“Whenever I remember I shed tears and can’t speak”: A thematic analysis of trauma experiences and resiliency amongst displaced women fleeing the Sudan war
Main Article Content
Abstract
Background: The ongoing war in Sudan has resulted in the world’s largest humanitarian crisis to date, and the widespread violence and displacement has resulted in poor mental health outcomes. This study explores the mental health impact of violence and displacement on women and girls fleeing the conflict in Sudan to South Sudan.
Methods: A cross sectional, mixed methods study was conducted in South Sudanese settlement sites in July 2024. The study gathered data on women’s and girls’ experiences of migration across the border from Sudan to South Sudan at Aweil North, using a sensemaking approach which captured micronarratives from participants aged 13+. Qualitative data were screened manually for inclusion, and narratives related to mental health and resilience were analyzed thematically.
Results: A total of 327 narratives were included in the study. Main themes included experiences of psychological trauma, impact of trauma, life at settlement centres and resilience. Our study found high levels of traumatic experiences amongst study participants, including sexual violence, death or killing of a family member, torture, and abduction, with a wide range of mental health impacts. The lack of support and services at settlement centres appeared to compound these concerns. Despite adversity many participants demonstrated resilience, indicating the potential for post-traumatic growth.
Conclusions: Our study found strong evidence of the mental health impact of the ongoing war and insufficient aid in South Sudanese settlement centres amongst women and girls. As resilient behaviours were found amongst study participants, interventions which harness resiliency may help foster post-traumatic growth in this population. Finally, as both mental health research and humanitarian response in this area are often overlooked, there is a clear need for coordinated advocacy efforts to increase mental health support and services in response to this ongoing conflict.
Keywords:
war-related trauma, women and girls, mental health, resilience, thematic analysis, Sudan conflict, South Sudan refugees
Article Details
How to Cite
PETZ, Jess F. et al.
“Whenever I remember I shed tears and can’t speak”: A thematic analysis of trauma experiences and resiliency amongst displaced women fleeing the Sudan war.
Medical Research Archives, [S.l.], v. 14, n. 2, feb. 2026.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7314>. Date accessed: 14 apr. 2026.
doi: https://doi.org/10.18103/mra.v14i2.7314.
Keywords
Mental health, resilience, displacement, Sudan, South Sudan, Women
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. D’Agoôt M. Beyond state capture: the case of the Rapid Support Forces (RSF) in Sudan. Small Wars & Insurgencies. 2025;36(4):1-29. https://doi.org/10.1080/09592318.2025.2464435
2. Savage R. Sudan in “world’s largest humanitarian crisis” after two years of civil war. The Guardian. Published April 15, 2025. https://www.theguardian.com/world/2025/apr/15/sudan-in-worlds-largest-humanitarian-crisis-after-two-years-of-civil-war
3. de Waal A. Lineages of Genocide in Sudan. Journal of Genocide Research. Published online April 29, 2025:1-19. https://doi.org/10.1080/14623528.2025.2495792
4. Gallopin JB. “The Massalit Will Not Come Home.” Human Rights Watch. Published online May 9, 2024. https://www.hrw.org/report/2024/05/09/massalit-will-not-come-home/ethnic-cleansing-and-crimes-against-humanity-el
5. Konozy HE. Sudan’s devastating war: unravelling its multifaceted impact. Medicine, Conflict and Survival. 2023;40(1):1-5. https://doi.org/10.1080/13623699.2023.2299736
6. Konozy EHE, Baleela RMH. The Rapid Support Forces (RSF): the militia that ruined Sudanese lives. Medicine, Conflict and Survival. 2025;41(3):1-9. https://doi.org/10.1080/13623699.2025.2524890
7. New Satellite Evidence Shows Mass Graves Following Paramilitary Massacre in Sudanese City. FDD. Published November 6, 2025. https://www.fdd.org/analysis/2025/11/06/new-satellite-evidence-shows-mass-graves-following-paramilitary-massacre-in-sudanese-city/
8. Ardianti P, Fidela MR, Setiawan ZZ, Suratiningsih D. Motives of extremism movements of Sudan rapid support forces in the Sudan conflict 2023. Tirtayasa Journal of International Law. 2024;3(1):85-102.
