      |
Gaining acceptance for mental healthcare in Darfur It couldn’t have helped that Musa’s family, along with the estimated 90,000 others living in one of the biggest camps for internally displaced people (IDPs) in Darfur, had to cope with the stress of surviving a humanitarian crisis of devastating proportions. Five years of arson, killings, rape, looting and fear is more than most could bear. Camp dwellers experience the added stress of wondering if peace will ever return so that they can migrate back to their home villages, to their farms. It doesn’t help when the camp that is supposed to be their refuge is attacked or becomes the scene of inter-ethnic violence. Over the years, Médecins Sans Frontières (MSF) has expanded its notions of comprehensive medical care in conflict zones to include what are called psychosocial interventions. These include counseling, clinical support, and community education programs for those suffering the impacts of war and displacement. And they’re essential for survivors in Darfur. “Violence does not only cause pain in the body but also pain in the heart,” explains MSF mental health advisor Kaz de Jong. “Survival in emergencies depends not only on physical fitness but also the mental condition of the people. We have seen people in therapeutic feeding centres, for example, not wanting to eat because they did not see a reason for living.” MSF began providing primary healthcare in Kalma Camp in early 2004 and, by 2006, had added a mental health program to help those experiencing violence-related stress, adjustment problems, psychosis, anxiety and a host of other burdens. Amal Hashim Algack, a Khartoum-trained psychologist, was involved in the earliest days of training a dozen IDPs in the camp to become outreach workers and psychosocial caregivers. The central idea was, and still is, to offer workshops that help people recognise in themselves and in others the symptoms of psychological stress. The next goal is to give families support as they strengthen their own remarkable coping skills. The overwhelmed can seek therapy for themselves and their loved ones at the MSF clinic.
“It was a big effort to change the minds of these people, for them to believe in mental health treatment,” Algack says. “Most will just say it’s devils in people’s minds.” This is what Musa’s parents believed. They first tried with a traditional healer who attempted to expel the demons by inscribing some paper with verses and dipping it into a glass of water until the ink seeped out. Musa then drank the blackened liquid, but time and again, the treatment failed. A relative of Musa’s who knew about the MSF mental health program, who was impressed by its positive results, invited the organisation to try its methods on the young man chained up on the far reaches of the sprawling camp. “He was like an animal,” Algack shudders, recalling what they witnessed. His hands and feet were chained together to that stump, amidst the stench of years of excrement and urine. “He was aggressive towards everyone - beating his father and mother when they came near.”
The MSF counselors urged Musa’s parents to release him into their care. The father doubted their methods, and wanted to see yet another fakhi, or traditional healer. After five sessions with the family, the psychologist was finally permitted to talk to Musa. These sessions went on for months. The MSF team would come back day after day, filled with sorrow at the young man’s situation. Watching him struggle against the chains. He was delusional, dangerous. A severe psychotic living an inhumane existence. “We even cried,” Algack admits. “Everybody who saw Musa cried, even the MSF drivers.” Over the course of seven months they persisted. There were three failed attempts when Musa’s parents relented and unchained him. Every time, he exacted violent outrage. By January 2007, MSF’s mental health program started including prescription medication. This made all the difference to someone in Musa’s condition. Within a month on neuroleptic drug therapy, Musa was freed. The counseling finally began to take effect. “Now he is a man again,” she reflects. “He’s smart and can function with the help of the medication.” Musa, now 33, works with his father, weaving straw mats that they sell in the South Darfur hub of Nyala, 15 km away. It took drug therapy to trigger Musa’s positive response to the home visits, individual and family counseling that MSF offered. MSF considers mental healthcare an essential element of its primary health program in Kalma Camp. The goal is to help people regain some sense of control over their emotions, their behaviour, their stress levels and their ability to function despite the precariousness of camp living. For most, community education workshops give them the information they need to help themselves and one another survive day after day of traumatic experiences in an IDP camp. Here, families remain totally dependant on a massive humanitarian effort to stabilise their physical health and nutritional status. Yes, their biological survival is important. Some are even benefiting from services, like clinics and schools, that were not available to them before the war. But Kalma’s basic health indicators obscure multiple layers of torment that MSF is committed to alleviating. by Avril Benoît, director of communications, MSF Canada › read more about MSF's work in mental health
|
|
|
|||||||
|
|||||||||
