Beyond Hijrah (هِجْرَة ): perspectives on resettlement, health and quality of life for Afghan and Kurdish refugees in Christchurch and Perth (original) (raw)

Worldwide, conflict situations and the resultant number of refugees continue to increase, with over 43 million recorded at the end of 2009. Nearly half of those currently under the protection of the United Nations High Commissioner for Refugees (UNHCR) originally came from Iraq or Afghanistan. Although less than 1% will eventually be resettled in new host nations, their long term health and settlement prospects are a matter of continuing relevance. Since 2000, Australia alone has accepted over 58,000 Afghan refugees, with more than 5000 resettled in New Zealand. Although refugees accepted under humanitarian programs receive state support frequently denied to asylum seekers, they are still vulnerable to acculturative stress. Public attitudes and government policies to immigration in receiving countries inevitably play an important role in resettlement outcomes. The overall aim of this research project was to examine the resettlement experiences of refugees settled in Australia and New Zealand, taking into consideration the different policy and social setting in each location. A mixed methods approach was adopted for this exploratory study, utilising both qualitative and quantitative methods to investigate the social and political environment surrounding refugee issues in the public sphere, as well as assessing the health and wellbeing of former refugee participants. A comparative study of newspaper reporting of refugee issues was conducted to monitor trends in reporting over time, to assess public attitudes in each location, and provide background context to the main study findings. This media study provided insights into the politics of the refugee debate and policy environment in New Zealand and Australia, revealing significant differences in the way refugee issues are portrayed by the media in each location. Compared to New Zealand, newspaper articles in Australia were more politicised, and less likely to portray refugees in a positive manner. Since 2001, political attitudes to asylum seekers hardened, as revealed in Australian coverage, reflecting increasing negativity towards refugees overall. In particular, reporting suggests public attitudes towards refugees and those who are visibly different may be shifting over time. This was followed up by a survey of former refugees from Afghanistan and the Kurdish regions of Iraq and Iran, who were living in Perth, Western Australia and Christchurch, New Zealand at the time of data collection in 2008. A mixed methods approach was used to evaluate the perceived effectiveness of resettlement programs in addressing the psychosocial and health care needs of these groups. For the purposes of the study, it was necessary to define what was meant by 'successful resettlement'. Based on the availability of suitable quantitative instruments this was primarily conceptualised by measuring subjective well being and psychological distress. An iv additional instrument was also included to assess general self efficacy, as this can influence motivation and attitudes to change. Translated and culturally validated Instruments were provided in Farsi (Persian), Arabic and English for self completion during interview. Participants were recruited by a snowball sampling technique, using multiple initial contacts with short chains of contacts within each of the refugee groups to improve representativeness and reduce selection bias. Comparison with census data and community profile maps provided reassurance that this had been achieved. Ascending methods help to overcome some of the sampling challenges encountered with difficult to access and vulnerable populations such as these, accepting that achieving an indicative sample provides valuable information even if not truly representative. Quantitative data collected using individual, questionnaire-based interviews was obtained from 193 participants settled up to 20 years. This assessed key outcome variables using the Kessler-10 Psychological Distress Scale (K10), the Personal Well Being Index (for subjective well being) and the General Perceived Self Efficacy scale. In combination with demographic data, this allowed comparisons across domains based on ethnic group, gender, temporal variables and country of settlement. Qualitative material from open ended questions, presenting the personal perspectives of 124 participants, offered valuable insights into their overall resettlement experiences, quality of life, sources of stress and coping responses. Psychological distress was revealed to be a chronic problem, with 60% of those settled more than 8 years still above the K10 threshold. Despite this, many people were reluctant to seek professional help despite considerable morbidity. Introspection and depression were the main sources of concern for participants at all stages of resettlement, closely