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Qualitative Health Research http://qhr.sagepub.
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Coping With Trauma and Hardship Among Unaccompanied Refugee Youths From Sudan
Janice H. Goodman
Qual Health Res 2004; 14; 1177
DOI: 10.1177/1049732304265923
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QUALITATIVE
Goodman / COPING
HEALTH
AMONG
RESEARCH
UNACCOMP
/ November
ANIED200410.1177/1049732304265923
REFUGEES FROM SUDAN
Coping With Trauma and

Hardship Among Unaccompanied
Refugee Youths From Sudan
Janice H. Goodman
The purpose of this study was to explore how unaccompanied refugee youths from Sudan,
who grew up amid violence and loss, coped with trauma and hardship in their lives. The
author used a case-centered, comparative, narrative approach to analyze the narratives of 14
male unaccompanied refugee youths from Sudan recently resettled in the United States. She
analyzed narratives for both content and form and identified four themes that reflect coping
strategies used by the participants: (a) collectivity and the communal self, (b) suppression
and distraction, (c) making meaning, and (d) emerging from hopelessness to hope. The find-
ings underscore the importance of understanding the cultural variations in responses to
trauma and are discussed in relation to the concept of resilience.
Keywords: narrative method; refugees; unaccompanied refugees; trauma; coping; resil-

ience; culture; Sudan
O f the estimated 14 million refugees worldwide, approximately half are chil-

dren (United States Committee for Refugees, 2000). Refugees are at high risk
for mental health problems, and refugee children and adolescents are particularly
vulnerable. Among refugee children, those who are unaccompanied are at highest
risk because of the interplay between traumatic experiences and separation from
significant emotional relationships (Ressler, Boothbay, & Steinbock, 1988; Rous-
seau, Said, Gagne, & Bibeau, 1998; Sourander, 1998). Parents often mediate or buffer
the effects of difficult experiences in a child’s life (Bat-Zion & Levi-Shiff, 1993), and
family and community support are important requisites for successful coping of
children traumatized by war or violence (Bat-Zion & Levi-Shiff, 1993; Jensen &
Shaw, 1993; Macksoud, Aber, & Cohn, 1996). Refugee children who have experi-
enced the loss of their family and community have shown more emotional distress
and poorer adjustment than children who experienced the refugee process with
their families (Masser, 1992; Melville & Lykes, 1992; Ressler et al., 1988). Several
reports have indicated a high incidence of behavioral problems, depression, and
somatization among unaccompanied refugee minors, as well as suicide attempts
AUTHOR’S NOTE: This study was supported by an American Nurses Foundation grant, #201109. I
would like to gratefully acknowledge the expert guidance and assistance received from Catherine
Riessman, Ph.D., and Karen Aroian, R.N., Ph.D., F.A.A.N., in the conduct of this research. I am also
indebted to the young men who generously shared their stories with me, thus making this study
possible.
QUALITATIVE HEALTH RESEARCH, Vol. 14 No. 9, November 2004 1177-1196
DOI: 10.1177/1049732304265923
© 2004 Sage Publications
1177
1178 QUALITATIVE HEALTH RESEARCH / November 2004
and transitory psychotic episodes (Charron & Neww, 1981; Pask & Jayne, 1984;
Ressler et al., 1988). Younger unaccompanied refugee children are especially vul-
nerable to emotional distress and have shown significantly severe behavioral prob-
lems (Sourander, 1998). Rousseau and colleagues (1998), however, found a remark-
able psychological strength and resilience in a sample of unaccompanied Somalian
refugee children, which they attributed to the cultural interpretations the children
made of the traumatic situations they experienced and to the culturally based
coping strategies the children used to face these situations.
THE UNACCOMPANIED REFUGEE

YOUTHS FROM SUDAN
In the late 1980s, during an upsurge in Sudan’s long civil war, an estimated 17,000
children fled their homes when their parents and families were killed and their vil-
lages burned in violent attacks by the northern government’s Arab militia. Most of
these children were boys from the Dinka and Nuer tribes of southern Sudan, and
many were as young as 3 or 4 years old when they fled. The children found refuge
hundreds of miles away at Pignudo Refugee Camp in Ethiopia, where they stayed
until 1991, when the Ethiopian dictator was overthrown and replaced by a leader
unsympathetic to their plight (Corbett, 2001). The refugees were suddenly forced by
gunfire back into Sudan, many of them perishing in the crocodile-infested waters of
the Gilo River during their flight (Radda Barnen, 1994). The next many months were
spent traveling by foot over very large distances through the forests and deserts of
Sudan. They moved in groups of 10s, or even 100s, traveling mostly under cover of
darkness, trying to avoid hostile government troops, rebel recruitment squads,
slave traders, and rival tribes (Corbett, 2001). In the summer of 1992, roughly 10,000
surviving boys stumbled into Kakuma Refugee Camp in northern Kenya. They
lived there for at least 8 years in mud huts that they built with their own hands, sub-
sisting on rations of corn mush and lentils and raising themselves and each other.
Roughly 5,000 of them survived and stayed together, growing into young adulthood
in Kakuma (Barry, 2001).
In 1999, the United Nations High Commissioner for Refugees (UNHCR), work-
ing together with the U.S. State Department, recommended 3,600 of these unaccom-
panied refugee youths for resettlement in the United States. By the end of 2000, 500
of them, all under age 18, arrived in the United States in the largest resettlement of a
group of unaccompanied refugee children in history. Most of these young refugees
were placed in foster homes or group homes to begin a new and very different life.
Originally from a seminomadic, pastoralist, tribal society, and having grown up in
refugee camps with limited resources, these Sudanese experienced such things as
automobiles, computers, light switches, novels, and myriad other inventions of the
modern world for the first time on their arrival in the United States.
Very little research has been conducted that addresses the mental health status,
needs, or adaptive strengths of this population of young people. Radda Barnen
(Swedish Save the Children) (1994), which initiated a mental health program in the
refugee camps where the unaccompanied refugee youths lived, reported that the
number of children with serious psychiatric symptoms who needed institutional
care was extremely low. Those working with this population have noted a
Goodman / COPING AMONG UNACCOMPANIED REFUGEES FROM SUDAN 1179
remarkable resilience among these young people (J. Woodward, personal commu-
nication, December 2000). A 1994 UNICEF report noted, “These boys do not seem to
be in as poor condition as other unaccompanied children in Africa’s many emer-
gency areas,” and they “seem on balance, to be strong, independent and vigorous
youths who can make great contributions to their country in the future” (Zutt, 1994,
pp. 44-45).
PURPOSE
Unfortunately, the number of refugees in the world shows no signs of decreasing,

