Intervention Journal

March 2016 - Volume 14 - Issue 1

From the editor: aftermath
Authors:
Tankink, Marian
Announcement
Authors:
Editorial Board

ARTICLES

A post disaster capacity building model in Peru
Authors:
Rivera-Holguín, Miryam; Velázquez, Tesania; Morote, Roxana
Mental health and psychosocial support for the internally displaced persons in Bannu, Pakistan
Authors:
Humayun, Asma; Azad, Nadia; Haq, Israr ul; Khan, Faisal Rashid; Ahmad, Ambreen; Farooq, Rai Khalid

FIELD REPORTS

REFLECTIONS, COMMENTS, LETTERS

REVIEWS

SUMMARIES

Summaries in Arabic
Authors:
Editors
Resumés en Francais
Authors:
Editors
Summaries in Russian
Authors:
Editors
Summaries in Pashto
Authors:
Editors
Summaries in Sinhala
Authors:
Editors
Resumenes en Espagnol
Authors:
Editors
Summaries in Tamil
Authors:
Editors

From the editor: aftermath

From the editor: aftermath

Tankink, Marian

In the language of mental health and psychosocial support, the word ‘aftermath’ usually denotes the lasting human and community impacts that linger long after the war, armed conflict, torture or natural disaster emergency has ended. In this issue of Intervention, most of the articles deal, very differently, with the aftermath of an emergency or conflict. However, there are three important exceptions, including where the emergency is ongoing, yet the interventions have already begun with all of the complications of working within an emergency or conflict area.

The issue opens with an article that highlights one of the most damaging side-effects of large scale mobilisation after a disaster; when all the nongovernmental organisations pack up and leave. It is quite common post disaster that most humanitarian organisations and external professionals working in mental health care and psychosocial support withdraw after a short, predetermined period. The damage occurs when they have not embedded the support into community and public organisations, nor mental health care policies. The risk is that the structures built-up to support people in need will often collapse, or any potential positive results will fade away.

After the earthquake in Peru in 2007, public institutions did not acknowledge the populations’ needs in the aftermath of the disaster and no democratic spaces for participation remained. Miryam Rivera-Holguín Tesania Velazquez & Roxana Morote state in their contribution that in the aftermath of the disaster, social unrest and clashes between public institutions and civil organisations continued. As a response, and with the potential impact of further damage in mind, the contribution of Rivera-Holguín et al. is a good example of a well thought-out activity to increase leadership and community participation in a way that external professionals could withdraw and not negatively impact the community: ‘a post disaster capacity building model in Peru’. This particular model is grounded in the recognition of local capacities, and putting collective action into practice.

Although the contribution of Brian Guthrie also focusses on the aftermath, post disaster, it is the only similarity. Guthrie describes ‘Single Session Therapy as a framework for post disaster practice in low and middle income countries’ The article is a continuation of an article on Single Session Therapy (SST) by Karen Elizabeth Paul & Mark van Ommeren (Intervention 11(1)), which sparked quite a debate in the journal. SST is an individual therapeutic approach that can be utilised when access to follow-up and treatment for mental health issues may be not possible. The article is a case study of a SST with a woman who suffered tremendous loss in the earthquake in Haiti, having lost all of her children. It would be interesting to follow-up in order to discover what was the longer term aftermath of this single therapy session.

Asma Humayun, Nadia Azad, Israr ul Haq, Faisal Rashid Khan, Ambreen Ahmad & Rai Khalid Farooq describe a mental health and psychosocial support project for internally displaced persons in Bannu, Pakistan who are living with the long-term aftermath of displacement. Additionally, they are still living within a conflict zone, which meant that the intervention took place under the agreement of the army, and in an area still deemed to be ‘dangerous’. Volunteer mental health professionals together with government and nongovernmental organisations, visited the refugee camps on a monthly basis and offered psychological and pharmacological treatment, while also training non specialist staff in the mental health gap action plan.

The next paper addresses interventions for children and is written by Dessy Susanty, Mark J. D. Jordans, Rima Irmayani, & Wietse A. Tol. They describe lessons learned from a Classroom Based Intervention, which was implemented in the post conflict area of Poso, Indonesia, using the socio-ecological perspective. The lessons learned are, to my mind, not only interesting in terms of interventions for children, but for interventions in general. Of particular interest was the finding that boy and girls reacted differently to the interventions and therefore, interventions and activities need to be gender specific. Other lessons learned that stood out for me was the fact that more attention needed to be given to local somatic expressions of psychological distress, and the fact that interventions should not ignore the damage to the wider social fabric.

