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Somali Bantu Refugees

Author(s): Christine Wilson Owens
Reviewer(s): Bob Johnson, International Rescue Committee in Seattle; Iman Hussein, Somali Bantu community leader/medical interpreter
Date Authored: January 01, 2004
Date Last Reviewed: May 01, 2008
It is expected that 8-12,000 Somali Bantu refugees are relocating to the United States during FY2003-004.  

Recent History

In the eighteenth and nineteenth century, the Bantu were brought as slaves from Tanzania and Mozambique to Somalia. They were marginalized in Somalia. The Bantu did not belong to, nor did any Somali clan or tribe protect them. In 1991 during the civil war in Somalia, 12,000 Bantu were displaced to Kenya. 3,300 Bantus, it is estimated, escaped to Tanzania, back to the lands of their ancestors.

Somali Bantus who fled to Kenya settled first in Dadaab refugee camp. They were then relocated 900 miles and a 3-day road trip across Kenya to the rural, dry environment of Kakuma refugee camp. The film The Final Exodus is a documentary of that relocation and speaks about the dangers and mistreatment in the camps, of the rapes of women and beatings of men who are Bantu. In 1999 the U.S. designated the Somali Bantu refugees as "persecuted". The process of immigration to the U.S. has been slow, due in part to conditions of insecurity and violence in the camp at Kakuma.

Coming to the United States and to our Community

8 to 12,000 Somali Bantus are scheduled to relocate to various communities (suburban, urban, possibly rural) in the United States. It is expected that about 250 Bantus will arrive in the greater Seattle area. As of May 2008, an estimated 500 to 600 Somali Bantu families (includes both Kizigua- and Maimai- speaking) live in the Seattle area . Many families arrived in other areas of the United States first and then migrated secondarily to Seattle (and therefore are not reflected in the numbers tracked by the local resettlement agencies.) 35 states in all, including Washington, Georgia, California, Oregon, Arizona, Utah, Colorado, Virginia, and New Jersey will be resettlement locations for Bantu refugees. The first Bantu refugees arrived in April 2003 in New York.

The need and readiness for providing assistance to the Bantus with housing, employment, literacy, youth programs, and general receptivity to a new community are factors being considered in planning Bantu resettlement in greater Seattle. Agencies and services may be needed in the cities of Burien, SeaTac and Tukwila, located south of Seattle, where housing is more likely to be affordable for newly arriving refugees. Existing Somali organizations may be able to provide assistance, a language bridge. Resettlement issues, like finding affordable housing, overcoming lack of skills and lack of employment experiences that are relevant for this job market, are concerns Bantus will likely share with many other refugees who have settled in the area. Some Sudanese refugees reportedly have plans to welcome the Bantu; potentially both groups have the Swahili and English languages in common from their time spent living in Kenya.

In Washington State, voluntary agencies in contract with the federal government are set to provide case management and other services to refugees for six months after their arrival.

Health Related Information on the Somali Bantu

Somali Bantu health in Kakuma is poor, and there are many factors related to their poor health conditions. According to a recent medical report, these factors include: lack of health care information within the community, poverty, limited utilization of public health facilities, inadequate resources and certain cultural beliefs and practices, all of which contribute to diminishing health conditions. Resettlement agencies may wish to monitor health carefully in the period after arrival. Here is a list of significant points that have been learned from the International Office on Migration's medical examinations and cultural orientation classes:

Traditional Medicine

Superstitions

Some Somali Bantus may believe that children who have fallen ill have been cursed or targeted by an evil spell. Instead of seeking medical assistance, some Bantus may go to a traditional healer and request that the curse be removed or countered. Superstitious beliefs most likely contribute to a certain degree to the poor health practices among this group. Traditional healers may perform ceremonies to chase out evil spirits from sick people. These rituals often include drumming and incense.

Bone Setting

Somali Bantus have specialist bonesetters within their communities. These bonesetters serve as the medical providers for anyone who has a dislocation or fracture. Such specialists have evolved in the Somali Bantu (and other rural communities) due to the limited access to hospitals and clinics. Once in the US, Somali Bantus should seek out professional medical care for anyone with a dislocation or fracture.

