An exploration of alcohol use in Karen refugee communities in the context of conflict-related displacement

Abstract

Refugees who are displaced due to political conflict often experience a range of traumatic events throughout displacement and resettlement including exposure to events such as imprisonment or gender-based violence, protracted periods of time in refugee camps or resettlement related stress. Refugees who are displaced across borders bring cultural beliefs and values with them, although often the structures that support culture such as family and community are disrupted due to displacement. All of these factors can influence patterns of alcohol consumption and the consequences of alcohol use. Traditionally, high levels of alcohol consumption in refugee communities have been explored using models of self-medication of trauma symptoms or acculturation (Ezard, 2011). There have been almost no studies conducted of refugee alcohol use that qualitatively explore refugees' perceptions and experiences of alcohol use from their own perspectives. This dissertation describes a qualitative that study drew from critical ethnographic and phenomenological methodologies to explore the experiences and perceptions of alcohol use in Karen refugee communities displaced by political conflict. I collected data through focus group and individual interviews (N=62) and participant-observation in two locations: refugee camps in Thailand and a resettlement community in St. Paul, Minnesota. Analyzing the data using domain analysis (Spradley, 1979), I found that both culture and displacement related traumatic experiences contributed to increased levels of problematic alcohol use and negative consequences of alcohol use after displacement. I also discovered that geographic location may have played an influencing role on patterns of alcohol use. Participants said that many cultural structures and patterns were disrupted during displacement and this disruption of culture led to increased problems related to alcohol. Finally, Karen participants described people with problematic alcohol use as people who had stopped thinking about community and family and had begun to think only of themselves, which is counter to traditional Karen ways of thinking communally. These findings contain knowledge that will contribute to the development of culturally relevant treatment programs that consider the cultural, historical and political factors that contribute to alcohol use in Karen refugee communities as well as the ways in which communal cultural values impact both use of alcohol and quitting problematic alcohol use.