Political violence and war are push factors for migration
and social determinants of health among migrants. Somali migration to Sweden
has increased threefold since 2004, and now comprises refugees with more than
20 years of war experiences. Health is influenced by earlier life
experiences with adverse sexual and reproductive health, violence, and mental distress
being linked. Adverse pregnancy outcomes are reported among Somali born
refugees in high-income countries. The aim of this study was to explore
experiences and perceptions on war, violence, and reproductive health before
migration among Somali born women in Sweden.
Qualitative semi-structured individual interviews were
conducted with 17 Somali born refugee women of fertile age living in Sweden.
Thematic analysis was applied.
Before migration, widespread war-related violence in the
community had created fear, separation, and interruption in daily life in
Somalia, and power based restrictions limited access to reproductive health
services. The lack of justice and support for women exposed to non-partner
sexual violence or intimate partner violence reinforced the risk of shame,
stigmatization, and silence. Social networks, stoicism, and faith constituted
survival strategies in the context of war.
Several factors reinforced non-disclosure of violence
exposure among the Somali born women before migration. Therefore,
violence-related illness might be overlooked in the health care system.
Survival strategies shaped by war contain resources for resilience and
enhancement of well-being and sexual and reproductive health and rights in
receiving countries after migration.
“…they [the militia men] abused me. […] They think that if someone happens to see the genital organs of a married woman, the woman has to be stoned – stoned to death. […] It was just after the delivery I escaped. I had recently given birth.” (Woman 5)
“This with rape, I think is something new in Somalia. So, the general public or the people have not learned how to support and what kind of help is available. There are different women’s organizations helping. Not many know they exist. And before the war I don’t think there has been such an organization helping women that have been exposed to violence […] So, I think it will be that you keep it to yourself, in the small family.” (Woman 17)
Table 2
Themes and sub-themes on war, violence and SRH in Somalia
| Theme | Subthemes |
|---|---|
| Violence is everywhere in war-torn Somalia | Controlled by the fear of violence |
| Interrupted life and scattered families | |
| Childbearing – natural but hazardous | |
| The silence of sexual and intimate partner violence | Rape happens, but who can intervene? |
| Intimate partner violence is a family issue | |
| Stoic women keep life together | We cannot dwell on what cannot be changed |
| We have learnt to be strong |
Full article
at:
School of
Education, Health and Social Studies, Dalarna University, S-791 88 Falun,
Sweden
Department of
Women’s and Children’s Health, Uppsala University, Akademiska sjukhuset, S-751
85 Uppsala, Sweden
Centre for
Clinical Research, Nissers väg 3, S-791 82 Falun, Sweden
Ulrika Byrskog, Email: es.ud@ybu.
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