Kiev, October 11, 2017 – Earlier this month the Center for International Humanitarian Cooperation provided a two-day training in Human Rights and Humanitarian Law – Theory & Practice in Kiev, Ukraine in partnership withthe Ukraine NGO Forum and sponsored by USAID and the Danish Refugee Council.
Under Florian’s instruction, 20 Ukraine-based humanitarian and human rights workers received in-depth training on the theory and practice behind protection mechanisms for crisis-affected populations as well as basics of human rights and international humanitarian law.
Ukraine NGO Forum
“I focused the training on enhancing participants’ understanding of the legal concepts of human rights and humanitarian law and, most importantly, on the tools for monitoring and documenting human rights abuses in the field. We thoroughly discussed measures that ensure humanitarian protection work is strategic and effective,” said Florian.
July 3, 2017, New York – The Institute of International Humanitarian Affairs (IIHA) reached a meaningful milestone on Friday with the graduation of 25 humanitarian workers from the Institute’s 50th International Diploma in Humanitarian Assistance course and four from the Master of Arts in International Humanitarian Action at Fordham University.
Surprising the graduates, Hollywood actor and IDHA commencement speaker Robert De Niro joined for the occasion to honor their commitment to humanitarian action in a world increasingly challenged with a “lack of humanity.”
“You’ve found your own inner humanitarian and you have let it guide you to making our world better. You serve with compassion and dignity while you make sacrifices that take heroic risks. Now you’ve gone through this program so you can perform your work even more effectively. You have distinguished yourselves here and you will take these lessons with you for the rest of your lives,” said Mr. De Niro.
The graduates join a network of more than 3,000 alumni who hail from 140 countries, each making significant strides in responding to conflicts, natural disasters, displacement and other crises worldwide.
“My head is full of little videos, of vignettes, of cameos, of heroic deeds, that you have written to me, which have been involving you in the field. Ambushed in Syria, taken hostage in Afghanistan, crossing frontlines under fire, emergency medicine in makeshift hospitals, opening schools in remote camps. Of simply staying on when others have left, of fighting fear, of overcoming despair, feeding the hungry, holding the hands of the vulnerable. We are in that unique position that we’re not in uniform, but we fight in the frontline. Our enemy is poverty, hunger, homelessness and our allies are the beneficiary,” said IDHA 50 Course Director Larry Hollingworth, CBE in commemoration of the cumulative impact of the IIHA alumni network.
IDHA 50 and MIHA graduates work as medical professionals, logisticians, communicators, operational managers, military officers, among other roles in response to humanitarian crises and emergencies in South Sudan, Niger, Egypt, Sri Lanka, Mexico, North Korea, and beyond.
For the past month, they paused their work to take a step back from the field and study topics crucial for effective humanitarian response.
“We were all on a ship named IDHA 50, together floating on a wide ocean of experience with an incredible depth of knowledge. Luckily, we had superb and skilled captains on board with us, who navigated the ship in the right humanitarian direction and provided us with professional lectures, professional personal experiences, in quality and quantity, in form and content,” said Bart Vermeiren, IDHA 50 Student Representative who came to the course with more than 15 years of experience working for the International Committee of the Red Cross.
Throughout the IDHA course, 33 humanitarian experts, practitioners, Fordham academics, and leaders in the field gave lectures on topics such as humanitarian law, disaster management, communicable disease, logistics, civil military cooperation, and dozens of others. Lecturers also presented a series of case studies illuminating the complexity of today’s humanitarian interventions in Ukraine, Nepal, Palestine, Ethiopia, and beyond.
In his opening comments, Kevin M. Cahill, M.D. commended the students for their willingness to “not be blocked in by academic barriers or the barriers that separate us from each other.”
The Institute of International Humanitarian Affairs congratulates these graduates in their successful completion of their training and warmly welcomes them to a network of innovative and impactful humanitarians.
