Journal of Social Development in Africa (1993),8,2, 91-104
Book Reviews
Refugee Children. Theory, Research, and Services, Frederick LAheam, Jr and
Jean LAthey (eds), Johns Hopkins University Press, Baltima-e, 1991 (230 pp).
(ISBN 0-8018-4160-7). Price £30.
This collection of authors will be familiar to those working in the field of refugee
children's services in the United States. The mental health issues discussed do not
stray far from that focus. While not written for use in other countries, it still
provides a body of relevant information regarding children, mental health and
refugees that could be useful in emergency settings. The title suggests a purely
theoretical approach, but the book itself is divided into three fairly practical and
applicable sections on Theoretical Overview. Research Studies and Services and
Treatment Issues. The most informative comes at the beginning of the book with
a thoughtful and well written overview of mental health issues for refugee children
by the editors, Jean Athey and Frederick Ahearn.
The Theoretical Overview starts with reference to the early FreudandBurlingham
studies of children in 1943, under the heading of "Stress and Coping", then moves
on to the "Refugee Family and Child Development" and then the "Larger
Community and the Refugee Child". Within these three areas such topics as
trauma, loss, deprivation, coping, culture and social relations are touched on.
Following the review, John Berry's theory of acculturation is presented; while it
is generally applied to the integration of refugee families into host countries, the
basic premise of how minority groups are integrated and/or isolated from the
mainstream culture, is certainly applicable where refugees are seeking asylum,
even temporarily, within a larger, host country. Third in this presentation of
theoretical approaches is a timely discussion of child abuse and maltreatment
definitions within a cultural context and a view to cross-cultural examination of
such events.
As stated in the chapters on Research Studies, the amount of research available
on the emotional and social adjustment of refugee children is quite limited. This
section focuses on three different countries, the flfSt of which examines the many
variables influencing adaptation of Indo-Chinese adults and their adolescent
children. These variables are then assessed for their effects on psychological
distress. This is followed by a study of Cambodian children, documented as having
experienced massive trauma and the resulting effects over time. The third study
looks at the correlation between levels of exposure to violence prior to arrival in
a new country and how present stress adds to the difficulties of Central American
92 Book Reviews
children. Subsequent chapters on stress, trauma and adaptation are useful in the
repetition of recognisable behaviours of children within different cultural settings.
The final section concerning Service and Treatment is understandably focused
on provision of services within the United States. However so little has been
written to date on mental health services for refugee children that the chapters
presented will be of interest to anyone working with refugee mental health. Joseph
Westermeyer's chapter on psychopathology among refugee children is a good
exarnpleof identifying emotional problems within a cultural context, emphasising
the need to always work within a cultural framework. The case examples illustrate
this point, and he concludes with an interesting presentation of a model treatment
programme, again pointing out that "therapeutic modalities are not uniquely
culture-bound". Finally the brief presentation on pharmacotherapy and adaptions
of therapy for different cultures stimulates important questions concerning such
methods, especially within an emergency setting.
The information of service delivery in ''Recovery and Rebuilding" is difficult
to tranSlate from resettlement to emergency settings but it includes interesting
points for service providers to consider in their overall approach to children,
families and linkage within a community. The book closes with a reminder of the
importance of continuing efforts to research, document and prepare information on
the crucial role the community and family play in children's survival under
extreme trauma and stress.
"Survivors are the bridge between the past and thefuture. Their experiences
have given them a view of life to be shared in order to spur personal and
social change. They are the voices that challenge complacency and the
denial of reality as they know it" (Families After Trauma, Moffat and
Moffat, 1984).
Reviewed by Jan Williamson, International Consultant for Refugee Children's
Programmes
There are No Children Here - The Story of Two Boys Growing Up in the Other
America, Alex Kotlowitz, Anchor Books, Doubleday, New York, 1991 (323pp).
(ISBN 0-385-26552-5). Price US $12.
One might question the relevance of a book written in the United States to the
developing nations of Africa. Yet the appalling reality of poverty and violence in
US inner-citypublic housing projects portrayed by Alex Kotlowitz, a writer f(J:the
Wall Street Journal, is far closer to life in the impoverished, civil war-tom area<;
of some developing countries than most Americans would imagine or admit.