9. Raymond NA, Howarth C. HUMAN SECURITY EMERGENCY Day Two of RSF Control: Mass Killings Continue in El-Fasher.; 2025. https://files-profile.medicine.yale.edu/documents/b9c14991-6b22-492e-9e16-f903d25d9b49
10. Sudan Crisis: Displacement in Sudan and Mixed Cross-Border Movement Overview | Displacement Tracking Matrix. dtm.iom.int. Published 2025. https://dtm.iom.int/node/24896
11. Osman M. Sudan Conflict Fuels World’s Largest Internal Displacement. Human Rights Watch. Published January 31, 2024. https://www.hrw.org/news/2024/01/31/sudan-conflict-fuels-worlds-largest-internal-displacement
12. Goldhagen J, Elkrail SE, Affan A. Responding to the humanitarian crisis in Sudan. BMJ Paediatrics Open. 2024;8(1):e002893. https://doi.org/10.1136/bmjpo-2024-002893
13. Two years of war in Sudan: An updated picture of the humanitarian impact (April 2025) - Sudan. ReliefWeb. Published April 15, 2025. https://reliefweb.int/report/sudan/two-years-war-sudan-updated-picture-humanitarian-impact-april-2025
14. Osman AHM, Bakhiet A, Elmusharaf S, Omer A, Abdelrahman A. Sudan’s mental health service: challenges and future horizons. BJPsych International. 2019;17(1):17-19. https://doi.org/10.1192/bji.2019.19
15. World Health Organization. Sudan Conflict and Refugee Crisis: Multi-Country External Situation Report N.2 Sudan Conflict and Refugee Crisis Multi-Country External Situation Report N. 2.; 2024. Accessed January 13, 2026. https://cdn.who.int/media/docs/default-source/documents/emergencies/situation-reports/20240717_sudan-emergency-sitrep-2.pdf
16. Goldsmith A, Cockcroft-McKay C. Mental health in South Sudan: a case for community-based support. Disasters. 2019;43(3):534-554.
17. De Graaff A. Integrating mental health services into primary health care in South Sudan: a case study. HealthNet TPO/Dutch Consortium for Rehabilitation; 2015.
18. Ayazi T, Lien L, Eide A, Shadar EJS, Hauff E. Community attitudes and social distance towards the mentally ill in South Sudan: a survey from a post-conflict setting with no mental health services. Soc Psychiatry Psychiatr Epidemiol. 2014;49(5):771-780.
19. Hussein MF, Saleeb M, Tolba B, et al. Assessment of post-traumatic stress disorder and well-being among Sudanese during the ongoing war: a cross-sectional study. BMC Psychol. 2025; 13(1):181.
20. Khalil KA, Mohammed GTF, Ahmed ABM, et al. War-related trauma and posttraumatic stress disorder in refugees, displaced, and nondisplaced people during armed conflict in Sudan: a cross-sectional study. Confl Health. 2024;18(1):66.
21. Mohammed Bilal M, Elnour SMB, Elmahdi ZZ, Ahmed EMM. Mental health consequences among Sudanese due to the armed conflicts and civil unrest of 2023: a cross-sectional study. Int J Soc Psychiatry. 2024;70(3):563-573. doi:10.1177/0020 7640231221101
22. Heltne U, Dybdahl R, Sharif S, Breidlid A. Local adults’ perceptions of adverse experiences and psychosocial consequences among refugee children in Sudan and South Sudan. Child Youth Serv Rev. 2025;108368.
23. Alfahal MS. Sudan’s mental health landscape: evaluating mental health system and strategic opportunities in a conflict-affected nation. EC Psychol Psychiatry. 2025;14:01-09.
24. Elidressi S, Ahmedalgabri R, Ali R, Elhardlu H. Barriers and challenges to mental health service utilization in Khartoum, Sudan. BJPsych Open. 2025;11(S1):S5-S5.
