Sri Lankan tsunami refugees: a cross sectional study of the relationships between housing conditions and self-reported health

BACKGROUND: On the 26th December 2004 the Asian tsunami devastated the Sri Lankan coastline. More than two years later, over 14,500 families were still living in transitional shelters. This study compares the health of the internally displaced people (IDP), living in transitional camps with those in permanent housing projects provided by government and non-government organisations in Sri Lanka. METHODS: This study was conducted in seven transitional camps and five permanent housing projects in the south west of Sri Lanka. Using an interviewer-led questionnaire, data on the IDPs' self-reported health and housing conditions were collected from 154 participants from transitional camps and 147 participants from permanent housing projects. Simple tabulation with non-parametric tests and logistic regression were used to identify and analyse relationships between housing conditions and the reported prevalence of specific symptoms. RESULTS: Analysis showed that living conditions were significantly worse in transitional camps than in permanent housing projects for all factors investigated, except 'having a leaking roof'. Transitional camp participants scored significantly lower on self-perceived overall health scores than those living in housing projects. After controlling for gender, age and marital status, living in a transitional camp compared to a housing project was found to be a significant risk factor for the following symptoms; coughs OR: 3.53 (CI: 2.11-5.89), stomach ache 4.82 (2.19-10.82), headache 5.20 (3.09-8.76), general aches and pains 6.44 (3.67-11.33) and feeling generally unwell 2.28 (2.51-7.29). Within transitional camp data, the only condition shown to be a significant risk factor for any symptom was household population density, which increased the risk of stomach aches 1.40 (1.09-1.79) and headaches 1.33 (1.01-1.77). CONCLUSION: Internally displaced people living in transitional camps are a vulnerable population and specific interventions need to be targeted at this population to address the health inequalities that they report to be experiencing. Further studies need to be conducted to establish which aspects of their housing environment predispose them to poorer health

Dinâmicas comunitárias em deslocados e não deslocados residentes em áreas de exclusão social em Barranquilla (Colômbia)

El sentido de comunidad, la participación y el empoderamiento permiten comprender el proceso de desplazamiento y reasentamiento en el contexto de recepción, así como las consecuencias derivadas de ambos fenómenos. Los objetivos de la investigación son a) evaluar los tres constructos mencionados, b) analizar la sinergia que existe entre estos y c) proponer estrategias para aumentar su capacidad de influencia en los procesos de toma de decisiones. Llevamos a cabo una investigación exploratoria y transversal con población desplazada (n=30) y no desplazada (n=32) en dos localidades de bajos ingresos en Barranquilla (Colombia). Existe retroalimentación positiva entre los procesos evaluados, aunque no se observan diferencias significativas entre el grupo de desplazados y el de no desplazados. La dimensión Pertenencia (sentido de comunidad) es la que mejor explica la varianza del empoderamiento y de la participación en ambos grupos. Presentamos iniciativas para reforzar el sentido de comunidad y facilitar el acceso a los recursos socio-comunitarios en población desplazada.The sense of community, participation and empowerment enable us to understand the process of displacement and resettlement in the context of reception, as well as the consequences of both phenomena. Our objectives are a) to assess the three constructs mentioned above, b) to analyze the synergy existing among them and c) to propose strategies for increasing their capacity to influence the decision-making processes. We carried out a cross-sectional exploratory study with displaced (n=30) and non-displaced (n=32) people in two low-income districts of Barranquilla (Colombia). There is positive feedback between the processes evaluated, although no significant differences are observed between the displaced and the non-displaced groups. The dimension of belonging (sense of community) is the one that best explains the variance of empowerment and participation in both groups. Finally, we present a set of initiatives to reinforce the sense of community and to facilitate access to the community’s social resources for the displaced population.O sentido de comunidade, a participação e o empoderamento permitem compreender o processo de deslocamento e reassentamento no contexto de recepção bem como as consequências derivadas de ambos os fenômenos. Os objetivos desta pesquisa são: a) avaliar os três construtos mencionados; b) analisar a sinergia que existe entre estes e c) propor estratégias para aumentar sua capacidade de influência nos processos de tomada de decisões. Realizamos uma pesquisa exploratória e transversal com população deslocada (n=30) e não deslocada (n=32) em duas localidades de baixa renda em Barranquilla (Colômbia). Existe retroalimentação positiva entre os processos avaliados, embora não se observem diferenças significativas entre o grupo de deslocados e o de não deslocados. A dimensão Pertencimento (sentido de comunidade) é a que melhor explica a variância do empoderamento e da participação em ambos os grupos. Apresentamos iniciativas para reforçar o sentido de comunidade e facilitar o acesso aos recursos sociocomunitários em população deslocada

