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SOMALI BANTU HEALTH SHEET Colonial rule divided the Somalis from the mid-1800s until 1960, when two territories were reunited to form modern Somalia. Somalias government fell in 1991 after opposition from clan-based militias and three years of civil war. Since then, there is no government. Mass starvation has ensued and the level of violence is extreme with rape and torture commonplace. An estimated 400,000 Somalis died during this period, and at least 45% of the population has been displaced by the fighting. Many Somalis still remain in refugee camps, some have been repatriated and several thousands have been resettled to the U.S. and Europe. In the spring of 1994, all foreign troops had been withdrawn due to the instability. Resettlement programs have enabled families to move to Europe and the United States. SOMALI BANTU HEALTH SHEET

Colonial rule divided the Somalis from the mid-1800s until 1960, when two
territories were reunited to form modern Somalia. Somalias government fell in
1991 after opposition from clan-based militias and three years of civil war.
Since then, there is no government. Mass starvation has ensued and the level
of violence is extreme with rape and torture commonplace. An estimated
400,000 Somalis died during this period, and at least 45% of the population has
been displaced by the fighting. Many Somalis still remain in refugee camps,
some have been repatriated and several thousands have been resettled to the
U.S. and Europe. In the spring of 1994, all foreign troops had been withdrawn
due to the instability. Resettlement programs have enabled families to move to
Europe and the United States.














health refugees immigrants


Source:
Http://www3.baylor.edu/~_Charles_Kemp/somali_refugees.htm




Pre-migration
During flight & refugee
camps
Post-migrational &
Resettlement
exposure to infectious
and parastitic diseases,
physical and
psychological trauma
malnutrition, exposure to
the elements, exposure
to infectious and parasitic
diseases, physical and
psychological trauma
increasing susceptibility
to chronic diseases,
problems and stressors
of resettlement (racism,
unemployment, ESOL,
crime, etc.)

Upon resettlement in the US, health practitioners should be aware of the
following possible medical issues in the Somali Bantu: Susceptibility to chronic diseases
Stressors
Mental health issues
Oral Health Deficiencies
Gynecologic Complications
Nutritional Deficiencies

Within Kakuma, Somali Bantu health is poor due to a lack of health care
information within the community, poverty, limited utilization of public health
facilities, and inadequate resources.
The Somali have the combined challenges of the after effects of trauma
from violence and the intergenerational culture of inferiority and second-class
citizen status.
The prevalence of violence and constant threat of attack in the refugee camps
have further eroded the Somalis sense of security and well-being.
IOM reports trauma-related problems, including hopelessness and depression,
among the Bantu being interviewed for resettlement. Symptoms of PTSD,
depression, anxiety, and physical injuries resulting from torture are prevalent
among refugee populations.

Family Structure
The societal structure is markedly fractionated by membership in patrilineal
clans (descent through male lines).
Men and elder family members are assigned positions of highest respect by
religious traditions.
Loyalty, peace, harmony and health promote the stability of the spiritual
unity of families.
Cooperation and responsibility of role functioning supports social unity.
Patterns of family interaction directed women to defer to men, especially in
public.
Loss of extended family support creates increased stress for resettled family
members.
There is a strict separation of the sexes. Women, including prepubescent girls,
are expected to cover their bodies, including hair when in public.
An ideal Bantu family consists of between 4-8 children. The extended family
includes grandparents, uncles, aunts, and other relatives.
A married woman retains membership in her fathers family. A two-parent family structure describes the ideal form for Somali families.
There are words for divorced and widowed women but not for single mother (it
violates religious family structure).
Somali family conflict management strategies require arbitration
by the elderly.

Reproductive Health
Contraception and similarly, abortion, are anathema to most Somalis, given
the
strong Muslim belief that pregnancy is a blessing from God.

Sexing of the fetus is not encouraged as it is Gods will and cannot be
changed.
Most women fear Caesarean section delivery, as it is thought that the surgery
may impede subsequent pregnancies.
Specific to Bantu women, the experiences of circumcision, rape, lack of
education, second-class status in Somali society, high birth rates, single parent
status and trauma from past experiences requires appropriate social services,
ensuring as much as possible that people belonging to the same social support
network are resettled in the same geographic location.
Female Genital Mutilation (FGM) is performed throughout Somalia on girls
between the ages of four and ten, and has a prevalence of over 95%.
Infibulation, the extreme form of FGM, is the most common cause of difficult or
prolonged delivery, and is one of the main causes of maternal mortality. It affects
the physical, mental and psychosocial wellbeing of girls and women.
Gynecologic complications may occur as a result of Female Cutting (FC) /
Female Genital Mutilation (FGM): tetanus, chronic pelvic infection, urinary tract
infection, infertility, incontinence, difficulty with urination and menstruation;
obstetric complications of FC/FGM: severe perineal lacerations, obstructed labor,
fistulas, and uterine rupture.
Women may experience difficulty with sexual intercourse because of the
reduced size of the introitus, or vaginal opening. For the same reason, pelvic
exams may be physically painful and difficult.
The history of sexual abuse among many refugee women may evoke strong
emotional and psychological responses to gynecological exams.
In the USA, Somali refugees seek pre-natal care. There is a preference for
female examiners. Bantu women will be further challenged if they cannot draw
upon their extended family and kin networks to assist them with child rearing and
moral support.
Antenatal and postnatal care

Poor antenatal and postnatal care, with the almost complete lack of
emergency obstetric referral care for birth complications, further contribute to
these high rates of mortality and disability.
Maternal and Child Health
In Somalia, current indicators relating to children and womens welfare
almost universally demonstrate a deterioration over the stats as measured before
the war period.
There is a high birth rate among this population: 29% of deliveries in Kakuma
since July 2002 were Somali Bantu while this community represents only 12% of
the total population of the camp. Data from UNICEF notes that maternal
mortality (MMR) is estimated at 1600 per 100,000, placing Somali women among
the most high-risk groups in the world. Nonetheless, approximately 1 in 48
women is at risk of dying from a pregnancy or childbirth related complication.
Because Somali women do not practice birth spacing, the mortality rates in
infants is high and the prevalence of low birth weight infants is common.
Haemorrhage, prolonged and obstructed labour, infections and eclampsia are
the major causes of death at childbirth.
Anaemia and female genital mutilation (infibulation) have a direct impact on,
and aggravate these conditions.
There is a high prevalence of low birth weight infants. Nineteen percent (19%)
of Somali Bantu infants born in Kakuma since July 2002 had a low birth weight.
Women may reduce their food intake in order to limit the size of their baby in
order to prevent a difficult birth after experiencing female circumcision/female
genital mutilation.
Anemia is common among pregnant women in Somalia. Malaria and other
parasitic diseases can cause severe disease or worsen pre-existing iron
deficiency anemia.
Women often stop breastfeeding as soon as the