25. REACH. Humanitarian situation overview: Aweil East and Northern Bahr el Ghazal. Published 2024. https://reliefweb.int/report/south-sudan/humanitarian-situation-overview-aweil-east-and-northern-bahr-el-ghazal-october-2024-aweil-east-northern-bahr-el-ghazal-south-sudan
26. Médecins Sans Frontières. Fleeing war, seeking hope: the struggle for survival in South Sudan’s Renk County. ReliefWeb. Published 2025. https://reliefweb.int/report/south-sudan/fleeing-war-seeking-hope-struggle-survival-south-sudans-renk-county
27. Médecins Sans Frontières. South Sudan: a crisis within a crisis as people fleeing conflict in Sudan struggle for survival. Published 2023. https://www.doctorswithoutborders.ca/south-sudan-a-crisis-within-a-crisis-as-people-fleeing-conflict-in-sudan-struggle-for-survival/
28. HealthNet TPO. Sudan conflict: supporting South Sudanese returnees. https://healthnettpo.org/post/sudan-conflict-supporting-south-sudanese-returnees/
29. Bashir S, Eltayeb S, Badri A. Exploring trauma and resilience of urban South Sudanese refugees in Sudan. Comp Migr Stud. 2024;12(1):57.
30. Betancourt TS, Newnham EA, Layne CM, et al. Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States. J Trauma Stress. 2012;25(6):682-690.
31. Ellis BH, MacDonald HZ, Lincoln AK, Cabral HJ. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol. 2008;76(2):184.
32. Miller KE, Rasmussen A. The mental health of civilians displaced by armed conflict: an ecological model of refugee distress. Epidemiol Psychiatr Sci. 2017;26(2):129-138.
33. Chandiru Drama J, Abdalla BE, Lindrio PI, et al. “This caused our journey”: the relationship between sexual and gender-based violence and cross-border Sudan to South Sudan migration. Confl Health. 2025;19(1):58. doi:10.1186/s13031-025-00699-5
34. Urquhart C, Cheuk B, Lam L, Snowden D. Sense-making, sensemaking and sense making—a systematic review and meta-synthesis of literature in information science and education. J Assoc Inf Sci Technol. 2025;76(1):3-97.
35. Van der Merwe SE, Biggs R, Preiser R, et al. Making sense of complexity: using SenseMaker as a research tool. Systems. 2019;7(2):25.
36. Mukumbang FC, Adebiyi BO. Using resilience theory to understand and address migrant pandemic precarity among South African migrant populations. Arch Public Health. 2025;83(1):89. doi:10.1186/s13690-025-01573-9
37. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.
38. American Psychological Association. Resilience. https://www.apa.org/topics/resilience
39. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi:10.1191/1478088706qp063oa
40. Joffe H. Thematic analysis. In: Harper D, Thompson A, eds. Qualitative Research Methods in Mental Health and Psychotherapy. Wiley-Blackwell; 2012:203-223.
41. Charlson F, van Ommeren M, Flaxman A, Cornett J, Whiteford H, Saxena S. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet. 2019;394(10194):240-248.
42. Kakaje A, Al Zohbi R, Aldeen OH, et al. Mental disorder and PTSD in Syria during wartime: a nationwide crisis. BMC Psychiatry. 2021;21(1):2.
43. Mesa-Vieira C, Haas AD, Buitrago-Garcia D, et al. Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis. Lancet Public Health. 2022;7 (5):e469-e481.
