Posts tagged Mental health

Photo: Salwah Mekrsh was shot by a sniper in Aleppo. In this photo, taken in April 2013, she is about to start a mental health consultation with MSF staff in Kilis. Turkey 2013 © Anna Surinyach “I feel better, but I can’t walk.” Eighteen-year-old Salwah Mekrsh is unable to walk. Her mother and her sister push Salwah’s wheelchair through the streets of Kilis, a Turkish city near the border with Syria, then enter a small courtyard and stop under the shade of a lemon tree. While Salwah waits for her mental health consultation with MSF to begin, they talk about how their lives have changed. “Before the war, we used to have everything,” says Salwah, “but since it started we have suffered too much.” Salwah was pushed into marriage shortly before the first wave of protests in Syria, in March 2011, when she was 15. Soon she became pregnant; her daughter was born just as the country’s strife was becoming an all-out civil war. After her husband tried to assault her, their marriage disintegrated, and he left, taking the baby. “He took my daughter and doesn’t let me see her,” says Salwah. “I have no way to contact them. I haven’t seen my daughter for a year.”

Photo: Salwah Mekrsh was shot by a sniper in Aleppo. In this photo, taken in April 2013, she is about to start a mental health consultation with MSF staff in Kilis. Turkey 2013 © Anna Surinyach

“I feel better, but I can’t walk.”

Eighteen-year-old Salwah Mekrsh is unable to walk. Her mother and her sister push Salwah’s wheelchair through the streets of Kilis, a Turkish city near the border with Syria, then enter a small courtyard and stop under the shade of a lemon tree. While Salwah waits for her mental health consultation with MSF to begin, they talk about how their lives have changed.

“Before the war, we used to have everything,” says Salwah, “but since it started we have suffered too much.”

Salwah was pushed into marriage shortly before the first wave of protests in Syria, in March 2011, when she was 15. Soon she became pregnant; her daughter was born just as the country’s strife was becoming an all-out civil war. After her husband tried to assault her, their marriage disintegrated, and he left, taking the baby. “He took my daughter and doesn’t let me see her,” says Salwah. “I have no way to contact them. I haven’t seen my daughter for a year.”

Photo: A street view in Basra. Iraq 2009 © Khalil Sayyad Healing Iraq: The Challenges of Providing Mental Health Care

Photo: A street view in Basra. Iraq 2009 © Khalil Sayyad

Healing Iraq: The Challenges of Providing Mental Health Care

Photo: Basra, where MSF established an international team in 2008. Iraq 2009 © Khalil Sayyad Increased Mental Health Care Needed in Iraq “Many Iraqis have been pushed to their absolute limit,” said Helen O’Neill, MSF’s head of mission in Iraq. “Mentally exhausted by their experiences, many people struggle to understand what is happening to them. The feelings of isolation and hopelessness are compounded by the taboo associated with mental health issues and the lack of mental health care services that people can turn to for help,” she said. Since 2009, MSF and the IMoH have introduced psychological counseling services in two hospitals in Baghdad and one in Fallujah. The programs focus on non-pharmaceutical approaches to address anxiety and depressive disorders commonly experienced by people exposed to violence and uncertainty. There are plans to replicate this counseling model across the country, with the IMoH starting programs in Kut, Karbala, and Sulaymaniyah hospitals.

Photo: Basra, where MSF established an international team in 2008. Iraq 2009 © Khalil Sayyad

Increased Mental Health Care Needed in Iraq

“Many Iraqis have been pushed to their absolute limit,” said Helen O’Neill, MSF’s head of mission in Iraq. “Mentally exhausted by their experiences, many people struggle to understand what is happening to them. The feelings of isolation and hopelessness are compounded by the taboo associated with mental health issues and the lack of mental health care services that people can turn to for help,” she said.

Since 2009, MSF and the IMoH have introduced psychological counseling services in two hospitals in Baghdad and one in Fallujah. The programs focus on non-pharmaceutical approaches to address anxiety and depressive disorders commonly experienced by people exposed to violence and uncertainty. There are plans to replicate this counseling model across the country, with the IMoH starting programs in Kut, Karbala, and Sulaymaniyah hospitals.

