Case Study – Refugee Relocation

This case study suggests appropriate theories and concepts that can be used to understand a client who has been forced into migration and relocation, first to a refugee camp, and subsequently to the United States. Theories and concepts are presented to provide the necessary tools to understand the client and her family, in order to help them adjust to a new life. Through the Systems theory, including the ecological theory, the social constructionist theory, and the conflict theory, the concepts of role, family, oppression, inequality, human rights, culture, and gender are explored.

The case study provides suggestions and applications of issues surrounding the plight of refugees forced to resettle away from their home country.

The case study addresses the need for social workers to understand the “impact of trauma faced by refugees fleeing persecution” (Ostrander, Melville, & Berthold 2017). “The United Nations General Assembly 1951, Article 1[A][2], defines a refugee as a person who, owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership or a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country” (Ostrander, et al 2017).

Social workers are in a position to provide care for these diverse and traumatized individuals who have been forced to relocate and adjust to a life and a society very different from their own. Practitioners in both micro and macro practice have a need to understand this impact to “promote policies, social work training, and clinical practice” that benefits the client’s emotional health and sense of well being (Ostrander, et al 2017).

Bhutanese refugees, Manisha and her family were victims of ethnic cleansing in their country in the late 1980’s. Forced to give up their home and citizenship, they lived in a refugee camp in Nepal for 17 years, where their children were able to continue their education. Manisha exhibited resilience and formed social connections in the refugee camp, serving as camp secretary for 3 years. Finally recognizing that they would have to leave their country, they resettled with their children to America. They have both learned to speak English. Manisha’s resilience and desire to maintain the active lifestyle she had known her entire life caused her to seek employment in the community to improve her English skills, and to maintain social connections. Manisha’s husband, who had been taken prisoner during the government uprising in Bhutan, suffered from the trauma he experienced, and had not been able to be as resilient as his wife. Both have spent many years living in fear, uncertainty, and with a deep desire to return to their country. Although they are beginning to take citizenship classes, they have described periods of isolation and adjustment difficulty (Hutchison 2015).

Through the systems theory, ecological theory, social constructionist theory, and conflict theory, the concepts of role, family, oppression, inequality, human rights, alienation, culture, and gender are explored to help understand and better support Manisha and other refugees.

The systems theory allows a clearer understanding of the various systems in Manisha’s life and her role in those systems. This perspective “sees human behavior as the outcome of interactions within and among systems of interrelated parts” (Hutchison 2015). To better understand the intersection of systems and their effect, social workers must realize that, “The refugee experience does not begin upon entry in the host country, but instead is comprised of a ‘continuum of displacement, transition, and resettlement’. Working with refugees requires an understanding of their pre-migration and migration, and post-migration trauma and other experiences” (Ostrander, et al 2017). Ecological theory provides a framework to understand and organize refugee experiences. Using Bronfenbrenner’s ecological framework to understand Manisha’s life as an interconnected system of influences on her past and present gives deeper understanding of her circumstance. “In order to apply this framework to understand the experience of refugees, we must conceptualize these refugees as embedded in an interactive multi-leveled system, which are separated into five nested subsystems consisting of the microsystem, mesosystem, exosystem, macrosystem, and chronosystem” (Ostrander, et al 2017).

Looking at the refugee’s experience as an interrelated set of life events allows the social worker to look at larger issues that affect the client (Ostrander, et al 2017). Manisha has experienced individual loss on several levels due to her experience of ethnic cleansing and discrimination in her home country. She went from a stable life and economic autonomy to loss of culture, family, land, and imprisonment of her husband. In Manisha’s case, understanding her experience allows for compassion in approaches when working to help her achieve successful integration into her new world.

Identifying Manisha’a social system and the system influences on her life prior to relocation provides an understanding of how she perceives her life. The social constructionist perspective and the narrative theory can be used to create a relationship where Manisha can open up about the meanings and their importance to her life. “The social constructionist theory helps to understand human behavior by focusing on how a sense of self and meaning in their social world is constructed by individuals” (Hutchison 2015). Manisha has attached personal meaning to the concepts of family and shared cultural meanings of life. Her life before relocation existed in one way, she had to adjust to life in a refugee camp, and again in the United States. To understand her story, “ It becomes important to explore their meaning of community, natural environment, and culture and how they restructure their practices and interactions pertaining to social factors in a new country”(Roka 2107).

Narrative theory allows refugees to “write out their story in their own language,” and “research has shown that narrative therapy has proven to be the most effective theory approach with clients who’s English is their second language.” (Guevara 2013) Learning about refugee’s culture, family structure, attached meanings, concerns, and fears allows the social worker to address issues important to the client’s success in relocation. Refugees are faced with many concerns when relocating to a different society. According to the CDC, “ the most common post-migration challenges contributing to mental health issues were language barriers, worries about family back home, separation from family and difficulty maintaining cultural and religious traditions.” (Roka 2017) Becoming proficient in English language and the ability to find a job were major concerns of the refugees, with women and the elderly most vulnerable to isolation related to poor English-speaking skills due to lack of formal education (Roka 2107). This concern was so high that respondents to a survey suggested the option of suicide as a solution to the stress of learning English, passing the citizenship test, finding a job, and continued receipt of welfare benefits (Roka 2017). Understanding these factors of extreme stress informs the social workers approach to programs and solutions for their clients.

