Motivated by the ongoing and widespread xenophobia in South Africa, this study explores the experiences of health access and the health sector by refugees and asylum seekers so as to understand intergroup relations, and more specifically the tensions between nationals and non-nationals. In achieving this, an ethnographic fieldwork was conducted in Cape Town, South Africa during Spring 2017; semi-structured interviews with refugees and asylum seekers provide the material for analysis to identify key perceptions on health and xenophobia to shed light on what possible peacebuilding initiatives should address. Key themes uncovered that intergroup violence based on nationality is prevailing in the areas and townships where refugees and asylum seekers live side by side with (black) South Africans. The presence of violence and the fear of risk of violence appear to fuel intergroup resentment and hostility. The lack of social well-being of the refugee became apparent in their frustrations in attaining safety in their everyday life. Moreover, it positions them so that they are unable to improve their own situation and attain health, health access, and health rights. Additionally, it found that a major obstacle to the realisation of health is connected to legal documentation as well as perceived competition for scarce health service. Specifically, it uncovered the perception of assumed hostile attitude (or fear hereof) by nationals among refugees and asylum seekers constitute both visible and invisible access barriers to the public health system and social integration. The application of the instrumental group conflict theory to the ethnographic interview material thus showed that to end what I term ‘norms of protracted social conflict rooted in xenophobia’, refugees and asylum seekers access to and treatment in the health sector is integral for their inclusion into society. It can simultaneously foster relations with the locals and, at the same time, allow for an everyday life wherein the individual can participate in and contribute to the South African society.

Text in English / Disasters are global phenomena, often occurring without warning and with physical and psychological consequences among those affected. In May 2008, refugee and migrants living in South Africa were exposed to xenophobic violence, which may be described as a human caused disaster using the Shultz, Espinel et al. (2008) definition of disaster. Refugee and migrant women were particularly vulnerable during this time due to heightened risk for exposure to violence and pathology. During 2014, a mixed methods convergent study was conducted in Johannesburg to determine the presence of acute stress disorder symptoms (ASD), posttraumatic growth (PTG) and experiences of xenophobic violence among refugee and migrant women. One hundred and three refugee and migrant women completed a selfadministered questionnaire, while semi-structured individual interviews were conducted with a sub-set of 22 women.The quantitative results showed a positive, linear association between moderate ASD-total symptoms, as assessed by the Stanford Acute Stress Reaction Questionnaire (SASRQ) (Cardeña, Classen, Koopman, & Spiegel, 2014) and moderate posttraumatic growth-total, assessed by the posttraumatic growth inventory (PTGI) (Tedeschi & Calhoun, 1996). All ASD symptom subscales were predictors of posttraumatic growth. The qualitative results from both the SASRQ open-ended responses and semi-structured responses showed that refugee and migrant women were adversely affected by the xenophobic violence, with a prevailing fear that the xenophobic violence would re-occur. There was convergence in the quantitative findings and the qualitative findings for the pathological and adaptive outcomes. Policymakers must address xenophobic violence by working towards prevention of this type of violence. In instances where policies fail to address or prevent xenophobic violence, disaster programmes should consider xenophobic violence in disaster planning. Further to this, mental health intervention programmes should not only focus on alleviating ASD symptoms but also emphasise enhancing PTG. / Psychology / M.A. (SS (Psychology))