Search the XCEPT
content database.

Tag Archive: trauma

  1. Aid cuts, differentiated assistance, and implications for fatherhood in Kakuma refugee camp, Kenya

    Comments Off on Aid cuts, differentiated assistance, and implications for fatherhood in Kakuma refugee camp, Kenya

    Centring local knowledge and voices is key to conducting impactful research. On the Cross-border Conflict, Evidence, Policy and Trends (XCEPT) research programme, we are collaborating with South Sudanese poet, Peter Kidi. His poetry highlights the human experience behind many of the themes we explore on XCEPT – including the effect that material factors like food insecurity have on undermining social structures and community relationships – provoking all of us to think more deeply about the reality of our research.

    Around the world, governments are slashing aid budgets in favour of increased spending on defence. These cuts have had a devastating impact on the provision of humanitarian services in many parts of the world, and experts warn that this could cause millions of avoidable deaths.[i] In Kakuma camp – Kenya’s second largest refugee camp – a new system of aid delivery, known as Differentiated Assistance, has been introduced in response to the cuts. This system is not just denying people access to food, but is stripping away their sense of agency. As parents face the heartbreaking reality of not being able to feed their children, it is having a significant impact on mental health, family structures, and family cohesion.

    The aid cuts in Kakuma

    USAID had funded over two-thirds of refugee food aid in Kenya, and Kakuma’s population felt the brunt of the cuts almost immediately. Faced with a severe funding shortfall, the World Food Programme (WFP) and UNHCR halted the Bamba Chakula cash transfer initiative, and, in an attempt to ensure that the most vulnerable continued to receive aid, they introduced the Differentiated Assistance framework.[ii] Under this system, households have been placed into categories of ‘need’, according to their perceived vulnerability. Households in categories 1, 2, and 3 are entitled to receive food rations at 55 percent, 35 percent, and 20 percent of the recommended minimum food basket respectively. Those in category 4 are deemed to have the ability to meet basic needs and so receive nothing.

    The WFP and UNHCR have since reintroduced Bamba Chakula for those in categories 1, 2, and 3, but there are concerns about the reliability of the categorisations.[iii] There are also some households that have not yet been categorised or who have found themselves removed from the system in the second cycle. Not only this, but the assumption that those who don’t receive aid can find other sources of income is troubling. It is very difficult to find work in Kakuma, and the new system is exacerbating the problem. Although Differentiated Assistance was introduced in response to the funding cuts, it is also part of the Kenyan government’s longer-term strategy to promote self-reliance amongst refugees.[iv] Yet, when assistance is reduced, it also reduces purchasing power.[v] This means that local traders in Kakuma can no longer rely on customers, which undermines their ability to be self-reliant.

    Peter Kidi, observational poet

    Peter is 24 years old and was born in Kakuma after his family fled their home in what is now South Sudan, during the second Sudanese Civil War (1983 – 2005). A self-taught poet, he has spent the last ten months documenting the reality of the aid cuts on the ground in Kakuma. Peter spends much of his time observing, listening, and reflecting upon what he sees and hears in ‘normal’ spaces in the camp, such as in the market, the street, and within his own family. He has recently been working on a collection of poems focused on fatherhood, showing how the cuts have increased the difficulties of being able to fulfil the expected social role of being a father. One of his poems that highlights these difficulties is The father who stopped building.

    The father who stopped building

    Before the dust and the borders,
    ‎his hands could tame timber,
    ‎nails bent to his will,
    ‎and walls stood because he told them to.
    ‎He was the kind of man
    ‎whose shadow looked like a scaffold,
    ‎and every house he raised
    ‎was a promise to his children
    ‎that they would always be safe.

    ‎Now,
    ‎he sits in the shade of a leaning shelter,
    ‎eyes fixed on something only he can see.
    ‎The hammer sleeps under his bed,
    ‎its handle cracked and thirsty,
    ‎its head cold with silence.