“You are a treasured part of our IDHA family all over the world. Make use of it. Continue to give back. Continue to come back. Continue to be in touch and be involved with our programs, no matter where you are or where we are. And please, no matter where you are, remember these days as we will remember you,” Brendan Cahill, IIHA Executive Director, reminded the graduates before they left the halls of Fordham University and returned to their posts around the world.
For more than 20 years, the IIHA has trained humanitarian aid workers in cities around the world, including Geneva, Goa, Amman, Barcelona, Kathmandu, Nairobi, New York, and more. Upcoming humanitarian trainings will be held in Amman, Malta, Vienna and Kathmandu and are open for registration.
Fordham University Institute of International Humanitarian Affairs
Media reports and images inundate the world with humanitarian crises: refugees drowning at sea, populations ravaged by famine, and seemingly endless conflicts. Collective and coordinated responses to humanitarian crises have never been more essential. Good intentions to respond and act must be informed by practical experience, technical knowledge, and academic critique.
Grounded in social justice and humanitarian ethics, the Institute of International Humanitarian Affairs (IIHA) at Fordham Universityendeavors to make the global response to humanitarian crises more sustainable, effective, and dignified. Through the intersection of critical academic analysis and concrete hands-on experience, we believe that humanitarian action can transform the world.
Photo provided by IDHA Alumnus Rahul Singh, Founder of GlobalMedic Mission
The International Diploma in Humanitarian Assistance (IDHA), the flagship program of the IIHA, equips mid-career humanitarian professionals to drive the humanitarian sector of the future in a more innovative direction. For 20 years, the IIHA has trained thousands of humanitarian workers in cities around the world – from Kathmandu to Amman, Geneva to Cairo.
This June the IIHA will commence its 50th IDHA course in New York City and we want you to join us! IDHA 50 students will join a cohort of diverse and highly qualified aid and development professionals from all over the world in a one-month intensive course to receive one-of-a-kind training from world-renowned experts in the humanitarian field.
The course provides the critical skills and knowledge to more effectively intervene in the complex emergency and protracted crises of the 21st century. The curriculum is highly interactive and participants will gain:
Extensive insight to the needs of people affected by conflict, disaster, and displacement;
Skills in facilitating cooperation and dialogue between international, governmental, and non-governmental agencies;
Awareness, understanding, and skills essential for effective service in emergency and protracted humanitarian crises;
Opportunities to collaborate and network with colleagues working for diverse international, governmental, and non-governmental humanitarian agencies;
Tools to evaluate interventions and identify examples of good practice; and
Methods for anticipating and preventing humanitarian crises.
Housed at Fordham, the Jesuit University of New York, the Institute of International Humanitarian Affairs (IIHA) educatesa future generation of humanitarians in the classroom, shapes humanitarian leaders in the field, and innovates solutions to challenges in humanitarian crises.
Today is World Mental Health Day, a day to raise awareness and mobilize efforts in support of mental health and psychosocial issues around the world. The 2016 theme “Dignity in Mental Health-Psychological & Mental Health First Aid for All” takes mental health out of the shadows so that people in general feel more confident in tackling the stigma, isolation and discrimination that continues to plague people with mental health conditions, their families and careers (World Federation for Mental Health).
The IIHA and CIHC are proud to recognize that our Mental Health in Complex Emergencies (MHCE) training course, organized in conjunction with UNHCR, HealthNet TPO, and International Medical Corps (IMC), takes place this week in Geneva, Switzerland. The course allows us to do our own part in continuing to train and educate humanitarian professionals who respond to the mental health and psychosocial needs of the most vulnerable in crises around the world.
And that‘s not all.. after a long summer, this edition is full of IDHA alumni updates from IDHA reunions around the world to new positions to recently published articles! Read now, and stay tuned for more!
