Social Service agencies charged with the task of helping refugees resettle in the United States competently assist refugees in many ways. Often, though, one of the greatest challenges refugees face, that of maintaining a physically and mentally healthy lifestyle, is overlooked, or approached ineffectively from only a western medical perspective.
Many assume that once refugees are resettled in the United States, access to Western medical practices makes them less susceptible to disease and other illnesses. Certainly, in some respects, this is true: refugee camps, particularly Kakuma camp in Kenya where many Somali Bantus lived, are notorious for their overcrowded living conditions, inadequate hygiene, and shortage of safe water. However, the "healthy migrant" phenomenon demonstrates that, while upon arrival in the United States refugees have a higher burden of infectious diseases, they are in many ways actually healthier than U.S.-born residents. Studies show that among incoming refugee populations, the incidence of chronic disease is significantly lower. Over time, though, this health advantage effectively disappears. Indeed, the length of time that a refugee spends in the United Statesis directly related to increases in low birth weight infants, adolescent risk behaviors, cancer, high blood pressure, high cholesterol, and diabetes.
In addition, many refugees who are resettled in the United States suffer from mental health problems such as depression and Post Traumatic Stress Disorder, which can lead to flashbacks, nightmares, angry or irritable behavior, insomnia, etc. Somali Bantu refugees suffer from these mental health problems at a high rate, due to their long history of marginalization and abuse. In more recent years, they were disproportionately affected by the civil war in Somalia, and after fleeing, they again endured terrible violence and abuse at refugee camps in Kenya, where they lived among the same majority group that forced them to flee in the first place. Furthermore, the "healthy migrant" effect applies to mental health as well: the longer refugees are in the United States, the more they suffer from depression. Not only can new and seemingly strange living conditions exacerbate feelings of isolation and hopelessness, because of differing cultural understandings of the sources of and solutions for mental health problems, Western medical approaches to treating such afflictions are largely ineffective. As one doctor explains, "I don't even use the term 'depression' with my Somali Bantu patients any more. When I do, they don't come back."
The difficultly Somali Bantus have maintaining a physically and mentally healthy lifestyle once in the United States can be understood through an examination of traditional Somali Bantu health and healing practices. In Somalia, the Bantus lived in a rural environment, with little access to modern medical care. While some efforts were made to bring "modern" medical practices to the Jubba Valley, their needs were mostly ignored. Thus, Somali Bantus were left to fend for themselves, and find their own ways both to understand and to cope with the health issues they faced. They turned to their Islamic and spiritual beliefs in order to manage many medical problems. Local health practitioners also developed detailed knowledge about the healing properties of local wild plants.
For some illnesses, such as hydrocephalus, stomach aches, and migraines, Somali Bantus used burning, a practice in which they would apply a heated nail or other metal object to the skin. They also used herbal remedies, and nearly every village had a bonesetter who would treat those patients suffering from a dislocation or a fracture. Other problems were attributed to evil spirits and curses. For such illnesses, treatment revolved around healing rituals, known as boronay, during which women, accompanied by traditional healers, performed ceremonies which often involving drumming and incense.
While to some these health practices may seem outdated, certain aspects of traditional Somali Bantu healing techniques should not be overlooked when working with Somali Bantus in the United States today. For over 150 years, these practices provided comfort and relief to a population that managed to survive in an often harsh and unforgiving environment that left them vulnerable to disease, famine, and traumatic injury. Now, in a different kind of harsh environment where they must find a way to cope with new challenges and obstacles, these tools can again be used to help the Somali Bantus thrive.