Extreme weather events and refugee youths’ experiences of physical health in a Ugandan humanitarian setting: qualitative insights

Abstract

Purpose: Refugee settlements globally experience increased exposure to extreme weather events (EWE) compared with host national settings; however, refugee youth climate-related health experiences in humanitarian settings are understudied. We explored the lived experiences of climate change and EWE related to physical health among refugee youth aged 16–24 in a Ugandan refugee settlement. Methods: We conducted a community-based, multi-method study. We purposively sampled refugee youth living in a Northern Ugandan refugee settlement reporting recent (past 14-day) EWE and/or resource insecurity. We conducted 32 refugee youth walk-along interviews to elicit a rich understanding of lived experiences in a target environment. During each interview, the youth brought the research assistant to places where they obtained resources (i.e. food, water, sanitation), took photos of their chosen places on a tablet, and described the photo and the place. We also conducted 12 in-depth interviews with key informants, comprising adults with experience working in this refugee settlement on refugee well-being, food security, water and sanitation hygiene (WASH), and/or climate change. We analysed the findings using template thematic analysis informed by the resource scarcity framework, which examines ecologic, social, and socioeconomic factors associated with resource insecurities. Findings: Participants (n = 44) included refugee youth (n = 32; mean age: 20.0, standard deviation [SD]: 2.4; 50% men, 50% women) and key informants (n = 12; mean age: 37.0, SD: 5.8; 75% men, 25% women). Participant narratives identified how flooding, heavy rain, and drought contributed to youth experiencing resource insecurities (food, water, sanitation), in turn increasing malnutrition risks, water-borne diseases, and risks of bodily harm. Flooding and heavy rains also contributed to vector-borne diseases, and drought to dehydration and hygiene-related infections. Conclusions: The findings highlight the need for better WASH infrastructure and increased food aid in Ugandan humanitarian settings, along with refugee youth-led initiatives to address the impacts of climate change on refugee well-being.