Prevalence of Posttraumatic Stress Disorder and Depression Among Internally Displaced Persons In Mogadishu

Background Nearly three decades of conflict and frequent droughts and environmental hardships, have left 2.6 million of Somalis in displacement camps. Even though psychological impact of war and natural disasters are well documented, little is known about the unseen scars of psychological trauma in Internally displaced persons in Somalia. The purpose of the study was to determine the prevalence of post-traumatic stress disorder (PTSD) and depression amongst internally displaced persons (IDPs), and examine association between displacement and these psychiatric conditions. Methodology A cross-sectional quantitative study was conducted among 406 IDPs in Mogadishu. Harvard Trauma Questionnaire was used to determine levels of trauma exposure and PTSD, and Hopkins Symptom Checklist-25 was used to estimate prevalence of depression. Multivariate and bivariate analysis was conducted to analyze the association of demographic and displacement variables on the outcomes of PTSD and depression. Results More than half (59%) of participants met the symptom criteria of depression, and nearly one third (32%) of respondents met the symptom criteria for PTSD. The most prevalent traumatic event was lack of food or water (80.2%). Important predictive factors in development of psychiatric morbidity were unemployment, cumulative traumatic exposure, frequency and duration of displacement. Conclusion The study revealed high levels of Depressive disorder and Post-Traumatic Stress Disorder among internally displaced persons in Mogadishu. Furthermore, this study provided evidence to IDPs’ susceptibility to trauma exposure and lack of essential services and goods. Study also highlighted the importance of provision of Mental Health and Psychosocial Support (MHPSS) service in IDP camps.

Gerontological aspects of improving the quality of medical and social assistance to older displaced persons in the context of the COVID-19 pandemic in Ukraine

Исследование посвящено вопросам организации медицинского и социального обслуживания переселенцев пожилого возраста на уровне первичной медико-санитарной помощи (ПМСП) на Украине, определению основных задач и особенностей организации и предоставления им паллиативной и хосписной помощи (ПХП) в условиях пандемии COVID-19. По результатам социологического исследования с использованием методов опроса, экспертных оценок были проанализированы социально-психологические характеристики переселенцев пожилого возраста, особенностей их социальной адаптации, финансирования и медико-социального обслуживания. Были определены пути улучшения организации амбулаторной помощи переселенцам старшего возраста на уровне ПМСП, включающие структурную модернизацию и оптимизацию организационного обеспечения. Внедрение доступных и экономически обоснованных подходов позволяет усилить взаимодействие специалистов учреждений здравоохранения и социальной защиты, оптимизировать соблюдение стандартов и принципов медицинской помощи. В рамках организации ПХП базовыми являются европейские подходы формирования стратегии непрерывности предоставления паллиативной помощи в условиях пандемии COVID-19. Внедрение предлагаемых подходов в организации медицинской и социальной помощи на уровне амбулаторий ПМСП и обеспечение доступной ПХП являются актуальными для переселенцев пожилого возраста, находящихся в группе повышенного риска при пандемии COVID-19. This work aimed to study the organization of medical-social services for the elderly internally displaced persons at the level of primary medico-sanitary aid (PMSA) in Ukraine, assessment of the main tasks and specifics of organization and provision of palliative and hospice care (PHC) under COVID-19 conditions. As a result of the sociological investigation, using the questionnaire methods and experts’ evaluations, we have analyzed the socio-psychological characteristics of the elderly internally displaced persons, the specifics of their social adaptation, financing and medico-social servicing at the level PMSA, including structural modernization and optimization of organizational provision. The introduction of an affordable and economically viable system allows for the interaction of specialists from health care and social protection institutions, and optimizes compliance with the standards and principles of medical care. Within the framework of the PНC, we use the European approaches of formation of the strategy of palliative care expansion under COVID-19 pandemic. One of the main tasks is the provision of constant PHC. Introduction of the organization-structural system of the medical-social care at the PMSA level and provision of accessible and highly qualitative constant PHC are actual for the elderly displaced people, who are in the group of high risk COVID-19 death group.

Structural Violence among Internally Displaced Persons (IDPS) Within Idp Settlements in Mogadishu Somalia

Background: Gender based violence (GBV) remains a public health concern. Internally displaced persons (IDPs) and refugees have been shown to be at the highest risk of gender based violence. Somalia has been without a stable government for 26 years resulting in weak community and formal protection structures hence disproportionately increasing the vulnerability of females to gender based violence. Continued displacement of community members in South Central Somalia due to war, inters clan conflicts and the ongoing drought has resulted in more IDPs living in settlements along major urban areas. These IDPs continue to face violations such as forced evictions, discrimination and gender based violence. Objective: This study was aimed at investigating the past and present forms of structural violence faced by IDPs in Mogadishu as well as their knowledge and perceptions regarding the same. Methods: A descriptive cross sectional design was used in this study, in the month of May 2017. The study population for this survey was 320 IDPs in 10 IDP settlements in KM-11 and KM-13 regions of Mogadishu, South Central Somalia. Results: The study established a 91.7% prevalence rate of female genital mutilation among the female respondents. World Health Organization (W.H.O.) type III was the most common form of FGM that female respondents in the two IDP settlements (38.9%) had faced, followed by W.HO. type 4 (23.1%) and W.H.O. type I and II (15.9%). The mean age at which FGM was carried out among this group was 7 years while forced and early marriages (mean of 16 years) are common among this population group. Sexual assault and rape were singled out as the most common forms of violence faced by females in the two IDP settlements with the risk factors for this violence being described as displacement, overcrowding in IDP settlements, poor lighting in the IDP settlements at night, unaccompanied females in the IDP settlements and female headed households. Respondents expressed their overwhelming preference for community protection structures in averting GBV and customary law in arbitrating gender based violence cases. There was low awareness on services available for GBV survivors and so was the knowledge on the urgency to seek medical services within the 72 hours window period following rape. Conclusion: The study has established that structural violence is common among IDPs living in Mogadishu and it is constraining them from achieving the quality of life that would have otherwise been possible if they were not displaced. There is need to strengthen both community and formal protection units as well as raise awareness regarding the effects of the various forms of violence facing female IDPs, create awareness regarding services available for GBV survivors and ensure that these services are available and accessible to the IDPs

