“Psychological harm just as bad as physical injuries”, says head of Red Cross Reference Centre for Psychosocial Support

Published: 7 April 2008 0:00 CET

Psychosocial support is a major component of most emergency operations conducted by National Red Cross and Red Crescent Societies worldwide, since healing the psychological  wounds of victims is as important as addressing their physical injuries and material losses. Red Cross and Red Crescent societies can rely on the International Federation Reference Centre for Psychosocial Support to assist them in helping communities to overcome the trauma associated with any disaster or conflict. Ifrc.org asked Nana Wiedemann, director of the centre, to outline its activities.

Question: Ms Wiedemann, in addition to the constant challenges in health and development, there is an increase in the number of natural catastrophies and conflicts around the world.  How is the Reference Centre for Psychosocial Support working to address all those challenges?

Answer: Disasters, epidemics and conflicts cause severe psychological wounds and disrupt social ties. Although invisible, this harm is just as real as physical injuries and often takes far longer to overcome. Psychosocial support programmes help communities heal the psychological wounds and rebuild social structures. We work with National Red Cross and Red Crescent Societies and other parts of the International Federation of Red Cross and Red Crescent Societies to help them to provide psychosocial support during and after a critical event. Experience shows that early and adequate psychosocial support can help affected people to cope better, and prevent distress and suffering from developing into something more severe.

Question: If we go back ten years, the knowledge in the field of psychosocial support was limited. Since the mid-1990s we have seen an ever-growing interest and focus on this work. What do you think can explain this growth?

Answer: In my view there has been an increased awareness on the importance of psychosocial support both within international organizations and the western world in general. Consequently, this issue has been included in the Sphere guidelines (2004) and the Interagency Standing Committee Guidelines (2007) were developed with a particular focus on psychosocial support. Furthermore, increased awareness has led to more funding being available for this type of activities.

The first humanitarian response that included clear psychosocial components took place during the Balkan wars in the 1990s. In my view, integration of psychosocial support articulates a holistic approach to providing relief assistance, ensuring that not only physical damage but also emotional and psychosocial well-being are addressed. For example, after natural disasters such as the 2004 tsunami or the recent cyclone Sidr in Bangladesh, massive destruction affects people’s livelihoods for a long time. In such situations, psychosocial support programmes help people regain hope for the future.

Question: The centre is an outsourced function of the International Federation, aiming to increase the capacity of National Societies to respond to psychosocial needs. How do you work to extend your support to the National Societies?

Answer: The centre was established to help National Red Cross and Red Crescent Societies to develop the capacity needed to provide psychosocial services in areas affected by catastrophic events or armed conflict. It is physically located in Copenhagen, and is hosted by Danish Red Cross. Organizationally, the centre is part of the health and care department in the secretariat and liaises closely with colleagues both in Geneva and the field.

Our most direct point of entry for psychosocial work is the National Red Cross and Red Crescent Societies, helping them to set up psychosocial support programmes. Support is either given directly by centre staff, or by members of our roster group of psychosocial support experts who may be deployed on behalf of the centre. After the school siege in Beslan in 2004, a roster member supported the Russian Red Cross and the International Federation delegation in setting up a psychosocial programme, and later with the evaluation of the programme.

Question: We know that when disaster strikes or people are displaced by conflict, it is not only those directly affected who suffer. Humanitarian workers are also emotionally influenced by the human consequences that they work to alleviate. How do you ensure that their well-being is maintained?

Answer: Whilst the need for psychosocial support to people affected by critical events is becoming more common, care for the carers is a less addressed issue. Our staff and volunteers work mainly with affected people, and are in many cases also directly affected by the same critical events that they are working to address. We need to take better care of our own people, and make sure that they get the support required. In Southern Africa, a realization of the stress placed on staff and volunteers providing home based care to people living with HIV and AIDS has led to the development of particular procedures and a series of special activities to maintain the well-being of the carers. I hope that this issue will continue to develop, and that we will become known as an organization that also takes care of our own.

Question: Do you ensure that professional help is given to those who are more severely affected by these events?

Answer: Addressing the needs of people who are mentally ill is an important concern because this is an area that is often both overlooked and under-resourced. While some people with mental disorders may show up at primary health care facilities, many will stay away because of isolation, stigma, and fear, self-neglect or poor access. This group is doubly vulnerable, both because of their disorders and because the emergency may causes their normal social supports to break down, leaving them to fend for themselves.

The International Federation mainly provides psychosocial support through community interventions, targeting the general population. However, we try to refer those who need professional attention, either to the local health system or to other organizations that specialize in this area.

Question: You are not the only actor working in this particular field. How are you coordinating with other actors within the International Red Cross and Red Crescent Movement and externally to make sure that the best possible support is given to those who need it the most?

Answer: In 2007, the Inter-Agency Standing Committee issued guidelines for Mental Psychosocial Support in Emergencies. The centre has taken actively part in the multi-stakeholder task force, comprising around 35 organizations, which has developed the guidelines. During the Lebanon bombings in 2006, the task force issued a technical note with guidance on how to address psychosocial concerns in this particular emergency.

One key lesson learned is that coordination between different actors is vital to ensure the fast and meaningful delivery of services to those affected. Collaboration with local health authorities is also crucial, as they are formally responsible for the health care of the affected population. Identified gaps may be filled by a local or international response which targets those needs.