With rising mental health and psychosocial support needs in Ukraine, a volunteer hotline, supported by Humanity & Inclusion, allows affected populations to access services any time, from anywhere.Read more
Anfal Mahmoud Ali, shares how her experience living amid conflict shapes her work as a mental health and psychosocial support officer for Humanity & Inclusion in Iraq.
I remember May 5, 2017, like it was yesterday.
My family had been hiding in our bathroom for days without food or water, clutching our IDs. Our neighborhood in Mosul had been liberated from ISIS, but fighting on our street persisted. Then the airstrike happened. Our family home crumbled around us. By a miracle, we survived and managed to escape first to a neighbor’s house, then to a displacement camp.
Later that year, we returned to Mosul. We had nothing. A friend of mine told me that Humanity & Inclusion was hiring, so I applied. Since working here, I've been able to support my family, repair my house, and rebuild our lives.
I've seen first-hand the effect that conflict has on civilians. They lose their loved ones, their jobs, and their homes. And they usually face poor conditions, even after the fighting is over. Violence and devastation can cause people to experience depression, sadness and sometimes suicidal thoughts. Some people suppress their feelings. Others develop physical or chronic illness as their mental health needs go untreated.
My colleagues and I conduct awareness sessions with people experiencing psychological trauma, encouraging them to seek help and teaching coping mechanisms. When I meet all of these wonderful people, I am motivated to wake up in the morning and do my work with love. My neighbors understand that we need to stand by each other to survive. I thank those who are helping survivors of conflict, like me, access essential resources—shelter, rehabilitation, mental health support, and more.
Caglar Tahiroglu, Humanity & Inclusion’s Emergency Mental Health and Psychosocial Support Manager, explains the needs and resilience teams are seeing in Ukraine.Read more
Dorothy Namara is a Mental Health and Psychosocial Support (MHPSS) Specialist for Humanity & Inclusion’s South Sudan program.
With a master’s degree in clinical psychology, Dorothy has held a variety of MHPSS roles within the organization since 2018, when she first began working in her home country of Uganda. Always eager to take on a new challenge, Dorothy shares the needs, highlights, and challenges of taking on such an important role. Below, Dorothy shares her experience as a mental health specialist for Humanity & Inclusion in South Sudan.
Q: What are your daily responsibilities?
I engage in a variety of activities depending on what is planned for a given month. I provide technical support for the mental health projects in the program, provide capacity building trainings, and ensure quality assurance to make sure the mission’s MHPSS programs are in line with Humanity & Inclusion’s global standards. I also represent the organization externally and provide an MHPSS lens for stakeholder activities.
I also have to take into account the different mental health emergencies that arise from the project sites. They may not come up every day, but when they do, I give them priority.
Q: What do you like most about your job?
Positive change! Seeing the smile on a person’s face is very rewarding. I wake up every day looking forward to it. I love seeing the transition from their first meeting to their last meeting, and watching them develop positive coping strategies about life amidst adversity. It gives me courage, especially when I see persons with disability. I’m a person with disability myself, so I take a lot of pride in seeing these changes.
Q: What is unique about the context of the South Sudan program?
South Sudan is a very unique context. It has diverse cultures and languages that spread across 10 states. Each of the cultures has its own practices and dynamics that you have to understand before introducing an intervention or project. Community acceptance is key to a project’s success, and not everything that has worked elsewhere works in South Sudan.
You may wake up in the morning ready to go to work, then you encounter a security situation and cannot do what you had planned. You may also have to organize counseling sessions around other projects that participants are involved in, such as cash for work. So, you really have to be flexible and take things one day at a time. Every day has its own unique context.
Personally, I embrace it positively. It gives me the opportunity to think outside of the box and ask myself: How can I best empower the team to accommodate changes positively and move on without being frustrated? It gives me a learning point to embrace the context, embrace the culture and appreciate the people, so for me, it’s very positive.
Q: What are the greatest needs?