and current world politics portend the continued traumatization of children around
the globe. Further research is needed to understand how children cope with such
extreme trauma and hardship and to develop ways of promoting healing and opti-
mal functioning of child survivors. Given the enormity of the trauma and loss that
the unaccompanied refugee youths from Sudan have experienced, and the remark-
able lack of evident psychopathology or dysfunction, the purpose of this study was
to explore how unaccompanied minor refugee youths, who grew up amidst vio-
lence and loss, coped with trauma and hardships in their lives. Specific aims were to
identify strategies the refugee youth used to cope and to examine the effectiveness
of those strategies.
METHOD
Design
I used a case-centered, comparative, narrative approach to data collection and
analysis of interview data.
Sample
Fourteen unaccompanied refugee youths from Sudan who had been living in the
United States for 6 to 12 months were recruited through a Boston area refugee reset-
tlement agency. All participants were males, aged 16 to 18, from the Dinka tribe of
southern Sudan. Sudanese refugee girls were not included, because they represent
only a small portion of this population of refugees (Radda Barnen, 1994) and likely
had very different experiences because of cultural and gender issues. At the time of
the study, all participants were living either in private homes with foster families or
in a small group home. Although English was the second or third language for all
participants, they all spoke English fluently.
Data Collection
I obtained Human Subjects approval prior to initiation of the study. I first obtained
permission to recruit participants from the resettlement agency that had legal
guardianship of the participants. A male Sudanese research assistant introduced
the purpose and procedures of the study to interested potential participants and
explained the concept of informed consent. The interviewer repeated information
about the study and informed consent procedures prior to the interview and
obtained signed consent.
Study participants were interviewed between May and August 2001. Partici-
pants were given a choice for the interview site, and all chose to be interviewed in
their homes. Interviews were conducted in English using an unstructured inter-
view guide consisting of broad, open-ended questions designed to elicit each ado-
lescent’s story. The option to have a translator present during the interviews was
offered, but none of the participants chose to do so.
I began each interview with the following statement:
I’d like to start by asking you to tell me in your own words the story of your life. And
I want you to tell me about your life as if it’s a story with a beginning, and a middle,
and then how things will look in the future for you. There’s no right or wrong way to
tell the story. Just tell me in a way that’s most comfortable for you.
Each boy participated in one interview, lasting approximately 1 to 1½ hours, and

received $10 as an appreciation gift for participating in the study. Interviews were
tape-recorded. I offered each participant the opportunity to debrief after the inter-
view, and all participants expressed positive feelings about the interview
experience.
In addition to interviews with the participants, I held informal discussions with
caseworkers, refugee camp workers, resettlement staff, foster parents, teachers, and
others working with this population. I also conducted participant observation of
the unaccompanied refugee youths previous to and over the course of this study,
during both formal and informal gatherings, to inform contextual understanding of
the findings. Participant observation included volunteer work with resettling Suda-
nese refugees and facilitating a support group for Sudanese refugee youths. Several
of the study participants knew of my involvement with refugee resettlement efforts,
and this seemed to contribute to their trust in me and to their enthusiasm for
participating in the study.
Data Analysis
Preparing the narratives for analysis involved several steps, each constituting a
form of interpretation. Verbatim transcriptions were made of the audiotaped inter-
views and checked for accuracy. Next, these original transcriptions were carefully
retranscribed, with altering of syntax and grammar to make language more read-
able in common English. Because English was not the participants’ primary lan-
guage, retranscription corrected the grammar and syntax to make their stories flow
more smoothly. I tried to keep intact the idiosyncrasies and poetic expression of the
narrations. Because of the language issues, I did not consider linguistic devices such
as pauses, false starts, and stuttering, which are often used as important informa-
tion for narrative analysis (Mishler, 1986; Riessman, 1993), to be reliably significant
or valid for interpretation in this study, and thus, I did not analyze them. After
retranscription, I identified discrete, bounded stories within each life story narra-
tive, and delineated the structural elements of each. I have used pseudonyms
throughout to protect participants’ confidentiality.
I analyzed narrative data using descriptive narrative techniques suggested by