    ‎I’ve seen him watch
    ‎the wind pull at the plastic walls,
    ‎as if the gusts are old friends
    ‎reminding him of roofs he once built
    ‎roofs that kept rain from his children’s beds,
    ‎that held the sound of their laughter inside.

    ‎But here,
    ‎there is no wood worth cutting,
    ‎only thin poles,
    ‎plastic sheets that rip in the sun,
    ‎and rations that feed the body
    ‎but starve the pride.
    ‎He can no longer build them a home,
    ‎only watch the years
    ‎and the dust settle around them.

    ‎At night, they say,
    ‎he dreams in brick dust,
    ‎hears the rhythm of nails finding home,
    ‎and builds a house in his sleep
    ‎with doors wide enough
    ‎to let his children run through laughing,
    ‎and his manhood
    ‎walk in after them.

    Expectations of fatherhood in Kakuma

    Understandings of fatherhood vary cross-nationally, but a traditional gendered order is the norm amongst populations in Kakuma camp, who predominantly come from South Sudan, Burundi, and the Democratic Republic of Congo.[vi] In this context, the father is associated with being the provider of resources, while mothers are associated more directly with the caring and nurturing of children.[vii] Fatherhood is also traditionally aligned with being the ‘protector’ of the family: within the home, from economic hardship, and from security threats.[viii] In addition to providing for the family, fathers are expected to give advice, love, and guidance to their children, whilst also being a role model to their male children.[ix] Importantly, a father is supposed to be able to provide additional support if a child is sick or if there is an emergency.[x]

    Perpetuating tensions in the home

    In Kakuma, the ability of men to carry out these roles has already been undermined by the government’s encampment policies which have created a dependency on aid among the camp’s residents.[xi] Following the aid cuts, the situation has been exacerbated, and this is having a negative impact on both the men and their families. The inability to fulfil the ‘breadwinner masculinity’ role has caused many men to feel powerless, useless, or as though they lack agency – and with this comes a fear of losing one’s family. [xii] Within the traditional gendered order in Kakuma, having a ‘useless’ husband is viewed by many as a legitimate reason for a woman to leave her husband and seek out someone who can better provide for her children.

    In an attempt to fulfil their expected roles, some men have sought to migrate to neighbouring countries to find work, while others have attempted to make the perilous journey north in an effort to get to Europe. These efforts to provide for their families serve only to distance fathers from their children, and this can have far-reaching consequences. Research conducted with Syrian refugee children found that those children whose fathers were absent had higher levels of depression symptoms and lower self-efficacy and self-esteem, indicating there had been significant disruption to their development.[xiii]

    The inability of men to fulfil expected roles can, in some cases, also contribute to increased domestic tension, gender-based violence (GBV), crime, and alcoholism.[xiv] In August 2025, the NGO Refugee Group carried out a survey to assess the combined impact of funding cuts and the rollout of Differentiated Assistance among refugees in Kenya, which found that cases of GBV had more than doubled in the previous six months. Over half of refugee respondents also reported witnessing an increase in domestic violence, while there has been an increase in thefts and assaults among refugees.[xv] Peter has also observed how feelings of despair have led to a rise in alcoholism and drug use amongst men who are not able to work. Unregulated and high-strength alcohol is easy to gain access to in Kakuma, and a rise in consumption has been visible since the fallout of the aid cuts has taken hold.

    It has also been reported that suicidal thoughts in Kakuma are widespread and that there has been an increase in suicides since the aid cuts.[xvi] Although it is important to be cautious about generalisations, research shows that men are more likely to develop negative coping mechanisms in response to psychological and material strain,[xvii] including self-harm.[xviii]

    In his poem I am still here, Peter recalls a case of a young father attempting suicide in the camp. This takes place after the young man has been left with no means of income, faces the loss of his family and, feeling like there is no other option, tries and fails to take his own life. However, after his failed suicide attempt, he faces further ostracisation due to the Kenyan legal system, which treats suicide as a criminal offence.

    I am still here

    Peter… before the cuts, my hands smelled of paper and stamps.
    ‎I could sign my name at the end of a day’s work and know I had brought something home.
    ‎Maize. Soap. Maybe sugar, if the month was kind.
    ‎My children would run to meet me,
    ‎and my wife’s shoulders would loosen when she saw my arms full.

