Challenges 

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. The acute physical healthcare needs arising from conflict and gendered violence, particularly against women and girls, has received considerable attention in protracted displacement contexts.

However, the associated chronic mental health conditions – such as post-traumatic stress disorder, depression, anxiety, and adjustment disorders – are neglected and urgently in need of attention. Moreover, sexual and gender-based violence against men, boys, and people who identify as LGBTQI+ is chronically under-researched. And as well as long-term physical and mental health challenges, there can be social implications such as isolation, abandonment, and marginalisation, which can increase the risk of survivors engaging in risky livelihood strategies, including sex work, which can increase exposure to further violence. 

Context 

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.  

Field Sites 

The DiSoCo project has eight field sites in Eastern DRC, Somalia, Kenya, and South Africa. 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. 

Project Aims 

DiSoCo aims to help Somali and Congolese displaced people in Somalia, Eastern DRC, Kenya, and South Africa to access appropriate healthcare for chronic mental health conditions associated with protracted displacement, conflict, and sexual and gender-based violence by: 

• Improving diagnosis, provision, and accessibility of healthcare for neglected chronic physical and mental ill-health conditions amongst displaced populations. 
• Helping develop resilient, responsive, inclusive health systems which ultimately contribute to strong and welcoming societies. 
• Supporting the development of mechanisms and organisations that empower displaced communities when they seek healthcare. 

For more information, please email the Principal Investigator Laura.Jeffery@ed.ac.uk