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Psychological support
Enhancing psychological support
Loss of lives and livelihoods is not the only suffering caused
by natural disasters. Stress-related mental health problems
are known to be widespread. These psychological traumas are
not as evident as the physical destruction of homes and communities;
however, recovery from them often takes far longer.
The International Federation of Red Cross and Red Crescent Societies,
responding to a number of technological disasters, acknowledged
the need to offer psychological assistance in addition to traditional
relief activities. With no formal training and little preparation
in this area, officials initiated efforts to develop response
methods to this hidden emergency. In 1993, he International
Federation and the Danish Red Cross established the Federation
Reference Centre for Psychosocial Support as part of this
effort. Today, psychological support is systematically being
integrated into relief operations alongside programmes for shelter,
health and food.
Additionally, the Federation's Strategy 2010 identifies
health and care as one of its four core business areas. Emotional
support provided by volunteers to vulnerable people in the community
is specifically highlighted as a crucial programme area.
Psychological support is increasingly becoming an accepted element
in relief, care, support and first aid throughout the world.
However, it differs from material support in that the recovery
process is much longer and less visible. Only a reliable and
long-term commitment will ensure that the psychosocial aspects
of relief work are professionally implemented and make a crucial
difference to the victims and volunteers affected by disasters.
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A
child's world
"We can really see an improvement. When
they started they were drawing with black.
Now they have really opened up," explains
Mladin Telebak. Telebak is a teacher and
participant in a programme to help war-
traumatized children in Banja Luka,
Bosnia Herzegovina. The programme,
supported by the Danish Red Cross, aims to
assist children recover from the painful
experience of the conflict in the former
Yugoslavia. Telebak describes the impact the
psychosocial support has had on the children
"At first the children did not want to talk.
Now they are forming very strong
friendships and are sharing their experiences
from the war."
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Areas of action:
building on comparative advantages
Stress-related emotions can overwhelm people's capacity to surmount significant personal grief and
begin rebuilding their lives. If ignored, these psychological symptoms can progress into more severe
disorders. Psychological support can help prevent this from occurring. Through the use and distribution
of simple psychological tools in training workshops and seminars, volunteers are empowered to assist
people overcome their traumas.
Federation programmes are targeted at three groups, who suffer from a variety of psychological reactions
and need support following a crisis:
a) the victims and other people affected by the event,
b) National Societies' volunteers and staff engaged in disaster response,
c) expatriate delegates.
Victims and other people affected by the disaster receive assistance to move through a normal sequence
of psychological reactions in response to the grief and loss. National Societies' volunteers and staff are
trained and supported to help them cope with the situation and to ensure that their own psychological
needs are recognised and met. The expatriate delegates on assignment for the Federation are frequently
exposed to various types of pressures. To prevent negative long-term effects, psychological assistance is
provided to help them manage this stress.
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Following the
massive
earthquake in
Turkey in 1999,
the Federation
established a
psychological
support
programme to
assist people with
the long and
difficult process of
rebuilding. |
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a) Victims and other people affected by the event
Victims of a disaster need to regain an acceptable physical quality of life as well as heal emotional scars.
This requires attention to both traditional relief and to the psychological reactions. The Federation is
committed to assisting the individual as an entity.
The key components of psychological assistance for victims are ongoing interaction and presence with
the aim of bolstering feelings of security and hope. This support endeavours to help the affected person
strengthen his or her personal coping capacities and reinforce support from family members and friends.
The goal is to empower communities to be responsible for their own caring and healing.
Psychological support programmes are increasingly part of relief
operations. Recently two major programmes were launched in
Kosovo and Turkey. Both programmes run parallel to traditional
relief efforts, with the objective to help people heal from the
psychological traumas, and to empower and assist them in meeting
other basic needs. The crucial component of both programmes is the
presence of psychosocial centres established in the most affected
communities.
Children are among the most vulnerable victims of violent events,
primarily because they are dependent on others for both their safety
and the healthy development of their minds and bodies. The
Children Affected by Armed Conflict (CABAC) programme is
currently being implemented in the Balkans and Africa. This
programme is built on an existing and recognized institution - the
school - and is implemented through a respected profession - the
teacher. Group-based and creative activities allow the children to
express their emotions and concerns.
