Monday, December 01, 2008
Afraid to work in their fields, afraid of dying, by Noémie Cournoyer
In the region of Kirotshe, Democratic Republic of Congo (DRC) to the west of Goma, Médecins Sans Frontières (MSF) is working on both sides of the front, supporting a referral hospital and conducting mobile clinics. In the Shasha camp for displaced people, MSF provides psychosocial assistance. Carmen Martinez, a psychologist working for MSF in the area, explains .
Carmen, can you describe the psychosocial activities in the Shasha camp?
We started a psychosocial program to help displaced people, as well as certain members of the resident population, to overcome the trauma they have suffered as a result of the war. This is a community program, namely a program using the community base, without “technicians.” I am the only psychologist. Last week, I trained 22 outreach workers. They are organized in six groups, which correspond to different sections of the camp. In addition to these group or community activities, there is a one-on-one component to the program, with individual consultations for those who have been most deeply affected.
In concrete terms, what do the outreach workers do?
They organize discussion groups, with a discussion theme. There are 60 to 80 people in each discussion group. During a session last week, the theme was health. Health in a global sense: physical, social and mental. Some people spoke about headaches, stomach aches, sleeping difficulties. Others experience a sense of isolation. Today, we talked about the population’s concerns. We tried to identify the events that marked them. They spoke to us about their fear of going into the fields to grow crops, their fear of dying. They recalled their flight as something very sudden. We tried to find some tools that would help them overcome this situation. For example, having spokespeople to gather information about community needs. Or using traditional practices such as rituals.
What do the individual interviews involve?
In addition to social motivation, there is also individual counselling. Two people have been
trained to work with me as psychosocial counsellors. A counselling session takes place much like a medical consultation, where we try to identify the most important problems, recent events they have experienced, or very intense life experiences. First we deal with the physical and mental reactions, by allowing the person to express what they’ve gone through. One session was with a demobilized soldier. In other words, he had left the armed group to return to civil life. He spoke about flash-backs, night terrors, nightmares, intense emotions at night when he hears the slightest sound. He said he was afraid to leave his home. In fact, through this behaviour, he was avoiding a situation that could remind him about something he had lived through. There are many similar examples among the displaced people.
What are living conditions like in the camp?
Here, in the Shasha camp, there are approximately 4,300 displaced people. Some of these people are also in foster families. They left everything behind them, families were separated. At Shasha, about 20 children are unaccompanied, most because we don’t know where their parents are. People have also told me that armed men have stolen their belongings. On Oct. 27, everyone quickly evacuated the Shasha camp to go to Minova, farther south. Once the area was secure enough for them to return, everything had been pillaged. They have almost nothing; they received a few blankets, plastic sheets, buckets. Their huts are very small. The hygiene conditions in the camp are abominable. It’s important for us to insist on basic hygiene and health promotion measures. Some of the discussion groups, for example, focus on hygiene.
How can people get over such traumatizing experiences?
Together with the patient, we have to find mechanisms that still work well. For example, the ability to confide in someone or, for some people, to be with their whole family, etc. The demobilized soldier I spoke about told me he was still able to work at least, that he could go into the field occasionally. During individual counselling we identify these positive points and we come to an agreement about what we can do together. We have to make them understand their reactions are normal and that they are a response to events that are not normal.
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Labels: Congo, Doctors Without Borders, Noémie Cournoyer
# posted by Francis Chartrand @ 12:02 AM 
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