The conflict theory can also be used to understand the realities that refugees who have experienced trauma face. “The conflict theory emphasizes conflicts that arise because of inequalities in the distribution of resources” (Hutchison 2015). Power imbalances contribute to oppression, inequality, exploitation, and alienation of marginalized and less powerful groups as in the case of Manisha and her family. Discriminated against due to their ethnicity and religion, they were forced to relocate to a refugee camp, and denied the ability to return to their home country. The concepts of human rights and oppression presented in the conflict theory again give support to the types of support needed by refugees. “In each form of oppression- economic, racial, sexual- a dominant group receives the unearned advantage of privilege, and a targeted group is denied the advantage” (Van Wormer 2005). Social workers have used empowerment theories and practices to “focus on processes by which individuals and collectivities can recognize patterns of inequality and injustice and take action to increase their own power” (Hutchison 2015). There is a correlation between trauma victims and higher incidences of depression, anxiety, and even suicide in refugee populations. Understanding the mental and physical health issues that can result from oppression and human rights violations can help the social worker work with clients to ensure that their emotional health is considered as a part of successful well-being and relocation (Roka 2017). According to journal article, Addressing the Need for Mental Health Screening of Newly Resettled Refugees: A Pilot Project,

“The prevalence rates for mental illness among refugees vary between studies and populations although rates for posttraumatic stress disorder (PTSD) and depression have been found to be as high as 30% for refugee populations. This is significantly higher than the prevalence rates for the average US adult citizen, which are 6.9% for depression and 3.5% for PTSD” (Plummer 2019). The concepts of culture, diversity, and globalization are also a part of the story of a relocated refugee. “Globalization is increasing our experiences with social diversity and raising new questions about inequality, human rights, and social justice” (Hutchison 2015).

As more and more international refugees are relocated to the United States, an understanding of the interconnectedness of the world informs contemporary social work practice. “Diversity recognizes social groups, groups of people who share a range of physical, cultural, or social characteristics within a category of social identity.” (Hutchison 2015). This knowledge helps the social worker recognize the value of location of various diverse ethnic groups in the community to enhance Manisha’s quality of life, and to provide services that are culturally meaningful to the client (Hutchison 2015). Understanding a refugee’s culture aids in the process of integration of the refugee into a more urbanized society (Roka 2017). Food, ways to make a living, religious practices, family relationships, gender roles, and social customs are all a part of the refugee’s story. (Roka 2017) The impact of gender inequality on a female refugee, reveals that, “Narratives of the forcibly displaced and dislocated reveal the ‘refugee/IDP experience is a fundamentally disenfranchising process. The refugee is denied the right to represent himself. With women and children constituting the majority of the forcibly displaced, their rightlessness in international humanitarian discourses and their presumed passivity in practice, is naturalised” (Manchanda 2004). In the case of Bhutanese women and forced migration, factors that contributed to gender inequality included “discriminatory citizenship law, persecution, violence, rape” that resulted in mass migration to refugee camps in Nepal. (Manchanda 2004) However, in the camps, the same gender discrimination was reinforced by national laws that were both patriarchal and oppressive (Manchanda 2004). In refugee camps, women were not allowed to register themselves or their children as refugees, which would have enabled them to have access to food, clothes, education, and health care (Manchanda 2004).

The gender discrimination that is a part of Manisha’s culture and her life story affects her perception of life and carries through to relocation. Awareness of the cultural background of refugees can inform social workers about the need for sensitive education about opportunities for women in a more equal society.

As a vulnerable population, displaced refugees such as Manisha need the sensitivity of well-trained social workers to help them navigate the many changes they face. The strategies discussed in this case study will enhance Manisha’s well-being by allowing her a voice to her own narrative, the opportunity to benefit from services that can provide her with stability and opportunity for economic well-being, potential therapy to heal from long term trauma, opportunities to connect with others of her same culture for mutual support, and advocacy for increased awareness to change her experience with gender inequality.

In conclusion, the complex factors that affect the lives of those who experience forced relocation in an ever-changing globalized world puts social workers in an important position to help refugees adjust to a new life due to their strong ethical values of protection of human rights and respecting the dignity of people. It is important that social workers take the necessary steps to increase their competency and understanding of the difficulties that refugees face in order to enhance their ability to integrate into a new society. This study gives the social worker who has not worked with refugee populations a place to explore theories and concepts that can address issues facing refugees to provide better service to their clients.

References

1. Guevara, C. (2013). Narrative Therapy with Immigrants. Retrieved from https://prezi.com/izqtxs3m0s6j/narrative-therapy-with-immigrants/
2. Hutchison, E. (2015). Dimensions of Human Behavior, Person and Environment. Fifth Edition. SAGE.
3. Manchanda, R. (2004). Gender Conflict and Displacement: Contesting ‘Infantilisation’ of Forced Migrant Women. Economic and Political Weekly, 39(37), 4179-4186. Retrieved from http://www.jstor.org.ezproxy.uta.edu/stable/4415535
4. Ostrander, J., Melville, A., & Berthold, S. M. (2017). Working with refugees in the United States: Trauma-informed and structurally competent social work approaches. Advances in Social Work, 18(1), 66-79, DOI: 10.18060/21282. Retrieved from https://digitalcommons.sacredheart.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=1029&context=socwk_fac.
5. Plummer, K. Unpublished manuscript, University of Texas Arlington. (2019). Help for Bhutan Refugees.
6. Roka, K. (2017) Adjusting to the New World: A Study of Bhutanese Refugees’ Adaptation in the US. Journal of Sociology and Social Work, Vol. 5, No. 2, pp. 98-108ISSN: 2333-5807 (Print), 2333-5815 (Online)Copyright © The Author(s). All Rights Reserved. Published by American Research Institute for Policy Development DOI: 10.15640/jssw.v5n2a11. Retrieved from https://doi.org/10.15640/jssw.v5n2a11
7. Van Wormer, K. (2005). Concepts For Contemporary Social Work: Globalization, Oppression, Social Exclusion, Human Rights, Etc. Social Work and Society International Online Journal, Vol 3, No 1. Retrieved from https://www.socwork.net/sws/article/view/207/468.

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