44. UNHCR. South Sudan population overview of refugees and asylum-seekers. Published 2025.
45. Eltayeb S, Badri A. Exposure to violence and psychosocial trauma among Sudanese survivors. J Aggress Confl Peace Res. 2025;17(1):57-75. doi: 10.1108/JACPR-07-2024-0926
46. Kizilhan JI, Berger T, Sennhauser L, Wenzel T. The psychological impact of genocide on the Yazidis. Front Psychol. 2023;14:1074283. doi:10.33 89/fpsyg.2023.1074283
47. Meffert SM, Marmar CR. Darfur refugees in Cairo: mental health and interpersonal conflict in the aftermath of genocide. J Interpers Violence. 2009;24(11):1835-1848. doi:10.1177/0886260508325491
48. Rugema L, Mogren I, Ntaganira J, Krantz G. Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide. BMJ Open. 2015;5(6):e006778. doi:10.1136/bmjopen-2014-006778
49. Meierhenrich J. The trauma of genocide. J Genocide Res. 2007;9(4):549-573. doi:10.1080/14 623520701643327
50. Roberts B, Damundu EY, Lomoro O, Sondorp E. The influence of demographic characteristics, living conditions, and trauma exposure on the overall health of a conflict-affected population in Southern Sudan. BMC Public Health. 2010;10(1):518.
51. Lane R, Taylor H, Ellis F, Rushworth I, Chiu K. Resilience and its association with mental health among forcibly displaced populations: a systematic review and meta-analyses. J Affect Disord. 2025.
52. Siriwardhana C, Ali SS, Roberts B, Stewart R. A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants. Confl Health. 2014;8(1):13.
53. Fayaz I. Role of religion in posttraumatic growth among population exposed to armed conflict: a systematic review. Ment Health Relig Cult. 2023;26(5):455-469. doi:10.1080/13674676. 2023.2237909
54. Russo-Netzer P, Tarrasch R, Saar-Ashkenazy R, Guez J. Meaning and resilience in war-affected populations during crisis. Front Psychiatry. 2025; 16:1678205.
55. Kimhi S, Baran M, Baran T, et al. Prediction of societal and community resilience among Ukrainian and Polish populations during the Russian war against Ukraine. Int J Disaster Risk Reduct. 2023; 93:103792.
56. Lancaster SL, Gaede C. A test of a resilience-based intervention for mental health problems in Iraqi internally displaced person camps. Anxiety Stress Coping. 2020;33(6):698-705.
57. Peterson C, Park N, Pole N, D’Andrea W, Seligman MEP. Strengths of character and posttraumatic growth. J Trauma Stress. 2008;21(2):214-217.
58. Subandi MA, Achmad T, Kurniati H, Febri R. Spirituality, gratitude, hope and post-traumatic growth among survivors of the 2010 eruption of Mount Merapi. Australas J Disaster Trauma Stud. 2014;18(1):19.
59. Askay SW, Magyar-Russell G. Post-traumatic growth and spirituality in burn recovery. Int Rev Psychiatry. 2009;21(6):570-579.
60. Schweitzer R, Melville F, Steel Z, Lacherez P. Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry. 2006;40(2):179-187.
61. Vernon LL, Dillon JM, Steiner AR. Proactive coping, gratitude, and posttraumatic stress disorder in college women. Anxiety Stress Coping. 2009;22(1):117-127.
62. Thabet A, Ghandi S, Barker EK, Rutherford G, Malekinejad M. Interventions to enhance psychological resilience in forcibly displaced children: a systematic review. BMJ Glob Health. 2023;8(2).
63. Tol WA, Barbui C, Galappatti A, et al. Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet. 2011;378(9802):1581-1591.
64. Tol WA, Stavrou V, Greene MC, et al. Sexual and gender-based violence in areas of armed conflict: a systematic review of mental health and psychosocial support interventions. Confl Health. 2013;7(1):16.
