Intervention Journal

July 2016 - Volume 14 - Issue 2

From the editor: current affairs
Authors:
Tankink, Marian

CURRENT AFFAIRS

Syria: the challenges of parenting in refugee situations of immediate displacement
Authors:
El-Khani, Aala; Ulph, Fiona; Peters, Sarah; Calam, Rachel

ARTICLES

The microcosms of violence
Authors:
Holslag, Anthonie

REFLECTIONS, COMMENTS, LETTERS

Them and Us
Authors:
Jones, Lynne Myfanwy

REVIEWS

SUMMARIES

Summaries in Arabic
Authors:
Editors
Résumés en Français
Authors:
Editors
Summaries in Russian
Authors:
Editors
Summaries in Pashto
Authors:
Editors
Summaries in Sinhala
Authors:
Editors
Resumenes en Español
Authors:
Editors
Summaries in Tamil
Authors:
Editors

From the editor: current affairs

The inability of the European countries to find answers to cope with the ongoing ‘refugee crisis’ has resulted in human rights abuses and neglect of physical and psychological needs of refugees. This abysmal failure appears across the board: in the hell of refugee camps in Calais, on the borders with Macedonia, in Greece, Italy, Turkey, Syria and Libya, as well as in western European countries. The huge political tensions created between the fear of ‘the other’, considered a threat to cultural and democratic values in many countries on one hand, and the need for a safe haven and a future on the other hand, has forced refugees into conditions that are both inhuman and unimaginably insane.

Along the western Balkans route, and many other places, refugees are blocked and for many of these refugees there is currently no psychosocial and mental healthcare network in place to connect refugees with mental health and psychosocial care. Although many refugees in transit have emotional coping mechanisms that allow them to continue onward, there are also refugees who collapse under the hopeless, shameful and almost dead-end situation they and their children find themselves. Many of them have suffered multiple traumas in their land of origin and during their flight, and the terrible situation they have arrived in worsens the negative impact; emotionally, cognitively and socially. This horror is even more true in the case of vulnerable groups, such as children, especially if they are unaccompanied. We have read in the previous two issues ofIntervention the problems refugee women in Jordan face and how health workers are trying to support border security, police and voluntary aid workers with training in psychological first aid.

At Intervention we consider it essential to continue to shine the spotlight on this and other major ongoing crises. Therefore, we have created a new section in the journal, ‘Current affairs’, just to address these current crises and the questions they raise from a mental health and psychosocial support perspective through articles, field reports and personal reflections. At this moment, it is the refugees’ experience in the Middle East and Europe, but this will change in the future as the global disaster contexts change.

Another important difference to our usual focus is that the ‘Current affairs’ section will highlight not only reports from caregivers, projects and interventions, but will actively seek to provide the ‘other’perspective, that of the receivers of care, projects or interventions – and those who have been neglected or ignored. We consider it vital to provide this platform to aid in our understanding of the impact of disaster response and psychosocial care on daily lives and conditions, and how political powers and decisions affect vulnerable populations. Therefore, Intervention invites and requests the submission of papers and to encourage refugees to send us their testimonies, or contact us so they may be interviewed on how they have been treated and their psychosocial needs. As you will see in this issue, we are happy to respect anonymity for whatever reason.

In this first publication launching the Current affairs section you will find two contributions that, between them, cover both the helpers and the refugee's experience. The first one is a research article by Aala El-Khani, Fiona Ulph, Sarah Peters and Rachel Calam entitled ‘Syria: The challenges of parenting children in refugee situations of immediate displacement.’ It is qualitative research that addresses the parents (mainly mothers) of Syrian refugee families living in reception camps, and who still strive to educate their children. The authors show that parents struggled physically and emotionally to support their children who express ever increasing negative behaviours, emotions and trauma. Moreover, they explain how parenting techniques have not adjusted to these harmful pre-resettlement situations, and offer training suggestions for these parents. This latter point also makes this study important for policy and humanitarian organisations decision makers.