Riessman (1993) and Mishler (1986, 1999). The narratives were analyzed with
regard to content, theme, and structure, which helped me to interpret them in more
complex ways. I paid attention to how things were said, including the linguistic
devices the participants used to convey what they wanted to convey, as well as to
what was said. Coherence between these two areas strengthened the interpretation
of the refugees’ stories. I analyzed narratives individually and compared them to
each other, resulting in a description of individual life stories as they related to the
larger social group and its sociocultural context. To guard against cultural misinter-
pretations, a Sudanese research assistant checked the analysis and interpretations
of the study and served as a resource for clarification of cultural and language issues
throughout the research process. Field notes from participant observation and
informal discussions with caseworkers, foster parents, resettlement agency work-
ers, and others were examined in relation to the findings from the interview data
and contributed to analysis and interpretation.
FINDINGS
The participants’ narratives were replete with tales of the horrors and sufferings of
young children caught in a struggle for life in the midst of a brutal civil war. The par-
ticipants told of danger, violence, and constant hardship, and the coping strategies
that enabled them to survive. The participants’ narratives were remarkably similar,
sharing a common plot based in their shared sociocultural and historical context.
The narratives were temporally sequenced, telling of a journey from place to place
through time, with key moments in the plot common across the stories. Where the
stories differed was in what the participants attended to in their narratives and how
they told their stories. In these individual stories, the unique way each participant
interpreted his experiences came into view.
Much of the content of the narratives centered on the difficult and traumatic
experiences, such as violence, death, hunger, and thirst, that the boys endured from
the time they fled their villages at a very early age until their resettlement in the
United States years later. Each of the participants began the story of his life at the
time when his life was disrupted by an attack on his village and his flight from
home. Mayan recounted the attack on his village as a string of events as follows: “So
these Arab people, they just invaded our village. They set all the houses on fire.
Then they shot people. Then they took all the animals. Then I ran out.”
The dangers and hardship of traveling in hostile territory were recalled vividly
by many of the participants. The journey through Sudan to Kenya was replete with
dangers from wild animals and hostile enemies, disease, hunger, and thirst. One
episode in Mayan’s long account of the journey gives evidence of this.
Then they [Sudan People’s Liberation Army (SPLA) soldiers] came and they said,
“We better move the children.” Then we began the journey again, the journey across
Sudan at the south. It was really hard. It was during summer so thirst was really a
problem. A very big number of people began the journey. We went through the for-
ests to hide from the local people. The locals are black like us, but people in Sudan
are not in a mode of being united. Even though they are black and they are southern-
ers, they don’t have the spirit of being united. So even they are our enemy. We
passed through all this even though they [the Sudanese locals] were hiding with
guns and shooting people. They shot people. They shot many people among us. We
still proceeded. We proceeded until we reached another place where we stayed
about three days. We heard that Arab soldiers had captured Pochalla, the place we
had just left. But they said they were advancing and they wanted to come to this
area, so we moved again.
In the midst of constant danger, survival was the paramount preoccupation. John
stated,
It was actually a choice between death and life. You will die or you will live. So I had
to walk to live. And if I didn’t walk, I would die. I had to run to live. And if I didn’t
run, I would die. I had to run to get away from [the enemies], otherwise they would
catch me and they would kill me. I ran from the wild animals. If I didn’t run, they
could kill and eat me. So this is the way I survived.
Hunger was another dominant theme in the participants’ stories. One partici-
pant stated, “People lived and died of starvation.” Benedict used repetition for
emphasis to describe the lack of food during the flight from Sudan.
When we came to Pochalla there was very, very, very little food that people could
eat. People were really struck by starvation. The exception was when the Red Cross
people used to bring us some corn and beans. They served people by just giving a
little—only one cup of beans for three people, something like that. Some people ate
some grass. And there was really, really, really starvation.
Another participant described the hunger that the refugees endured living in
Kakuma refugee camp in Kenya.
Shortage of food was the great thing which affected people in Kenya as refugees. We
were given a very small amount of food—a very small quantity of raw wheat or
some kind of corn. They just gave us one bowl, maybe two bowls, for fifteen days.
And that would not last for fifteen days, or even ten days. So life was really, really
hard in Kakuma. Even if you didn’t have breakfast or lunch, just supper, that supper
was not something that could satisfy you.
Disease was another problem the refugees faced. Mayan recalled, “The diseases
were killing people. If you are unlucky then you get a disease and then you die.
There is no medicine.”
Peter told about the refugee children’s ongoing experience of fear of violence
and the related helplessness they experienced, even in the refugee camps.
At night they [local Turkana tribesmen] would come and shoot people. And you
didn’t know who was shooting at you and where they came from. You never knew.
We were innocent, and we didn’t know where to go.
Despite their experiences, none of the participants displayed a sense of victimhood

at the time of the interviews. They expressed that they were innocent children vic-
timized by enemy aggressors, and they conveyed a sense of powerlessness in the
past. Their present interpretation of themselves, however, was as survivors and
agents of their own future. Each participant positioned himself in his narrative as a
member of a group that survived, and each looked forward to a future that he could
shape. The tone of the narratives was not bitter. Instead, feelings of brotherliness,
kindness, and hope prevailed.
In addition to revealing the enormity of trauma and suffering that the partici-
pants experienced, the narratives also revealed what enabled their survival. The
content and structure of the narratives revealed the ways in which the participants
coped with the trauma and hardships of their lives. Four themes were identified in
the narratives that reflect coping strategies used by the participants: (a) collectivity
and the communal self, (b) suppression and distraction, (c) making meaning, and
(d) emerging from hopelessness to hope. Each of these themes is discussed in
further detail below.
Collectivity and the Communal Self: “What Is

Happening Is Not Happening to Me Alone”
The theme of collectivity, or the communal self, was revealed in the content of the
narratives, as well as by the linguistic devices participants used to tell their stories.
Each participant located himself predominantly as part of the group of refugee
boys, telling his story with the group voice, mainly using the pronouns we and us,
and only rarely using the personal pronouns I or me. A sense of shared experience
and collective coping enabled survival. Mayan told about older boys in the group
who provided security at night as they traveled, and about villagers, “black like us,”
who offered corn and grain on their journey. He related his belief that it was only
with the help of others that he survived. He stated,
If it was me by myself I could not have made it. But people were really friendly and
brothers to each other. One of the big kids used to help me a lot. I didn’t know him,
but he had a lot of compassion towards me.
Participants encouraged themselves and each other with the knowledge that,
as expressed by one boy, “What is happening is not happening to me alone.” Bol
stated, “We had to encourage each other, advise each other not to give up, to still
struggle for the future life. I encouraged myself and also I listened to other kids. See-
ing how they survived made me more encouraged.” Participants told of the sup-
portive social networks in their community wherein elders, though very few
among the refugees, acted as wise and respected advisors.
The notion of selfhood in which one has responsibility for others, and even
exists for the other, provided the impetus for many of the boys to continue their dif-
ficult journey, to not give up, and to plan for their future. Participants expressed a
sense of obligation to help others Sudanese refugees in need. Several of the refugee
boys expressed feeling obligated to carry on as representatives of their families.
Benedict explained, “If I live, I will be the ambassador of my family. And if God
wishes I will be alive and my family will not be lost totally. I will be my family.”
The participants’ sense of a communal identity with their fellow Sudanese refu-
gees continued in the United States, despite separation by great distances. Informal
conversations with foster parents and caseworkers recounted numerous phone
calls among Sudanese refugees resettled throughout the United States and Canada,
as well as phone calls to and from contacts in Africa. Most of the participants
expressed great concern and worry for the refugees still remaining in Africa, and a
strong connection with the suffering of fellow refugees who were left behind.
Ezekiel stated,
If you feel comfortable, and the rest of your brothers are suffering, that can give you
a lot of trouble in your blood, in your heart inside, how you feel inside. Because your
brothers and sisters are suffering a lot.
At a later point in the interview, he elaborated.
I remember the hunger facing us in Kakuma. I can remember because now in Amer-
ica I’m okay. But my brothers have remained behind and are suffering. In my blood I
can feel hunger because my brother is suffering. In my stomach I’m okay, but in my
blood I’m still suffering.
The feelings of concern for those remaining in Africa, even the internalization of
these feelings, underscores again the strong sense of community and the idea of the
communal self, which is reflected in the narratives.
Suppression and Distraction:

“Thinking a Lot Can Give You Trouble”
Suppression of traumatic memories and their associated feelings was a major cop-
ing strategy used by the participants both in the past and since their resettlement in
the United States. This strategy facilitated both individual and collective coping as
boys attempted to contain disturbing memories and worries, and encouraged each
other to not think about things, because, as summed up by Ezekiel, “Thinking a lot
can give you trouble.”
Closely related to the coping strategy of suppression was distraction. The par-
ticipants commonly used distraction as a way to avoid difficult thoughts and feel-
ings, both in Africa and since resettlement in the United States. They described their
efforts to keep busy with school and activities to protect themselves from feelings
that they feel powerless to handle. By keeping their minds occupied otherwise,
there were fewer opportunities to think about past and present difficulties. John
explained that sometimes, distraction was effective in keeping his mind from these
memories; but if he was not busy, the memories returned. He stated, “When I’m
concentrating on something that I’m doing they go away. But when I take rest, when
I want my mind to take a rest, they come into my mind.” John recalled how he
distracted himself from troubling thoughts.
If I think a lot, then I have to go and read a book or something. That is what I try to
do. And if I’m not reading, I have to go and play a game. If I sit alone, I start to think
about things. I have to have something to do to be free of thinking.
In some of the narratives, thinking too much was connected to dying. Benedict
described how the refugees encouraged each other to use suppression and distrac-
tion as a means of coping.
Sometimes it was very hard. Whenever I heard about something new it gave me a
sickness. Somebody might come and comfort you. They tell you “don’t think about
it.” They tell you to forget those things so that you may live. Somebody may come
and advise me to put that out of my mind. They said to just lose what you are putting
in your mind and come and play and do this and do that so you can forget. If you
keep something in your heart you can die of thinking. So that’s how people some-
times managed. You are able, if somebody came and advised you, and you knew
that what happened to you did not happen to you alone. So we did this, and that’s
how life went. And if they hadn’t advised me, maybe I would have lost my hope and
then died also because of thinking those thoughts.
The structure of the narratives mirrored the suppression of emotion that was
described by the participants. The participants recounted details of tremendous
horror and trauma with little emotion or evaluation. Stories were told in blow-by-
blow fashion, with sparse attention to detail. It could be that the participants did not
want to share these memories with me, a relative stranger. However, conversations
with Sudanese caseworkers and with teachers, foster parents, and others who have
frequent contact with this population echoed the observation that the boys talk very
little, and with very little emotion, about their previous experiences. It seems rea-
sonable to conclude that the unemotional retellings reflect the strategies of suppres-
sion that the participants referred to in their narratives. Emotion was largely edited
out of their consciousness, as well as out of their narratives, as a way to avoid the
difficult feelings that their memories of trauma and loss engendered.
The emotional suppression evidenced in the participants’ stories and in their
storytelling is exemplified by the participants’ stories of crossing the Gilo River. All
of the participants told a story about it, and many reported that it was the most trau-
matic event of their life. The boys, most of them between 7 and 9 years old at the
time, had spent close to 3 years in Pignudo Refugee Camp in Ethiopia, a relatively
safe place in which food was sufficient, and some boys had even been able to begin
their schooling. Suddenly and forcibly, they were expelled from the camp and the
country after a new Ethiopian government took power. While fleeing Ethiopia, the
refugee children were forced by gunfire to cross the Gilo River to get to back to
Sudan. In his account of this traumatic event, Mayan recounted the horror of sol-
diers chasing and shooting children as they fled. Reaching the border of Ethiopia
and Sudan, the refugees were faced with the Gilo River. Mayan’s story creates a pic-
ture of thousands of refugees, most of them children, on the bank of a wide raging
river, being forced by gunfire into the river. He expressed no emotion and provided
no evaluation of the incident. He simply stated, “They fired at people. Many people
jumped into the river. Even though they didn’t know how to swim. So thousands
and thousands of people drowned there. They really drowned there.” The same
horrible event was recounted by Bol in a similarly unemotional way. He stated,
The Khartoum government attacked along the Gilo River. The Ethiopian soldiers
fired on us. Many Sudanese lost their lives because we had to cross that river to
Sudan to escape. The river was very long and deep, and the water was flowing hard,
and many people could not make it because they did not know how to swim. And
there were many crocodiles eating people in that river. So many people were eaten
by crocodiles. Others drowned, and some were killed by Ethiopian soldiers. The
few who remained, including me, were able to cross the river and get to the other
side, which was Sudan.
In both Mayan’s and Bol’s telling of this incident, we gain insight into how sup-
pression of thoughts and emotions enabled perseverance and, ultimately, survival,
in spite of such trauma and difficulty. Suppression enabled the refugees to continue.
Mayan simply stated that after crossing the river, “we got out” and went to another
town. Similarly, Bol “went to the other side.” Repeatedly on their journey, the boys
were forced to move on, to keep going, because the enemy was in pursuit. During
their journey from Sudan to Ethiopia, and then later from Ethiopia back to Sudan
and, finally, to Kenya, these young boys often traveled by night to avoid attack.
They stayed in towns or villages for short periods, until SPLA soldiers told them
that Arab forces were approaching and they needed to move on again.
In addition to the tremendous loss of life that occurred at Gilo River, many refu-
gee children died from enemy and animal attacks, starvation, and disease. As John
stated, “You can’t spend two days without seeing a dead body.” Based in the histori-
cal reality of their situation, suppression provided an effective means of coping and
was often necessary for mere survival. The unaccompanied refugee youths who
resettled in the United States survived incredible violence and hardship. Many oth-
ers gave up and died along the way. Children too tired, sick, or hungry to continue
walking sat down, never to get up again. Others wandered away and were never
seen again. Some killed themselves. The boys constantly faced both the reality and
the threat of death. To keep going, they could not succumb to the expected emo-
tional response. It became necessary to detach emotionally to carry on. The partici-
pants reported there was no time to grieve over someone else’s death, because to
stop would risk one’s own life. They needed to keep their minds focused on sur-
vival. Ezekiel explained how he used suppression to cope in the midst of death and
loss, as follows:
If you make yourself to be safe, later on you can think about another person. When I
was in Sudan I could not remember, because maybe these memories would put me
in a difficult situation. I could not remember people’s deaths, because I myself
needed to deal with my own life, not another person’s. Someone who is dead is dead
already.
Although the strategy of not thinking about traumatic things was described as
effective for dealing with immediate danger and trauma, there was some indication
that this strategy was not as effective long term. When no longer in imminent dan-
ger, the participants reported recurrent, intrusive thoughts of the past. These
thoughts bothered them periodically during the day or kept them awake at night.
John described how his memories of the difficulties he had endured affected him
since his resettlement in the United States. He stated,
Sometimes, if my memory takes me back to those conditions and to the way that I
have lived, it may take me the whole night without letting me sleep, even here [in
the United States]. Those memories have stuck in my mind and I remember them. I
want to remember them, but I don’t want them to bother me when I want to do
something else. But sometimes they bother me when I am doing something else.
Ezekiel described how a sense of powerlessness to relieve his fellow refugees’

