Miriam Kuttikat, Ph.D., has traveled to India several times to study Tamil refugees displaced by the civil war in Sri Lanka. His work began with a visit to a refugee camp in 2007 and included six additional trips over the following decade. Along the way, Kuttikat’s efforts have evolved from a clinical social work focus to a research trajectory, shaped both by his area of expertise and by the use of evidence-based and committed interventions. the community to help people.
“Our domain [social work] can be distinguished among the professions for its efforts to improve the most difficult societal problems faced by the most vulnerable populations in society, ”said Kuttikat, Associate Professor at Virginia Commonwealth University School of Social Work.
These vulnerable populations have poignant stories. Kuttikat remembers a refugee mother who traveled to a camp in India by boat. She quoted the mother’s words:
“After several hours in the boat, my son had severe chorukku (seasickness). He died in my arms. I had no breast milk to feed him. I couldn’t even give him a drop of milk. ‘water before his death. ”
Little studied populations
More than a decade after starting her work with Tamil refugees, Kuttikat is now embarking on a related study much closer to home, and supported by an award last summer from the Presidential Research Quest Fund at Virginia Commonwealth University. . Working on a project originally titled “Testing Family Dynamics Among Eritrean Migrants in the Greater Washington, DC Area,” Kuttikat has expanded its work with Eritrean migrants and refugees to include those from other countries of the Horn of Africa: Somalia, Ethiopia and Djibouti.
“Recent research has shown that the Washington, DC area, including northern Virginia and northern Maryland, has become one of the top destinations for African migrants, especially [Horn of Africa] country, ”Kuttikat said. “More than 181,700 African-born people live in the DC-Virginia-Maryland region, and it is one of the region’s largest black migrant populations.
The main social problem, Kuttikat said, is that there is a gap in the delivery of mental health services and health supports because these populations have been under-studied.
“Anecdotes on the ground indicate that there is no statistical evidence to decide the percentage of those living in poverty, their average income and the number of migrants from the Horn of Africa who seek medical assistance. Kuttikat said. “These anecdotes corroborate my clinical experience with this population; there is a significant gap in the development of sources of support and the implementation of interventions for the [Horn of Africa] migrant community because they are poorly studied, high risk and vulnerable populations.
“They are more likely to experience inequalities in access and use of health care and health disparities, resulting in a high risk of migration-related stressors that negatively affect their health and their lives. well-being. ”
The project, said Kuttikat, aims to identify the stressors of the daily life of migrants from the Horn of Africa, family dynamics and challenges in healthcare and “develop data to submit a proposal for ‘comprehensive study to develop culturally appropriate and evidence-based interventions’. These results of the study, she said, will significantly increase the quality of life of migrants from the Horn of Africa and reduce the costs of follow-up treatment.
The research team includes faculty collaborators David Chan, Ph.D., associate professor at Department of Mathematics and Applied Mathematics in the College of Humanities and Sciences, and Kyeongmo kim, Ph.D., assistant professor in the School of Social Work; social work doctorate students Jennifer murphy, Paola roldan and Muna Saleh; and Sarah Nieburg and Jennifer Ramachandran, master’s students in social work. The group will also partner with community organizations such as Unbroken link and the International Rescue Committee.
Chan, whose current work includes analyzing student support networks and their effect on student success, will develop a similar model for immigrant support networks.
“I hope this research will lead to better outcomes for these immigrants by understanding which supports work, which don’t and maybe what supports are missing and would be helpful if they were included,” he said. “I believe this research is important not only for these immigrants, but some of these findings could help other immigrants in other places.”
Kim, meanwhile, brings expertise in aging and gerontology, refugees and immigrants, and mental health.
“This is an opportunity to examine family dynamics and stressors to develop a culturally appropriate intervention,” he said.
Haben Ghebremeschel formed the Bond Unbroken nonprofit as a resource for teaching the native Eritrean language of Tigrinya. Ghebremeschel, whose parents immigrated to the United States from Eritrea in 1985, cited the importance of cultural norms, such as a mother tongue, in fostering positive generational family dynamics and improving community support services.
“Sometimes the language is part of what is lost and is not passed down from generation to generation,” said Ghebremeschel, who will serve as the community liaison on the project and help connect the research team to other community partners. and interviewing subjects from target populations. .
“It’s also about seeing where the reluctance lies within those communities, and then seeing where the resources might turn into something more suited to the cultural backgrounds of those they seek to support,” said Ghebremeschel. . “I think there is sometimes a universal band-aid on mental health issues, and I don’t think they’re really focused on the trauma that particular communities face. If caregivers had a little more cultural understanding – grew up in or alongside the culture – this could be beneficial in ensuring that information provided to migrant families finds its way through these different types of pathways. support. “
This approach resonates with Kuttikat, which uses a model of community-based participatory research that “practices an equal partnership between researchers and migrant communities”.
“The [community-based participatory research] This approach has helped me build trust and strong relationships with migrant communities, allowed me to explore migrant experiences and express vulnerable and invisible migrants, ”she said. “Migrants from the Horn of Africa will have the same responsibility in the design and implementation of these interventions as they are part of the [community-based] approach we use in our research.
“The continued expression of their pain can heal them”
In his study of Tamil, Kuttikat examined migration trauma, psychological stress, repatriation issues, intergenerational conflict, and family dynamics. The Fogarty International Center at the National Institutes of Health funded his research from 2013 to 2018.
“I developed a community intervention to address family stressors, family conflict, parenting challenges, and family health,” Kuttikat said of the NIH-funded work. “We conducted studies with 120 refugee parents and their 120 teenagers; many of them were child soldiers, victims of physical and sexual assault and survivors of landmines.
“We had quantitative surveys and qualitative interviews on their family dynamics and focus groups on the development of intervention components. I continued to follow them until 2018 to track their life changes as the teens grew into young adults. For the next round of research, I will go to test before and after changes in families during family mental health intervention at multiple levels. “
Kuttikat said it’s natural to have an emotional response to the experiences of refugees, but the key is for researchers to have their own mentors or advisers to discuss their experiences. For refugees, sharing traumatic stories can be cathartic.
“I have found that the continued expression of their pain can heal them,” she said. “I believe people’s stories have a way of taking care of them; we have to learn to give them a way where they are needed.”
She still remembers the words of the mother whose son died in the boat on the way to India.
“I held him in my arms for hours, holding him close to my breath to give him warmth,” Kuttikat said, citing the mother’s words. “The shipmates did not want to travel with a corpse that would attract eagles. I was forced to throw my son’s body into the sea.
“I saw his body floating in the water. Kadalamma (Mother Sea) took my son away. What did he do to die at such a young age? Why did this happen to me? Why ?
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