences like this in most cases has been seen as a casual for self-relocation however this does not apply to all refugees. As to whether some may have more economic gain expectations over peace remains another concern, as this can be seen in some families of refugees where one family member the family head may flee hence leaving the entire family behind. This type of situation arose in one of the FGDs

Uganda is praised for ensuring peace in the country, more so it has extended this to the neighbouring countries facing insecurity like the Democratic Republic of Congo, South Sudan, and Somalia among others. This is the same support that has been extended to the refugees, they are given security rights from the border entry and also in the refugee settlement. UNHCR through its protection section security is given more attention because they can never be running activities in refugee settlements when there is insecurity. It will be noted that in Ugandan refugee camps the refugee commandant heads are more vigilant to security in the refugee camps as some refugees tend to be army deserters who need also to be handled by well-trained people in security-related aspects. In some camps, rebel groups have been re grouped there hence making the government ensure full-time security in these settlements. There is no camp in Uganda that you will enter without the permission of security. This has surely given refugees a sense of peace, they have also reported in the FGD that they see the armed security in Uganda as a promoter of peace but not to attack them. Prioritizing security can be associated with good psychological well-being among refugees and host communities in refugee settlements [14].

Culturally appropriate burials have been arranged within the refugee settlements. UNHCR protection partners in Rhino camp for instance IRC have always worked along with the refugees who lost their beloved ones to ensure that they bury their deceased family members in a well-arranged and culturally acceptable manner. Whereas it remains a concern that these people are not buried in Southern Sudan, some refugees are happy to bury their people other than losing them in a war which they say makes it impossible for them to even bury them. This may however have limited change but rather to accept it as the new normal among the refugee community. In moments of burial ceremonies, refugees are joined by fellow refugees to send off their deceased loved ones. This has also created more collaboration and emotional support among refugees not only those in Rhino Camp but also those in other refugee settlements in Uganda and the East African region. It is also possible that some refugees have stayed in the country for more than 15 years and call Uganda their home hence having appropriate and culturally acceptable burials in selected places continues to provide a sense of stability in such places associated ties like graveyards of their loved ones is taken seriously in most African cultures.

The study findings indicated various forms of how BPNS is expressed by both refugees and the host community in aspects of relatedness (collaboration and peer support, family separation and deaths). There was a lot of need and value for collaboration and peer support across all the two communities of refugees and host community. This spread further among different ethnic boundaries in the refugee community, they viewed it as something that unites them further and they hope to rely on the same for peace building when peace comes back to their respective countries as they will be repatriated back home. Similarly, the issue of family separation and anxiety was more valid in the refugee community but not anywhere in the host community. This can be attributed to the existing family support in host communities which is not case with refugees. But it was noted that host communities and refugees they join together to send off their loved ones in case of death, this brought more unity in the area.

Competence was expressed in form of (need for employment and income-generating activities, need for education and farmland). Education contributed to the psychological well-being of both refugees and Ugandans, however this was expressed differently. For the refugees attaining education and not finishing at tertiary institutions meant nothing to them much as each refugee zone has schools set up. While for the host community, they were grateful that the schools were set up reducing on long distances which students covered to access the few schools that existed before the refugee camp. For now, the host community reports that more girls have benefited from the education service as opposed to the past when they would mostly get into early marriages, this development is good news for the host community.

Income generating activities as well as employment was a uniform concern across the refugee and Ugandan community. However, Ugandans were open to various opportunities since they could attain higher positions as opposed to the refugees. What was noticed among refugees was applying for lower jobs sometimes which were significantly below their academic qualifications something that can be related to under evaluation of their potential.

The other component of BPNS of autonomy was primarily expressed through the need for favorable farm-land to self-provide supplementary food through farming, food availability and also they demanded their suggestions to be heard on decisions related to food matters since they are not always consulted when decisions are made towards food increase or decrease. Land brought in more concerns as it created more disputes on the other hand harmony depending on the way how it was handled in each zone. The host community was willing to rent out land to the refugees at a lower cost of about 80,000/- an acre for a whole year. This however was welcomed by those who could afford the money and opposed by those who are unable to afford it. In general, the host and refugee community is sharing land at the moment as refugees are not restricted to access host community. All this contributes to psychological well-being in either way.