Other psychological support programmes aim at HIV/AIDS
caregivers. Red Cross and Red Crescent volunteers are assisting
people with HIV through home-based care programmes. They focus
on providing emotional support to families and victims, encouraging
and teaching family members to care for ill relatives at home, and
preventive measures to avoid infection. The stresses on those caring for people with HIV/AIDS are
enormous. HIV/AIDS programmes cannot afford to focus on victims alone. Caring for carers - many
of whom are HIV positive - is a necessity, not a luxury. This programme will be expanded, giving
further attention to teaching HIV/AIDS carers to deal with stress and how to prevent burnout.
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Carrying on
Sabrie Zequiri, 38, lives in a small village
in Kosovo with her seven children. Her
husband disappeared during the conflict
between the NATO-led forces and the
Yugoslav army in 2000. The family held on
to the hope that he was in prison in Serbia
and would come home one day. The
uncertainty made it very difficult for them
to accept his loss and begin the grieving
process. To cope Sabre and her children
developed an unhealthy dependency on each
other, isolating themselves from the rest of
the community. An outreach mobile team
of Red Cross and Red Crescent
paraprofessionals sought to provide
counselling to help them overcome the
trauma. Today, the children are attending
school and participating in other activities
outside the family circle.
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b) National Societies' volunteers and staff engaged in
disaster response
Psychological support deals with basic human feelings and needs - shock, loss, bereavement, and
powerlessness. These feelings are common to everyone, but coping mechanisms vary with different
cultures. Local staff and volunteers provide Red Cross and Red Crescent psychological support thereby
overcoming any cultural barriers. Furthermore, education and training utilises local resources and
professionals to ensure that implementation is culturally sensitive.
Trained volunteers provide active listening, information and referral, and help beneficiaries meet their
basic needs. Support groups are established to help solve common problems, allow for emotional
ventilation, improve communication skills, develop social networks, and build trust, empathy, and
understanding.
Psychological support programmes have an important long-term goal of strengthening a country's
preparedness to respond to stress-related problems should another disaster occur. This ensures a major
developmental and capacity-building component is integrated into the programme thereby
strengthening its sustainability within the local branch or chapter.
Emphasis is put on creating strong support systems around the volunteers. Mental health professionals
organize their work and provide regular supervision. Volunteers are also vulnerable, as they themselves
are often part of the collective crisis. Supervision is the most effective tool to avoid or deal with traumas
and burnout among volunteers.
c) Expatriate delegates
Relief work is stressful and may lead to limited operational capacity at a time when the skills of delegates
are most needed. Taking care of staff, therefore, is a priority. Delegates are briefed about typical reactions
and symptoms of stress and trauma and trained on basic stress management skills. This service is furthermore available during and after missions. Psychological debriefing allows the delegate to express
him or herself, gain feedback on stress and other factors affecting his psychological well-being and ease
the re-entry process.
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Helping yourself
by helping others
David Mukasa is a counsellor for the
HIV/AIDS Network in Uganda. David,
who is also HIV positive, gave a moving
testimony at the 5th Pan African Red
Cross and Red Crescent Conference on
living with the virus. His story began in
1989 when he first became ill and learned
of his diagnosis. His mother cared for him
at home during that time and his health
improved. After testing positive a second
time, he decided to change his life. He
took a part-time job and became involved
in HIV/AIDS counselling and education.
"If you're involved in HIV/AIDS
prevention and share your experiences, it's
like therapy and your quality of life
improves, though you are always conscious
of your mortality," he explains.
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Partners
The Federation continues to strengthen
its collaboration with UN agencies and other institutions that
have expertise in this area, including WHO, UNICEF, UNHCR, NGO's,
mental health professional associations and research institutions.
Mental health has been highlighted as an area of particular
importance for the WHO with mental health the designated theme
for World Health Day. The Federation will contribute to the
2001 World Health Report with case histories of Red Cross and
Red Crescent psychological support programmes.
To further enhance global networking and professional participation,
Memorandums of Understanding with the Disaster
Mental Health Institute at the University of South Dakota,
USA, the Nottinghamshire Healthcare NHS Trust, Centre for Trauma
Studies & Traumatic Stress Service, United Kingdom, as well
as with the International Society for Health and Human Rights,
Norway, were recently signed. A Memorandum of Understanding
with the Copenhagen University, Denmark, is also anticipated. |
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