Elsevier

Social Science & Medicine

Volume 200, March 2018, Pages 83-91
Social Science & Medicine

Safety, trust, and disclosure: A qualitative examination of violence against refugee adolescents in Kiziba Camp, Rwanda

https://doi.org/10.1016/j.socscimed.2018.01.018Get rights and content

Highlights

  • Examines the nature of violence against adolescents in Kiziba Camp, Rwanda.

  • Obtains comparative data from both caregivers and adolescents.

  • Uses an ecological framework to analyze protection risks and abuse disclosure.

  • Argues for a systems approach to global violence against children research.

Abstract

Refugee adolescents face increased vulnerability to child protection risks including abuse, neglect, violence, and exploitation. The aim of this qualitative study was to examine the nature of violence against adolescents in Kiziba Camp, Rwanda, using an ecological framework to analyze the factors that influence protection risks and abuse disclosure across multiple system levels. In order to understand these issues more comprehensively, a transgenerational inquiry sought perceptions from both adolescents and their caregivers. In April 2016, as part of a larger, comprehensive study on adolescent protection, 19 focus group discussions were conducted with a total of 70 adolescents and 68 caregivers from the Democratic Republic of Congo. A qualitative content analysis identified three salient themes. First, structural protection risks exist for adolescents in Kiziba Camp, with economic insecurity and resource constraints resulting in specific risks such as overcrowded housing and adolescents traveling for firewood collection. Second, intergenerational conflict between caregivers and adolescents was perceived to negatively influence abuse disclosure. Lastly, protection mechanisms and reporting pathways were underutilized as caregivers and adolescents expressed concern over the shame, embarrassment, and social rejection that characterized formal disclosure in Kiziba, often rooted in restrictive and inequitable gender norms. These findings suggest that efforts at child protection should be multi-faceted and address structural aspects of risk; household levels of communication and trust; and societal norms that deter abuse reporting. The study also underscores the need for further research on risk and protective factors in camp settings to better tailor interventions aiming to reduce violence against children.

Introduction

Of the approximately 22.5 million refugees across the world today, over half are children and adolescents under the age of 18 (UNHCR, 2017c). Refugees face numerous hardships as they seek safe havens for themselves and their families, including but not limited to lack of financial resources, insecure shelter, and disruption of social networks prior to displacement, during flight, and in refugee camps (Miller and Rasco, 2004). Whether residing in urban or camp settings, refugees may experience decreased access to clean water, food insecurity, and limited healthcare and education, often compounded by a precarious legal status (Grafham et al., 2016, Murray, 2016). The stress of forced migration, particularly for adolescents who have been exposed to conflict or violence, is occurring during an already challenging time of maturation and identity formation (Belfer, 2008, Fowler et al., 2009, Meeus, 2011).

While reliable estimates of violence against children in humanitarian settings are lacking (Stark and Landis, 2016), prior research has shown the issue to be of concern, even when active conflict has ceased (Saile et al., 2014, Stark et al., 2017b). Adolescents who have lived in conflict zones may suffer challenges to mental health, including anxiety, depression, and aggression (Vossoughi et al., 2016) with such outcomes influenced by continued exposure to violence within their current communities (Mels et al., 2010, Reed et al., 2012). Adolescents who witness sustained interpersonal or community violence are more likely to suffer a range of negative psychological outcomes (Fazel et al., 2012) including depression (Kennedy et al., 2010) and social maladjustment (Schwartz and Proctor, 2000). Indeed, this cumulative exposure to violence, one that prolongs a compromised sense of safety even after fleeing conflict, can be detrimental to adolescent development and well-being (Garbarino, 2010). At the same time, in contexts where violence is chronic and enforcement systems inadequate, the likelihood of abuse disclosure is often limited for fear of social sanctions (Jayasuriya and Gibson, 2013). Research in settings where inter- and intra-household violence is common indicates that reporting abuse to authorities is often rare (Horn, 2010, Stark et al., 2013), demonstrating an underutilization of formal protection mechanisms that typically include law enforcement, social workers and other officials charged with child protection.

Conversely, feelings of safety and security have been shown to mediate the effects of past exposure to violence or abuse (Miller and Rasmussen, 2010, Overstreet and Braun, 2000). A key factor in an adolescent's sense of safety is the household environment, specifically the relationship between an adolescent and their caregiver. Adolescent and caregiver relationships can fracture in refugee settings as family roles and responsibilities often shift during flight (Miller and Rasco, 2004), a change that has been identified as a major stressor in displacement settings (Deng, 2016, Muruthi and Lewis, 2017). These stressors can lead to increased restrictions imposed by parents and cause intergenerational tensions (Koh et al., 2013). Displaced caregivers also face resource challenges, limiting their ability to meet the basic needs of their children, a limitation that has been linked to both low self-esteem and withdrawal from community and family support systems (Stark et al., 2015). Further, breakdowns in caregiver-adolescent communication that can result during migration and subsequent acculturation processes often disrupt perceptions of safety and security for adolescents (Koh et al., 2013).