For almost 20 years, the International Diploma in Humanitarian Assistance (IDHA) has served as one of the leading multidisciplinary training programs for humanitarian aid workers worldwide. Supported by a core team drawn from Fordham University faculty and some of the top humanitarian professionals in the field, the IDHA effectively balances theory and practice to bring participants to the cutting edge of humanitarian knowledge and application.
Organized by Fordham University’s Institute of International Humanitarian Affairs (IIHA) and the Center for International Humanitarian Cooperation (CIHC), the IDHA has welcomed esteemed lecturers and speakers including H.E. Nassir Abdulaziz Al-Nasser, Kofi Annan, Elhadj As Sy, Boutros Boutros-Ghali, H.E. Jan Eliasson, Francis M. Deng, Ibrahim Gambari, Bernard Kouchner, Jemilah Mahmood, Lord David Owen, and Margareta Wahlström. Founded by Kevin Cahill, M.D. and Directed by Larry Hollingworth, C.B.E. since the inaugural course, the IDHA has been held in numerous locations around the world including Amman, Barcelona, Berlin, Dublin, Goa, Geneva, New York, Nairobi, Kuala Lumpur, and Pretoria.
Together, the IIHA and CIHC have trained over 2,500 participants from 133 countries.
Each IDHA course is made up of a diverse body of students with a wide array of backgrounds and a broad range of skills and interests acquired through years of professional experience. The unique perspective each participant brings to the program is essential to creating the dynamic learning environment on which the IDHA thrives. IDHA 48, which took place in June 2016 in New York, was one of the most diverse courses yet, featuring 41 participants from 27 nations, representing 36 organizations, and working in 26 countries around the world.
IDHA 48 is off to a strong start in New York City! Last week, the IIHA welcomed 41 students hailing from 27 nations, representing 36 different organizations in 26 countries around the world. Tony Land, Ph.D. (IIHA Senior Fellow),GonzaloSánchez–Terán(IDHA 16, CIHC Deputy Humanitarian Programs Director), Mark Little (IDHA 27, IDHA Alumni Council), Angie Jackson (IDHA 27), and Al Panico (IDHA 30) return to their roles as IDHA tutors, and welcome Naomi Gikonyo (IDHA 29) to the IDHA NY tutor team. The course was opened by Larry Hollingworth, C.B.E. (IIHA Humanitarian Programs Director), Kevin M. Cahill, M.D. (CIHC President), and Brendan Cahill (IIHA Executive Director, IDHA 9) who provided welcomes and introductions to the IIHA and CIHC and offered words of wisdom, guidance, and encouragement to the IDHA 48 class.
The first week began with leadership and team-building exercises facilitated by the dynamic Pamela Lupton-Bowers and included some team bonding and discussion outside of the classroom on a sight-seeing cruise around lower Manhattan. The week also featured lectures by the IDHA 48 tutors to set the scene of the humanitarian landscape; presentations on various aspects of law pertaining to humanitarian crises, human rights, and immigration delivered by Elisabeth Wickeri (Executive Director for the Leitner Center for International Law and Justice at Fordham Law School) and James Stillwaggon, Esq., (Counsel for Alvarez, Arrieta & Diaz-Silveira LLP); and lectures given by Peter Hansen (CIHC Board Member) and Darryl McLeod (Chair of the Economics Department at Fordham University).
As the 48th International Diploma in Humanitarian Assistance (IDHA) approaches this Sunday, we share with you a brief of a lecture given on last year’s course by Patrick Walsh, Senior Adviser at SDSN.
After 18 months of international dialogue with experts from UN organizations, academia, civil society, business, and various national statistical offices, the UN Sustainable Development Solutions Network (SDSN) headed by economist Jeffrey Sachs drafted its 2015 report. The report, Indicators and a Monitoring Framework for the Sustainable Development Goals, “outlines how a comprehensive indicator framework might be established to support the goals and targets proposed by the Open Working Group on [Sustainable Development Goals (SDGs)].”
