Perceptions of German Healthcare Among Yazidi Refugees in Germany

Abstract

Background: At the height of the global refugee crisis, providing adequate and effective healthcare to these vulnerable populations has presented an enormous challenge. In 2014, in what is now called the “Forced Conversion Campaign,” the so-called Islamic State perpetrated an alleged genocide of the Yazidi people, abducting women and children and killing thousands of civilians. The Special Quota Project (SQP) is a German humanitarian assistance program that sought to resettle and rehabilitate 1100 Yazidi women and children. Survivors have endured one of modern day’s most brutal conflicts, yet little is known about their journey through recovery and experiences with healthcare in countries of resettlement. Objective: Our aim is to assess healthcare as perceived by Yazidi refugees resettled in Germany and to identify potential factors influencing these physician-patient relationships. Methods: Of the 1100 participants of SQP, we conducted in-depth semi-structured one-on-one interviews with 117 adult beneficiaries regarding their experiences with healthcare providers and perceptions of effectiveness of their treatments. Transcripts were analyzed using qualitative content analysis to systematically code and identify themes and patterns. Results: A multitude of factors were identified as influencing patients’ perceptions of healthcare provided. Avoidance, feelings of hopelessness, and language barriers were identified as factors influencing the women’s negative perceptions of the care they received. Support, relief, and somatic symptom treatment were identified as prominent themes in positive healthcare interactions. Conclusion: Interventions and therapy addressing themes of avoidance and helplessness may lead to improved healthcare utilization and retention. However, further research is needed in order to assess the efficacy of trauma-focused therapy and ideal duration of treatment in extremely traumatized refugee populations.