2. Savage R. Sudan in “world’s largest humanitarian crisis” after two years of civil war. The Guardian. Published April 15, 2025. https://www.theguardian.com/world/2025/apr/15/sudan-in-worlds-largest-humanitarian-crisis-after-two-years-of-civil-war
3. de Waal A. Lineages of Genocide in Sudan. Journal of Genocide Research. Published online April 29, 2025:1-19. https://doi.org/10.1080/14623528.2025.2495792
4. Gallopin JB. “The Massalit Will Not Come Home.” Human Rights Watch. Published online May 9, 2024. https://www.hrw.org/report/2024/05/09/massalit-will-not-come-home/ethnic-cleansing-and-crimes-against-humanity-el
5. Konozy HE. Sudan’s devastating war: unravelling its multifaceted impact. Medicine, Conflict and Survival. 2023;40(1):1-5. https://doi.org/10.1080/13623699.2023.2299736
6. Konozy EHE, Baleela RMH. The Rapid Support Forces (RSF): the militia that ruined Sudanese lives. Medicine, Conflict and Survival. 2025;41(3):1-9. https://doi.org/10.1080/13623699.2025.2524890
7. New Satellite Evidence Shows Mass Graves Following Paramilitary Massacre in Sudanese City. FDD. Published November 6, 2025. https://www.fdd.org/analysis/2025/11/06/new-satellite-evidence-shows-mass-graves-following-paramilitary-massacre-in-sudanese-city/
8. Ardianti P, Fidela MR, Setiawan ZZ, Suratiningsih D. Motives of extremism movements of Sudan rapid support forces in the Sudan conflict 2023. Tirtayasa Journal of International Law. 2024;3(1):85-102.
9. Raymond NA, Howarth C. HUMAN SECURITY EMERGENCY Day Two of RSF Control: Mass Killings Continue in El-Fasher.; 2025. https://files-profile.medicine.yale.edu/documents/b9c14991-6b22-492e-9e16-f903d25d9b49
10. Sudan Crisis: Displacement in Sudan and Mixed Cross-Border Movement Overview | Displacement Tracking Matrix. dtm.iom.int. Published 2025. https://dtm.iom.int/node/24896
11. Osman M. Sudan Conflict Fuels World’s Largest Internal Displacement. Human Rights Watch. Published January 31, 2024. https://www.hrw.org/news/2024/01/31/sudan-conflict-fuels-worlds-largest-internal-displacement
12. Goldhagen J, Elkrail SE, Affan A. Responding to the humanitarian crisis in Sudan. BMJ Paediatrics Open. 2024;8(1):e002893. https://doi.org/10.1136/bmjpo-2024-002893
13. Two years of war in Sudan: An updated picture of the humanitarian impact (April 2025) - Sudan. ReliefWeb. Published April 15, 2025. https://reliefweb.int/report/sudan/two-years-war-sudan-updated-picture-humanitarian-impact-april-2025
14. Osman AHM, Bakhiet A, Elmusharaf S, Omer A, Abdelrahman A. Sudan’s mental health service: challenges and future horizons. BJPsych International. 2019;17(1):17-19. https://doi.org/10.1192/bji.2019.19
15. World Health Organization. Sudan Conflict and Refugee Crisis: Multi-Country External Situation Report N.2 Sudan Conflict and Refugee Crisis Multi-Country External Situation Report N. 2.; 2024. Accessed January 13, 2026. https://cdn.who.int/media/docs/default-source/documents/emergencies/situation-reports/20240717_sudan-emergency-sitrep-2.pdf
16. Goldsmith A, Cockcroft-McKay C. Mental health in South Sudan: a case for community-based support. Disasters. 2019;43(3):534-554.
17. De Graaff A. Integrating mental health services into primary health care in South Sudan: a case study. HealthNet TPO/Dutch Consortium for Rehabilitation; 2015.
18. Ayazi T, Lien L, Eide A, Shadar EJS, Hauff E. Community attitudes and social distance towards the mentally ill in South Sudan: a survey from a post-conflict setting with no mental health services. Soc Psychiatry Psychiatr Epidemiol. 2014;49(5):771-780.
19. Hussein MF, Saleeb M, Tolba B, et al. Assessment of post-traumatic stress disorder and well-being among Sudanese during the ongoing war: a cross-sectional study. BMC Psychol. 2025; 13(1):181.
20. Khalil KA, Mohammed GTF, Ahmed ABM, et al. War-related trauma and posttraumatic stress disorder in refugees, displaced, and nondisplaced people during armed conflict in Sudan: a cross-sectional study. Confl Health. 2024;18(1):66.