Burning, Cutting and Lacerating as Healing Techniques

Somali Bantus use burning, "coining"", cutting and lacerating as traditional ways of healing illnesses and pain. Different methods are applied, depending on the illness or location of pain. For example, a searing flat metal nail is applied to the foreheads of babies born with an enlarged head due to the condition known as hydrocephalus, a common condition involving fluid accumulation in newborns. This treatment is believed to alleviate the condition. Children and adults have notable burn scars on their foreheads, chests, faces and other body locations from such healing techniques. These are common practices among various rural cultures across the world.

Removal of Infants' Teeth

Children under two years old who fall sick with diarrhea, malnourishment or other illnesses are often taken to a traditional healer, or medicine man. The traditional healer will remove a "bad" tooth or teeth using a knife. This traditional healing practice ostensibly cures the child of the ailment. This is often practiced on children between six and nine months old who begin teething and have diarrhea as a result.

Removal of Uvula

Traditional healers will remove an infected uvula with a sharp implement - the uvula is the small mass of tissue suspended from the center of the soft palate above the back of the tongue. Removal of an infected uvula is common practice among many cultures.

Treatment of Infected Tonsils

Traditional healers commonly treat infected tonsils by burning the corresponding area on the upper neck.

Home Child Birth

Somali Bantus commonly give birth at home, often with a traditional Somali Bantu birth attendant to assist. Recently in Kakuma camp a Somali Bantu woman passed away in childbirth at local hospital from a Caesarian Section. This incident and other similar incidents have created a fear of hospitals among some in the Somali Bantu community. They prefer to give birth at home.

Female Circumcision

As with many African cultures, Somali Bantus in Somalia have traditionally practiced female circumcision. However, camp-based NGOs have implemented awareness campaigns surrounding the negative health effects of female circumcision. Somali Bantu community leaders say that female circumcision is no longer being practiced within the community. Incidentally, before Somali Bantus arrived in Somalia (some two hundred years ago) their communities apparently did not practice female circumcision.

Reproduction

(The information below is taken mostly from an International Rescue Committee Report, titled: Anthropometric Survey: Somali Bantu (new arrivals): Kakuma Refugee Camp, January 2003)

High Prevalence of Low Birth Weight (less than 2.5 kilos) Infants

The health statistics indicate that 19% of the infants born since July 2002 had a low birth weight (LBW). LBW infants are born undernourished and are at far higher risk of dying in later infancy. If they survive, they are unlikely to catch up on this lost growth later and are thus more likely to be underweight or stunted in early life. Therefore, the high prevalence of LBW infants may significantly contribute to high rates of chronic malnutrition as well as acute malnutrition when these infants are exposed to disease.

Poor Maternal Nutritional Status

Pregnant and lactating mothers of Somali Bantu origin represent, on average, 62% of the total admissions in the Supplementary Feeding Program [in Kakuma]. The high number of admissions suggests... that Somali Bantu mothers are nutritionally more vulnerable than the rest of the camp. Their poor nutritional status is also related to the high rates of LBW infants. When poor nutrition starts in-uteri and extends, particularly for girls and women, well into adolescent and adult life, mothers have a greater chance of becoming stunted and thus giving birth to LBW infants.

High Crude Birth Rate

Health statistics indicate that 29% of the deliveries [in Kakuma] since July 2002 arose from the Somali Bantu community. However, the Somali Bantu represent only 12% of the total population in the camp. On average, the crude birth rate is 2 times higher in the Somali Bantu community. Frequent pregnancies in women affect their nutritional status and thus increase the already high chance of having LBW infants.* (IOM note: Between January and March 2003, 368 babies were born within the Somali Bantu community. If this birth rate is maintained throughout the year it's possible that close to half of the child bearing age women will give birth in 2003)

Poor Infant Feeding Practices

Close deliveries interfere with breast and complementary feeding practices. Women often stop breastfeeding as soon as they are pregnant and start weaning their children before the recommended age of 6 months. This exposes their children to high risk of disease and malnutrition. There is a close link between appropriate infant feeding practices and the health, nutrition and survival of young children. In addition, the quality of care a mother can give to her children is affected when she has to attend to a high number of young siblings.

