Research Chat

Global Health Policies and African Women Refugees’ Mental Health and Well-being.Rosemary Dupuis, Balsillie School of International Affairs

Episode Summary

The final season 2 episode of Research Chat features Rosemary Dupuis, pronouns she/her, a human rights advocate and feminist pursuing her Ph.D. in Global Governance at the Balsillie School of International Affairs, Wilfrid Laurier University interviewing Tin Vo, an equity-focused researcher and public health practitioner who is pursuing a PhD in Social Work at Wilfrid Laurier University’s Lyle S. Hallman Faculty of Social Work. They have a mutual research interest in safe spaces and inclusion, discrimination, intersectionality and well-being.

Episode Notes

The episode features:

Episode Transcription


Unknown  00:00

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Shawna Reibling  00:04

Welcome to the second season of Research Chat. In this season graduate students share the details and challenges of their research work at Laurier. In this episode Tin Vo will interview Rosemary Dupuis.


Unknown  00:16

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Shawna Reibling  00:23

Tin Vo, who uses pronouns he/him/his, is an equity focused researcher and public health practitioner who is pursuing a PhD in Social Work at Wilfrid Laurier University's Lyle S Hallman Faculty of Social Work. Tin is in his fifth year of study with Dr. Michael Woodford at Laurier. Rosemary Dupuis, pronouns she/her, is a human rights advocate and feminist pursuing her PhD in global governance at the Ballsillie School of International Affairs, Wilfrid Laurier University. Rosemary is in her sixth year of study with Dr. Jenna Hennebry. Her expertise is in global health, governance, mental health, gender violence and trauma, human rights and refugee protection. She brings this knowledge, expertise and 12 years of applied research and policy experience with grassroots organizations to the classrooms at Laurier as contract faculty in the Women in Gender Studies and Human Rights departments. Her current research nexus is violence against women and girls, human rights and trauma informed global health governance policy. Rosemary is a recipient of a SSHRC graduate doctoral fellowship. Prior to joining the PhD program, she earned her MA in Cultural Analysis and Social Theory and received a medal of Academic Excellence nomination from Wilfrid Laurier University. She also received a BA in Psychology, honors specialization, and major in English Language and Literature from Western University. She also has a diploma in aeronautical engineering avionics. She is founder and executive director of Jami Circle, an NGO supporting the health and well being of resettled refugee women in the southwestern Ontario region, including Huron, Perth, Oxford, and Middlesex counties through non medical evidence based wellness services. Rosemary is affiliated with Laurier's International Migration Research Center or the IMRC, the Gender and Migration Hub at the Ballsillie School, the Thsepo Institute for the Study of contemporary Africa, and the UNESCO inclusive Policy Lab. Both of you have a special interest in exploring themes around resistance and oppression, specifically safe spaces and inclusion, discrimination intersectionality and well being I'm glad you both can be here today to discuss these themes in the context of your dissertation research.


Tin Vo  02:43

Hi Rosemary, thank you for chatting with me about your research today. Maybe before we start, the first question is, what did you set out to discover in your research?


Rosemary Dupuis  02:55

Hi Tin. The purpose of my research was to find out how trauma and violence moves with the bodies of women from camps to Canada, and how there is a gap in continuity of care in regards to their mental health, physical health and their sexual and reproductive health, including the emotional well being. So how they access health services and how the services are delivered. And how the women utilize Health Services is where the gap lies. So the gap in continuity of care is, of course, linked also to the gap in funding for health care services at the global, regional and local level. My research is with women, refugees from the East and Horn of Africa, whose bodies mark them as visible, they're black and brown bodies, but they're also marked as invisible in the system when it comes to protection and care because of systemic racism.


Tin Vo  03:55

How did you set out to answer your research question then?