Rape is a crime that affects many aspects of human life; it is a medical emergency, it is a psychological trauma and it has deep consequences on both family and societal level. It is of utmost importance that survivors of rape have access to immediate medical and psychological care, and also for the sake of preventing sexual violence altogether in a long-term perspective it is important that women’s rights in general are improved.
MSF Mental Health Officer, Minja, reflects on the horrors of gang rape. Her main role is providing mental health care and psychological support for victims of family and sexual violence, mainly with female patients in Papua New Guinea. Please leave your questions and comments for Minja below her blog post.
Life happens to you even when you work in the field. In MSF you work to alleviate human suffering. You strive to help and support people as much as possible, every day. In the midst of this, it is easy to forget that you too are only human, that on occasions you too will need support.
Minja is a mental health officer working with MSF on psychological support for victims of family and sexual violence in Papua New Guinea. Please leave your questions and comments for Minja below her blog post.
MSF in Tari provides medical and psychological help for persons who have survived rape. Rape is a crime that affects many aspects of human life; it is a medical emergency, it is a psychological trauma and it has deep consequences on both family and societal level.
Minja is a mental health officer working with MSF on psychological support for victims of family and sexual violence in Papua New Guinea. Please leave your questions and comments for Minja below her blog post.
Our psychosocial department has developed a play therapy program for the hospitalized kids. Two of our counsellors go in each weekday morning for two hours. We offer health education about TB, give them rules of behavior and cooperation, and the children can choose from different activities that stimulate development, like puzzles, Lego, drawing and coloring, and socially interactive games. What always strikes me is their eagerness to learn and the way they just soak up all the stimulation they’re being offered and even ask for more.
Terry is a psychosocial support officer working with MSF in Tajikistan. Please leave your questions and comments for Terry in the box below her blog post.
The amount of violence and the triggers for it can feel absurd… A husband can chop his wife if she asks why he comes home late. A woman beat her husband with a stick after he asked her for money.
In the highlands of Papua New Guinea, Minja finds family arguments commonly end in someone getting hurt. Please leave your questions and comments for Minja below her blog post.
Stigma of TB in TajikstanYou know how even back home, people are still reluctant to let it become known that they need psychological help? It still seems to be seen as a weakness to have feelings and moods and tension, and to go to a professional for help in working through them. I mean, I get it. It’s in our culture to be valued for being strong and not needing any help, and we all fear appearing to be weak. Yet talk to anyone who has seen a good psychotherapist or mental health counselor and they will all say how they wish everyone could have that experience. Slowly the attitudes are changing, back home. Imagine how much longer it is taking, then, in countries – like here in Tajikistan – where there is no word for ‘counselor’, let alone something like ‘psychosocial support’. There are few mental health services here and suggesting someone could use them often causes dismay, or even shame. And we haven’t even started to talk about TB yet and how that is a subject for mental health. Changing attitudes is a long way off, I’m afraid, yet in my humble opinion after just one month, is the main thing we need to help out with! So we start at the beginning: talking, listening, supporting, doing whatever it takes to help them stay on the program. But privately, because no one must know. Psychosocial help signals weakness, but in this culture so does having TB. Which brings me to the stigma … families here are being shunned and devalued by those around them just for having TB. Misconceptions and misguided beliefs about the disease are the main reason. Terry explains the debilitating stigma around TB in Tajikistan. Please leave your questions and comments for Terry in the comments box below her post.

Stigma of TB in Tajikstan

You know how even back home, people are still reluctant to let it become known that they need psychological help? It still seems to be seen as a weakness to have feelings and moods and tension, and to go to a professional for help in working through them. I mean, I get it. It’s in our culture to be valued for being strong and not needing any help, and we all fear appearing to be weak. Yet talk to anyone who has seen a good psychotherapist or mental health counselor and they will all say how they wish everyone could have that experience. Slowly the attitudes are changing, back home.

Imagine how much longer it is taking, then, in countries – like here in Tajikistan – where there is no word for ‘counselor’, let alone something like ‘psychosocial support’. There are few mental health services here and suggesting someone could use them often causes dismay, or even shame. And we haven’t even started to talk about TB yet and how that is a subject for mental health. Changing attitudes is a long way off, I’m afraid, yet in my humble opinion after just one month, is the main thing we need to help out with!

So we start at the beginning: talking, listening, supporting, doing whatever it takes to help them stay on the program. But privately, because no one must know. Psychosocial help signals weakness, but in this culture so does having TB. Which brings me to the stigma … families here are being shunned and devalued by those around them just for having TB. Misconceptions and misguided beliefs about the disease are the main reason.

Terry explains the debilitating stigma around TB in Tajikistan. Please leave your questions and comments for Terry in the comments box below her post.