An exploration of social determinants of health amongst internally displaced persons in northern Uganda

Social determinants of health describe the conditions in which people are born, grow, live, work and age and their influence on health. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Armed conflict and forced displacement are important influences on the social determinants of health. There is limited evidence on the social determinants of health of internally displaced persons (IDPs) who have been forced from their homes due to armed conflict but remain within the borders of their country. The aim of this study was to explore the social determinants of overall physical and mental health of IDPs, including the response strategies used by IDPs to support their health needs. Northern Uganda was chosen as a case-study, and 21 face-to-face semi-structured interviews with IDPs were conducted in fifteen IDP camps between November and December 2006

Plan Colombia: illegal drugs, economic development and counterinsurgency - a political economy analysis of Colombia's failed war

This article examines the socioeconomic effects of the illegal drug industry on economic and social development in Colombia. It shows that illegal drugs have fostered violence and have had a negative effect on economic development. This article also shows that the Plan Colombia anti‐drug policy has been an ineffective strategy in terms of decreasing drug production, generating economic development and reducing violence. Since this study includes both a statistical analysis of the effects that violence and illegal drugs have on the economic growth of Colombia, along with an evaluation of the Plan Colombia policy programme, it fills the gap between existing empirical studies of the Colombian illegal drug industry and specific analyses of Plan Colombia

The impact of armed civil conflict on household welfare and policy

This paper offers a framework for analysing the effects of armed conflicts on households and the ways in which households in turn respond to and cope with the conflicts. It distinguishes between direct and indirect effects, and shows that the indirect effects are channelled through (i) markets, (ii) political institutions, and (iii) social networks. Drawing upon the recent empirical literature, the paper portrays the processes running along these various channels and offers policy suggestions to be adopted at both national and international levels. Keywords: armed conflict; civil conflict; household welfare; transmission mechanism; coping mechanism; remittances

Molecular, clinical, and muscle studies in myotonic dystrophy type 1 (DM1) associated with novel variant CCG expansions

We assessed clinical, molecular and muscle histopathological features in five unrelated Italian DM1 patients carrying novel variant pathological expansions containing CCG interruptions within the 3'-end of the CTG array at the DMPK locus, detected by bidirectional triplet primed PCR (TP-PCR) and sequencing. Three patients had a negative DM1 testing by routine long-range PCR; the other two patients were identified among 100 unrelated DM1 cases and re-evaluated to estimate the prevalence of variant expansions. The overall prevalence was 4.8 % in our study cohort. There were no major clinical differences between variant and non-variant DM1 patients, except for cognitive involvement. Muscle RNA-FISH, immunofluorescence for MBNL1 and RT-PCR analysis documented the presence of ribonuclear inclusions, their co-localization with MBNL1, and an aberrant splicing pattern involved in DM1 pathogenesis, without any obvious differences between variant and non-variant DM1 patients. Therefore, this study shows that the CCG interruptions at the 3'-end of expanded DMPK alleles do not produce qualitative effects on the RNA-mediated toxic gain-of-function in DM1 muscle tissues. Finally, our results support the conclusion that different patterns of CCG interruptions within the CTG array could modulate the DM1 clinical phenotype, variably affecting the mutational dynamics of the variant repeat

Patterns of Passage into protected areas: drivers and outcomes of Fulani immigration, settlement and integration into the Kachia Grazing Reserve, Northwest Nigeria

