Objective To study gendered experiences of the long-term effects of a chemical warfare agent (CWA; sulfur mustard).
Design Qualitative face-to-face semi-structured in-depth interview study using content analysis approach with thematic analysis and anthropological inquiries.
Setting The city of Halabja in the Kurdistan Region of Iraq.
Participants Survivors 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.
Results Latent 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.
Conclusion Survivors 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.
- chemical warfare agents
- social abandonment
- iraqi kurdistan
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Contributors FarM: Conceptualisation, data curation, methodology, validation, data analysis and interpretation, and writing—original draft. FazM: Methodology, validation, theoretical analysis and writing—review, editing and critical revision. MS: Critical revision, review and editing. A-CO: Read the final version of the manuscript. ML: Supervision, critical revision, review and editing.
Funding The study funded as part of a PhD thesis doctoral study grant (DOS) awarded to FarM by Region Västra Götaland, Närhälsan Research and Development Primary Health Care, Gothenburg. Project number: 272 597.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study was approved by the ethical review board at the MMAA Bureau of Sulaymaniyah and by the Regional Ethical Review Committee in Gothenburg, Sweden.
Provenance and peer review Not commissioned; externally peer-reviewed.
Data availability statement Data are available upon reasonable request. The sharing of the data used in this study has been restricted because they contain sensitive, identifying information which is not possible to suitably anonymise for public sharing. Data can be made available upon request after any details that may risk the confidentiality of the participants have been removed. To request access to these data, please contact the corresponding author.
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