Abstract
Objective To study gendered experiences of the longterm 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 decisionmaking around marriage and other social and family
challenges.