Abstract Increasing land use and associated competition for natural resources in the wake of high human and livestock population pressures have been major challenges confronting pastoralists of West Africa. This is especially true in Nigeria where Fulani make up 4% of the national population and prevailing national insecurity issues are impacting on pastoral livelihoods, including violent conflicts over land and ethnic, religious and political disparities. This study examined the dynamics of immigration within the Kachia Grazing Reserve (KGR), an exclusively Fulani pastoralist community in Kaduna State, northwest Nigeria, prompted by concerns from both the farming communities and the authorities about mounting pressure on existing limited resources, particularly in regard to availability of cattle grazing resources. Drawing from a household census conducted in 2011 and employing a range of qualitative methods (focus group discussions and key informant interviews), this study explored the drivers and consequences of immigration and subsequent integration within the KGR community. The study revealed two types of immigration: a steady trickle of pastoralists migrating to the reserve to settle and acquire land, secure from the stresses of competition from cultivators, and the sudden influx of internally displaced persons fleeing violent clashes in their areas of origin. Population pressure within the reserve has risen steadily over the past three decades, such that it is severely overgrazed (as evidenced by reports from the KGR community that the animals run short of pasture even during the wet season due to desertification and the spread of non-edible weeds). The newer immigrants, fleeing conflict, tended to arrive in the reserve with significantly larger herds than those kept by established residents. Pastoralists in the reserve have been forced back into the practice of seasonal transhumance in both wet and dry seasons to support their herds, with all the attendant risks of theft, clashes with cultivators and increased disease transmission

Conflict-induced displacement as a catalyst for agricultural innovation: findings from South Sudan

This article explores how conflict-induced displacement influences agricultural innovation processes and systems, and its implications after the return home or permanent resettlement of smallholder farmers. Results show that high rates of agricultural innovation occurred during displacement in the Sudanese Civil War (1983-2005), many of which were maintained afterwards. Respondents cited the need for adaptation to new social and physical circumstances, changed gender roles, and enhanced inter-household communication as contributing to increased opportunities for knowledge exchange, trade, and importantly, the development of new networks, modes of organisation and social norms. Furthermore, returnees to South Sudan have embodied these changes together with new values, habits and expectations. New linkages continued across borders between returnees and non-returnees, facilitating knowledge exchange and access to resources, markets and sources of ideas. A high degree of autonomous innovation capacity was also evident. Further research is required on the dynamics and processes associated with innovation in conflict-induced displacement. It is important for policy makers to encourage approaches that seek to actively tap into and build on the institutional, human and social capital built during displacement

Moving with risk: Forced displacement and vulnerability to hazards in Colombia

The paper examines the processes through which people forced from their homes by conflict can become exposed to heightened risk from environmental hazards in the places where they resettle. It reports on research undertaken with internally displaced people who moved to informal settlements in four locations in Colombia. With one of the world’s largest displaced populations and a high annual incidence of hazard events such as landslides and floods, enabling people to create a durable sense of security in their places of resettlement is a major development challenge for the country. However, as the testimonies from individual experiences and perspectives makes clear, this problem is not one that can or should be addressed simply by enforcing existing land use and tenure regulations. The study combined qualitative interview methods with arts-based elements designed to facilitate and open up dialogue with research participants. We found that creating a permanent home, however modest, has symbolic meaning that reflects both personal struggle and collective effort: it represents security and stability, even in sites people know are associated with hazards. In tracing how they have interacted with multiple forms of risk, our work shows how displaced people have had to weigh up the threats they face against limited resettlement options, in an ongoing context of marginalisation. For complex reasons, this is a population that tends to be excluded from formal disaster preparedness and mitigation. However, there are indications that this prevailing situation could be challenged, promoting greater flexibility on the part of governmental organisations and enabling communities to become more engaged in disaster risk reduction. In bringing empirical depth to a topic of global significance at the intersection of displacement, disaster and development, we support the call for adaptable approaches to disaster risk management that can support displaced people more effectively and equitably