In the field report by Jane Gilbert, is entitled ‘The problem is the silence’: challenges providing support to local INGO staff in Gaza’. Gilbert describes some of the challenges she confronted in providing staff support to nongovernmental organisation staff in Gaza. The staff members also suffered in the aftermath of the recent conflict with Israel, experiencing the same stress and problems as the people they support. Gilbert concludes with lessons learned and some recommendations for further staff support in the future.

In this issue, we also have two personal reflections, with the first one from Ibado Mahamoud Hilole. Hilole is a Somalian woman who fled after her son was killed in Mogadishu in 2010, she now lives in a refugee camp in Ethiopia. She describes how her life has been affected by the violence in her country. In spite of the problems and stress she has experienced, she was able to become a peer counsellor for other refugees. After training, she is now able to provide a listening ear, as well as giving practical support and advice.

The other personal reflection is from Nikolaos Gkionakis, about the refugee crisis in Greece. Gkionakis trained, together with others, border security, police, volunteers and aid workers in psychological first aid. He is one of the founders of the Babel Day Centre that provids mental health care and psychosocial support for migrants and refugees. His personal reflection gives context and background to the crisis, discusses the Babel Day Centre, and highlights and details the psychological first aid project and the impact of working within an ongoing crisis.

The issue ends with a book review by Harry van Tienhoven of the book of Sharon Alane Abramowitz. ‘Searching for normal in the wake of the Liberian war.’ During the first decade of post war reconstruction, many humanitarian organisations offered programmes that were intended to heal trauma, prevent gender based violence, rehabilitate former soldiers and provide psychosocial care to the transitioning population. Abramowitz, an anthropologist, has examined the structure and impact of these mental health care interventions in the aftermath of long term violence.

© 2016 War Trauma Foundation, Diemen, The Netherlands

PDF
Authors:
Tankink, Marian

Announcement

Mental Health and Psychosocial support for Refugees, Asylum-seekers and Migrants on the move in Europe.

PDF
Authors:
Editorial Board

ARTICLES

A post disaster capacity building model in Peru

​This paper presents a model of a capacity building intervention, which encompasses twophases: reception and familiarity (a process of getting to know people to beyond their problems) and community mobilisation. This intervention was conducted with 65 participants from Chincha (Peru) urban and rural areas after the earthquake of 15 August 2007, highlighting a community intervention that was based on the content and methodology generated during the sessions. It is grounded in the recognition of local capacities and putting collective action into practice, through workshops and art to enhance culture and identity and empower participants. The 65 participants were able to mobilise their communities to design and create 17 murals and signboards. The main achievements of this model of intervention were the progressive withdrawal of external professionals involved, the development of personal skills of community leaders (e.g. self efficacy, organisation), and the systematic increase of leadership and community participation.

PDF
Authors:
Rivera-Holguín, Miryam; Velázquez, Tesania; Morote, Roxana

Single Session Therapy as a framework for post disaster practice in low and middle income countries

​In response to a disaster in high income countries, disaster mental health professionals typically have, at most, one encounter with a survivor of the event. After providing the initial psychosocial interventions, the individual is either referred to follow-up mental health resources or has access to the mental health delivery system. When disasters occur in low and middle income countries, access to follow-up and treatment for mental health issues may be unavailable or limited in capacity. Underdeveloped and poorly resourced primary and secondary care services, a deteriorating health care infrastructure and the limited availability of health care professionals are all barriers that contribute to limiting access to mental health care for survivors of a disaster. This paper will discuss implementing Single Session Therapy as a framework of practice for providing mental health interventions, post disaster, when it is not possible to provide either continuity of mental health treatment or follow-up for survivors.

PDF
Authors:
Guthrie, Brian

Mental health and psychosocial support for the internally displaced persons in Bannu, Pakistan

​Following armed conflict in the North Waziristan Agency, a mental health and psychosocial support initiative was launched for internally displaced persons in Bannu, Pakistan. This was convened by volunteer mental health professionals, in collaboration with a variety of agencies (provincial government, military, humanitarian agencies) in a security compromised region. As part of the initiative, monthly camps were held for a period of six months. Mental health needs were assessed. A multidisciplinary team (psychiatrists, psychologists, psychiatric nurses and psychosocial workers) offered mental health care to 680 people who attended the camps, of which 28% were under the age of 18 years old. Twenty-one percent returned for follow-up, while others were followed-up in the community by psychosocial teams. Estimates of common mental disorders were found. Both pharmacological and psychological treatments were offered, according to existing guidelines. Active efforts were made to conduct holistic assessments and avoid a pure biomedical approach. This also provided an opportunity for training non specialist staff and led to formal (World Health Organization) mental health gap action plan training for primary care staff.