In the past decade, a systems approach has gained acceptance as the industry standard for understanding global efforts to protect children from violence, exploitation, and abuse (Wulczyn et al., 2010). Based on the notion that children are influenced by a multitude of factors across system levels – from relationships with parents at the micro level to the functioning of formal protection mechanisms at the exo-level to community norms and attitudes at the macro-level – an ecological systems framework enables scholars and practitioners alike to visualize the simultaneous and interconnected factors affected children's well-being (Brofenbrenner, 1992). As efforts to address violence against children has become an increasing priority globally (UNICEF, 2014), there is a need for research to contextualize prevention and response pathways, particularly that which conceptualizes the issue as a multi-faceted phenomenon.

Rubenstein and Stark (2017), published one of the first studies to use an ecological framework to examine violence against children in humanitarian emergencies. This study identified literature to support the notion that protection risks for children originate from multiple and interconnected domains, including conflict-induced loss of livelihoods, changing gender roles, and erosion of endogenous protection systems. However, it also highlighted numerous gaps in the literature and issued a call for more complete data on violence against children in humanitarian contexts, including through qualitative methods which can provide rich insight on the complex dynamics that drive violence against children in these settings.

Building upon Rubenstein and Stark (2017), our study analyzes primary qualitative data to examine the nature of violence against adolescents in Kiziba Camp, Rwanda, exploring the risks that exist in the camp and the ways in which residents respond to violence against adolescents after it occurs. The study then employs an ecological framework to analyze the factors that influence protection risks and abuse disclosure across multiple system levels, factors that can inform the design of much needed longitudinal studies on the structural and household-level determinants of violence against adolescents in humanitarian settings. In order to understand these issues more comprehensively, a transgenerational inquiry sought perceptions from both adolescents and their caregivers in order to obtain comparative data on the factors that inhibit or contribute to the creation of a safe and protective environment for adolescents.

Section snippets

Methods

This qualitative analysis used transcripts from focus group discussions conducted in April 2016 as part of a larger study, Measuring Impact with a Child Protection Index (CPI) (Meyer et al., 2017a, Meyer et al., 2017b, Meyer et al., 2017c). This parent study employed an initial quantitative assessment of adolescent exposures to violence, exploitation, and abuse that was followed by a child protection systems strengthening intervention. Subsequent to the intervention, a second assessment sought

Structural drivers

During adolescent and caregiver focus group discussions, participants were asked to reflect on the protection risks facing young refugees residing in Kiziba Camp. Across both age cohorts, two key themes emerged – economic insecurity and resource constraints. These structural deficits were considered key drivers of protection risk, increasing the vulnerabilities of adolescents and the likelihood they would be victims of violence. These broader structural risks were perceived to be root causes of

Discussion

This study utilized a qualitative design to examine transgenerational perceptions of protection risks and abuse disclosure among adolescents in Kiziba Camp, Rwanda. The findings centered around three salient themes. First, structural protection risks exist for adolescents in Kiziba Camp, with economic insecurity and resource constraints resulting in more specific risks such as overcrowded housing and the need to travel to collect firewood for fuel. Second, intergenerational conflict between

Limitations

This study is limited in scope and application as it is based on data obtained solely from focus group discussions therefore not generalizable to the broader population of refugee adolescents. Refugee data collectors utilized a convenience sample, recruiting discussion participants based on their ability to be available and accessible in the camp. These conditions may introduce biases that affect the applicability of the findings to adolescents and caregivers with differing profiles from those

Conclusions

This study examined the nature of violence against adolescents in Kiziba Camp, Rwanda, exploring the risks that exist in the camp and the factors that facilitated or deterred the establishment of a protective environment. It contributes to the literature by exploring child protection through a transgenerational lens, comparing and contrasting viewpoints from adolescents and their caregivers. It also reiterates the importance of addressing violence against children from a systems perspective,

Funding

This work was supported by Bureau of Population, Refugees and Migration through the Safe from the Start initiative. The funder of the study had no role in study design, data collection, analysis, interpretation, or writing of the manuscript.

Disclosure statement

The authors declare that they have no conflicts of interest.

Acknowledgements:

We acknowledge the following colleagues from UNHCR for input into study design and support for the research: Monika Sandvik-Nyland, Gita Swamy Meier-Ewert, Janis Ridsdel, Richard Sollom, Joanina Karugaba and Yukiko Iriyama. In addition, we acknowledge colleagues from Plan International for their respective contributions: Mr. Casimir Youmbi, Liberata Muhorakeye, Anne Toussaint, Marie Mediatrice Umfuyisoni, Gerard Bizimana, Jean Bosco Havugimana and Jennifer Lee.

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