Photo: A group mental health session in Doro Camp. South Sudan 2012 © Christina Jo Larsen/MSF Voice From the Field: A Tale of Healing and Music Athena Viscusi, MSF’s Mental Health Officer in the Jamam refugee camp in South Sudan, trained a team of refugees in psychological first aid, providing education on stress and trauma, basic psychological support, and detection of more serious cases for referral to the mental health officer and the medical team. Along with a group of 13 musicians, singers, and actors trained to deliver messages about mental health, MSF’s mental health team provides weekly performances throughout the camp.  “Khaled* is a 30-year-old man, tall and thin, from the Ingessana Mountains in Blue Nile State, Sudan. He first came to the attention of MSF staff when he wandered into our compound, disoriented and disheveled, with one of his friends who was working with us. At that time, we didn’t yet have a mental health program, but as soon as I arrived as mental health officer, his friend was sent to get him. I spoke to him through my interpreter, but he answered mostly in whispered monosyllables and hand signs. He said he was married but that his wife left because “my mind is not good.”  We started him on an antipsychotic drug, and monitored his progress. During one of his visits, we asked Khaled to join us at the musical performance we had scheduled that day and he followed us there. After the theater piece, he asked to borrow the rebaba and played and sang several numbers.  A woman approached us and said that she had seen Khaled’s progress. If we had been able to cure him, maybe we could help her husband who had become reclusive and would not leave their tent and help her care for their eight children.” Read more about Khaled’s story  and our mental health work in refugee camps.

Photo: A group mental health session in Doro Camp. South Sudan 2012 © Christina Jo Larsen/MSF

Voice From the Field: A Tale of Healing and Music


Athena Viscusi, MSF’s Mental Health Officer in the Jamam refugee camp in South Sudan, trained a team of refugees in psychological first aid, providing education on stress and trauma, basic psychological support, and detection of more serious cases for referral to the mental health officer and the medical team. Along with a group of 13 musicians, singers, and actors trained to deliver messages about mental health, MSF’s mental health team provides weekly performances throughout the camp. 

“Khaled* is a 30-year-old man, tall and thin, from the Ingessana Mountains in Blue Nile State, Sudan. He first came to the attention of MSF staff when he wandered into our compound, disoriented and disheveled, with one of his friends who was working with us. At that time, we didn’t yet have a mental health program, but as soon as I arrived as mental health officer, his friend was sent to get him. I spoke to him through my interpreter, but he answered mostly in whispered monosyllables and hand signs. He said he was married but that his wife left because “my mind is not good.” 

We started him on an antipsychotic drug, and monitored his progress. During one of his visits, we asked Khaled to join us at the musical performance we had scheduled that day and he followed us there. After the theater piece, he asked to borrow the rebaba and played and sang several numbers. 

A woman approached us and said that she had seen Khaled’s progress. If we had been able to cure him, maybe we could help her husband who had become reclusive and would not leave their tent and help her care for their eight children.”

Read more about Khaled’s story  and our mental health work in refugee camps.

Photo: A patient tells his story during a mental health consultation in Dagahaley camp. Kenya 2012 © Robin Hammond Psychologists Sans Frontières: Bringing Mental Health Care to People Who Need It During wars or following natural disasters, the proportion of people suffering from depression or anxiety—both normal reactions to traumatic events—often doubles or triples. In extreme situations, the whole population experiences increased anxiety or sadness. Most people get through it alone or with the help of friends and family. But for others, psychological or psychiatric care is necessary.  Psychologists are an integral part of our teams, and play a vital role in patient recovery. In 2011, MSF psychologists carried out almost 17,000 individual mental health consultations and 19,2000 group counseling sessions. Learn more about how and why we’re providing mental health care in projects around the world. 

Photo: A patient tells his story during a mental health consultation in Dagahaley camp. Kenya 2012 © Robin Hammond

Psychologists Sans Frontières: Bringing Mental Health Care to People Who Need It

During wars or following natural disasters, the proportion of people suffering from depression or anxiety—both normal reactions to traumatic events—often doubles or triples. In extreme situations, the whole population experiences increased anxiety or sadness. Most people get through it alone or with the help of friends and family. But for others, psychological or psychiatric care is necessary. 

Psychologists are an integral part of our teams, and play a vital role in patient recovery. In 2011, MSF psychologists carried out almost 17,000 individual mental health consultations and 19,2000 group counseling sessions. Learn more about how and why we’re providing mental health care in projects around the world. 

Photo: The entrance to Mullaitivu Hospital. Sri Lanka 2012 © Eddy McCall/MSF MSF Hands Over Its Last Remaining Hospital in Sri Lanka Handing over MSF facilities to the local government and other NGO efforts is a sign of stability in a previously conflicted region. Over the last 18 months, there has been a progressive transfer of medical activities to the Sri Lankan Ministry of Health. In August 2012, MSF handed over its remaining project—a mental health program in Mullaitivu District—to World Vision. “The partnership with the Ministry of Health teams, either in Colombo or at provincial level, led to much better access to health facilities for communities in Mullaitivu district. In terms of human resources, the government is also scaling up staff in these structures, which means MSF can now reallocate these resources to emergency contexts where medical services and facilities are in shorter supply,” said Marie Ouannes, MSF’s program manager for Sri Lanka.