These goals encompass economic, social, and environmental policy fields and aim to provide a quantifiable framework for the construction and monitoring of local, national, regional, and global SDG progress. “We can’t isolate economic, social, and environmental policy anymore,” noted Patrick Walsh, Senior Adviser at SDSN. Walsh was leading IDHA’s afternoon lecture on the transition from crisis to development—where the need for humanitarian relief turns to that of nation building and sustainability. “Maybe in talking about that transition,” proposed Walsh, “we really see how to connect development to the humanitarian world.”
This connection, however, contains multiple points of resistance. The policy fields included in the report “have to be integrated both in the developing world and the developed world,” noted Walsh. But as the students quickly confirmed, such sustainable integration, not only between policy fields but also between international departments and organizations, often proves to be a difficult—and arguably unfeasible—partnership.
“Jeffrey Sachs’ answer to this is, of course, [that] development is what’s really important,” Walsh explained, “because if you don’t make progress in development, you’re just setting up crises of the future.” Ascribing financial primacy to crisis aid may provide temporary security solutions, but it fails to combat the very conditions from which future conflicts, and therefore future spending, will later arise—and will continue to arise—at the expense of the international community. Development becomes imperative, and Sachs “already thinks the resources are being wrongly allocated.”
Unfortunately, such challenges will not simply evaporate, nor can they be swept aside. In fact, successful progress with the sustainability goals outlined in the report hinges on resolving precisely these difficulties. Partnership is the fulcrum by which SDG progress is set into motion; progress is not made unless partnership is achieved. The “transformative ideas” brought to light by the report underscore this need for universality.
“Before we used to think of development as simply overseas development aid or foreign aid, where it’s the northern hemisphere donating to the southern hemisphere,” Walsh explained, “and that the southern hemisphere has to ‘catch up’ and work.” Environmental issues and climate change models radically challenge such assumptions and put pressure on the global community—though in terms of climate change, responsibility rests primarily with the northern hemisphere.
“But we fear it’s not just environmental issues,” Walsh admitted. “When people look at global value chains and industrial structures, there’s more and more of a realization with global finance and global trade—and even with global migration—that really the world has gotten much more interconnected.” The interconnectivity of global challenges calls for a holistic approach, despite the continued “polarization” of governmental departments and institutions. “We cannot in isolation look at security, in isolation look at social development, in isolation look at environment,” explained Walsh. Nor for that matter can these issues be solely the responsibility of governments. “Solutions have to be found where private sector, civil society, the government, and academia” intersect and where the incentives of each align.
“Households naturally [implement] sustainable approaches,” began Walsh, hoping to better explain the difficulty in aligning interests. “Any household I know, they focus a lot on children (they sacrifice a lot to put kids through school); […] the adults are investing in pension schemes and other things so that they will have security when they’re old; there is always a struggle around nutrition, so that when you’re young you eat properly so that you’ll be healthier when you’re older. This is what households are doing: they are all the time on the medium-long-term plan—always. When there’s a big financial shock, […] they delay fertility decisions; they take kids out of private schools; […] they don’t go on holiday. […] Whatever they have to do, they make that adjustment and that response to keep them on track to meet their long-term goals. Do we think governments do that? No. Do we think the private sector does that? Do we think NGOs do that? And this is the problem. This, to me, is the essence of [the question] of how do we somehow align the values and align all these groups and have a more medium-term, long-term perspective.”
“The vision here, under Jeffrey Sachs,” Walsh concluded, “was to start thinking about these types of partnerships and how they might deliver sustainable development goals.” For the UN, ‘sustainability’ entails the interaction between “three pillars:” economy, society, and environment. Walsh anticipated the audience’s concern: Oftentimes, “you might look at foreign direct investment and investment goals, and you might say, ‘that’s the evil of the world; their going in with their value chains to get the lowest cost labor, the lowest cost raw materials without much respect for the environment—the whole world is fused with these value chains and its very very destructive.’”