Clinical phenomenology of anxiety disorders in internally displaced persons

In recent years, reports from international organizations have focused on the mental health of internally displaced persons and the provision of timely medical care. Involuntary resettlement is accompanied by transformation of the entire system of socio- psychological relations, including interpersonal, family, parental, labor and leads to a significant strain on pathopsychological mechanisms, which ultimately contributes to the formation of anxiety disorders. In examined patients from main group, along with mood depression and anxiety, there were various fears and anxieties, asthenic manifestations and autonomic paroxysms, as well as against the background of anxious symptoms, they noted presence of isolated obsessive fears, closely related to anxious thinking about assessments in the eyes of others, short-term violent reactions to minor emotional events, mismatch of the strength of emotional reactions to the situation. At the same time, patients of the control group showed sensitization to external stimuls, especially during sleep and in the process of falling asleep.

International Standards of Social Protection of Internally Displaced Persons: Administrative and Criminal Aspects

This article reveals the problem of social security of internally displeased persons. The scope of social protection directed at this category of population is not the same in different countries. Taking into account the origin of the authors of the article, the questions of social protection of internally displaced persons in Ukraine are described in detail. Conclusions. Special attention was paid to the need to provide people with the opportunity to exercise their rights and freedoms as well as the proper conditions for social rehabilitation, that has arisen before the state. As a result of the research – ways how to strengthen the social security, increase the level of social protection and make it more effective are proposed. The European standards of social protection of internally displaced persons are a set of norms fixed in the acts of the Council of Europe, the European Union, decisions of the European Court of Human Rights, which, as a result of their implementation in the internal law of the states become mandatory for implementation and determine the decent living conditions of internally displaced persons, the responsibilities of the state in this area for ensuring security and full decent development of personality. In the system of European standards for social protection of internally displaced persons, the relevant norms developed by various institutions of the Council of Europe are extremely important.Keywords: social protection, social security, internally displaced persons, displacement Standar Internasional Perlindungan Sosial Bagi Pengungsi Internal: Aspek Administratif dan Criminal Abstrak. Artikel ini mengungkapkan masalah jaminan sosial orang-orang yang tidak senang secara internal. Cakupan perlindungan sosial yang ditujukan pada kategori penduduk ini tidak sama di berbagai negara. Mempertimbangkan asal usul penulis artikel, pertanyaan tentang perlindungan sosial bagi para pengungsi internal di Ukraina dijelaskan secara rinci. Kesimpulan. Perhatian khusus diberikan pada kebutuhan untuk memberikan orang kesempatan untuk menggunakan hak dan kebebasan mereka serta kondisi yang tepat untuk rehabilitasi sosial, yang telah muncul sebelum negara. Sebagai hasil penelitian diusulkan cara bagaimana memperkuat jaminan sosial, meningkatkan tingkat perlindungan sosial dan membuatnya lebih efektif. Standar Eropa tentang perlindungan sosial bagi pengungsi internal adalah seperangkat norma yang ditetapkan dalam tindakan Dewan Eropa, Uni Eropa, keputusan Pengadilan Hak Asasi Manusia Eropa, yang, sebagai hasil dari implementasinya dalam hukum internal. negara menjadi wajib untuk implementasi dan menentukan kondisi kehidupan yang layak dari orang-orang yang dipindahkan secara internal, tanggung jawab negara di bidang ini untuk memastikan keamanan dan pengembangan kepribadian yang layak sepenuhnya. Dalam sistem standar Eropa untuk perlindungan sosial bagi pengungsi internal, norma-norma relevan yang dikembangkan oleh berbagai lembaga Dewan Eropa sangat penting.Kata kunci: perlindungan sosial, jaminan sosial, pengungsi internal, pengungsian. Международные стандарты социальной защиты внутренне перемещенных лиц: административные и уголовные аспекты Аннотация. В статье раскрывается проблема социальной защищенности внутренне недовольных. Объем социальной защиты, направленной на эту категорию населения, в разных странах неодинаков. С учетом происхождения авторов статьи подробно освещены вопросы социальной защиты внутренне перемещенных лиц в Украине. Выводы. Особое внимание было уделено необходимости предоставить людям возможность реализовать свои права и свободы, а также создать соответствующие условия для социальной реабилитации, которые возникли перед государством. В результате исследования - предложены способы, как усилить социальную защищенность, повысить уровень социальной защиты и сделать ее более эффективной. Европейские стандарты социальной защиты внутренне перемещенных лиц - это совокупность норм, закрепленных в актах Совета Европы, Европейского Союза, решениях Европейского суда по правам человека, которые в результате их имплементации во внутреннее право государств становятся обязательными для реализации и определяют достойные условия жизни вынужденных переселенцев, обязанности государства в этой сфере по обеспечению безопасности и полноценного достойного развития личности. В системе европейских стандартов социальной защиты внутренне перемещенных лиц чрезвычайно важны соответствующие нормы, разработанные различными учреждениями Совета Европы.Ключевые слова: Социальная Защита, Социальное Обеспечение, Внутренне Перемещенные Лица, Перемещение.