PDF
Authors:
Humayun, Asma; Azad, Nadia; Haq, Israr ul; Khan, Faisal Rashid; Ahmad, Ambreen; Farooq, Rai Khalid

A classroom based intervention in conflict affected Poso, Indonesia: synthesising lessons learned from research and practice

​This paper describes lessons learned from a classroom based intervention, which was implemented in the post conflict area of Poso, Indonesia. These lessons are drawn from qualitative research and a randomised controlled trial in the area, as well as data from our own programme monitoring and evaluation. We describe these lessons learned from a socio-ecological perspective, making recommendations to strengthen the classroom based intervention's connection with critical mental health and psychosocial issues relevant at individual, family and wider community levels. Lessons learned include: the need for further adaptations to address local somatic expressions of psychological distress; consideration of changes at the cognitive level; a need for gender specific activities; engaging families in school based interventions; and addressing the damage to the wider social fabric, including at peer level. The engagement of trained paraprofessional health care is also discussed as an essential consideration.

PDF
Authors:
Susanty, Dessy; Jordans, Mark J. D.; Irmayani, Rima; Tol, Wietse A.

FIELD REPORTS

‘The problem is the silence’: challenges providing support to local INGO staff in Gaza

​This field report reviews some of the challenges encountered in providing support to local international, nongovernmental organisations staff in Gaza, shortly following the cessation of conflict in July and August of 2014. Methodology and the content of group sessions are described. The paper concludes with highlights from the evaluation, reflections on what was learned, and some recommendations on the provision of further staff support in the future.

PDF
Authors:
Gilbert, Jane

REFLECTIONS, COMMENTS, LETTERS

The story of a Somalian refugee woman in Ethiopia: how I became a peer counsellor

​Ibado Mahamoud Hilole, a Somalian woman, fled to Ethiopia after her son was killed in Mogadishu in 2010. Since then, she has lived in a refugee camp situated on the border where Somalia, Kenya and Ethiopia meet. In this personal reflection, she describes how her life has been affected by the violence in her country, how she survived periods of despair, and yet was able to find the courage to become a peer counsellor for other refugees. After training, she is now able to provide a listening ear, as well as giving practical support and advice.

PDF
Authors:
Hilole, Ibado Mahamoud

The refugee crisis in Greece: training border security, police, volunteers and aid workers in psychological first aid

​As the Syrian refugee crisis continues unabated, Greece remains one of the first ports of sanctuary. While the country is still gripped by one of the worst financial and societal crises of the past 40 years, little attention or funding was available to provide mental health and psychosocial support to migrants or refugees. In 2007, Nikolaos Gkionakis, along with other colleagues, founded the Babel Day Centre to provide mental health care and psychosocial support for migrants and refugees. When the current crisis began, he was perfectly placed as one of the trainers for a project training border security, police, volunteers and aid workers in psychological first aid and self care for carers in Greece. This personal reflection gives context and background to the crisis, discusses the Babel Day Centre, and highlights and details the psychological first aid project, which was supported by both the War Trauma Foundation and the United Nations High Commission for Refugees.

PDF
Authors:
Gkionakis, Nikolaos

REVIEWS

Sharon Alane Abramowitz. Searching for Normal in the Wake of the Liberian War. Pennsylvania: University of Pennsylvania Press, 2014 (280 pages). ISBN 978-0-8122-4626-1 | $65.00

PDF
Authors:
Van Tienhoven, Harry

SUMMARIES

Summaries in Arabic

PDF
Authors:
Editors

Resumés en Francais

PDF
Authors:
Editors

Summaries in Russian

PDF
Authors:
Editors

Summaries in Pashto

PDF
Authors:
Editors

Summaries in Sinhala

PDF
Authors:
Editors

Resumenes en Espagnol

PDF
Authors:
Editors

Summaries in Tamil

PDF
Authors:
Editors