Photo: The entrance to Mullaitivu Hospital. Sri Lanka 2012 © Eddy McCall/MSF

MSF Hands Over Its Last Remaining Hospital in Sri Lanka

Handing over MSF facilities to the local government and other NGO efforts is a sign of stability in a previously conflicted region. Over the last 18 months, there has been a progressive transfer of medical activities to the Sri Lankan Ministry of Health. In August 2012, MSF handed over its remaining project—a mental health program in Mullaitivu District—to World Vision.

“The partnership with the Ministry of Health teams, either in Colombo or at provincial level, led to much better access to health facilities for communities in Mullaitivu district. In terms of human resources, the government is also scaling up staff in these structures, which means MSF can now reallocate these resources to emergency contexts where medical services and facilities are in shorter supply,” said Marie Ouannes, MSF’s program manager for Sri Lanka.

Music Opens Doors To A Girl’s Recovery in Haiti

Musicians in a Doctors Without Borders hospital in Haiti can play a key role in getting traumatized patients to open up and talk to counselors. Eight-year-old My Darling is one of those patients. Watch the first of three daily videos on three young patients being treated at Drouillard Hospital in Port-au-Prince.

Introducing a New Concept: Mental Health Support in Northwestern Pakistan “I still remember there was a big bomb blast in April 2010, about 300 meters [about 984 feet] away from our hospital. Within a few minutes, dozens of injured patients were already outside the emergency room. We needed to quickly identify who needed to be attended first,” recalls Dr. Muhammad Zaher, who is working with Doctors Without Borders as assistant medical focal person in Timergara, in the Lower Dir district of northwestern Pakistan’s Khyber Pakhtunkhwa (KPK) province. Mental health services are scarce in Pakistan, and Lower Dir is no exception. There are very few psychologists for the district’s estimated population of 1.2 million people. Indeed, the MSF team in Lower Dir knows of only one. In response to this situation, MSF started providing mental health counseling and psychosocial support in the hospital in February 2012. The mental health team is made up of both male and female staff. They provide individual and group counseling to patients referred from the mother-and-child health department, the emergency department, and the post-operative wards. Photo: An MSF staff member and a young patient in the triage area of the DHQ hospital in Timergara Pakistan 2012 © P.K. Lee/MSF

Introducing a New Concept: Mental Health Support in Northwestern Pakistan

“I still remember there was a big bomb blast in April 2010, about 300 meters [about 984 feet] away from our hospital. Within a few minutes, dozens of injured patients were already outside the emergency room. We needed to quickly identify who needed to be attended first,” recalls Dr. Muhammad Zaher, who is working with Doctors Without Borders as assistant medical focal person in Timergara, in the Lower Dir district of northwestern Pakistan’s Khyber Pakhtunkhwa (KPK) province.

Mental health services are scarce in Pakistan, and Lower Dir is no exception. There are very few psychologists for the district’s estimated population of 1.2 million people. Indeed, the MSF team in Lower Dir knows of only one.

In response to this situation, MSF started providing mental health counseling and psychosocial support in the hospital in February 2012.

The mental health team is made up of both male and female staff. They provide individual and group counseling to patients referred from the mother-and-child health department, the emergency department, and the post-operative wards.

Photo: An MSF staff member and a young patient in the triage area of the DHQ hospital in Timergara
Pakistan 2012 © P.K. Lee/MSF

Focusing on People, Not Politics: Providing Trauma Care in the Palestinian Territories MSF runs mental health programs in the West Bank aimed to alleviate the impact of trauma, stress, and pervasive and often targeted violence, offering psychological and social support as well as medical care to the victims of violence caused by Israeli forces and settlers and intra-Palestinian disputes.Photo: An MSF staff member runs a counseling session in Hebron. Occupied Palestinian Territories © Juan-Carlos Tomasi

Focusing on People, Not Politics: Providing Trauma Care in the Palestinian Territories

MSF runs mental health programs in the West Bank aimed to alleviate the impact of trauma, stress, and pervasive and often targeted violence, offering psychological and social support as well as medical care to the victims of violence caused by Israeli forces and settlers and intra-Palestinian disputes.

Photo: An MSF staff member runs a counseling session in Hebron.
Occupied Palestinian Territories © Juan-Carlos Tomasi