This assumption is certainly not unfounded. But “on the other hand,” countered Walsh, “you could look at industrial policy at a nation state where governments can have investment criteria.” Governments possess the capacity to dictate economic terms and set clear investment incentives. In theory, companies and corporations “should not really be trying to exploit gaps in societies and environments,” said Walsh; “all those gaps should be closed.” They should instead be incentivized to be on one level “mindful of human rights” and on another level “creating positive outcomes for societies and environments.”
This is of course the ideal, but as Walsh explained, such a project is not unattainable. Creating positive outcomes becomes a matter of creating “a demand for responsible investment.” The difficulty arises in the reconciliation of two key policy challenges: sustaining economic growth and tackling rising inequality. “The challenge of the Sustainable Development Project,” Walsh clarified, “is that we need to start thinking about new institutions, new ways of doing things, new policies that actually allow us to have economic prosperity but [those that generate] much more inclusive societies.”
Walsh drew the students’ attention to one particular working group goal outlined in the report—Goal 16: “Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels.” Indicators for attaining this include the reduction of violence, abuse, exploitation, trafficking, and arms flow, as well as the promotion of the rule of law and equal access to justice.
This goal, Walsh believed, falls most closely in line with the efforts of humanitarians on the ground. While it is certainly ambitious and perhaps lacking in the level of accountability or adequate “benchmarks” that many students believed requisite in assessing development, the goal, nevertheless, acts as a clear enunciation of sustainable objectives for the international community. One must consider the “developmental histories” of our own countries, Walsh explained. A state does not simply “jump” from one stage of development to the next; the process occurs slowly and often with the assistance of external players. “We have to build the nation state before the nation state can take responsibility,” Walsh concluded.
To better understand this development, it can be useful to run the process in reverse—understanding the factors that destabilize states and lead to collapse. “I wanted to try and get back to why a state fails,” explained Walsh, “and then—in terms of even your basic military and humanitarian intervention and what happens at ground zero—[ask] what sort of principles and what sort of things should really be happening in the humanitarian, the military, and the development interface.” What factors contribute to societal unrest and state instability, and how can the knowledge of these factors produce potential solutions for external organizations in constructing “development pathways from conflict”?
In his paper, Patterns of Conflict in the Great Lakes Region, Walsh analyzes the discrepancy between conflict developments across neighboring African states. The report juxtaposes two separate “zones”: zone 1—comprising Burundi, Rwanda, Uganda, and the Democratic Republic of Congo—representing the “conflict” states, and its “counterweight,” zone 2—comprising Kenya, Malawi, Tanzania, and Zambia —representing the “peaceful states.” The goal, as outlined in the report, is to “identify a set of structural and historical factors (if any), that differentiate the zone 1 from the zone 2 states and which can explain the incidence of conflicts across time and countries.”
“What I’m searching for is a set of structural factors—a combination of things, whether they’re economic, social, or government structures—that makes you more vulnerable to conflict or less,” Walsh explained. By juxtaposing historical, economic, societal, and governmental developments, Walsh was searching for the underlying conditions that gave zone 1 a greater propensity for unrest. “The argument that I am going to make is that those who embraced development—particularly more openness in [their] society and their economies —and were less fractional (less [prone] to creating two separate groups) were the ones who came out the other side without conflict.”
Walsh noted some possible objections to his methodology. Some theorists maintain that every conflict is “idiosyncratic” and thus resistant to the kind of statistical analysis academics such as himself may hope to perform. If this idiosyncrasy were the case, however, analysis would reveal statistical uncertainties, and Walsh believed his findings told a much different story. Though the largest single indicator on the regression was precisely these “idiosyncratic effects by region and by conflict,” the indicator only accounted for about 40% of the variation, meaning there was a combination of separate, quantifiable factors contributing to zone 1’s propensity for conflict. (The fact that the idiosyncrasies was the largest single indicator means only that no other one factor could determine the variation between zones; it was thus a combination of historical, economic, societal, and governmental factors that contributed to this variation).