Rosemary Dupuis  03:58

So to get to the heart of my research, I did extensive interviews at two levels. First, I did interviews with women refugees resettled in Canada to gather their stories and their experiences. Second, I did interviews with key stakeholders and informants, that is people and professionals who play a key role in the lives of women refugees, particularly during their journey and once they resettled in Ontario. So these key stakeholder interviews included mental health research professionals, settlement personnel in relation to housing and transportation, peer group facilitators, refugee camp security and funders at the international and national levels, and also personnel who work with nongovernmental organizations who are involved in the care of women, for example, church and local community groups. So the stakeholder interviews are important because for my research, they provide the on the ground substance of the policies and how they're instituted and hence, connect to this idea of care. That is how the policies are interpreted and implemented. The women interviews on the other hand, give me the lived experiences of violence and trauma, traveling with the bodies and memories of the women, and therefore connect for me the spaces, places and geographies that this woman have traveled through. So both sets of interviews provide insights to policymaking. The process also included looking at international policies and laws pertaining to the protection of women refugees and how national governments like Kenya and/or Canada because those are my two key countries interpret these documents to meet their international obligations to the mental health and well being of women.


Tin Vo  05:49

What is the key message that emerged from your research?


Rosemary Dupuis  05:52

So one of the key messages that emerged from my research, particularly pertaining to the stakeholder interviews, is the issue of funding and lack of funding for women's initiatives, particularly those related to their mental health and well being in the host country like Kenya, and Kenya in this reference is a country of first asylum, because it's the first place the women refugees would seek asylum, where most of the funding is through international organizations, and international NGOs, and also funding in Canada, which is our final resettlement country for refugees, where what is on paper, for instance, access to mental health services, through the interim federal health program does not match reality. So let me talk a little bit about that gap in funding to show how they are connected. So because refugees, by definition, are stateless people, and therefore, access to health services has to come through funding by international donors, for example, through the UNHCR, or through UN Women, or the Bill and Melinda Gates Foundation and, if we think about the regional level through the African Union, funding is scattered. So for example, in Ontario, health care for resettled refugees is not provided by OHIP, the Ontario Health Insurance Program, but rather it's through IFHIP, which is the Interim Federal Health Insurance Program. So we see stop gaps in who provides health services and how the women can access those services across the different levels based on who's providing the funding. For example, a woman who has experienced sexual violence during her journey may access mental health services at the camp funded through the UN Women's safe spaces programs. But when she leaves the camp and arrives in Canada, as a resettled refugee, access to mental health services is hampered. So even though the interim Federal Health Program covers and to some degree provides access to mental health services, including psychological services, the wait times can be three months to one and a half years. So therein lies a crucial gap and the only professionals who are covered through this program are general practitioners, psychiatrist, mental health hospitals and clinics registered within the Interim Federal Health Program Administrator who is Blue Cross. So this gap has real world consequences for the women. And we know that research has shown suicide rates are high neglect of children, alcohol and substance abuse, homelessness, exposure to further acts of violence. So when we have the long wait times, and the gaps, and only specific registered professionals are included in the funding, then of course, this is troubling, because our Western version of healing is therapy and medication. So other ways of healing and coping strategies, that can be and are as effective, or not funded or recognized. So local groups that do not fit this professional designation, although maybe helping women with the healing and coping would not be funded. So that lack of funding is connected to a second key message that came in, which was this implementation of the international policies and laws at the country level. And funding is important in this and there's no consistency across the countries. It's difficult, if not at times impossible, because of course, there's competing interests. And those interests are connected to national politics and economics. So a third message that was connected to the second and of course to the first, is that trauma and violence has a long tail impact and this particular message comes out through the women interviews. So The women's health, even seven to ten years after resettlement in Canada still has an everyday impact on the lives and well being. And of course, this long tail impact is connected to gaps in how policies are implemented. And the reality of continuity of care, and how policies are implemented are connected to funding. So we have this idea that healing and coping has to happen, particularly through therapy and medication. But of course, healing and coping strategies are also intergenerational. And they're connected from what people learn from their mothers, aunts, their grandmothers and the methods are not related to what in the West willing to answer therapy and psychological services or medication. So for example, faith based healing, prayer, meditation, healing cycles, or action based healing, like cooking, crafting, drumming, singing, these are not funded. So but they are other methods of coping particularly from women in the African context. So this different methods of healing and coping are, of course, woven with the women's ideas of resilience and something that emerged was this idea that being grateful to the Canadian nation then critiquing the state, for not meeting your mental health needs can be read as ingratitude. And this is connected to this long tail aspect of trauma and violence, and how one is being rescued from a horrible situation of being a refugee. And therefore, it's this idea of being saved, and therefore demanding the basic right to mental health, outside of the context of therapy and medication is impossible. So there are many discriminating stereotypes, of course, linked to this idea of critiquing gratitude that is linked to healing and coping. 