The Personal reflection included in the Current affairs section is that of an anonymous Syrian refugee who requested anonymity to ensure his testimony did not have a negative impact in his new host country, in this case, the Netherlands. Originally a psychosocial worker in Syria, he has now crossed many literal and figurative borders to become a refugee, and is now, finally, a psychosocial worker once again. ThisPersonal reflection tells the story of that journey. He describes the problems people face in a refugee camp in Turkey, and the problems he has faced in the asylum seekers centre in the Netherlands. His story shows that the lack of sufficient, and urgently needed, mental health care and psychosocial support is not only endemic on the chaotic front lines or reception camps, but in host countries across Europe recognition of refugees with psychosocial and mental health problems does not appear to meet any concept of minimum standards.

 
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Other contributions

The article by Anthonie Holslag, ‘The Microcosms of Violence’, is an atypical contribution for Intervention. As a scholar, his focus is the Armenian genocide, but a personal experience of a violent attack has made him aware of how the intrusive nature of violence influences the subjective perception of the victims, and has impact the way he views violence. In particular, the internalisation of the perpetrators’ world view by the victimised group, or as he states ‘the will of the perpetrator becomes the will of the victim’. Holslag shows how the objectification of the victim, especially during genocide, plays a key role as to how the violence is experienced and in the transgenerational consequences of genocide.

The following article is a critical literature review by Khalifah Alfadhliand John Drury. The aim of this paper is to examine the psychosocial needs and stressors among refugees of conflicts in developing countries, and their group based, social support mechanisms. They conducted a systematic literature search and found that in dealing with secondary stressors, socially shared identity plays an important role in collective coping processes and psychosocial support among refugees from conflict. They state that understanding groups of refugees within the context of social identity terms could help both explain and boost the collective resilience of these populations.

The paper by Clodagh O'Sullivan, Tania Bosqui and Ciaran Shannonis another systematic review. However, in this case, they address interventions for children and youth who grow-up in areas of armed conflict or political violence and search for evidence for the effectiveness of interventions. Their conclusion is that Group Trauma Focused Cognitive Behavioural Therapy is effective for reducing symptoms of people with a psychiatric disorder, such as posttraumatic stress disorder, anxiety and depression. However, they could not find evidence that interventions aimed at non clinical groups within this population are effective. This raises the question: are these interventions not working, or do we simply lack good evaluation and research papers for this specific group?

Lynne Myfanwy Jones’ Personal reflection, ‘Them and us’, addresses two elements. In the first part, she describes the immense difficulties young mothers face in their daily lives in the northern and poorest province of Mozambique. While in the second, she incisively describes the problematic system (international) nongovernmental organisations [(I)NGOs] and governments have created in the field, by inadvertently creating a system that has proven to be divisive. It should be a mirror for (I)NGOs and governments, and I do hope that this contribution will encourage them to examine their policies along the principle of ‘do no harm’ first and foremost.

Finally, it is important to highlight the Announcement of the World Mental Health Day, where the World Federation for Mental Health and WHO have included psychological first aid in the theme for World Mental Health Day 2016 on 10 October. The announcement examines the importance of psychological first aid in the toolkit of disaster response, but also warns it is not a panacea, but one of a myriad of tools that should be employed.

Marian Tankink,

Editor-in-Chief, Intervention

© 2016 War Trauma Foundation, Diemen, The Netherlands

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Authors:
Tankink, Marian

CURRENT AFFAIRS

Kelly & Michèle O’Donnell (Eds.). Global Member Care: Crossing Sectors for Serving Humanity. Pasadena, CA: William Carey Library, 2013 (421 pages) ISBN-13: 9780878081226: ERRATUM

The first sentence of the third paragraph should read that the editors “identify themselves as practicing Christians.”

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Authors:
Tankink, Marian

Syria: the challenges of parenting in refugee situations of immediate displacement

Abstract: The way parents care for their children during displacement plays a key role in children's emotional and behavioural outcomes. Yet, sparse literature exists regarding the parenting challenges faced by families fleeing conflict in transitional, pre-resettlement stages. This study, therefore, aimed to identify the parenting experiences of Syrian families living in refugee camps, focusing on understanding how their parenting had changed and the impact displacement had had on their parenting. Methods used included: interviews and focus groups discussions with 27 mothers living in refugee contexts, two interviews with professional aid workers, with the data analysed using thematic analysis. Data were structured in three themes; 1) environmental challenges; 2) child specific challenges; and 3) parent specific challenges. Results clearly showed that parents struggled physically and emotionally to support their children. Such challenges could be addressed by parenting interventions to reduce the trauma impact experienced by children.