21. Mohammed Bilal M, Elnour SMB, Elmahdi ZZ, Ahmed EMM. Mental health consequences among Sudanese due to the armed conflicts and civil unrest of 2023: a cross-sectional study. Int J Soc Psychiatry. 2024;70(3):563-573. doi:10.1177/0020 7640231221101
22. Heltne U, Dybdahl R, Sharif S, Breidlid A. Local adults’ perceptions of adverse experiences and psychosocial consequences among refugee children in Sudan and South Sudan. Child Youth Serv Rev. 2025;108368.
23. Alfahal MS. Sudan’s mental health landscape: evaluating mental health system and strategic opportunities in a conflict-affected nation. EC Psychol Psychiatry. 2025;14:01-09.
24. Elidressi S, Ahmedalgabri R, Ali R, Elhardlu H. Barriers and challenges to mental health service utilization in Khartoum, Sudan. BJPsych Open. 2025;11(S1):S5-S5.
25. REACH. Humanitarian situation overview: Aweil East and Northern Bahr el Ghazal. Published 2024. https://reliefweb.int/report/south-sudan/humanitarian-situation-overview-aweil-east-and-northern-bahr-el-ghazal-october-2024-aweil-east-northern-bahr-el-ghazal-south-sudan
26. Médecins Sans Frontières. Fleeing war, seeking hope: the struggle for survival in South Sudan’s Renk County. ReliefWeb. Published 2025. https://reliefweb.int/report/south-sudan/fleeing-war-seeking-hope-struggle-survival-south-sudans-renk-county
27. Médecins Sans Frontières. South Sudan: a crisis within a crisis as people fleeing conflict in Sudan struggle for survival. Published 2023. https://www.doctorswithoutborders.ca/south-sudan-a-crisis-within-a-crisis-as-people-fleeing-conflict-in-sudan-struggle-for-survival/
28. HealthNet TPO. Sudan conflict: supporting South Sudanese returnees. https://healthnettpo.org/post/sudan-conflict-supporting-south-sudanese-returnees/
29. Bashir S, Eltayeb S, Badri A. Exploring trauma and resilience of urban South Sudanese refugees in Sudan. Comp Migr Stud. 2024;12(1):57.
30. Betancourt TS, Newnham EA, Layne CM, et al. Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States. J Trauma Stress. 2012;25(6):682-690.
31. Ellis BH, MacDonald HZ, Lincoln AK, Cabral HJ. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol. 2008;76(2):184.
32. Miller KE, Rasmussen A. The mental health of civilians displaced by armed conflict: an ecological model of refugee distress. Epidemiol Psychiatr Sci. 2017;26(2):129-138.
33. Chandiru Drama J, Abdalla BE, Lindrio PI, et al. “This caused our journey”: the relationship between sexual and gender-based violence and cross-border Sudan to South Sudan migration. Confl Health. 2025;19(1):58. doi:10.1186/s13031-025-00699-5
34. Urquhart C, Cheuk B, Lam L, Snowden D. Sense-making, sensemaking and sense making—a systematic review and meta-synthesis of literature in information science and education. J Assoc Inf Sci Technol. 2025;76(1):3-97.
35. Van der Merwe SE, Biggs R, Preiser R, et al. Making sense of complexity: using SenseMaker as a research tool. Systems. 2019;7(2):25.
36. Mukumbang FC, Adebiyi BO. Using resilience theory to understand and address migrant pandemic precarity among South African migrant populations. Arch Public Health. 2025;83(1):89. doi:10.1186/s13690-025-01573-9
37. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.
38. American Psychological Association. Resilience. https://www.apa.org/topics/resilience
39. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi:10.1191/1478088706qp063oa
40. Joffe H. Thematic analysis. In: Harper D, Thompson A, eds. Qualitative Research Methods in Mental Health and Psychotherapy. Wiley-Blackwell; 2012:203-223.
41. Charlson F, van Ommeren M, Flaxman A, Cornett J, Whiteford H, Saxena S. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet. 2019;394(10194):240-248.
42. Kakaje A, Al Zohbi R, Aldeen OH, et al. Mental disorder and PTSD in Syria during wartime: a nationwide crisis. BMC Psychiatry. 2021;21(1):2.
