Prevalence of vicarious traumatisation among caretakers in Kakuma refugee camp, Kenya
Muli-Karugu, Elizabeth M
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BACKGROUND Many individuals who work with trauma survivors expenence an enhanced sense of meaning,self-esteem, respect for the strength of others, and connection with humanity. However, these caretakers or professional helpers exposed in the line of duty to client's traumatic stories, face an occupational hazard not present in other occupations. They may therefore experience changes in frame of reference, self capacities, ego resources, memory system, and cognitive schemas which are indicative of Vicarious Traumatization. OBJECTIVES 1.To determine the prevalence rate of Vicarious Traumatization caretakers in Kakuma Refugee Camp. 2. To determine the socio-demographic factors associated with Vicarious Traumatization among caretakers in Kakuma Refugee Camp. DESIGN The design of the study was cross-sectional descriptive study. SITE The study was conducted in Kakuma Refugee camp in Kenya. This camp is located in Turkana District, North-West Kenya. The camp is 127Km south of the Kenya-Sudan border and covers approximately 25Km2• SUBJECTS A sample size of 145 caretakers working in Kakuma Refugee Camp was studied. METHOD The subjects were interviewed USIng a researcher - designed Socio-demographic questionnaire and the Trauma and Attachment Belief Scale (TABS). Data was keyed into a computer and analyzed using SPSS version 12. RESULTS Out of 145 subjects studied the ratio of male to female was 1:3; the age range was 30 years of age with 10% being between 18 to 22years, 43% being 23 to 28 years and 47% being above 28 years. The mean age was 29; the SD was 28.5, the median 28 and mode of 30 years. The prevalence of VT was found to be 37% -54 (low to moderate levels of VT) and 63% -91 (extremely high levels of VT). Results showed that of those interviewed 86% were Christians while 10% were Muslims and other were 4%. Ninety percent were of refugee status while Kenyans were ten percent of those studied. Forty one percent were married while unmarried were fifty nine percent of the sample. From the results 8% were of primary or below in education level and 59% above primary school level. In this study 73% of subjects were of non-medical training. The mean for duration of work was 3 years, median 2.5 and mode 3. From the results, 39% of those interviewed found frequency of trauma work as often and 13% as being very often. Eighty one percent of subjects had history of personal trauma and of these forty one percent had sought professional help. On the socio-demographic profile the only variable - age showed statistical correlation with VT (p=O.OOI). Result on VT scales scoring showed extremely high levels of VT in subscales of self safety (mean of 67), other safety (mean of 72), self esteem (mean of 68) and self control (mean of 70). CONCLUSIONS: The prevalence of Vicarious Traumatization among caretakers was found to be 91 (63%) extremely high VT levels and 54 (37%) low to moderate levels of VT. These findings were similar to those in other studies although in this study all those sampled were found to have varying levels of VT. Age variable was found to be of statistical significance with severity of VT where caretakers above age of 28 had elevated TABS score. The mean age was 29 years and mean for duration of work was found to be 3 years. Majority of those sampled were of refugee status and those unmarried were more than those married. In this study majority of those sampled had experienced a traumatic incident. Other risk factors that were assessed in relation to presence and severity of VT included self-care and therapy, exposure to trauma material, workload, duration of work, organizational support, education, supervision and gender. Within the VT subscales substantial disruption was found in safety subscale -both self subscale (mean = 67) and other subscales, self esteem subscale (mean = 68) and self-control subscale (mean = 70). RECOMMENDATIONS: 1. Organisations involved in care of refugees should be sensitized on the impact of trauma work on their employees and risk factors associated with VT. 2. Individuals entering into trauma work should be sensitized and trained on effects of handling trauma work to empower them to minimize effects of trauma work. 3. Organizations should increase as well as improve already existing measures to reduce impact of Vicarious Traumatization. 4. A study to find out prevalence of VT in other refugee camps where trauma work is done in Kenya and find out associated risk factors in those other settings.