    ‎Then, Peter, the U.S. closed its fist on the funds.
    ‎It was just a headline somewhere far away.
    ‎But here in the camp, it broke us.
    ‎Jobs vanished.
    ‎Men went quiet.
    ‎I walked from one gate to another until even the dust learned my footsteps.
    ‎Still, I came back with nothing.

    ‎Then came the rollout.
    ‎Differentiated Assistance, they called it.
    ‎Sounds harmless, doesn’t it?
    ‎It put my family in Category Four.
    ‎No rations.
    ‎No soap.
    ‎No oil.
    ‎Nothing.

    ‎Hunger I could live with.
    ‎But my wife’s voice at night…
    ‎that was harder.
    ‎“What kind of man are you?
    ‎Why can’t you bring something home?”
    ‎Her words cut in places I didn’t know could bleed.
    ‎One day she stopped speaking altogether.
    ‎She stepped out of our silence and into the arms of a man who could feed her.

    ‎Peter, I didn’t shout.
    ‎I didn’t beg.
    ‎I took a rope and walked into the dark.
    ‎The knot felt solid in my hands.
    ‎The rope was the last thing I wanted to speak to.

    ‎But death wouldn’t have me.
    ‎I woke up coughing in the arms of strangers.

    ‎The police came.
    ‎Not to ask why.
    ‎Not to listen.
    ‎To punish.
    ‎To drag me before a law that has no space for hunger,
    ‎only for crime.
    ‎Young people blocked their way,
    ‎but I knew the government would never want my story
    ‎only my name on a charge sheet.

    ‎Now I hide in the corners of this camp.
    ‎I breathe, but I am not alive.
    ‎I sleep where no one looks.
    ‎Eat when someone remembers I exist.

    ‎Some nights, I hear whispers
    ‎How many more Johns are still here,
    ‎measuring the distance between their heart and the end,
    ‎wondering if the rope will hold next time?

    ‎Peter… I am still here.
    ‎But I don’t know for how long.

    The impact of aid cuts on the population of Kakuma has been devastating.[xix] While the Differentiated Assistance model aims to ensure that the most vulnerable still receive support, there is a hidden human cost. As highlighted in Peter’s poetry, one consequence has been the diminished ability of men to fulfil expected fathering roles. This has a significant impact on the mental health of these men, but it also affects the lives of their families and communities, as it can contribute to increased domestic tension, GBV, crime, and reduced support within the home as men seek work in other countries.

    The experience in Kakuma also has important implications for other contexts, particularly in fragile and conflict-affected areas where the feelings of insecurity caused by the aid cuts risk reinforcing instability and violence. As aid agencies respond to the funding shortfalls, it is important to recognise that the impact of food insecurity extends beyond physical health and needs; it also affects mental health, family cohesion, and can, in some cases, contribute to increased tensions and violence.

    About the authors

    Dr Heidi Riley is an Adjunct Research Fellow in the School of Politics and International Relations at University College Dublin, and a consultant for the XCEPT research programme at King’s College London. She is currently working with other XCEPT researchers to understand how conflict and insecurity have disrupted meanings and practices of fatherhood among pastoralist communities in South Sudan.

    Peter Kidi is a South Sudanese poet and activist, who was born in Kakuma refugee camp in Kenya. His work has been published in The New Humanitarian and by the London School of Economics. He is collaborating with the XCEPT programme on our research on food insecurity, social roles, and moral personhood.

    Clara May is the Communications Manager at the XCEPT research programme in King’s College London.