Health Problems

The high mortality rate of children below five years is mainly related to health problems. Also, it is possible that malnutrition may primarily be the result of chronic diseases coupled by inappropriate food intake and caring practices. The leading health problems for Somali Bantu children are pneumonia (41% of the deaths), malaria (24.5% of the deaths) and watery diarrhea (16.9% of the deaths).  Hygiene may be influenced by a history of little access to water.

Poor Health-Seeking Behavior

As compared to the rest of the camp, pneumonia is significantly more prevalent amongst the Somali Bantu community. This may be attributed to poor health-seeking behaviors. It has been observed that mothers do not seek medical care in good time. This observation is equally true of the feeding programs, where it has been noted that mothers bring their children when they are already at a critical stage.

"PTSD" and other mental health concerns

Some Bantu refugees may suffer from hopelessness, depression, and nightmares. There may be new trauma or hardship experiences in the U.S.

Some Additional Points to Cover in a Health Orientation with Somali Bantus

The International Organization for Migration, Cultural Orientation Africa Program is collecting various reports on Somali Bantus in order to pull out relevant information that can be incorporated into and inform cultural orientation classes.

Punctuality

Explain importance of being on time for medical and all other appointments.

Health Care:
Different kinds of health care available: Emergency care, urgent care, and routine care.

Explain the importance of scheduling regular check-ups for pregnant mothers and children. (Emphasize the importance of well-baby check ups.)

Prescriptions:
Importance of following prescriptions and finishing medication even if symptoms of sickness have disappeared.

Where to buy Medications:
Explain prescription medication and over-the-counter medication and where to buy these.

Interpreter:
Explain that refugees have a right to a medical interpreter. Before any medical exam, refugees should make arrangements to have an interpreter available.

Insurance:
Explain insurance and how to pay for health care.

Information for Doctors:
Explain how American doctors require information on the background of the patient. American doctors often ask questions about medical history and personal background. These questions might not appear to have anything to do with the immediate health of the patient. However, American doctors like to collect a range of information on the patient in order to more properly understand what medical problems exist and what medical problems could arise in the future.

Proactive Approach to Health Care:
Explain that Americans normally take a proactive approach to their health. This includes scheduling regular yearly check-ups for adults, even if an individual is not sick, and well-baby check ups following childbirth. Somali Bantus, along with many other cultures, often take more of a reactive approach to their health, only planning to see if a doctor if an individual is sick.

Nutrition Classes:
Somali Bantus will not recognize most of the food in the US. Provide a basic overview of nutrition and of healthy foods.

Summary/Cultural Background Information: language, religion, education employment, family

  • The main language of the Somali Bantu is Af Maay, sometimes referred to as Maay Maay,which is spoken in Southern Somalia. Though some Somali Bantus speak tribal languages from Tanzania, like Kizigua, or Swahili, the majority of Somali Bantus resettled in the U.S. speak Af Maay/Maay Maay. Af Maxaa – the language referred to as “Somali” in the U.S. – is the language spoken throughout the rest of Somalia. Af Maxaa/Somali is spoken by 50-75% of the Somali Bantu. Though Af Maay/Maay Maay and Af Maxaa/Somali have some similarities in written form, they are distinct enough in their spoken form that they are mutually unintelligible. The Office of Global Health Affairs recommends that resettlement groups and professionals first use Af Maay/Maay Maay interpreters when communicating with this group. EthnoMed has received numerous reports of instances where health care providers unfamiliar with the Somali Bantu have used Af Maxaa/Somali interpreters instead of Af Maay/Maay Maay, resulting in inability to communicate during the medical encounter. For more information about considerations regarding interpretation for the Somali Bantu, see EthnoMed’s Somali Bantu Literature Review
  • The six main Somali Bantu tribes are Magindo, Makua, Manyasa, Yao, Zalamo and Zigua. Each tribe has many clans and sub-clans.
  • Most Somali Bantus are Muslim, although a small minority converted to Christianity in Dadaab (there is at least one Bantu church in Dadaab)
  • Education levels may be inconsistent or low. Most adults have never attended school and do not read or write in their own language. There are English classes in Kenya camps, and there is some "cultural orientation" received by the refugees before coming to the United States.
  • Most Bantus have never lived with electricity or been exposed to any other aspect of modern living, although they have been exposed to western housing and facilities through the Cultural Orientation Program that all Bantu being resettled in the U.S. are required to attend before departure.
  • Somali Bantus have lived for 10 years on World Food Program rations of maize (corn), beans, lentils, oil, flour and salt. They will not recognize 99 percent of the food in American supermarkets.
  • Employment experience is likely in farming, construction, fishing, driving, cooking, and technician work. Somali Bantus make up about 10% of the 130,000 refugees in Dadaab, yet they hold over 90% of the heavy labor, construction, cooking, cleaning, and other manual labor jobs.
  • A psychosocial description might include traits like quiet, reserved and at times passive and submissive
  • Marriage usually happens between 14 and 16 years of age. Divorce and remarriage are common. Polygamy is accepted. A woman becomes pregnant for the first-time around age 15. The average size family is four to six persons, but may include cousins or other family members that have become part of their family unit. About 60% of the Somali Bantus are 17 years old or younger and 31% are under age 6.
  • Traditional Bantu arts and fabric are bright and multicolored.

