Survivors of war in the Northern Kosovo (II) : baseline clinical and functional assessment and lasting effects on the health of a vulnerable population
This study documents torture and injury experience and investigates emotional well-being of victims of massive violence identified during a household survey in Mitrovice district in Kosovo. Their physical health indicators such as body mass index (BMI), handgrip strength and standing balance were also measured. A further aim is to suggest approaches for developing and monitoring rehabilitation programmes.
Source: Conflict and health ; 4: 16
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Methods: A detailed assessment was carried out on 63 male and 62
female victims. Interviews and physical examination provided
information about traumatic exposure, injuries, and intensity and
frequency of pain. Emotional well-being was assessed using the
"WHO-5 Well-Being" score. Height, weight, handgrip strength and
standing balance performance were measured.
Results: Around 50% of victims had experienced at least two
types of torture methods and reported at least two injury
locations; 70% had moderate or severe pain and 92% reported
constant or periodic pain within the previous two weeks. Only 10%
of the victims were in paid employment. Nearly 90% of victims had
experienced at least four types of emotional disturbances within
the previous two weeks, and many had low scores for emotional
well-being. This was found to be associated with severe pain,
higher exposure to violence and human rights violations and with a
low educational level, unemployment and the absence of political or
social involvement. Over two thirds of victims were overweight or
obese. They showed marked decline in handgrip strength and only 19
victims managed to maintain standing balance. Those who were
employed or had a higher education level, who did not take
anti-depressant or anxiety drugs and had better emotional
well-being or no pain complaints showed better handgrip strength
and standing balance.
Conclusions: The victims reported a high prevalence of severe
pain and emotional disturbance. They showed high BMI and a reduced
level of physical fitness. Education, employment, political and
social participation were associated with emotional well-being.
Interventions to promote physical activity and social participation
are recommended. The results indicate that the rapid assessment
procedure used here offers an adequate tool for collecting data for
the monitoring of health interventions among the most vulnerable
groups of a population exposed to violence.