followed by separation from family and friends, feeling overwhelmed by the challenges facing them and relationship issues. Unemployment was significantly associated with poor mental health, especially as it often resulted in people sitting at home 'thinking too much'. In addition, the impact of political events and the situation of significant others in their home countries, as reinforced by media reporting of conflicts in Iraq and Afghanistan, was also influential. Women in particular, struggled due to a lack of family support, changing roles and expectations, and social isolation. The perception that public attitudes towards Muslims changed as a result of political events elsewhere, resulted in some people believing that they would never really fit in. This may be linked with the cultural and religious concerns expressed by some participants and reflect wider societal attitudes to refugees in general, or Muslims in particular, especially in Australia. Reality often fell short of expectation as refugees experienced difficulties vi CONTENTS Declaration ii Abstract iii Contents vi List of Tables & Figures x Acknowledgements xi Abbreviations xiii Definitions xv List of included publications xviii Contribution of author and co-authors xix CHAPTER 1 INTRODUCTION & THESIS OVERVIEW 1 1.1 Background 1 1.2 Research problem and objectives 3 1.3 Personal background and reflections 3 1.4 Orientation to the thesis 10 CHAPTER 2 CONTEXT OF THE RESEARCH & RESEARCH PARTICIPANTS 14 2.1 Refugee resettlement: International imperatives 14 2.1.1 Refugee status determination 2.1.2 Durable solutions for refugee populations 2.2 Refugee resettlement: New Zealand Response 17 2.2.1 Quota refugees 2.2.2 Family Reunification 2.2.3 Convention refugees/Asylum seekers 2.2.4 Resettlement support 2.3 Refugee resettlement: Australian Response 24 2.3.1 Humanitarian Program Onshore Protection vii 2.3.2 Humanitarian Program Offshore Resettlement 2.3.3 Family reunification 2.3.4 Resettlement services 2.4 Summary of Australian and New Zealand resettlement policies 2.5 Australian immigration-White Australia Policy 2.6 The politics of asylum in Australia 2.6.1 The Tampa incident 2.6.2 Other high profile incidents 2.6.3 Mandatory detention: national inquiries 2.6.4 International concerns 2.7 Geographical and political background of refugee study populations 2.7.1 Afghanistan 2.7.2 Iran, Iraq and the Kurds 2.8 Community profiles of refugee study populations 2.8.1 Christchurch 2.8.2 Perth 2.9 Refugee Stories 2.9.1 Afghan life story-Ali 2.9.2 Kurdish Life Story-Ahmad 2.9.3 Commonalities and differences 2.10 Summary CHAPTER 3 REVIEW OF LITERATURE 3.1 Migration 3.2 Forced migration and health 3.2.1 Physical health concerns 3.2.2 Common mental health disorders 3.3 Migration phase 3.3.1 Trauma and the refugee experience 3.3.2 Detention of asylum seekers 3.4 Paradigm debates 3.5 Post-migration phase 3.6 Social determinants of health viii 3.6.1 Income 3.6.2 Housing 3.6.3 Employment 3.6.4 Education and Language 3.6.5 Access to information and culturally sensitive services 3.7 Separation from family 3.8 Acculturative stress 3.9 Discrimination and visible difference 3.9.1 Media representations of refugees and minority groups 3.10 Factors influencing post migration adaptation 3.10.1 Coping processes 3.10.2 Belief systems 3.10.3 Social support 3.10.4 Self efficacy 3.11 Subjective well being and quality of life 3.12 Long term settlement trends 3.13 Summary, identified gaps and research questions CHAPTER 4 MEDIA STUDY 4.1 Conceptual framework and study design 4.1.1 Aims of the study 4.1.2 Theoretical and conceptual framework 4.1.3 Study design 4.2 Sample selection 4.3 Data analysis 4.4 Article 1: Changing images of refugees: A comparative analysis of Australian and New Zealand print media 1998-2008 4.5 Summary of media study findings CHAPTER 5 METHODOLOGY FOR REFUGEE STUDY 5.1 Conceptual framework and study design 5.1.1 Theoretical and Conceptual framework 5.1.2 Research paradigms and philosophical debates 5.1.3 Approaches to mixed methods research ix 5.1.4 Design of the study 5.1.5 Research questions 5.2 Language considerations & translation procedure 5.3 Data handling 5.3.1 Data collection 5.3.2 Quantitative data processing 5.3.3 Quantitative data analysis 5.3.4 Analysis of qualitative material 5.3.5 Mixing of data and analysis 5.4 Article 2: Selecting instruments for assessing psychological wellbeing in Afghan and Kurdish refugee groups 5.5 Article 3: Sampling challenges in a study examining refugee resettlement 5.6 Summary CHAPTER 6 RESEARCH FINDINGS 6.1 Introduction 6.2 Article 4: 'Thinking Too Much'-Psychological distress, sources of stress and coping strategies of resettled Afghan and Kurdish refugees 6.3 Article 5: Afghan and Kurdish refugees, 8-20 years after resettlement, still experience psychological distress and challenges to well being 6.4 Article 6: Learning to Fit in: An Exploratory Study of General Perceived Self Efficacy in Selected Refugee Groups