suffering compelled him to struggle to suppress his thoughts and feelings and dis-
tract himself from thinking. When asked if he thought about the refugees still in the
refugee camp in Africa, he responded,
I think a lot about my people who remain behind. I think, but I put it aside, because I
can think, but I don’t have the power to give them anything to relieve their suffering.
That’s why I put it aside. I cannot put it in my mind, because I don’t have power. I
don’t like to think about it. So I just try to live myself. If I can learn to make a good
thing for my future, then if I achieve the good, I can help them another time in the
future. But if I think about the people who remain behind, I can fail without achiev-
ing the goal. Even though I always think about it, I cannot find the way to help them
or give anything to them. So it’s better for me to follow my school and not always
think a lot all the time. It’s better for me to leave all these things. I’m just going to
think about what I need for myself—going to school, going to work—and leave
thinking about other things.
At the time of the interviews, many of the boys, resettled in the United States,
were feeling safe for the first time since they fled their parents’ home. The opportu-
nity to reflect back on early experiences seemed possible in this new, safe situation.
However, the desire to remember and the desire to forget created a dilemma. For
most, the memories continued to be problematic. Suppression and distraction con-
tinued to be used as a way to avoid difficult thoughts and feelings. Keeping busy
with school and activities were efforts to protect themselves from feelings that they
felt powerless to handle.
Making Meaning: “If God Wishes, Maybe I Will Be Alive”

The participants interpreted their experiences through a belief in the power of
God’s will and the view that “God decides when you die.” The convictions that God
is in control and that one’s time of death is decided by God were echoed by many of
the participants in the study. For example, Peter remarked, in reference to the death
of someone he knew,
I think God let that guy pass away. And maybe I will pass away like him too.
So . . . I’m waiting for my time to die. Maybe I can die any time, you know. God
knows. God knows every second that somebody dies.
Most of the participants readily accepted their life circumstances as God’s will
rather than struggle with questions about why God would allow them to live and
others die. John simply stated, “God did not want me to die. Otherwise I would
have died like the others.” Such a closure helped facilitate the suppression of feel-
ings as discussed previously. Attributing death to God’s will provided an easy
answer and enabled the participants to avoid thinking about the reasons for or
meaning of the suffering all around them.
Some of the participants expressed beliefs that provided meaning and the rea-
son to resist despair. For some boys, the belief that they were alive for a reason was
important. Bol stated, “I believe that I am now alive because of God. I can’t believe I
escaped all those difficulties by myself. I believe God was working with me at that
time.” Majok expressed a belief in his responsibility to his family. He believed that it
was his duty to represent them through his own existence. This belief that one repre-
sents one’s family after they are gone, previously mentioned in relationship to feel-
ings of collectivity and the communal self, is one that provided moral direction,
purpose, and hope to Majok and other boys who had lost their families, homes,
country, and ways of life. Majok also expressed a sense of responsibility to other
who might need his help in the future. He expressed these beliefs as follows:
We were born by our parents for a certain reason—that later on we would remain
and represent them, and we will help people here. If you kill yourself, what have
you done? It is not good to get to the point where you kill yourself. You would not be
there for your parents, and maybe you wouldn’t be there for all the people who
might need you. If you kill yourself, those who are waiting for you will lose their
lives.
Another participant, Benedict, expressed this same sentiment regarding represent-

ing his family, defining it as an “African belief.” He stated,
If God wishes I will be alive. My family will not be lost totally. I will be my family.
This is the African belief. So maybe that’s why people cannot kill themselves.
Although all of them [his family] died, people will point to me as from such a clan.
So I may continue the life of my people. Because of that, you cannot kill yourself.
Although most of the boys made meaning by attributing their life circum-
stances to God’s will, a few related other reasons for their suffering. For one boy, the
historical and political context of his experiences played an important role. He put
the blame for the “bad things in Sudan” on his Arab enemies. Another participant
concluded that he was part of “an unlucky generation.” John had not resolved the
question of meaning yet. He stated that he desired to look for the reason why he
“had to suffer like that.” Although he also claimed a belief in God, unlike the others,
he had not been able to make meaning out of his experiences to his satisfaction yet.
For John, the question of why he had to suffer like that had not yet been satisfied.
There was no resolution to his story.
Emerging From Hopelessness to Hope: “Now We