One of the most significant of such factors was colonial history. Colonization often lead to linguistic and ethnic fractionalization, destabilizing factors that later impacted social and economic development. The colonial power that had the most detrimental effect on states was Belgium. The Belgians used a particular type of strategy of indirect rule where they would “use and augment previous distinctions to define a local ruling elite.” This system proved the most destructive and “was a much bigger feature of Rwanda, Uganda, etc. that naturally had a north-south divide,” Walsh explained. Belgian rule acts a natural indicator of ethnic divide, but the Belgians were not the only force that perpetuated such divisions —Uganda, for instance, while belonging to zone 1, was not colonized by Belgium, but was rather divided due to its topography. What the Belgian indicator represents is rather the much greater destabilizing trend of ethnic divisions, perpetuated either by history or geography.
As the report concludes, “zone 1 states began the period of independence with serious vulnerabilities: particular forms of colonialism interlocked with ethnic divisions to produce conflict potential. However this was far from determining. It was the addition of other factors—military dictatorships, an isolation from the wider economy, and, particularly as violence developed, a hollowing out of the adult population and a destruction of civil society, that produced high conflict risk.” Likewise, countries in zone 2 though beginning their development trajectories on much more favorable historical conditions, nevertheless, required “subsequent choices and events, openness to international trade and aid, civilian dictatorships with strong integrative ideologies [(dictatorships indicated statistically greater levels of stability)], that permitted the building of cultural, political, and civil society barriers— [like an] immune system—against conflict.”
Though the conclusion produces no groundbreaking discoveries in the generation of conflict, it does provide a quantifiable explanation to compliment contemporary literature. It also helps to isolate developmental factors such as economic and political structures that may themselves help to “mitigate the initial conditions” of conflict —colonization, ethnic divisions, language, etc.
“When we go in with humanitarian action or we do capacity building, to build a state, build a colony, build a society,” explained Walsh, “we [should be] looking at how these economic or social indicators of development” may help in the intervention during times of conflict, and later, in the prevention of future conflicts. And in the end, the knowledge that prevention is critical and indeed possible becomes essential. “Those who are in the humanitarian world and the development world,” concluded Walsh, “have to believe that if we go into other countries, that we have to [contribute to a] change for good—that we’re pushing or nudging society, politics, and the economy in a direction that’s peaceful, that’s inclusive and responsible.” Otherwise, why go in at all?
Lecture given by Patrick Walsh, Senior Adviser at UN Sustainable Development Solutions Network (SDSN) to the IDHA 45 class at Fordham University, New York, June 2015
Brief written by Joshua Paul St. Clair, IIHA Summer 2015 Intern
Professor Patrick Walsh also gave a TED talk this past February 2016 focusing on the UN 2030 Sustainable Development Agenda and how it is an agenda of the people with the responsibility of implementation by the people. He delves into how people must use their influence over their livelihoods, civil society, and governance to create successful partnerships on local, national, and international levels.
“The kinds of trainings provided by the IIHA at Fordham University bring the MHPSS community within the NGO and humanitarian sectors a step closer to understanding how best to implement MHPSS programs in various, and often very difficult, contexts. It helps us to direct the conversation at the ground level, at the national and international level, and then to express the needs (and potential solutions) to the donors. The training in Ethiopia has really given me the direction I need both within my work in psychosocial programming, and also at the country level. I am able to feed into the coordination mechanisms and reference the training and experiences of experts in the field, in order to guide the discussion and suggest options for improving the provision of services. This is something that will take time. With experiences such as the one I had in Ethiopia, I do think with time and passion and imparting of knowledge, we can edge closer to supporting countries to provide basic mental health services to their people.”
Read Caitlin’s full reflection on the IIHA blog and more about her experience on Sujen’s blog. The next MHCE course will take place in October 2016 in Geneva, Switzerland. Learn more on the IIHA website.