Conclusions

According to the study findings, food distribution, security in the camp, family separation/death and physical health care were found to be the major sources of PWB/ frustration. Furthermore, the provision of mental health and psychosocial support did not have more attention as compared to other services provided to refugees like WASH, protection, food and others. This study, therefore, recommends more emphasis be put on empowering refugees to grow their own food, strengthen family systems and social support, strengthening the provision of health services increasing the partners who implement mental health and psychosocial support, training refugees and host communities in brief MHPSS interventions like Self-help plus as these will leave these groups more empowered to support themselves in the absence of partners and they can use the same when they return to their respective countries. These short-term interventions are inexpensive to train for and are sustainable.

This study finds an interesting aspect where refugee youth have good relations not only among themselves but also with the youth in the host community. This is a sign of good co-existence among this community which aspire to collaborate and work with each other. Therefore, this study recommends boosting youth interaction-related activities that bring them together. These aspects include but are not limited to sports activities, inter-school co-curricular activities like debates where schools may visit each other doing these competitions, youth dialogues that may focus on youth-related concerns like career development, life skills among others can be discussed and youths sharing ideas amongst themselves hence complementing on the aspect of relating with other peacefully.

As a section of refugees continue to have frustrations due to delayed resettlement and the failure to have concrete information on the progress of the process worsens their anxiety even when they are provided with other things like WASH, protection, education and others. The findings point to the need to provide clear and forthright information of the dynamics that underlay in resettlement not only telling them information regarding resettlement progress. In this case, they will be more prepared for any eventualities that may happen, for example, delayed resettlement or even failure to be resettled. More so the parties in charge may need to assess the areas that lead to the day and speed up this process for the better of the people’s concern as some refugees can only feel safer when they are relocated to other safer places this is their right too.

The study can conclude that almost all the refugees as well as the majority of host community members live without employment or any income-generating activity. This has forced some Ugandan nationals to register themselves as refugees so that they can benefit from the free services given to refugees, in other circumstances some have violently participated in riots around and within the refugee’s settlements while demanding inclusion to receiving free services like food among others since they offered land to the refugees. This study recommends more activities be set up to empower both communities to provide for themselves rather than relying on aid from partners. In this case, income-generating activities can be set up with the key emphasis of first teaching beneficiaries how to handle and manage finances, some lack this aspect of financial management which see them spend recklessly the hard-made money and strive for money thereafter. Employment too can be boosted but mainly by encouraging refugees with relevant skills to apply for those specific jobs other than applying for low paying jobs yet some have the required skills. More skills training and education to those who are in the ages of attaining education should be provided. More focus on the provision of education to technical and higher education be made available because this study observed that education at lower levels like primary is provided, such as providing scholarships that match the refugee standards and also encourage learners to stay in school as it was found out by this study that not all the refugee and host community who were in ages of attaining education went or go to school even when schools are in place. Once these are provided and opportunities to attain education are made, there might be more skilled refugees and Ugandan nationals who will be in a position to apply learnt skills to earn a living or even apply for relevant jobs and earn for the services there offer. All this will increase the chances of self-reliance and promote competence among refugees and Ugandan nationals.

This study contributes to the literature regarding the psychological well-being of refugees in Rhino Camp refugee settlement as well as the Host community in Arua District. The finding can be relied upon for an impression of what might be the concern(s) in other refugee settings in Uganda and across the region. The documented findings have implications to the partners implementing various services in the refugee settings not only in Uganda but also in other refugee settlements. These findings also provide directions or future research on the development of interventions for this populations.

Basic Psychological Needs Satisfaction and Psychological Wellbeing of Refugees in Africa.

Abstract

Introduction

Method

Results

Discussion

Study Limitations And Future Considerations

Conclusions

Declarations

References