We have traumatized populations that are constantly in conflict. Today there may be conflict in one place, another day you will find it somewhere else. We see a lot of trauma cases. Depression, PTSD, anxiety, domestic violence and suicide are all common. Alcohol and substance abuse are particularly common. We also see a lot of protection cases, such as early child marriages and gender-based violence.
Mental health needs to be addressed as part of the bigger pictures of health and protection—especially when it comes to the most at-risk populations, including persons with disability. This population really needs support because most of the time they are left behind. This is why I’m really happy with Humanity & Inclusion’s advocacy efforts. We’re able to create awareness among our partners about mainstreaming disability in their programs, but more support is needed.
Q: What do you wish more people knew about your work?
People should know that the diversification of mental health projects, by including skill development, livelihood initiatives and income-generating activity has a greater impact and results on the psychological wellbeing of the population. For example, coupling mental health with livelihood projects works wonders. Whenever someone is able to get their mind settled, and then you give them a skill to make a living, it empowers them to maintain their coping strategies. They cope better. If they come to the sessions and talk about their stressors, and then they go back home and sleep hungry, this will bring them back to the same situation they were talking about in-session.
There are not many MHPSS actors in South Sudan. South Sudan is a huge country, and mental health coverage is just a drop in the ocean. We can only do as much as our funding can cover. Because mental health is not a tangible thing that entices donor funds, there are very few that really invest in mental health. When you build 10 schools, they are physically there and are visible. But, when you have group counseling sessions with 500 mothers or 200 children, it’s hard to see the evidence until donors can hear participants share the benefits. It’s really a challenge.
Q: Is there anything else you would like to share?
We appreciate those that have been able to fund the cause of Humanity & Inclusion in South Sudan. We call upon them to continue, because mental health is not a one-day change. It is a process. For a mental health project to be effective, we need years of implementation to document tangible, more permanent changes and see more of the community benefit.
Everyone is a candidate for mental illness. Anyone can be affected at any time. No one chooses these illnesses. We cannot predict that one day there will be no mental health issues. There are very many stressors in the environment that can cause them, just like any other health-related illness.
Lastly, it is important that we not forget the link to people facing specific hardships, including people with disability who are disproportionately affected. At Humanity & Inclusion, we believe that every life matters, and there is no health without mental health. It is important to invest in mental health and psychosocial support, because not all wounds are visible.
Mohammad Rasool is base coordinator for Humanity & Inclusion in Afghanistan, managing our work in the Kandahar and Nimroz provinces. There, our teams are providing rehabilitation and psychosocial support. In this interview, Mohammad describes the situation on the ground.
Q: What is it like living in Afghanistan at the moment?
People are still struggling with poverty, displacement, drought, the risk from Improvised Explosive Devices (IEDs) and threat from ISIS. Additionally the country is facing a failing health system and the economy is also on the edge of collapse. So people are highly distressed as they don't know what will happen next in this highly unpredictable situation.
Daily, thousands of people are aiming to leave the country due to protection issues or to seek a better life out of the country. Everywhere in Afghanistan, there is food insecurity and there's a huge need for humanitarian assistance.
Q: What is the level of need for rehabilitation services in Afghanistan?
Even though the conflict is now over, I mean the big conflict between the previous government and the IEA, the battlefields and the districts are still highly contaminated with explosive remnants of war and IEDs. So, of course, the need for physical rehabilitation and risk education, and also for psychosocial support, remains high.
Q: Could you describe how Humanity & Inclusion's teams are supporting people in Afghanistan?
We have several approaches to reach people in need of services, especially rehabilitation, psychosocial support or skill development (which is for income-generating activities).
For instance, we provide support in the rehabilitation center where people are referred to us by other stakeholders including humanitarian partners. And we also have mobile teams. We go to the communities where we deliver the services directly to people. We also refer them for follow-up services to other partners and also to the rehabilitation center if they need further support.
Q: What is the level of injuries at the moment in Afghanistan?