Tin Vo  11:37

So if I understood you correctly, there are four key messages that I heard. First being a gap in funding, second being variations in healing and coping, which is associated with a gap of funding because some ways of healing and coping are not really federally funded, and supported. Third, being trauma has a long term impact. And then the fourth being this, this idea that perhaps the way that folks are resettling, and there is a gap in their adjustment to their new place of settlement, and this almost silencing of voices because there is a gap in their services. They're not allowed to speak up, because they should be grateful for this place that they've just resettled. Is that a good summary of the things that you just talked about?


Tin Vo  11:57

Yes, it is an actually an expectation to be grateful. As a refugee, there is an expectation to be grateful to the Canadian nation for saving and rescuing you. So that is a good summary of that. And, for example, even if a woman has experienced sexual violence, they may not be comfortable with having a male doctor, but that is who is available and provided to the woman. In most cases, she will remain silent, as you mentioned, and she will endure the experience of shame and humiliation, because the gratitude idea is one in which if she voices, her position, could threaten access to other services, because she will be labeled as ungrateful and problematic within the system. And so it's almost a gratitude that is disempowering.


Tin Vo  13:51

So how does your research relate to your advocacy work, Rosemary?


Rosemary Dupuis  13:55

So during my master's research, my interviews with women refugees was on integration into Canada. And this is what revealed that experiences of violence and trauma, I ignored through the whole process. An integration was mainly focused on settlement in terms of housing, transportation, and work. And of course, this is pertinent to successful integration, but it's still a gap. So this degree resulted in two things: One, my PhD research, and two my advocacy work. So at that point, I started a nonprofit, Jami Circle, which is Swahili for community of refugee women, and it is a peer based refugee group in my community. A kitchen table sort of conversation space where we meet and talk and support each other. It's a way of addressing mental health in an organic and holistic manner as a viable alternative to counseling because not all the women have access to mental health services, because of finances, geographic location, traditional beliefs and systems. It's a safe space where we can meet and talk and do activities we enjoy, like yoga, meditation, art, cooking, singing, meeting crafting. So when we think about how do we provide change, I connect my research to my advocacy by creating this one safe space. So my research targets changes in policy, while my advocacy targets everyday realities in my community. So in a way, while I wait for policies to shift and change, which can take a long while in the now I am able to provide a space for the women. So it's an alternative healing space, a space of resistance, where women are taking control of their healing and mental health and well being, and it is run for the women and by the women. So there are no counselors, no doctors, there are no normative ways of healing or coping. But of course, outside of this space, we do have the women who can and do seek counseling or therapy because that is still an important aspect, yes. But it is a resistance space, saying that there are other ways of healing and coping, that do not need to be the normative therapy, medication style, it is also linked to their own traditions, and the healing strategies. So one aspect of my research is social justice, and the creation of this safe spaces for the women through, for example, the peer system, where women can be in a space that has no repercussions, where what they say, is not viewed as ingratitude, or where they can air their grievances, or their complaints about an unfair system that functions on systemic racism. So in trying to shift policy norms and beliefs at the grassroot level, discrimination based on sexism, racism, and colonialization, comes to the forefront. Because the narratives of the women, the stories of the women, whether it's the women I've interviewed, or whether it's the women located in the peer group at the grassroot location, those narratives are located in the legacy of racism and colonization, because they are raced bodies. So the experiences are not the same as those of women who are not from Africa. For example, children of refugees who arrived from Portugal were greeted at the airport with much fanfare and teddy bears. But at the same time, the children of refugees coming from Somalia did not have the same treatment. So refugees in Africa, actually spent the most amount of time in refugee camps where we have third and fourth generation refugees being born in camps. And are rarely government sponsored to Canada, or are rarely sponsored through the private system, as we saw with the Syrian refugee crisis. So we see a level of systemic racism at play within policies and institutions that reflect a wider general public attitude. And this impacts the funding that comes to grassroots organizations. And so you will find that certain organizations will be funded, and others are not. And if you investigate, there's a level of discrimination connected to systemic racism that is at play. 