Feel Like People—We Have Hope for the Future”
The study narratives presented the progression from hopelessness to hope in the
participants’ lives. The hopelessness that the refugees experienced throughout their
flight from Sudan and during the many years in a refugee camp was juxtaposed
with the hope that life in the United States held for them. Benedict expressed the
sense of hopelessness he felt in the face of constant death.
There’s no way that you can even hope. When my half-brother died we hoped that
maybe another guy would not die. And then it happened again: He died, and then
another died. There’s no way that you can even prevent it. So it becomes a situation
where you just know that you will probably die also. You just think that maybe
tomorrow it will be your turn to die.
Hopelessness was also related to living day to day for so many years in a refugee
camp with an emptiness of existence, which was likened to being “dead,” and
where their lives did not “count.” Peter put it this way:
We had eight years in Kenya, and it was really very boring. Because you can’t work,
you can’t go to school, you can’t even hope for your future. There was no hope for
the future. So we just lived there as . . . we didn’t even count ourselves.
With little prospect of returning home or anywhere better, the refugees experienced
strong feelings of homelessness, displacement, and powerlessness. Peter stated,
“We were not going back to our country. We just stayed there. And we were stuck
there. We didn’t have anywhere to go.”
A turning point in Peter’s story came a few lines later, however, with a transfor-
mation from hopelessness to hope. Peter reported that the UNHCR came and began
the process of resettling the boys in America. Peter used the voices of the United
Nations officials, juxtaposed with the voices of the refugee boys, to tell this part of
the story.
And then UNHCR came in 1998. That was the time that this process [of coming to
America] started: 1998. They went and they took photos and they said, “You guys
should go to America.” And we said, “What?” because we could not believe it. They
said, “If you want to go, then come let us take your picture and write your name
down.” And we said, “Alright.” We did that until 1999. In 2000 they started taking
people here [to America]. And then people believed it, that people are going to
America. So . . . now we have hope for our lives.
This form of storytelling was very effective. The juxtaposition of Peter’s disbelief,
then belief, regarding resettlement in the United States, mirrored the hopelessness,
then hope of the situation. In the final lines of this story, Peter presented a resolution.
He stated, “So now we are really . . . we feel like people. Now we feel like people,
that we have hope for our future.” These lines contrast with his earlier statement
“We don’t even count ourselves,” when he talked about being alive but with no
hope. In the end, feeling like a person involved having hope. With hope for the
future, he felt like a person, and he counted at last. This is an eloquent testimonial to
the necessity of hope in human lives.
In addition to the hopelessness of life of the refugee camp, hopelessness was
also an outcome of the violent context of the participants’ lives. Both in Sudan and in
the refugee camps, the boys felt powerless and hopeless in the face of the violence.
Benedict told of his struggle to maintain hope in an environment in which death
was a constant fear and reality. He told a story of a “very clever boy” from his clan
who had journeyed from Sudan with him and who was murdered by a local
Turkana tribesman while in the refugee camp. He summed up the emotional impact
of this event on him, saying, “It was really a very hard situation to manage. I was
really losing my hope because of this case.” He identified with the boy and sur-
mised that if such a thing could happen to a boy who was so much like himself, only
maybe more clever, then what hope was there for him? He described living in con-
stant fear of dying, so much so that he assumed that his own death would come
soon.
That’s why I say I thought that there was really totally no hope of life in Kakuma.
You hope that tomorrow you will be killed or tomorrow something may come. You
don’t want to die, but you think that soon you will die, because you don’t know
what will protect you.
Benedict summarized his feelings about this outlook on life by stating, “It doesn’t
feel well.” A few lines later, he elaborated.
We were losing hope because one of our clan died in a bad way. When he was killed
in a bad way nobody complained. There was no way that you could complain about
these people who were killing people. And there was nowhere to go also. So that’s
the sort of hopeless life that we had before.
Benedict articulated the sense of powerlessness that pervaded the hopelessness.