In Kandahar, approximately one-fourth of the people we are seeing in our rehabilitation center are survivors of the conflict. Either they have acquired their injury in the recent conflict in the recent months, or they are the victims of the conflict in the previous years, but they didn't have the opportunity to access the center. We also see people who have injuries from road accidents as well as people who acquired a disability during birth.
Q: Are you able to share the story of a patient that particularly affected you?
I will share one of the story out of a thousand because in our center we are seeing 9,000 patients every year.
One of the people who was referred to us in the recent months was Anisa, an 8-year old girl from Zabul Province (pictured above). A mortar bomb hit her house while she was playing at home with her cousins. She was badly injured and she was taken to several hospitals to treat her.
Unfortunately, her left leg had to be amputated and then she was referred to the rehabilitation center in Kandahar, which is managed by Humanity & Inclusion. Our team at the rehabilitation center worked with her for several weeks to help her recover. She was happy that she could play again with her cousins or go to school.
Q: What are the major challenges you face at the moment?
Certainly, there have been some changes as the new government is not well established yet and the public service remain interrupted. So there are a lot of uncertainties and the new government is trying to introduce new guidelines procedures. Female staff who are working for the public sector, apart from the health sector, are still not able to attend work. We had some challenges related to access for our female staff to our community-based activities. We had a lot of interaction and intensive engagement with new authorities. Finally, we succeeded and access for our female staff was granted.
Q: What do you enjoy the most about your job?
I like visiting my team while they are delivering services to the people we support. I take the opportunity to directly hear from my team and their patients, listening to their feedback, suggestions and challenges that they face in the day to day activities.
Q: Do you have any message for our supporters here in the U.S.?
Of course, I have a message: The people of Afghanistan really need the support from the international community now more than ever. So please, please don't forget Afghanistan in this difficult time.
At least 144 people were killed after a fuel tanker exploded in Freetown, the capital of Sierra Leone, on Nov. 5. After assessing needs in the field, Humanity & Inclusion is moving on to the next stage of its response: assisting victims.
Humanity & Inclusion teams were working in Freetown when the explosion occurred and immediately began evaluating needs in the community. The victims include especially at-risk groups such as children, aging people and people with chronic diseases.
Focusing on rehabilitation and psychosocial support, Humanity & Inclusion will work in partnership with other organizations and the Freetown city authorities over the coming days to provide support to:
- 200 injured survivors of the explosion
- Relatives of the 144 people who have died
- 1,172 indirectly affected members of the community
- 50 health professionals
Rehabilitation and psychosocial support
In addition to emergency medical care, victims of the explosion will need long-term rehabilitation and psychosocial support.
Hundreds of people were injured in the explosion, many with severe burns. Burn victims risk developing joint contractures and difficulties with movement, and require special rehabilitation care. Unfortunately, physical therapists in Sierra Leone do not have expertise in caring for serious burn victims. Humanity & Inclusion plans to develop targeted rehabilitation activities so patients can get the care they need.
When people experience a traumatic event on this scale, victims and their families need help to overcome their pain and the impact of the accident.
“We plan to assist victims affected directly and indirectly by the disaster,” says Pauline Ducos, Humanity & Inclusion’s director in Sierra Leone. “Psychosocial support and rehabilitation care are among our main priorities. Humanity & Inclusion will help victims overcome the disaster and build their resilience. Social workers from our partner organization will reach out to each victim and their family, listen to them and refer them to specialized services, if necessary.”
Humanity & Inclusion’s emergency response includes:
- Rehabilitation care for burn victims: physical therapy sessions; patient follow-up; covering transportation costs
- Psychosocial activities: individual and group support; paying wages of psychosocial staff members
- Training health staff
More than 100 people were killed when a fuel tanker hit a large truck and exploded on Nov. 5 in Freetown’s Wellington district. Humanity & Inclusion staff in Sierra Leone are working to assist the community.
Humanity & Inclusion teams responded to the affected area, checking on people injured in the explosion, and their needs. Many people will require medical and rehabilitation care.
