VoxEU Column Development Health Economics Migration

Forced displacement and behavioural change in the Nuba Mountains

One of the most important effects of armed conflicts is the forced displacement of large numbers of civilians. When conflicts end, many who have left their homes return, facing the challenge of rebuilding their lives in post-conflict areas. This column analyses the outcomes of returning households during a short-lived interwar period in the Nuba Mountains of Sudan. Returning households, particularly those that are female-headed, face worse economic conditions. But returnees fare better on various health indicators, likely related to changes in sanitary habits picked up during displacement.

One of the most important effects of armed conflicts is the forced displacement of large numbers of civilians. According to UNHCR, the number of people displaced by war reached an all-time high in 2014, with almost 60 million people that were either internally displaced (IDPs) or crossed an international border and became refugees. As an unprecedented number of those refugees are trying to find a host community within Europe, the EU and its country members are divided about the best way to deal with the situation (Hatton 2015).

When conflicts end, however, many of those who have left their homes return to their place of origin, facing the challenge of rebuilding their lives in post-conflict areas where infrastructure and other public goods are often scarce or non-existent. In most cases, returnees find that their properties and assets have been destroyed or seized by others. Even though the reintegration of these returning community members poses challenges for post-conflict reconstruction and peace building, it also presents an opportunity to contribute to these processes.

Returnees in the Nuba Mountains

In a recent paper, we analyse detailed household-level data collected in 2008 during a short-lived interwar period in the Nuba Mountains of South Kordofan, Sudan (Abdel-Rahim et al. 2015). This region was one of the most affected during the Second Sudanese Civil War, a two decade-long conflict that was one of the longest and deadliest of the last century. It is estimated that two million people died and more than four million were displaced as a result of the conflict (IOM 2009). After the signing of the Comprehensive Peace Agreement in 2005, millions of displaced persons started returning to their communities of origin, before the beginning of yet another connected war in 2011.1

We compare the social and economic conditions of “returnee” households vis-à-vis the non-displaced population (“stayers”) in eight villages of the Nuba Mountains. Our findings point to a number of important differences between returnee and stayer households. In line with previous studies (e.g. Ibáñez and Moya 2010, Fiala 2012), we find that returnees have fewer assets than those who stayed during the conflict in terms of both land size and livestock ownership. We also find differences in the composition of agricultural production between the two groups, with stayers more involved in the cultivation of cash crops and returnees relying on staples.

In our sample, more than half of the households are female-headed, largely as a consequence of men losing their lives during the armed conflict. We find that many of the differences between returnees and stayers are gender related, as the female-headed returnee households are those that are more likely to only produce staple crops and less likely to generate agricultural wage income and own livestock.

Even though returnees seem to face worse economic conditions, the data further suggest that they tend to perform better than the rest of the villagers in a series of health indicators, experiencing lower prevalence of a number of serious diseases common to the area, as well as lower mortality rates. This result contrasts to those of previous economic studies (e.g. Verwimp and Muñoz Mora 2013), though it is in line with some findings in the medical literature (Hynes et al 2002).

Explaining health difference with changes in sanitary habits   

In order to explain the somewhat counterintuitive results with respect to returnees’ health conditions, we suggest that different experiences associated with war-related events may induce behavioural change in the affected individuals. This is motivated by recent literature that supports the idea of behavioural change affecting post-war settings. For instance, Bellows and Miguel (2009) show that in Sierra Leone individuals involved in intense violence during the civil war are more likely to attend community meetings, to join community groups, and to vote. Similarly, Voors et al. (2013) find that exposure to conflict is positively related to altruistic behaviour in Burundi.

We take advantage of a detailed set of variables relating to hygiene and sanitary habits in our data to test the hypothesis that returnees may have potentially changed their behaviour because of their experiences during displacement. We think that these habits are important not only because they can proxy for other changes in attitudes (like risk aversion or time preferences), but also because of the important benefits of preventive health care given their positive externalities in the case of contagious diseases.

We find that returnee household members are indeed more likely to wash their hands, use mosquito nets, consume safe drinking water, and engage in family planning. Even though our data are limited in terms of providing information that can help us understand the sources of the these differences in attitudes between returnees and stayers, we think that it is likely to be related to the experiences during the displacement. We suggest that the exposure of displaced individuals to different habits in urban areas or IDP camps, or their contacts with the personnel and programs of NGOs and international organisations during displacement, may explain the changes in their health and sanitary habits.


While highlighting some of the problems of the return of displaced persons after a conflict, we have also pointed out positive aspects of this process. In particular, we have shown that returnees are more likely to use certain sanitary measures that appear to limit the occurrence of some severe diseases prevalent in the area. These sanitary measures not only have private benefits for the households adopting them, but also tend to create a positive externality for the community. This is a good example of how returnees can bring in useful knowledge and specific habits that can positively contribute to the reconstruction efforts after armed conflicts.


Abdel-Rahim, A, D Jaimovich and A Ylönen (2015) “Forced displacement and behavioural change: An empirical study of returnee households in the Nuba Mountains”, Defence and Peace Economics (forthcoming), Ungated version here.

Bellows, J and E Miguel (2009) “War and local collective action in Sierra Leone”, Journal of Public Economics, 93(11): 1144–1157.

Fiala, N (2012) “The economic consequences of forced displacement”, Households in Conflict Network, Working Paper 137.

Hatton, T J (2015)  “The Mediterranean boat people: What can be done?“ VoxEU.org, 5 June.

Hynes, M, M Sheik, H G Wilson and P Spiegel (2002) “Reproductive health indicators and outcomes among refugee and internally displaced persons in post-emergency phase camps”, Journal of the American Medical Association, 288(5): 595–603.

Ibáñez, A M and A Moya (2010) “Vulnerability of victims of civil conflicts: Empirical evidence for the displaced population in Colombia”, World Development, 38(4): 647–663.

IOM (2009) “IOM tracking of spontaneous returns project: Total returns to south Sudan post CPA to June 2009”, Geneva: International Organization for Migration.

Verwimp, P and J C Muñoz Mora (2013) “Returning home after civil war: Food security, nutrition and poverty among Burundian households”, Households in Conflict Network, Working Paper 123.

Voors, M J, E E Nillesen, P Verwimp, E H Bulte, R Lensink and D P Van Soest (2012) “Violent conflict and behaviour: A field experiment in Burundi”, American Economic Review, 102(2): 941–964.


1 The conflict in the Nuba Mountains remains largely unknown and neglected by the international community. A good source of information of the current events in the Nuba Mountains is NubaReports

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