Tin Vo  18:44

So what aspects of the space helps to ensure that there is safety among all participants?


Rosemary Dupuis  18:52

So the space is one that only includes refugee women or women with refugee backgrounds, it is held in a space that is not available to other people. If you're not part of the group, you would not know where the meeting is happening, or when the meeting times are happening. So it's this space that we have our mission and vision, where each and every one of us when we enter this space has aspects to abide with the mission and vision statement of the space that holds the privacy and confidentiality of what happens in the space. So what is discussed does not go beyond the boundaries of that space. And there's nothing that can be said, taken as negative, because we all have diverse experiences. 


Tin Vo  19:46

So you talked about these key messages and the findings that fell out of the research that you've conducted. So could you maybe reflect on how you relate to those findings and what resonates with you personally? 


Rosemary Dupuis  20:00

In the process of doing my research and collecting the interviews, one of the things that came through, although I would not reference it as a key message, but actually a key barrier that came through was language, and how language functions when we think of funding of coping of healing. When we think of resilience, and even define what is trauma, what is well being, what does healing look like for the women, as opposed to what does that look like for policymakers. So language was something that connects both the process of my research data collection that came through as a barrier, but also connects to the peer group advocacy work in that as a black female born in Kenya, Kenya, being a former British colony, English is my first language. So when I came to Canada, language was not something I struggled with. So I was able to navigate the system almost seamlessly, not completely, because I'm still a black woman, I'm a raced body. But in terms of language, I was able to navigate the system in a way that in many situations, I did not need to infer or need a translator to understand what the other person was saying. Because I have a high level English language communication ability. So when I was doing the interviews, I realized just how much that was a significant advantage for me, for many of the women, English and French are not primary languages. And so them navigating the system, including even the interview process was difficult. And it's where we're jumping from one language to the other language, to have communication, or where we need a translator, as part of the process, because language became this significant barrier. So I realized that going into it, as much as I knew language was a barrier. I didn't realize that as a researcher language posits me as a westernized researcher, as opposed to being part of my community. So the ability to be able to communicate fluently in Canada's first language, almost separated me from the women I'm interviewing, because that for them is a barrier, it is not for me. So I got to learn that language, whether English or French, has a significant trajectory to women, refugees, futures, what they can and cannot do within the Canadian state, and what dreams they can and cannot pursue, are deeply rooted in how you understand and communicate. And so one of the things that I realized I must do having encountered that is that my dissertation has to be in its entirety, translated into Swahili and Arabic for the women to read what they have contributed to. Because if I give them an English and French version, I am part of the problem within the system. And so if I'm talking about transforming the spaces they inhabit, then I have to be able to meet them at their space at their level, and realize that even as a black woman in Canada, I am experiencing a certain level of privilege based on my ability to communicate in English as a first language. So there is a way that language for me then becomes so important in how this individual narratives are given to me by the women, and they are given to me by the women, become a powerful collective narrative that tells their stories, and language becomes the central theme that connects my research to their lived experiences.


Tin Vo  24:20

So you talked about creating almost like a transformative research findings. And so creating almost this dissertation for the masses and for the people, what are the next steps for this research?


Rosemary Dupuis  24:36

At this part of it, you have to recollect the data when certain findings come up, you want to go back and re-interview some of the women in relation to what you have found just to clarify, so that's one of the things that is coming through. And the other, of course, is the analysis. And for me, it's this idea of how do I translate this into meaningful action at the policy level? That would be the next steps, how does all this data all this information, get translated in a way that transforms policies connected to how women access their mental health services, and how they heal and cope?


