Helping Children in Trauma in Low Income Countries: Emerging Themes from the ICMH Trail Blazer

1604432_10204960429064355_8071818172847661127_n 20150411_124640045_iOSPutting aside the reflections and personal experiences, what have I learnt from the first phase of the ICMH Trail Blazer? The question was so simple in its complexity: How can we help traumatized children whatever their experiences (individual, collective, societal) in non-westrn countries with limited specialist resources? I relied on some evidence on emerging and promising psychological, either trauma-focused or resilience-building, interventions; a widely accepted ecological framework that ideally we should intervene at child, family and community level; good models from other fields such as infant and maternal child health; and a few trusted friends to pave the way to NGOs, communities and motivated colleagues. The rest was, “off you go to find out for yourself, then come back, formulate models, and test them out for their generalizability”. So, what are the conclusions so far?

 

1. Despite the remaining mental stigma, individuals (victims, volunteers and practitioners), organizations and communities are ready and atively ask for psychosocial support, but are overwhelmed by the extent of need.

2. The answers mainly come from NGOs, who have trusting links, and provide access and engagement; but vary in their core mission, constantly need to seek funding, and often have limited own access to resources such as training. This does not negate the importance of forming partnerships with existing public services, no matter how strained they are, although realistically predominantly for future collaboration and currently for the seevere end of problems. Triangulation with local or national academic centres can also enhance training, set an evaluation agenda that can lead to further funding, and innovate e.g. by securing regul student volunteers, albeit within a clear programme and with specific tasks.

3. The layers for any child should move through:

  • Meeting basic needs and safety.
  • Resilience-building through education, skills attainment, sports, social or creative activities.
  • Counselling or psychological interventions integrated at all levels, and hopefully provided in a targeted manner at this third layer (the ‘how’ is a matter for future debate).

4. NGO colleagues have a lot more experience on how to define their categories and groupings, but in the context of the above child trauma model, I have come up with three types, and have been fortunate enough to set up the next phase accordingly with representative NGOs from each group, i.e.:

  • New or relatively small-scale NGOs: Here the priority is to estblish the charity according to its mission and make it sustainable, but training of volunteers at the right level is feasible to equip them with key skills.
  • More established or medium-size NGOs: As core structural and funding issues will have been taken care of, to some extent, training of volunteers as well a staff can become ongoing too, leading to a more systematic intervention programme. Counselling or therapeutic skills can be targeted next.
  • International or large-scale NGOs: These may have either already developed their psychosocial arm, whatever their model, or are in a position to do so next.

Let’s try these models out in the autumn in the second phase of the Trail Blazer, exchange notes, and plan the Big One (WACIT – watch out for details or get in touch to find out) for 2016!

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