Authors: Nour Hassan, Annalee Coakley, Ibrahim Al Masri, Rachel Talavlikar, Michael Aucoin, Rabina Grewal, Adl Khalaf, Shahla Murad, Kerry McBrien, Paul Ronksley, Gabriel Fabreau 

Location: Calgary, Alberta

Summary

In August 2014, the Islamic State of Iraq and Syria (ISIS), known as Daesh, targeted approximately 400,000 Yazidi individuals in northern Iraq for mass displacement, execution, systemic rape, and enslavement, leading to approximately 5,500 deaths and 7,000 kidnappings.

Between 2017 and 2018, Canada resettled approximately 1,500 Yazidi refugees, mostly women and children. Given that the complex health needs of Yazidi refugees have presented challenges to service providers, a comprehensive post resettlement health assessment is needed.

This study set out to answer the following questions: what are the sociodemographic characteristics, mental and physical health conditions, and family separation experiences of Yazidi refugees who resettled in Canada?

A retrospective cross sectional study was done which entailed reviewing the health records of 242 Yazidi refugees seen at a Canadian refugee clinic between February 2017- August 2018. Expert refugee clinicians were consulted to identify conditions likely to be associated with Daesh exposure. These findings were further interpreted and validated by two Yazidi leader co-investigators.

Findings

• Clinicians found a high prevalence of mental and physical health conditions among the Yazidi refugees.
• More than half of the sample were females (58%). A total of 124 refugees (51%) had direct Daesh exposure, among whom 42% were females. Daesh exposure was defined as captivity, torture, or violence.
• Yazidi women had the highest observed prevalence of mental and behavioral disorders (54%), there was a three-fold higher prevalence of mental health conditions likely associated with Daesh among women compared with men and children. This high prevalence of mental health conditions among Yazidi female refugees was associated with the gender-based violence, sexual assault, and rape they experienced.
• The majority of families (95%) experienced family separations after resettlement. Among 130 married adults, 19% reported their spouse was either captive, missing, or dead.
• Clinicians with expertise in refugee health suspected that nearly half of the Yazidis in the study had somatoform disorders. These are psychiatric disorders which cause unexplainable physical symptoms such as abdominal and pelvic pain.

How does this research apply to my work?

• Yazidi refugees require holistic trauma-informed care that incorporates the physical and psychological trauma they experienced. Understanding cultural nuances, such as how family-oriented societies like the Yazidi community perceive and manifest trauma, is important to prevent misdiagnoses and ineffective treatments.
• Findings can assist both health and settlement agencies better address the complex needs of Yazidi refugees as well as those of other genocide survivors. Whether direct or indirect exposure to Daesh, all Yazidi refugees are genocide survivors who experience ongoing individual, collective, and transgenerational trauma and require special considerations of their cultural background and specialized health care needs.
  
  

What should I take away from this research?

Yazidi refugees who resettled in Canada after surviving the genocide experienced substantial trauma, complex mental and physical health conditions, and widespread family separations. These findings highlight the need for comprehensive health care, community engagement, and family reunification for this and other groups.

What is the next step?

The authors noted that additional longitudinal studies with larger sample size is needed to determine trends of PTSD symptoms among resettled refugees and how to best manage these symptoms. In addition, qualitative research with refugees and families is needed to understand their experiences with the post-traumatic stress and coping strategies.

To read the full article, click here.