Improving healthcare at the intersection of gender and protracted displacement amongst Somali and Congolese refugees and IDPs

该项目旨在帮助流离失所者获得适当的医疗保健，以解决与长期流离失所、冲突和性别暴力有关的长期身心健康问题。性暴力和基于性别的暴力这一类受到极大关注。然而，关于流离失所者如何遭受性别暴力，包括与性有关的暴力的研究有限。对于性别、性行为和相关暴力如何影响获得医疗保健的机会，以及这如何导致被忽视的慢性健康状况，特别是精神疾病，人们的理解也很有限。同样，人们对性暴力和基于性别的暴力事件后的紧急医疗保健需求给予了很大关注，但长期的身心健康状况没有得到充分解决。在长期流离失所的情况下，流离失所者在寻求医疗保健时面临多重障碍，其结果是长期健康状况经常被误诊和虐待，或未被诊断和治疗。本项目考察了刚果（DRC）东部、索马里、肯尼亚和南非流离失所的刚果人和索马里人获得医疗保健的机会和医疗保健提供者的反应。自1990年代初以来，刚果民主共和国东部和索马里都经历了长期的冲突和流离失所，导致这些国家内有大量的国内流离失所者，整个地区有大量的难民人口。刚果民主共和国东部和索马里的冲突和流离失所的特点是性暴力和基于性别的暴力发生率很高，受害者因普遍的性别和性规范而被污名化。现有的健康研究往往侧重于暴力的直接后果，而不是长期的身心健康状况。该项目在四个国家有八个实地地点。四个境内流离失所者实地安置点分别是刚果民主共和国东部和索马里的一个正式营地和一个非正式定居点，这两个地方的卫生系统都很薄弱。这四个难民实地地点是肯尼亚和南非的刚果人和索马里人定居点，它们有不同的卫生系统和不同的难民法律和政策，该项目汇集了来自国际发展、移徙研究、性别研究、医学人类学、公共卫生和卫生政策以及医学的研究人员和从业人员，在这些长期流离失所的背景下进行跨学科的实证研究。Panzi基金会（刚果民主共和国）和战争创伤基金会（荷兰）将指导爱丁堡大学（英国），金沙萨大学（刚果民主共和国），索马里发展和研究所（索马里），Amref国际大学（肯尼亚）和威特沃特斯兰德大学（南非）的研究人员团队。项目活动旨在：1）提高伙伴组织的能力; 2）支持将流离失所者纳入医疗保健系统; 3）促进国际网络。

This project aims to help displaced people to access appropriate healthcare for long-term physical and mental health conditions associated with protracted displacement, conflict, and gendered violence. The category of Sexual and Gender-Based Violence (SGBV) receives a great deal of attention. However, there is limited research on how gendered violence, including violence relating to sexuality, is experienced in displacement contexts. There is also limited understanding of how gender, sexuality, and related violence affect access to healthcare, and how that can result in neglected chronic health conditions, particularly mental ill-health. Similarly, much attention is devoted to immediate healthcare needs following SGBV, but longer-term physical and mental health conditions are not adequately addressed. Displaced people face multiple barriers when seeking healthcare in protracted displacement settings, with the result that long-term health conditions are often misdiagnosed and mistreated or undiagnosed and untreated.This project examines access to care and the responsiveness of healthcare providers for displaced Congolese and Somalis in Eastern Democratic Republic of Congo (DRC), Somali, Kenya, and South Africa. Eastern DRC and Somalia have both experienced long-term conflict and displacement since the early 1990s, leading to large populations of Internally Displaced People (IDPs) within these countries and large refugee populations across the region. Conflict and displacement in Eastern DRC and Somalia are characterised by high rates of sexual and gender-based violence, and victims are stigmatised through prevailing gender and sexual norms. Existing health research tends to focus on the immediate aftermath of violence rather than on long-term mental and physical health conditions. The project has eight field sites in four countries. The four IDP field sites are one formal camp and one informal settlement each in Eastern DRC and Somalia, both of which have weak health systems. The four refugee field sites are Congolese and Somali settlements in Kenya and South Africa, which have different health systems and different refugee laws and policies.The project brings together researchers and practitioners from international development, migration studies, gender studies, medical anthropology, public health and health policy, and medical sciences to undertake interdisciplinary empirical research in these protracted displacement contexts. Panzi Foundation (DRC) and War Trauma Foundation (Netherlands) will guide teams of researchers based at the University of Edinburgh (UK), the University of Kinshasa (DRC), the Somali Institute for Development and Research (Somalia), Amref International University (Kenya), and the University of Witwatersrand (South Africa). Project activities are designed to: 1) enhance the capacity of partner organisations; 2) support the inclusion of displaced people in healthcare systems; 3) foster international networks.