Tin Vo  25:18

Rosemary, you talked earlier about these spaces of resistance, where you are resisting social norms around what healing looks like for these refugee women. And so I'm very curious to understand how this interfaces with policy. And so you're resisting social norms, is there a connection between resisting policies that exist, and as you talked earlier, a lot of the policies that do exist, there is a gap in being able to properly meet the wellbeing needs of these refugee women in Canada.


Rosemary Dupuis  25:55

When we talk about on the ground spaces, such as the peer group spaces, these are not spaces that are funded by the government or even private funding. And mostly because of course, these spaces are run by the women and for the women, and therefore do not connect with the policy level aspect of governance. So lack of funding means that you cannot hold simple things, even as workshops that connect policymakers to the women. So even in situations that funding does happen. So for example, immigration resettlement programs, that funding is connected to quotas, it's not connected to the quality of the services, but rather, the quantity, the amount of people we can pass through the door. And of course, there's an economics perspective to that for the government. It's this idea, "we want to process the people through the doors as fast as possible and as many as possible". And if you don't meet those quotas, your funding gets cut, because you have to justify as a not for profit, where your funding is going and how you use the funding. So this gap not only in that grassroots organizations do not get funding. But there's also the gap between policy and the lived realities of even settlement organizations that have been funded in terms of how the money is being used. And sometimes if we are discussing private funding, which can impact policy, as we've seen, with the Bill and Melinda Gates Foundation, or the Clinton Foundation, those specific foundations of private sponsored funding, comes with certain obligations, that grassroot organizations may not be able to perform or achieve, because their mandate, their mission, their vision, their agenda is very different from the funding organizations. So this gap is always there. And how we close this gap is where research becomes fundamental, but not just research for us at the PhD level, but research even within the settlement organizations, and how we connect researchers to the settlement organizations to policymakers, so that we can start closing this gap with evidence based information and create policies that are evidence based.


Tin Vo  28:27

How has the COVID-19 pandemic impacted your dissertation?


Rosemary Dupuis  28:32

That is interesting. One of the key aspects of data collection, especially when you are addressing women who have gone through violent, traumatic events, is that interviews are normally done face to face, because there's an aspect of well being that has to be woven into the interview. And so the pandemic has created isolation. So interviews are being done through Zoom. And one of the downsides of that is that you cannot actually guarantee that the woman you're interviewing is in a safe space. She could be in the location where her abuser is, she could be in a location that she's not comfortable with others knowing the information she's providing you. But I cannot guarantee that confidentiality and privacy because it's Zoom and she chooses where she feels that happens. And so how you go through the process of interviewing through Teams, or Zoom that the virtual space is very different from how those interviews would be if you're doing a face to face interview. So I would say there is an impact on the quality of the interviews and there's also this impact of women refugees or women with refugee backgrounds congregate in certain spaces. But with a pandemic, these spaces either shut down, or they're very limited. So even accessing your primary target group becomes difficult to the pandemic. Secondly, because these spaces were places that provided some level of well being, their absence affects their mental health. And that comes through in the interviews as well, where women will say, we cannot access that anymore, you know, I don't get to meet with my friends. I'm lonely, you know. And that was not an aspect that I was going to address at all at the beginning of the whole process. So that is a direct COVID impact.


Tin Vo  30:50

Well, thank you very much for your time today and for sharing your research with me.


Rosemary Dupuis  30:56

Thank you, Tin. It was my pleasure to be here and to talk about my research. I am looking forward to hearing about your research in our next episode. 


Shawna Reibling  31:04

Thank you to you both for chatting about your research. In the next episode, Rosemary and Tin will continue to chat about Tin's research area.



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Shawna Reibling  31:21

Please subscribe to Research Chat on your favorite podcast player to hear new episodes. Visit to read a follow up article show notes and related links. Research Chat is a partnership between the Office of Research Services, the Faculty of Graduate and Postdoctoral Studies and the Laurier Library. Thank you to everyone who's contributed to the creation of Research Chat. A gratitude list can be found on our webpage.



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