Not only was one of his clan brothers killed, there was also nothing that could be
done about it. There was no one to bring troubles to, no justice to be found, and no
escape. What on one level is the story of one particular boy, on another level is the
story of the hopelessness of all the boys’ lives in the refugee camp.
Another participant, Majok, told a story in which hopelessness and despair led
to a boy’s suicide. The boy had recently received word that the Arab militia had
killed all his family in Sudan. Majok told the main action in sparse, yet vivid, detail:
“So that guy, he took a rope, and he went to a very far place and he hung himself.”
No elaboration was given, no emotion expressed. He later summed up the meaning
he attributed to this tragedy by saying, “So . . . that is the life in Kakuma.” This sen-
tence, which provided a coda to the story, presented Majok’s interpretation of the
event as reflective of the loss and despair of life in the refugee camp. He informed us
that this is an example of how life was there.
In juxtaposition to the hopelessness the participants experienced, however, was
their expressed hope for a better life in the future and the implied necessity of hope
in their lives. The participants’ hope for their future lay in education. For some, the
hope that school provided, even the limited schooling they were able to get in the
refugee camp, provided the impetus for them to remain in the camps despite the
hardships. The hope of going to America, and all that that entailed, was pivotal, and
the transition from the hopelessness that predominated in the refugee camp to the
hope that resettlement in America held for them was a major story line in the narra-
tives. One participant stated, “If I were in Africa maybe I would say that I don’t have
hope in my life because everything has gone there. But here [in America] I really
have hope that I will be somebody maybe.”
When asked about the future, each participant told of his desire to graduate
from high school in the United States and go on to college, thereby ensuring a good
life for himself. The valuing of education was one of the strongest themes of the nar-
ratives and a predominant one in every interview. Education was seen as the “key”
and the means of being “somebody.” John stated, “Everything is all education. If
you are not educated you can do nothing.” Similarly, Samuel related, “The better
you are educated, the better comfort you will have. If you have a good education,
nothing will be difficult for you. Life will be easy for you.”
As boys who had lost so much, knowledge was seen as the one thing that could
not be taken from them. Cattle are the main form of currency, livelihood, and status
in the Dinka culture. The participants had seen their parents’ homes and cattle taken
from them in war. Samuel compared being educated to the traditional cattle-herd-
ing, nomadic life of his family and tribe. He concluded that as a cattle herder, an
enemy could take away all of your cattle, leaving you with nothing. However, edu-
cation could not be taken away.
Knowledge is the key. Wherever you go, you get a job. But the cattle, maybe an
enemy can appear and kill them all, and from there you’re left with nothing, because
you depend on cattle. But knowledge cannot be taken away from you until you die.
The valuing of education was striking and was exhibited in their motivation
and intense efforts in high school in the United States. Benedict told what getting an
education meant to him and why he was working so hard in school.
In my mind my hope is that since I will study I will have a good future. I hope I will
be somebody later on. If I get my education I will be somebody. It’s like this. If I start
building my life good like the way I’ve started now, maybe I will finish my high
school and go to college. If I finish and I have a lot of knowledge, then in the future I
will be able to manage my own life. Or with the knowledge that I have, maybe I’ll
become a teacher, or a doctor, or an engineer. I will teach other people. I will show
them. And I will be earning money. I will be able to support myself and have an
apartment. Maybe I will be somebody who will help himself. I will not even depend
on anybody. I will take care of myself. I will not ever depend on somebody again.
Similarly, Peter talked about his intent to finish school. He stated, in reference to
getting an education, “It can be good for me, so that I can have hope for my life. I will
be able to do anything for myself.” Education was seen as the route to achieving
independence. The goal of independence and self-reliance lay in contrast to the ref-
ugee’s lives of constant dependence on aid from others for survival. The sense of
powerlessness experienced by the participants in the past was replaced with a sense
of agency and power to effect change in their own lives. The participants looked for-
ward to the time when their dependence on others would be mitigated by their own
independence. They equated independence with hope and viewed education as the
means to independence, hope, and being somebody.
DISCUSSION
The analysis of the participants’ narratives revealed four themes related to how the
participants coped with the trauma and hardship in their lives: (a) collectivity and
the communal self, (b) suppression and distraction, (c) making meaning, and
(d) emerging from hopelessness to hope.
Feelings of collectivity and community provided strong protection against the
traumas and hardships experienced by the participants in this study. The protective
effect of social support on life stress is well documented and includes the support of
children helping children (Halpern, 1982). The unaccompanied refugee youths
relied on each other for encouragement and support. The knowledge that they were
not alone in their suffering provided comfort and an impetus to not give up. The
social value of representing one’s family further facilitated a will to survive. A sense
of responsibility to help others was a strong motivator to keep going and a deterrent
to despair.
Communal identity is strong in the southern Sudanese culture. Dinkas, includ-
ing young children, can recite their family lineage many generations back and are
very aware of kinship networks and to what groups they and others belong. They
have a history of collective and communal living and responsibility for each other.
At a very young age, Dinka boys traditionally leave their families for periods of
time to live out in the fields with their peers tending cattle (Radda Barnen, 1994).
Young boys were generally expected to herd cattle under very harsh climatic condi-
tions, where the food supply was insecure and where they had to travel long
distances on foot. Generations of Sudanese were faced with war and displacement,
and the children were taught to expect hardship. Children were taught to care for
those younger than themselves. The cultural context of the participants’ lives might
have played an important role in their coping abilities. According to the Radda
Barnen report, such preparations and experiences contributed to the ability of the
children to cope with stressful situations and to adjust to their conditions. A com-
munal identity, whether part of a family, a kin network, a tribe, or a group of refugee
children, reflects a cultural ideal that might have facilitated the refugee children’s
coping. Social support networks often operate as buffers for trauma and suffering
(Garmezy, 1983). Herman (1992) stated, “The solidarity of a group provides the
strongest protection against terror and despair, and the strongest antidote to trau-
matic experience” (p. 214). This seems to be true for the unaccompanied refugee
youth from Sudan.
Suppression and distraction were the main psychological coping strategies the
participants in the study used to cope with the trauma they experienced. Voluntary
suppression of thoughts and feelings was a means of altering an unbearable reality.
Suppression is similar to Herman’s (1992) concept of constriction, which includes
the narrowing of thoughts, memories, emotions, and sensations. In her book Trauma
and Recovery, Herman asserted that avoidance and constriction are common fea-
tures of chronically traumatized people. She stated, “When the victim has been
reduced to a goal of simple survival, psychological constriction becomes an essen-
tial form of adaptation” (p. 87). It is clear in the narratives that the boys survived, in
part, by keeping their minds focused on survival. Even in Kakuma, unsafe condi-
tions required that the refugees keep on their guard. The unaccompanied youths
resettled in the United States are the ones who survived incredible hardship. Many
others did not make it. Suppression and distraction seemed to work. Although
adaptive to some extent, however, the avoidant and constrictive behaviors associ-
ated with suppression might have also led to “a kind of atrophy in the psychological
capacities that have been suppressed” (p. 87). This pattern of coping, though adap-
tive in traumatic situations, can be problematic in the long run. It can be costly in
terms of withdrawal and detachment from everyday activities and numbing of
emotions (Van Der Kolk & McFarlane, 1996).
Herman (1992) defined three stages in recovery from trauma: (a) safety,
(b) remembrance and mourning, and (c) reconnection. The refugee youths inter-
viewed were, at the time of the interviews, just experiencing the first stage. Many of
the participants, now in the United States, were feeling safe for the first time since
they left their parents’ home, and the opportunity to reflect back on early experi-
ences seemed possible in this new, safe situation. It is only in the context of feeling
safe that they will be truly able to remember the traumas they have endured and
begin mourning their losses and reconnecting with themselves and others.
Although a common response to trauma is to suppress painful memories, such a
response does not allow young people to heal. Refugee youths need opportunities
to talk openly and safely about what occurred to them, to their families and loved
ones, and to their homes and countries. It is important, however, to respect each
individual’s timetable for healing. Suppression provided a fairly effective means of
coping for the refugee youths and should be considered to continue to be an impor-
tant pattern of coping among this population until other patterns have been
developed.
Stories allow us to see how storytellers have come to understand and interpret
the difficult experiences of their lives (Bell, 1988). Few studies have explored how
children derive meaning from their traumatic and/or violent experiences. Even
fewer have done so in the context of understanding the cultural dimensions of such
meaning making. This study revealed the Sudanese refugee youths’ culturally
embedded and contextualized understanding of their experiences, constructed
from “the building blocks available in their common culture” (Lieblich, Tuval-
Mashiach, & Zilber, 1998). How they conceptualized and managed the traumatic
experiences in their everyday lives gives insight into how their meaning making
facilitated their coping and survival. Belief systems can function as coping strate-
gies (Folkman & Lazarus, 1988), and firm belief systems have been found to be a
protective factor against posttraumatic disorders in traumatized refugees (Brune et
al., 2002). The participants found meaning in their cultural and religious beliefs
regarding suffering and life. Interpretation of events as God’s will helped the partic-
ipants cope by giving order to the disruption and chaos of their lives. Believing that
one’s life had purpose, whether to represent one’s family or to help others in the
future, provided meaning and resistance to despair.
With only one exception, the participants did not question why they had to suf-
fer so much. Most of the participants had imposed some level of closure, whether
permanent or temporary, on the interpretation of their lives thus far by attributing
their lives, and others’ deaths, to God’s will. These beliefs facilitated coping by help-
ing them make sense out of their experiences and by facilitating the suppression of
thoughts and feelings, as discussed previously. The unaccompanied refugee youths’
suppression of questions about why they suffered paralleled their suppression of
thoughts and feelings about the horrific events they encountered. While they were
in Africa, suppression might have facilitated their ability to cope with immediate
danger and hardship. Now safely resettled in the United States, the youths might
have more emotional energy to consider the existential questions about the mean-
ing of their suffering. Consequently, questions about the purpose of their personal
suffering might become more commonplace over time, and meaning making will
most likely continue to evolve for them.
Findings from this study of Sudanese unaccompanied refugee youth are consis-
tent with Rousseau et al.’s (1998) findings about the usefulness of the cultural mean-
ings the children in their study attributed to the traumatic situations they experi-
enced, and to the culturally based coping strategies the children used to face those
situations. Children’s responses to trauma cannot be understood by focusing only
on individual mediating factors; the mediating effects of the social, political, and
ecological contexts must also be considered (Punamaki, 1989). This study’s findings
point to the importance of understanding the belief systems and the cultural aspects
of trauma, symptoms, and coping. Listening to refugees’ beliefs and about how
they make sense of their experiences provided insight into how they managed diffi-
culties and how they ordered their world. Such insight can be used to support them
in their efforts for a better life. Future research is needed to determine if meaning is
lacking in other populations of unaccompanied refugee youths who do not have
positive emotional status. Rather than focusing on deficit and pathology, practitio-
ners and researchers need to consider the culturally based strengths of refugees.
Related to meaning making is the transition from hopelessness to hope experi-
enced by the participants. The importance of hope for people who have endured
trauma and loss is significant and was poignantly portrayed in the participants’
narratives. Hoping for and planning for the future became a major impetus for sur-
vival and helped participants endure the hardship and boredom of the refugee
camps. It also proved to be a significant motivating force in the refugee boys’ lives
after resettlement in the United States, as exemplified by their determination to
achieve in school as a means to a better life.
The participants’ narratives revealed the creative process of coping and mean-
ing making in the midst of extreme difficulty as the boys crafted narratives of hope
despite the realities of their daily lives. The narratives present interesting insight
into the psychological concepts of risk and resilience. The concept of resilience can,
arguably, be described as positive adaptation despite adversity (Luthar & Cicchetti,
2000). Refugees have often been noted as exemplars of resilience (Muecke, 1992).
The findings from this study imply that this group of refugee boys was, as a whole,
resilient, thus suggesting that resilience might be a culturally based phenomenon.
The sociocultural context from which this group of refugee boys came might have
fostered in them certain factors that contributed to their resilience. This raises ques-
tions, however, about traditional conceptualizations of resilience as an individual,
personal trait or process, and supports Rutter’s (1993) assertion that resilience
might reside in the social context as much as within the individual.
The study findings raise interesting questions about whether emotional sup-
pression will provide long-term or merely temporarily effectiveness as a coping
strategy for the participants. Effective coping is considered to be a primary conse-
quence of resilience (Dyer & McGinness, 1996). If coping is only temporarily effec-
tive, however, what looks like resilience might, in fact, be nonadaptive in the long
run. Resilience must be viewed not as a static condition but as “being in dynamic
transaction with intra- and extraorganismic forces (Cicchetti & Garmezy, 1993,
p. 499). Because developmental changes influence resilience (Rutter, 1993), ques-
tions remain about how the strategies these boys have used to cope with difficulties
will play out in their development. What at first looks like resilience (e.g., academic
achievement, environmental adaptation) might mask underlying distress, hidden
by overcompensation in one area to avoid distress in another. Some researchers
have suggested that childhood resilience can have some later associated negative
consequences (Higgins, 1994; Luthar & Ripple, 1994; Werner, 1992). Hunter (2001)
suggested that various dimensions of resilience in adolescents, such as self-protec-
tion and survival, though adaptive in the short term, might be dysfunctional in the
long term. The disconnections that children developed to survive childhood might
result in significant psychological maladaption later. Future research is needed and
should be longitudinal, following unaccompanied refugee youths through early
and later adulthood. A developmental framework must be taken into consideration
when looking at issues of trauma and resilience and the long-term outcome of
resilient children explored.
A significant limitation of the study is that the interviews took place across gen-
der, culture, and age lines. As a middle-aged, White female, I interviewed adoles-
cent boys from a dramatically different culture. The stories might have been very
different had they been told to someone from the same gender, age, and/or cultural
group. The study is further limited, in that participants were each interviewed only
once, thus providing only one telling at one point in time. There is no way to know
how the stories might have changed with retelling. No account is complete; each
narrative is a selective telling of what seemed appropriate in the context of the inter-
view, and only some of what was said was selected to be analyzed and presented.
CONCLUSION
A case-centered comparative approach to the analysis of narratives of unaccompa-