    [i] Lau, Stuart, ‘Trump global aid cuts risk 14 million deaths in five years, report says’, 1 July 2025, BBC. Available at: https://www.bbc.co.uk/news/articles/cx2jjpm7zv8o

    [ii] Bamba Chakula overview, available at: https://cdn.wfp.org/wfp.org/publications/BAMBA%20CHAKULA%20UPDATE%20MAR-JUN%202016.pdf

    [iii] Bakewell, Madison, Vittorio Bruni, and Olivier Sterck, Why it’s a bad idea to triage refugee food aid when everyone’s hungry, 7 November 2025, The New Humanitarian. Available at: https://www.thenewhumanitarian.org/analysis/2025/11/07/triage-refugee-food-aid-kakuma-camp-differentiated-assistance; Yahya, Joljol, Rethinking Refugee Differentiated Assistance Model: Refugees’ Struggle for Survival in Kakuma Refugee Camp and Kalobeyei Integrated Settlement, Turkana County, Kenya, 22 October 2025, Refugee Law Initiative. Available at:  https://rli.blogs.sas.ac.uk/2025/10/22/rethinking-refugee-differentiated-assistance-model-refugees-struggle-for-survival-in-kakuma-refugee-camp-and-kalobeyei-integrated-settlement-turkana-county-kenya/

    [iv] The Kenya Shirika Plan: An Overview, Available at: https://refugee.go.ke/kenya-shirika-plan-overview-and-action-plan; Yahya, Joljol, Rethinking Refugee Differentiated Assistance Model: Refugees’ Struggle for Survival in Kakuma Refugee Camp and Kalobeyei Integrated Settlement, Turkana County, Kenya, 22 October 2025, Refugee Law Initiative. Available at:  https://rli.blogs.sas.ac.uk/2025/10/22/rethinking-refugee-differentiated-assistance-model-refugees-struggle-for-survival-in-kakuma-refugee-camp-and-kalobeyei-integrated-settlement-turkana-county-kenya/

    [v] Maina, Joseph, Refugee entrepreneurs in Kenya’s Kakuma camp struggle to survive aid cuts, 7 August 2025,The New Humanitarian. Available at: https://www.thenewhumanitarian.org/news-feature/2025/08/07/refugee-entrepreneurs-kenya-kakuma-camp-struggle-aid-cuts

    [vi] UNHCR Data Portal, https://data.unhcr.org/en/situations/southsudan/location/9907

    [vii] Lwambo, Desiree. (2013) Before the War, I Was a Man’: Men and Masculinities in the Eastern Democratic Republic of Congo.” Gender and Development, 21(1), pp. 47–66

    [viii] Wojnicka, K. (2021). Men and masculinities in times of crisis: between care and protection. NORMA, 16(1), 1–5.

    [ix]  McLean, K. E. (2020). ‘Post-crisis masculinities’ in Sierra Leone: revisiting masculinity theory. Gender, Place & Culture, 28(6), 786–805.

    [x] Riley, Heidi, Killing is part of their life’: the men raised on violence who are both perpetrators and victims as South Sudan faces return to civil war, 28 May 2025, The Conversation, Available at: https://theconversation.com/killing-is-part-of-their-life-the-men-raised-on-violence-who-are-both-perpetrators-and-victims-as-south-sudan-faces-return-to-civil-war-256177

    [xi] Maina, Joseph, Refugee entrepreneurs in Kenya’s Kakuma camp struggle to survive aid cuts, 7 August 2025,The New Humanitarian. Available at: https://www.thenewhumanitarian.org/news-feature/2025/08/07/refugee-entrepreneurs-kenya-kakuma-camp-struggle-aid-cuts; H. (2022). Perception of Refugees towards International Humanitarian Aid in the Kakuma Refugee Camp, Kenya. Africa Journal for Social Transformation1(1), 1–13. Retrieved from https://journals.tangaza.ac.ke/index.php/AJST/article/view/8

    [xii] Hanlon, N. (2012). Breadwinner Masculinities. In: Masculinities, Care and Equality. Genders and Sexualities in the Social Sciences. Palgrave Macmillan, London.

    [xiii] Eltanamly, H., A. May, F. McEwen, E. Karam, and Michael Pluess. (2024). “Father-Separation and Well-Being in Forcibly Displaced Syrian Children.” Attachment & Human Development 27 (5): 715–35. doi:10.1080/14616734.2024.2406610.