Additional Reading

Literature Review by Anna Gruen, MSW, University of Washington, Seattle WA.  Reviewed by Iman Hussein, Somali Bantu community leader and medical interpreter. This literature review contains additional information about culture, politics, language, and the Seattle-area Somali Bantu population.

Somali Bantu Refugees: Cultural Considerations for Social Service Providers:
Author Lyn Morland, MSW, from the "Bridging Refugee Youth & Children's Services" organization (BRYCS) provides information specific to Somali Bantu children and youth, including medical practices, discipline, courtship, marriage, and guidelines for working with Somali Bantu families. The author stresses the importance that child welfare and other service providers be aware of this group's cultural background in order to provide the best care and avoid unnecessary interventions due to misinterpretations.

References

  1. Refugee Community Building Conference, June 27, 2003, SeaTac, WA, Marriott Hotel Session: "Somali Bantu Resettlement"
  2. Immigration and Refugee Services of America, Refugee Reports, November 2002, "Some Facts on the U.S.-bound Somali Bantus"
  3. International Organization for Migration, 1999, Film: The Final Exodus
  4. Refugees, "The Somali Bantu: A tale of two peoples", pg. 25
  5. Seymour K., The Utica Observer-Dispatch, The Associated Press & Local Wire, May 24, 2003, "First Bantu refugee begins new life in Utica"
  6. The Somali Bantu Their History and Culture Cultural Orientation and Resource Center

 

See also:

The International Rescue Committee in Seattle web page

 

Somali Bantu Association of Washington

Phone number: 253-850-4030
Fax number:253-850-4055
CELL PHONE:206-683-2839
Address: 1209 CENTRAL AVENUE S #122
Kent, Washington 98032
E-mail : ihussein@sbantuwashington.org

Website: http://somalibantucommunityassociationofwashington.org/default.aspx

Somali Bantu Association of Washington is a non-profit organization based in Kent, Washington. The purpose of this organization is to to enhance and improve the wellbeing and quality of life of the Somali Bantu families and individuals in the state of Washington, while maintaining the cultural heritage of the Bantu community. Tens of thousands of Somali Bantu fled war and famines in Somalia and went to refugee camps in neighboring Kenya, like Kakuma and Dadaab.  Somali Bantu Association of Washington helps all Bantu families  and individuals in King County/ Washington state regardless which language they speak. The majority of the Bantus in Washington are mai-mai and majority of them live in Kent, Tukwila, Renton , Rainier and few in Seattle. Most of the Somali Bantu people do not speak English and they have difficulties finding jobs, filling out applications, communicating with other people.

Services:   

  • Mai-mai and siguwa interpretations
  • Job search and job training
  • ESL classes
  • Citizenship classes
  • Cultural orientation for newly arrived refugees.
  • Case work
  • After school activities for youth, help with home work, etc.