nied refugee youths from Sudan identified some of the ways in which this particu-
lar group of refugee children coped with the traumas and hardships in their lives.
The study demonstrates the usefulness of a narrative approach for enhancing
understanding of the experiences and responses of a certain population. The find-
ings underscore the importance of understanding the cultural aspects of trauma,
symptoms, and coping, and the need to consider culturally based strengths, rather
than focusing on pathology, when working with refugees. The narratives revealed
the refugees’ culturally embedded and contextualized understanding of experi-
ences, and portrayed a shared group narrative. Questions were raised about the
long-term effectiveness of the coping strategies used, and the concept of resilience
was examined in relation to the findings.
Although the experiences of the Sudanese unaccompanied refugee youths are
unique, their situation has implications for the mental health of children worldwide
that have experienced war, violence, loss, and extreme hardship. This study pro-
vides information with implications for refugee and immigrant groups in general,
as well as contributing to the body of literature on stress, coping and resilience.
Future research should focus on describing further how refugee children and others
who have experienced extreme trauma and hardship cope, the effectiveness of their
coping strategies, and the implications of the coping strategies on individuals’
future psychological well-being.
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Qualitative Health Research http://qhr.sagepub.

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Coping With Trauma and

Keywords: narrative method; refugees; unaccompanied refugees; trauma; coping; resil-

O f the estimated 14 million refugees worldwide, approximately half are chil-

THE UNACCOMPANIED REFUGEE

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Each boy participated in one interview, lasting approximately 1 to 1½ hours, and

I analyzed narrative data using descriptive narrative techniques suggested by

Despite their experiences, none of the participants displayed a sense of victimhood

Collectivity and the Communal Self: “What Is

At a later point in the interview, he elaborated.

Suppression and Distraction:

Ezekiel described how a sense of powerlessness to relieve his fellow refugees’

Making Meaning: “If God Wishes, Maybe I Will Be Alive”

Another participant, Benedict, expressed this same sentiment regarding represent-

Emerging From Hopelessness to Hope: “Now We

Benedict articulated the sense of powerlessness that pervaded the hopelessness.

A case-centered comparative approach to the analysis of narratives of unaccompa-

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