In September 2015, I attended the Mental Health in Complex Emergencies (MHCE) training in Debre Zeit, an hour’s drive from Addis Ababa, the capital of Ethiopia. The training was organized by the Institute of International Humanitarian Affairs (IIHA) at Fordham University in collaboration with HealthNet TPO, UNHCR, and International Medical Corps (IMC).
I arrived to Ethiopia with my colleague Boniface Duku from South Sudan. He is the Mental Health Advisor for South Sudan’s programmes and at the time, I was the Coordinator for a Psychosocial Project we ran across four counties.
I had been to Addis Ababa before very briefly during a period of leave from South Sudan. However, this was my first time outside of the capital, and my first time to see the wonderfully serene surroundings of Lake Bishoftu where we were staying for the duration. Prior to the training, I had very few expectations due to the fact that I was so immersed in and consumed by my work in South Sudan that I hadn’t given myself the space to fully read up about the content of the course. All I knew is that it would be a prime opportunity to delve into challenges and opportunities of implementing mental health programmes in complex humanitarian emergencies worldwide. In all honesty, I hadn’t even researched the facilitators, who it turns out were renowned and highly experienced members of the mental health and humanitarian professional communities. Once I arrived and took some time to read the articles, look over the agenda and do a quick google of the facilitators I felt pretty sure that I’d lucked out on a potentially life-changing experience from which I would take away a vast amount of knowledge, experience and opportunities. I wasn’t wrong.
While working in South Sudan, I was also undertaking a distance MSc in International Humanitarian Psychosocial Intervention through the University of East London in the UK. Previously, I studied BSc Psychology, with a Professional Placement in a Psychiatric Hospital where I worked with people with severe mental health issues and those who needed additional support in the community. In my role as Psychosocial Project Coordinator in South Sudan, I was able to use some of these academic and practical skills to support people who have experienced trauma and high stress during the period of conflict, as well as during the displacement that ensued. I had never had comprehensive training or academic studies combining the two areas – the support of people with mental health issues within the context of humanitarian emergencies. The MHCE training was the perfect fit for me, and it provided me with information from a variety of sources, contexts and experts to supplement my academic background and work experience. Previously, I mentioned feeling privileged that I was put forward for this training by my organisation, HealthNet TPO. I stand by that and reiterate the fact, because the training did not only enhance my understanding in the short-term or specific context of South Sudan, it also provided me with lasting lessons and friendships with like-minded people.
During the training, the focus was primarily on clinical mental health service provision such as diagnosis and treatment of severe mental health disorders in fragile states, or disaster or conflict settings. This was extremely interesting for me as I hadn’t actually seen this up-close in South Sudan. There are limited clinical mental health services available in South Sudan as it is one of the most underdeveloped countries in the world. It has extremely limited infrastructure, very few resources and the personnel are few and far between, and when they are there they are barely trained, and when they are trained they are whipped up by better paying non-governmental organisations (NGOs) because they are often underpaid in government positions. This is extremely common, and desperately sad for the country, because it means the sustainability of any programming that requires government backing, continued resource supply or long-term supervision and follow-up from training is unlikely to withstand the restrictions mentioned. I also run a Psychosocial project, which although psychosocial issues and mental health issues are on a sliding scale, we aren’t able (given the context) to do very much in the way of clinical support. It was inspiring to hear the variety of challenging circumstances and experiences faced by the facilitators, in humanitarian emergencies across the world, spanning decades, and the innovative and varied ways they overcame and learnt from these situations. It gave me hope that even in the most dire of circumstances, in the least established countries, there are still opportunities where professional communities such as ours can at least initiate the conversation, create an evidence-base and forge the beginnings of quality and impactful work in relation to mental health service provision. Although, in terms of the situation in South Sudan, I fear these goals are still a long way off.