    [xiv] CGIAR, He said – She said: Reflections on gender relations at Tongogara Refugee Settlement,16 December 2024, CGIAR. Available at: https://www.cgiar.org/news-events/news/he-said-she-said-reflections-on-gender-relations-at-tongogara-refugee-settlement/

    [xv] The NGO Refugee Group, Kenya Refugee Response Under Strain: Funding Cuts, Differentiated Assistance, and the Rising Social Cohesion Crisis, August 2025, The NGO Refugee Group. Available at: https://reliefweb.int/report/kenya/kenya-refugee-response-under-strain-funding-cuts-differentiated-assistance-and-rising-social-cohesion-crisis-august-2025; Yahya, Joljol, Rethinking Refugee Differentiated Assistance Model: Refugees’ Struggle for Survival in Kakuma Refugee Camp and Kalobeyei Integrated Settlement, Turkana County, Kenya, 22 October 2025, Refugee Law Initiative. Available at: https://rli.blogs.sas.ac.uk/2025/10/22/rethinking-refugee-differentiated-assistance-model-refugees-struggle-for-survival-in-kakuma-refugee-camp-and-kalobeyei-integrated-settlement-turkana-county-kenya/

    [xvi] Bakewell, Madison, Vittorio Bruni, and Olivier Sterck, Why it’s a bad idea to triage refugee food aid when everyone’s hungry, 7 November 2025, The New Humanitarian. Available at: https://www.thenewhumanitarian.org/analysis/2025/11/07/triage-refugee-food-aid-kakuma-camp-differentiated-assistance

    [xvii] Riley, Heidi and Clara May, The Cost of Ignoring Conflict Related Trauma Amongst Men and Boys, 13 February 2024, CSNS. Available at: https://www.xcept-research.org/the-costs-of-ignoring-conflict-trauma-in-men-and-boys/

    [xviii] Slegh, H., W. Spielberg, and C. Ragonese. Masculinity and Male Trauma: Making the Connections. Washington: Promundo US, 2022.

    [xix] Soy, Anna, Starvation alert as children fill Kenya refugee ward after US aid cuts, 12 June 2025, BBC. Available at: https://www.bbc.com/news/articles/c1dew7zyg49o


  2. XCEPT Research Spotlight: Dr Fiona McEwen

    Comments Off on XCEPT Research Spotlight: Dr Fiona McEwen

    Hi Fiona. Please can you introduce yourself…

    I’m Dr Fiona McEwen, and I’m the Survey and Interventions Director for the XCEPT project at King’s College London. I’m responsible for managing a large longitudinal survey and a range of associated data collection, as well as interventions, that we’re doing in Iraq, South Sudan, and Syria/Lebanon.

    You’re leading our Impact of Trauma Survey. What is this, and why is it important?

    We know that many people living in conflict-affected zones experience potentially traumatic events and that this can have a significant impact on their mental health. But conflict also has many other effects, such as damaging trust in institutions and decreasing social cohesion. The aim of the research we’re doing at King’s is to understand whether trauma-related mental health problems may have the potential to increase people’s propensity to seek violent, or peaceful, solutions, and how that might interact with a range of other factors. The Impact of Trauma Survey (IoTS) is a huge part of this research. It will collect data on multiple different outcome measures, such as attitudes to reconciliation or the use of political violence, and many different risk and protective factors across time to try and understand how these factors work together.

    One thing which is particularly exciting about the IoTS is that it’s longitudinal. There have been lots of studies conducted in difficult contexts like this, but these are often cross-sectional, which means data is collected at a single point in time. The IoTS allows us to explore how changes in a particular factor at one point in time might influence attitudes at a later point. It’s also looking at a much wider range of factors than many studies do. We know that factors at the individual level, like people’s dispositions and personality traits, can have an impact on violent or peaceful outcomes, but conflict exposure, mental health problems, and social factors all play a role too. The IoTS will increase our understanding of the interplay between all these factors and how they feed into cycles of violence.

    You talk about measuring trauma, but what do you mean by ‘trauma’?

