For many in Somalia’s drought-stricken eastern provinces, the small dusty town of Dollo Ado, located across the border in Ethiopia, represents hope. The last few years have seen failing harvests and life has become nearly impossible under al-Shabaab control, which has blocked aid from entering this rural region of Somalia. Médecins Sans Frontières’ mental health activity manager Daniel Macía discusses the psychological challenges facing Somali refugees upon arrival in the refugee camps.
“As newcomers arrive in Dollo, they first register at the reception centre and over the next two or three days, we evaluate their condition. Our primarily focus is on first aid psychological support in order to help people through the crisis brought on by their experiences. We try to stabilise their symptoms and reactions, as well as provide useful information that allows them to gradually recover their sense of control. The trip to Ethiopia is tough, both physically and emotionally. In most cases, these refugees will have had a long walk to the border town. Many will have had to deal with food shortages, the inhospitable climate, violence, loss of family and uncertainty about their future.
"In most cases, these refugees will have had a long walk to the border town. Many will have had to deal with food shortages, the inhospitable climate, violence, loss of family and uncertainty about their future"
Their reactions can vary dramatically, depending on age, gender and the individual history of the person. Many men suffer deeply from the inability to fulfil their role as protector and provider. The loss of their job and the inability to feed their household can bring about feelings of depression and anxiety. Women also suffer from being disconnected with their previous daily activities. This can bring about frustration, sadness and anger that can often affect the way they treat their children. Frequently, newcomers have to deal with a loss of a place in the community. I remember the case of a teacher who had worked for many years building a school and educating the children of his village. When he arrived in the refugee camp, where education was the responsibility of international organisations, he suffered from how he was perceived by the community and how he perceived himself. Part of his process of recovery was through self-empowerment, through finding solutions and opportunities in the refugee camp.
Children, who make up a significant part of the population, can also have trouble adjusting to the new environment. The new rules, a new social group and a new school can be difficult at a very young age. They have been torn away from the place and the people they knew. They have many tools that allow them to deal with critical situations, and one of the most important is play. Their games represent a means of repeating over and over again the violence and hardship events and experiences that led to their current situation. This can become an unconscious means of understanding everything that they have been exposed to and their new position. Of course, their relationships with other children and their family as well as the ability to find a new structure to their lives are all essential.”