Tag Archives: UNHCR

Older Persons: A Priority to Protect

Angela Wells / Jesuit Refugee Service

January 30, 2018, New York City – The earthquake and tsunami that hit Japan in 2011 proved to be one of the most devastating natural disasters of the century. For the nation’s men and women aged 65 and over, who made up nearly a quarter of its population, the disaster proved severely catastrophic. Unable to evacuate or secure shelter and under precarious health conditions, older Japanese people faced disproportionate insecurity, as reported by the Guardian.

The aftermath of the Japanese disaster brought to light the vulnerability of ageing populations affected by humanitarian crises. This unsurprising yet deeply neglected reality is one humanitarian responders struggle to address in protracted and emergency crises globally.

Around the world, older persons hold the social fabric of their communities together – especially when crisis strikes. They serve as family guardians and community leaders, advocates and teachers. They are also the first to fall through the cracks of the humanitarian safety net – with limited mobility and frail health as they struggle more than most to reach safety, rebuild their homes, and continue their lives in dignity.

While the number of older persons living in protracted or emergency crises is unknown, the United Nations Department of Economic and Social Affairs has reported that by 2050 the global population of individuals over the age of sixty will more than double to comprise a quarter of the world’s population. In countries susceptible to climate change-induced disasters and conflict, older persons are sure to face greater protection risks, barriers to healthcare, and vulnerability to exploitation and abuse.

Despite this evident risk, the humanitarian infrastructure continually falters in its attempts to provide dignified response to older persons – as reported by the UN Refugee Agency. Immediately after fleeing, they are the first to be split up from their families and lose access to lifesaving medical services. As they begin to start life anew, they face age discrimination when pursuing employment opportunities, health care, and social services.

In a humanitarian sphere with competing interests and rapidly evolving crises, older populations are simply not a top priority. This leaves a huge gap in assistance and creates an environment where older persons struggle to prevail.

Furthermore, in urban areas, where more than 80 percent of the world’s displaced reside, older persons are extremely marginalized and unable to access basic services. Whether the hurricane in San Juan or conflict in Mosul, cities are increasingly becoming hubs for disaster and their older and displaced residents the most affected.

“The elderly are largely invisible in disaster preparedness programs, rescue efforts and reconstruction projects. Too often, they are the forgotten ones whom no one bothers to inform, check on or assist….Older persons are particularly at risk if they live in sub-standard or overcrowded housing, in shantytowns, or in areas with badly designed infrastructure, poor transport systems, or ineffective local leadership,” wrote Ann Pawliczko, PhD IIHA Research Fellow on Ageing in a soon-to-be-published book on urban disasters.

Fortunately, the international community has made a concerted effort to address the plight of older persons affected by crises.  In 2002, the United Nations adopted the Madrid International Plan of Action on Ageing which urged humanitarian responses to include older persons in project design and assessment, and to protect older individuals, especially women, from exploitation and abuse.

Fifteen years later, significant strides have been made. Non-governmental  organizations like HelpAge International and the International Rescue Committee promote the inclusion and protection of older persons amidst global crises and displacement.The 2030 Agenda and its 17 Sustainable Development Goals call on the international community to leave no older person behind. Nation states have convened to form bodies like the Group of Friends of Older Persons to address their rights and needs on the UN stage.

Humanitarians are also beginning to recognize the wisdom and leadership that older persons contribute to their communities in the aftermath of crises.

“Older people are more likely to be aid givers than receivers. Their assistance to others means that supporting older people – with healthcare or income generation activities, skills training or credit – supports their families and communities. Little attention has yet been paid to how older people can be helped to fulfill such valuable roles in rebuilding communities, and recognition of their special contribution should not lead to devolution of yet more responsibilities without a corresponding increase in support,” reports HelpAge International.

Looking forward, HelpAge and the UN Office for Disaster Risk Reduction are pursuing and promoting fourteen targets that seek to improve humanitarian response to older persons. These include involving older persons in the development of disaster and climate risk assessment, increasing access to early warning signals and information for older persons, and ensuring direct support to older persons including income support and disaster insurance.

These solutions and others will be more deeply explored by representatives of the  Permanent Mission of Japan, UNHCR, IRC, and independent experts and Fordham University at an upcoming side event of the 56th Session of the United Nations Commission for Social Development: “Humanitarian Action for Older Persons: Fifteen Years After The Madrid Plan” taking place at the United Nations Secretariat next week.

The event is being convened by the Center for International Health and Cooperation and the Institute for International Humanitarian Affairs at Fordham University in collaboration with the Permanent Mission of Japan to the United Nations, the Group of Friends of Older Persons (GoFOP), the United Nations Department of Economic and Social Affairs (UN DESA) and the Office of the United Nations High Commissioner for Refugees (UNHCR).

Angela Wells, IIHA Communications  Officer
Noel Langan, IIHA Communications Intern

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World Mental Health Day 2016

MHCE 12Today 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.

Learn more about the MHCE course!
Learn about World Mental Health Day!
Take part in World Mental Health Day! 
Follow the Twitter Feed of World Mental Health Day!