43. Mesa-Vieira C, Haas AD, Buitrago-Garcia D, et al. Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis. Lancet Public Health. 2022;7 (5):e469-e481.
44. UNHCR. South Sudan population overview of refugees and asylum-seekers. Published 2025.
45. Eltayeb S, Badri A. Exposure to violence and psychosocial trauma among Sudanese survivors. J Aggress Confl Peace Res. 2025;17(1):57-75. doi: 10.1108/JACPR-07-2024-0926
46. Kizilhan JI, Berger T, Sennhauser L, Wenzel T. The psychological impact of genocide on the Yazidis. Front Psychol. 2023;14:1074283. doi:10.33 89/fpsyg.2023.1074283
47. Meffert SM, Marmar CR. Darfur refugees in Cairo: mental health and interpersonal conflict in the aftermath of genocide. J Interpers Violence. 2009;24(11):1835-1848. doi:10.1177/0886260508325491
48. Rugema L, Mogren I, Ntaganira J, Krantz G. Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide. BMJ Open. 2015;5(6):e006778. doi:10.1136/bmjopen-2014-006778
49. Meierhenrich J. The trauma of genocide. J Genocide Res. 2007;9(4):549-573. doi:10.1080/14 623520701643327
50. Roberts B, Damundu EY, Lomoro O, Sondorp E. The influence of demographic characteristics, living conditions, and trauma exposure on the overall health of a conflict-affected population in Southern Sudan. BMC Public Health. 2010;10(1):518.
51. Lane R, Taylor H, Ellis F, Rushworth I, Chiu K. Resilience and its association with mental health among forcibly displaced populations: a systematic review and meta-analyses. J Affect Disord. 2025.
52. Siriwardhana C, Ali SS, Roberts B, Stewart R. A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants. Confl Health. 2014;8(1):13.
53. Fayaz I. Role of religion in posttraumatic growth among population exposed to armed conflict: a systematic review. Ment Health Relig Cult. 2023;26(5):455-469. doi:10.1080/13674676. 2023.2237909
54. Russo-Netzer P, Tarrasch R, Saar-Ashkenazy R, Guez J. Meaning and resilience in war-affected populations during crisis. Front Psychiatry. 2025; 16:1678205.
55. Kimhi S, Baran M, Baran T, et al. Prediction of societal and community resilience among Ukrainian and Polish populations during the Russian war against Ukraine. Int J Disaster Risk Reduct. 2023; 93:103792.
56. Lancaster SL, Gaede C. A test of a resilience-based intervention for mental health problems in Iraqi internally displaced person camps. Anxiety Stress Coping. 2020;33(6):698-705.
57. Peterson C, Park N, Pole N, D’Andrea W, Seligman MEP. Strengths of character and posttraumatic growth. J Trauma Stress. 2008;21(2):214-217.
58. Subandi MA, Achmad T, Kurniati H, Febri R. Spirituality, gratitude, hope and post-traumatic growth among survivors of the 2010 eruption of Mount Merapi. Australas J Disaster Trauma Stud. 2014;18(1):19.
59. Askay SW, Magyar-Russell G. Post-traumatic growth and spirituality in burn recovery. Int Rev Psychiatry. 2009;21(6):570-579.
60. Schweitzer R, Melville F, Steel Z, Lacherez P. Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry. 2006;40(2):179-187.
61. Vernon LL, Dillon JM, Steiner AR. Proactive coping, gratitude, and posttraumatic stress disorder in college women. Anxiety Stress Coping. 2009;22(1):117-127.
62. Thabet A, Ghandi S, Barker EK, Rutherford G, Malekinejad M. Interventions to enhance psychological resilience in forcibly displaced children: a systematic review. BMJ Glob Health. 2023;8(2).
63. Tol WA, Barbui C, Galappatti A, et al. Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet. 2011;378(9802):1581-1591.
64. Tol WA, Stavrou V, Greene MC, et al. Sexual and gender-based violence in areas of armed conflict: a systematic review of mental health and psychosocial support interventions. Confl Health. 2013;7(1):16.