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Authors:
El-Khani, Aala; Ulph, Fiona; Peters, Sarah; Calam, Rachel

Being a refugee in Turkey and western Europe: how it affects mental health and psychosocial wellbeing

Abstract: In this personal reflection, the author is a Syrian refugee who describes his experiences as a psychosocial worker in Syria and with refugees in Turkey and Greece. He highlights how women and children lack safety in the camps. The second section discusses how he became a refugee himself. Due to his experiences in Syria, he now finds himself in a difficult situation in the Netherlands, the county where he applied for asylum and has received a permit, but his ‘cry for help’ remains unheard and unrecognised by the (health) workers in the asylum centre.

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Authors:
Anonymous

ARTICLES

The microcosms of violence

Abstract: Acts of violence are often studied as facts, not as cultural and symbolic expressions. Within this article, the author will shed light on another dimension; explaining how a personal experience of unprovoked assault changed the author's scholarly vision of the intrusive nature of violence, as well as how violence influences the subjective perception of victims. He will show that during that moment of violence, all cultural meaning unravels and the social imagery of the perpetrator is internalised by those that are victimised. The aim of this article is twofold: a) that the specificity of violence needs very specific attention in terms of intervention and rehabilitation, and b) that objectification, especially during genocide, but also other war crimes, provides a key role as to how violence is experienced. Further, the author shows that violence is an intrusive act, where the will of the perpetrator is forced to become the will of the victim.

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Authors:
Holslag, Anthonie

Psychosocial support among refugees of conflict in developing countries: a critical literature review

Abstract: The aim of this paper is to examine the psychosocial needs and stressors among refugees of conflicts within developing countries, and their group based, social support mechanisms. Systematic literature searches of peer reviewed journal articles (n = 60 articles) were carried out using the following factors: type (refugee); cause (conflicts); location (developing countries). As refugees move towards a prolonged urban displacement phase, needs and stressors became different than those of the acute phase. While daily stressors affect far more people than posttraumatic stress disorder, many psychosocial support interventions focus only on the latter. Positive effects of social support on the mental health of displaced people have been established, while the process is not yet clear, group processes and identities appear to be important. The authors suggest, therefore, that a social identity approach can be applied to understand the emergence of a common refugee identity, and its role in empowerment through activating social support networks.

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Authors:
Alfadhli, Khalifah; Drury, John

Psychological interventions for children and young people affected by armed conflict or political violence: a systematic literature review

Abstract: Youths exposed to armed conflict have a higher prevalence of mental health and psychosocial difficulties. Diverse interventions exist that aim to ameliorate the effect of armed conflict on the psychological and psychosocial wellbeing of conflict affected youths. However, the evidence base for the effectiveness of these interventions is limited. Using standard review methodology, this review aims to address the effectiveness of psychological interventions employed among this population. The search was performed across four databases and grey literature. Article quality was assessed using the Downs and Black Quality Checklist (1998). Where possible, studies were subjected to meta-analyses. The remaining studies were included in a narrative synthesis. Eight studies concerned non clinical populations, while nine concerned clinical populations. Review findings conclude that Group Trauma Focused–Cognitive Behavioural Therapy is effective for reducing symptoms of posttraumatic stress disorder, anxiety, depression and improving prosocial behaviour among clinical cohorts. The evidence does not suggest that interventions aimed at non clinical groups within this population are effective. Despite high quality studies, further robust trials are required to strengthen the evidence base, as a lack of replication has resulted in a limited evidence base to inform practice.

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Authors:
O'Sullivan, Clodagh; Bosqui, Tania; Shannon, Ciaran

REFLECTIONS, COMMENTS, LETTERS

Them and Us

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Authors:
Jones, Lynne Myfanwy

REVIEWS

‘Medical Humanitarianism: Ethnographies of Practice’, edited by Sharon Abramowitz and Catherine Panter-Brick (2015). Philadelphia, University of Pennsylvania Press (274 pp). ISBN 978-0-8122-4732-9

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Authors:
Mikuš Kos, Anica

SUMMARIES

Summaries in Arabic

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Authors:
Editors

Résumés en Français

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Authors:
Editors

Summaries in Russian

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Authors:
Editors

Summaries in Pashto

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Authors:
Editors

Summaries in Sinhala

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Authors:
Editors

Resumenes en Español

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Authors:
Editors

Summaries in Tamil

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Authors:
Editors