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UNHCR Resource Update: Training Package on the Protection of LGBTI Persons in Forced Displacement

The comprehensive training package on the protection of lesbian, gay, bisexual, transgender, and intersex (LGBTI) persons in forced displacement, developed jointly with International Organization for Migration IOM, covers a wide variety of topics, including terminology, international law, communication, operational protection, conducting interviews, durable solutions, health, and refugee status determination, all with a focus on practical guidance for UNHCR and partner organizations. Through a series of field tests undertaken in 2015, UNHCR staff from around the world have helped to refine these materials to ensure that they are operationally relevant globally. All modules include a facilitation guide, participant workbook, and presentation, which can be downloaded. In addition to the main modules, short versions of the foundation topics, including a webinar that allows staff members to do basic self-study, are part of the training package. The training package includes general and module-specific guidance for facilitators, as well as other training aides, to promote the use of these materials in the field.

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UNHCR Resource Update: The Global Report “Protecting Persons with Diverse Sexual Orientations and Gender Identities”

This is the UNHCR’s first global overview of progress made in protecting lesbian, gay, bisexual, transgender, and inter-sex (LGBTI) asylum-seekers, refugees, and others of concern. The report is a significant contribution to UNHCR’s efforts to fill the information gap about the situation of LGBTI persons of concern to the Office, and it offers a blueprint for UNHCR to bolster LGBTI-inclusive protection programming. The key findings presented in the report are derived from an extensive review of protection activities undertaken by 106 UNHCR operations around the world, covering the following thematic areas: legal, cultural, and social context; identification and outreach activities; asylum and displacement conditions; refugee status determination and durable solutions; training on issues related to sexual orientation and gender identity; and, operational guidelines and advocacy efforts. The report identifies strengths and gaps in the protection of LGBTI persons of concern to UNHCR and concludes by proposing a way forward, which may be of broad interest to a diverse group of stakeholders, including UNHCR staff, other agencies of the United Nations, and governmental and non-governmental partners. Among the conclusions of the report, the following emerge as particularly critical areas for future attention both by UNHCR staff and other relevant stakeholders:

a. Train UNHCR and partner staff on sexual orientation and gender identity and the particular protection risks that displaced LGBTI people face, and specific means to address them.
b. Promote the creation of “safe spaces”, where persons of concern feel supported to express their sexual orientation and gender identity.
c. Develop partnerships with national and international LGBTI organisations and networks and with LGBTI people from refugee and host communities.
d. Explore possibilities for systematic data collection on asylum claims on the basis of sexual orientation and gender identity
e. Establish systems for identifying LGBTI refugees in need of resettlement, and ensure that LGBTI refugees are included in discussions with resettlement countries.

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UNHCR Resource Update: Community-based Protection Online Community

The community-based protection online community of practice facilitates peer learning and the exchange of experience between humanitarian and protection actors around the world. The community of practice brings together resources from UNHCR and other community-based protection actors, including tools, guidelines, videos, training material and examples of successful field practices. Specific thematic areas include age, gender and diversity, accountability to affected populations, and persons with specific needs. On the community of practice you will also find the first two issues of the new “Community-Based Protection in Action” series of thematic briefs, which aim to support the operationalization of community-based protection. The first two briefs cover the following topics: community centres and community-based outreach outside of camps. The community of practice is public and its resources are available to anyone interested in community-based protection. However, to truly make this a vibrant platform for peer learning and information sharing, the platform has been made available for anyone to upload material, share experiences, leave comments, and interact with other members. To do so, the sign up is possible here.

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IIHA Alumni Reflection: Caitlin Cockcroft-McKay

MHCE 11 - Ethiopia 2015

MHCE 11 – Ethiopia 2015

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.

Read the recap of the MHCE 11 course and read more about Caitlin’s experience on MHCE participant Sujen Man Maharjan’s blog. The next MHCE course will take place in October 2016 in Geneva, Switzerland. Learn more on the IIHA website.

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Humanitarian Newsletter: October 14-28, 2015

Read the latest IIHA Newsletter with a spotlight on World Mental Health Day 2015 and the recent Mental Health in Complex Emergencies (MHCE) course organized by CIHC and IIHA, UNHCR, HealthNet TPO, and International Medical Corps (IMC).

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IIHA Training Update: MHCE 11


Last week, the IIHA welcomed 25 students to Addis Ababa, Ethiopia for its 11th Mental Health in Complex Emergencies (MHCE) course, organized with HealthNetTPO, UNHCR, and International Medical Corps. The course was directed by Larry Hollingworth, C.B.E., Humanitarian Programs Director, Center for International Humanitarian Cooperation (CIHC) and Visiting Professor, Institute of International Humanitarian Affairs (IIHA), Fordham University; Lynne Jones, O.B.E. FRCPsych., Ph.D., Visiting scientist, FXB Center for Health & Human Rights, Harvard University and Consultant child and adolescent psychiatrist, Cornwall Partnership Foundation NHS Trust; and Peter Ventevogel, M.D. Senior Mental Health Officer, United Nations High Commissioner for Refugees (UNHCR). Congratulations to our recent MHCE graduates!

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Alumni Update: Stella Ngumuta (IDHA 38)

In March 2014, IDHA 38 Graduate and Class Speaker, Stella Ngumuta, started a new work assignment with the ICMC-UNHCR Resettlement Deployment Scheme, with her first assignment being in Solwezi, northwestern Zambia. Her primary responsibility is in the resettlement of refugees, as part of the International Protection mandate of the UNHCR in finding durable solutions for refugee problems.

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