Since the MHCE training, I have been able to integrate some of the elements into my daily work, and I was able to facilitate conversations regarding coordination of mental health and psychosocial support mechanisms within South Sudan. I have referred information to other interested partners, and referred back to it on many occasions as I continued my project through December 2015. I also earmarked many of the readings and research articles in relation to my Masters. There was a wealth of information and knowledge imparted that was invaluable to me and my career development. I can’t fault the content or the delivery of the training as it was varied and engaging throughout. Upon my return to South Sudan, I felt I didn’t fully have time to absorb the content and the lessons learnt because I jumped straight back into work as soon as the training had finished. I am now taking the time to immerse myself in the training again and go through it with fresh eyes to really take on some of the wisdom I may have missed first time around.
At the beginning of December I was fortunate enough to be able to attend another IMC event, this time a workshop in Juba, South Sudan. It was a presentation of the current delivery of mental health services in the country, drawing on experiences from other countries, and the disparity between them. It became very clear from the presentations that the current level of the health systems within the country would be an unfertile ground for consistent, quality mental health service delivery. This, combined with the previous ten-day training in Ethiopia were starting to bring together a formation of ideas for me to present to the coordination mechanisms in country, as well as discussions about how we can document this. From the MHCE training it was abundantly clear that we need to step up our game as an international community in terms of creating and sustaining an evidence base to support our work. It’s not good enough to share ideas once a year at trainings such as this; we need to have a systematic way of recording our experiences, both positive and negative, to inform future project implementation.
Stepping back from the technical side: the lack of systems, infrastructure, resources, funding and personnel, the poor attitudes and awareness of mental health in the communities, is really devastating. It is truly heart-breaking to hear about individual cases of people who are systematically uncared for because there is just no support available, or lack of knowledge or understanding. People with severe disorders are often chained to trees in order to ‘limit their aggressive behaviour’. A common misconception, or an immediate knee-jerk reaction to people expressing symptoms of mental health issues, is that violence will ensue. Sometimes, it does, but is usually related to the negative response from the community and the lack of effective treatment.
Much of the mental health and psychosocial work carried out in South Sudan currently is focused on internally displaced people (IDP) settlements or camps, because the needs are extremely high. Many of these people have experienced extreme levels of trauma. Some of these people are just children, infants, who have lost members of their families or even seen them killed in front of them whilst fleeing violence consuming their homes and communities. The needs are usually imminent and acute, and require some follow-up but can ultimately, often, be dealt with by mobilising community support systems and resources that the person or family already has. Often whole communities flee together, so their social structures are still around them, it’s just a case of reiterating this and encouraging them to utilise them. The issue for the rest of the country is that it’s in a state of chronic emergency. It’s no longer a humanitarian emergency because the threat or risk of violence is lower in some areas. It’s not, however, in a development stage because as I’ve mentioned, the infrastructure is not there to build upon. Therefore, there is a vast majority of the country that doesn’t fall in this ‘emergency’ phase, requiring only the immediate psychosocial support. People living with mental health issues are at the back of the queue as they don’t fall in the ‘emergency relief’ beneficiary category, nor are they provided for by the services already in place.
The needs are clear. The solutions, however, are not.However, the kinds of trainings provided by the IIHA at Fordham University and IMC bring the mental health and psychosocial support (MHPSS) community within the NGO sector a step closer to understanding what it is that can be done. It helps us to direct the conversation at the ground level, at the national and international level and then to express the needs (and potential solutions) to the donors. The training in Ethiopia has really given me the direction I need both within my work in psychosocial programming, and also at the country level. I am able to feed into the coordination mechanisms and reference the training and experiences of experts in the field, in order to guide the discussion and suggest options for improving the provision of services. This is something that will take time. South Sudan and its mental health services is like a metaphorical Rome; it won’t be built in a day, but with experiences such as the one I had in Ethiopia, I do think with time and passion and imparting of knowledge, we can edge closer to supporting countries such as South Sudan to provide basic mental health services to their people.