Health education for urban refugees in Cairo: A pilot project with young men from Sierra Leone and Liberia

This pilot project, conducted under the auspices of the Forced Migration and Refugees Studies Program (FMRS) at the American University in Cairo, arose as part of a continued commitment to outreach projects of direct benefit to the refugee community. Maintaining healthy behaviors and accessing adequate health care are particular challenges for refugees living in large urban areas such as Cairo. Young refugees are at risk for unplanned pregnancy, sexually transmitted diseases, and other health-related problems such as nutritional deficits and stress-related disorders. Education in their country of origin may have been disrupted, and in Cairo they may be separated from their families and have little or no access to formal schooling. At the same time, we know little about the health behaviors of refugees living in Cairo and there is limited research and documentation of their particular health needs. The participants in this pilot project were refugees from Sierra Leone and Liberia, who were young healthy men who had not experienced serious health problems in the past. A needs assessment at the outset showed that their health concerns included: an increased incidence of colds and flu (often attributed to the weather), general physical ‘weakness’, lack of exercise, sleep problems, frustrated sexual desire, general body aches and pains (headaches, stomachaches, etc.), poor nutrition and eating habits, and feelings of frustration, hopelessness and general stress. The program was in the form of an action research project designed to provide participants with information relevant to the specific health issues they may face as urban refugees, and to facilitate health problem-solving strategies through the use of focused discussion groups. The health education program consisted of a 10-week lecture series to address the concerns voiced by the refugees during the first session. The first half of the program focused on issues of reproductive health, including relationships, sexual practices, reproductive anatomy and physiology, fertility and family planning, female genital mutilation, and sexually transmitted diseases, especially HIV/AIDs. The second half of the program widened the health topics to cover nutrition, stress and coping mechanisms, and access to health services in Cairo. Interviews with participants after the program showed that some of the most important benefits of the program as a whole were that it gave them a place to gather, a forum for discussion, and intellectual stimulation. These particular refugees do not work or go to college nor do they have any real social support. They are inhibited from gathering in large numbers and therefore spend their days bored, frustrated and lonely. For this reason, programs such as this are highly valued in the community. Based upon the outcome of this pilot project, we recommend that the following steps be taken to continue the health education project for refugees in Cairo: 1. Develop flexible ‘content modules’ for different health education topics that can be easily accessed as needed. 2. Train refugees from each community to administer the health education programs. 3. Maintain ties with the health care community in Egypt. 4. Create ongoing programs for groups who demonstrate a need. 5. Find ongoing funding for the above-mentioned projects.