This study is, to the best of our knowledge, the first endeavour to describe and quantify war-related traumatic exposures and to assess the severity of PTSD symptomology amongst a sample of displaced Darfuri female university students. The ‘experiential level’ by which war exposures were measured revealed that approximately 54
% of the current participants experienced an echelon of severity associated with multiple types of exposures, including combat situations (witnessing someone being beaten or killed), material loss (burning or confiscation of home and possessions), family loss (imprisonment or kidnapped), and displacement (fleeing to escape aerial bombardment and suffering unhygienic camp conditions). Consistent with prior research concerning Sudanese experiences of war-related traumatic events [3
] this study indicates that even after a lapse of time, war-related traumatic events are ingrained in their memories, and are evident by the high incidences within each war-related dimension.
The implications, while consistent with other Sudanese samples, seem graver since the severity of war-related trauma is that which threatens the lives and safety of family members and close relatives. Traumatic loss and separation from parents and family members, displacement from home and village, and the exposures to combat situations provoked the highest symptom rates of PTSD. Furthermore, the cruel treatment or disappearance of family members is not only strongly related to the PTSD DSM-IV symptoms, but also strongly associated with the refugee specific self-perception of functioning sub-scale of PTSD symptomology. More significantly, the loss of family has intensified feelings of isolation, discrimination, and humiliation, survival guilt and shame, of these Darfuri women. The continuous endorsement of family loss highlights the family as a social structural support system which underlie a strong cultural and gender component of psychosocial functioning: the loss of family is the loss of normality; rendering these young Darfuri women vulnerable, intimidated, and isolated, without identity when family disintegration occurs on a large scale [7
% of the current sample who have been traumatized by war-related exposures endorsed items relating to the avoidance sub-scale of PTSD symptoms. However, avoidance behaviours, thoughts, feelings or activities need not necessarily be maladaptive responses to trauma. Several researchers have argued that the PTSD avoidance sub-scale may in fact be effective in reducing the disturbing memory which is a therapeutic objective in many forms of psychological interventions [23
]. The ability to avoid or numb emotions that remind people of their traumatic war-exposures may suggest a degree of compartmentalization [24
] of their responses to trauma: PTSD symptoms may occur which does not undo the ongoing suffering that the exposures have created, but may be obscured by more immediate and current concerns of daily life stressors, such as financial worries, urban-cultural adaptation and academic challenges, [3
]. The findings from the data may allude to the complexity with which the current Darfuris need to integrate their human response to war-related traumatic exposure and the experience of PTSD symptoms with current life stressors, while also not interfering with life as an undergraduate student.
The application of an appropriate psychosocial intervention aimed at ameliorating PTSD symptoms may be well placed within the existing AUW counseling center. Re-training of AUW counsellors within the realm of war-related trauma may provide significant skills needed in buffering against potential stigmatization associated with war exposures and PTSD. Training in psycho-education, and community mentored development activities, including, peer and social support groups, are some ways that have been shown to relieve the burden of mental health problems within the public health domain [25
]. Moreover, research among Sudanese refugees in Canada seem to suggest a process of cultural adjustment whereby psychological and social resources are met based on traditional coping strategies and customary social support networks [27
]. Also, culturally informed versions of Interpersonal Therapy (IPT) were found to be effective in the treatment of PTSD symptoms and depression among Darfuri refugees in Cairo [28
Further investigation is required to discover the best combination of these approaches that can be successfully integrated as a model of psychosocial intervention which provides support and counseling amongst this population of Darfuri female undergraduates.
There are a number of limitations to this study. Firstly, investigating a single sector of the general population (university students) and a single gender in one private university limits the generalisability of the results. However, it is the uniqueness of the sample in and of itself that makes for the rationale of undertaking the study: IDP Darfuri undergraduate female students having gone through war exposures and the potential for mental health problems. Furthermore, the exclusivity of investigating a female sector of the Sudanese society, addresses an empirical gap in relation to mental health where women’s health has traditionally been associated with child-bearing and reproductive health issues. Moreover, the study’s findings have the potential to serve the research community by providing a basis for comparison with other Sudanese undergraduate populations and possibly for cross-cultural comparison research between and within different Sudanese samples in mental health issues. Secondly, although our study included measures for PTSD, it would have been worthwhile in adding depression and anxiety as measurements for a complete picture of mental health description. Nevertheless, for the purposes of this explorative study, PTSD was the key outcome measure of interest. Finally, we must stress that our data only provide evidence regarding an association between war-related traumatic events and PTSD symptomology, not a causal relation. Further analysis should be undertaken before any firm conclusions may be established, although a causal relation would be matter of course.