Gendered lived experiences of marriage and family following exposure to chemical warfare agents: content analysis of qualitative interviews with survivors in Halabja, Kurdistan-Iraq

Abstract

ObjectiveTo study gendered experiences of the long-term effects of a chemical warfare agent (CWA; sulfur mustard).DesignQualitative face-to-face semi-structured in-depth interview study using content analysis approach with thematic analysis and anthropological inquiries.SettingThe city of Halabja in the Kurdistan Region of Iraq.ParticipantsSurvivors of CWA (n=16, female:male 10:6, mean age 45.5 years (range 34 to 67)) with lung damage diagnosis and with a range of sociodemographic variables.ResultsLatent content was expressed as: To get or not to get married? Two categories—social abandonment and uncertain marriage—emerged as expressions of the manifest content. The majority of the participants showed uncertainty as a central concern that affects all decision-making in their private and social life. Uncertainty over marriage and family were huge, corresponding to their fear of giving birth to children with congenital birth defects. Exposure to CWAs was conceptualised in terms of stigmatised illnesses, and consequently resulted in loneliness and social isolation, leading to negative impacts on other aspects of professional and social life. The results demonstrated a gendered pattern: CWA-exposed women were more affected psychosocially than CWA-exposed men. More CWA-exposed women were unemployed, divorced or single, or lived under vulnerable circumstances compared with men.ConclusionSurvivors of CWA exposure have developed a sense of gendered uncertainty around getting married and building a family. Sulfur mustard-exposed women, in particular, long to be desired in the community as they face social exclusion. Survivors should be provided evidence-based consultancy to optimise their decision-making around marriage and other social and family challenges.

The impact of sulfur mustard on quality of life and mental health in Kurdish survivors in Sweden, thirty years after exposure

“…The knowledge regarding the sex-related impacts of CWA exposure is scarce; thus, the existing data indicate long-term biopsychosocial gender differences, where female survivors are more affected than male survivors [ 13 , 22 ]. In the current study, no significant gender-related differences were found for outcomes of the RAND SF-36 variables (Table 5 ) and the MADRS-S (Table 6 ).…”

“…A new study showed that having a good relationship with a partner was associated with perceived good health [ 31 ]. In our previous study among survivors in Halabja, we revealed that SM exposure survivors suffered from poor marital relations and female survivors reported difficulties getting married which might contributed to impaired QoL [ 13 ].…”

“…There is an urgent need for more knowledge to improve medical care and treatment in preparation for CWA exposure and survivors. Previous studies reported that female survivors of CWA exposure experienced more pronounced psychosocial adverse effects than males [ 9 , 13 ].…”

Evaluation of Social Acknowledgment and Mental Health Among Kurdish Survivors of Genocide in 1988

“…This study focuses on the psychosocial situation of Kurdish survivors after over 30 years. Given that survivors previously reported stigmatization as a result of their experiences, 4 , 5 we anticipated that more genocide-related trauma would be associated with less perceived social acknowledgment and higher psychopathology.…”

Collective Memory in Post-Genocide Societies: Rethinking Enduring Trauma and Resilience in Halabja

“…M-Hasan wrote about enduring PTSD among Halabja residents, 15 and Moradi et al focused on survivor accounts with regards to their perceptions of marriage and fears of bearing children with birth defects. 16 Nicole Watt's work examined the politics of commemoration in Halabja at the local level, 17 Mlodoch laid out the groundwork for a better understanding of victims' discourses and contested memory in post-genocide societies, 18 and Moradi demonstrated the politics of genocide commemoration and its impact on survivors of the Kurdish genocide. 19 Finally, Six-Hohenbalken 20 and Toivanen and Baser 21 looked at commemoration practices in the diaspora and how the legacy of the genocide is transmitted to the diaspora youth.…”