    In this context, the core aspect is that many people will have been exposed to war events, so they may have witnessed a bombing, or seen people killed, or they may have lost family members. There may be multiple other traumas in a person’s life, however, so we’ll also be looking at things like Adverse Childhood Experiences, such as abuse, neglect, and exposure to domestic violence.

    We’re working on the assumption that there’s often a cumulative impact of these traumas. So, for example, someone who has had exposure to a major traumatic event during war, but otherwise benefits from protective factors like a supportive family, may not be affected by that single trauma as much as someone who also suffered maltreatment as a child. Where individuals have experienced a series of traumatic events throughout their lives, this can have an additive impact over time, and this is what we’re trying to account for, rather than assuming that, in a war-exposed population, trauma is related only to conflict.

    Tell us about your background…

    I originally studied biological sciences – neuroscience and veterinary medicine – but then went on to study and do research in developmental psychology and psychiatry. Most recently, I worked as the study coordinator for a programme of research centred on Syrian refugee families in Lebanon. The study was looking at mental health and resilience in these children, who were living in really challenging conditions in informal tented settlements. There were quite a few similarities between that work and the research we’re doing now on XCEPT: we used a longitudinal design to study changes in children’s mental health and behaviour over time, and delivered an intervention aimed at reducing mental health problems in children exposed to conflict and displacement. One thing we found that was really important was being alert to the fact that measures developed in one setting will not necessarily be valid in other settings.

    Accounting for different contexts and cultures when carrying out data collection like this is crucial. My colleague, Dr Nafees Hamid, and I were recently in Erbil, Iraq, training the field work team who are going to be collecting the IoTS data in the country, and it was a really useful process as it allowed us to understand how our survey questions might be interpreted differently in different contexts. There can be issues with the way things have been translated or with the concepts we’re exploring. Even within one country, it’s apparent there will be different interpretations according to dialect, for example. Differing experiences across the country may also mean a question could be interpreted in a certain way, or that it may be more sensitive to the interviewees. It’s vital that we understand those differences to make sure our measures are as good as they can be. When we’re interpreting the data, we really need that local input as well to help us understand how people might have been thinking about those issues.

    Why did you choose to work on XCEPT?

    There are so many really exciting things about the work the King’s team is doing for the XCEPT project. It’s rare that there are research programmes doing something so large-scale, and across multiple different countries, which allows you to make comparisons across countries. I was also really keen to join a multidisciplinary research project. To date, I’ve usually been working with psychologists, psychiatrists, and biologists, so it’s been great to have an opportunity to work with people from other disciplines, including sociologists and historians. It’s exposed me to a much wider range of research and ideas than I would have been otherwise. For the team, having all these different experts and perspectives also allows us to do much more powerful research.

    Another thing that really drew me to the project was the opportunity to use nested interventions – for example, psychosocial interventions that some people receive between waves of survey data collection. The advantage of this is that, once we’ve hypothesised the mechanisms by which we think something might be happening, it allows us to then manipulate that and measure the response. For example, you can try and reduce someone’s trauma-related mental health symptoms, and then measure to see if that has an impact on other outcomes you think it might be related to, like the propensity to violence. It’s rare that you have studies where you’re combining large-scale observational data with intervention data as well, and it’s great to be a part of this.

    What do you hope that XCEPT will achieve?

    One of the core driving questions we’re trying to explore is whether trauma-related mental health problems will have a subsequent impact on people’s behaviour or their attitudes to reconciliation. There’s an assumption that untreated trauma could act as a block on achieving stability post-conflict, but we don’t yet know if that’s true. Because our research allows us to control for lots of factors, I hope we’ll be able to get more conclusive data on whether untreated trauma itself causes a problem, or whether other factors have a bigger influence on people’s attitudes towards reconciliation.

    Our work should allow us to understand more about these questions, and I hope this will result in useful policy and intervention implications. This is a very large, complicated project, and it takes a long time to prepare and build, so I’m really looking forward to seeing the data coming in, and then we can get to work running analyses across the team.