“It’s important to treat the injured, particularly serious burns victims, by providing them with rehabilitation care,” says Pauline Ducos, Humanity & Inclusion’s director in Sierra Leone. “If casualties are not treated after they leave the hospital, they risk losing their functional abilities and may develop a disability.”
Humanity & Inclusion’s teams also plan to help survivors and their relatives with psychosocial support.
“Our current priority is to give casualties psychosocial assistance in order to prevent extensive psychological damage,” explains Mamoud Kargbo, Humanity & Inclusion’s operations manager in Freetown.
A ‘national disaster’
Declared a “national disaster” by the Vice President of Sierra Leone, the explosion occurred when a fuel tanker collided with a large truck carrying granite. Most of the casualties are street vendors and motorcyclists who were attempting to recover fuel from the tanker when it exploded.
A total of 101 people died and 200 more were injured. Half of the people with injuries are unlikely to survive, according to the latest reports.
All casualties are being treated in the city’s hospitals and clinics, which have been overwhelmed by the sudden influx of patients. The facilities do not have staff with expertise on caring for serious burns victims.
Humanity & Inclusion in Sierra Leone
Humanity & Inclusion began working in Sierra Leone in 1996, when it opened a rehabilitation center in Bo, followed by three other centers. Since then, Humanity & Inclusion has worked alongside the medical community to improve the standard of rehabilitation care. Teams also promote inclusive education, protection and mental health.
Humanity & Inclusion has responded to major health emergencies in the country, including the Ebola epidemic from 2013 to 2015, the mudslide in 2017, and the ongoing Covid-19 pandemic.
Over the last 25 years, Humanity & Inclusion has served tens of thousands of individuals, including people with disabilities, children and women to alleviate poverty and improve access to essential services.
After Riad, 20, lost his leg in a shooting, he feared that he could not care for his family. Today, with the help of Humanity & Inclusion’s psychosocial support, physical therapy and a new prosthetic leg, he can’t wait to show his family what he can do.
On February 15, Riad and his family heard gunfire outside of their house in the Central African Republic. The shooting continued for hours, so they fled in search of safety. Like many others, they sought refuge in a mosque in Bambari. But their safety was short-lived, as gunmen soon entered and opened fire on the families inside, taking several innocent lives. Riad was shot twice, once in his left ankle and once in his right leg. He lay wounded on the ground until the next day, too afraid to seek help until then. By the time he was taken to the hospital, his injury had become so severe that his right leg was amputated 21 days later.
The operation was a success, but Riad worried about the future. He lives with his mother, his siblings and their children in Bambari. His greatest fear after losing his leg was that he would not be able to take care of his family. After the amputation, Humanity & Inclusion psychosocial specialists helped him overcome his fears, cope with the pain, and start adjusting to life with a disability.
Always accompanied by his older brother, Riad has been attending physical therapy with Humanity & Inclusion specialists twice a week in Bambari. Ready for an artificial leg, Humanity & Inclusion recently paid for the brothers to visit the Central African Republic’s only fitting center in Bangui.
“I can’t wait to receive my prosthesis,” Riad said during his fittings. “I hope to be able to walk again and take care of my mother. I’ll be able to go get food and spend my day working outside of the house. I think I’ll feel brave again.”
After a week of casts and learning to walk again, Riad received his new prosthetic leg.
“I used to look at my leg and cry, but now I feel stronger,” he says. “I feel that I will have less to worry about from now on and I’m so grateful for the support I’ve received from HI, from my amputation until now. I can stand up and walk again. I can’t wait to show my family!”
Header image: Riad practices walking with his new artificial leg at a fitting center in Bangui. Inline image: Riad and his brother at a rehabilitation center in Bambari. Copyright: A. Servant/HI
A violent incident cost Hervé his right leg, but with support from Humanity & Inclusion, the 26-year-old proudly stands on two feet again.
One day in late June marked the start of a new beginning for Hervé, who took his first steps with his freshly fitted prosthetic leg. In the months since his right foot was seriously injured in an armed attack in Bambari in February, Hervé’s life—and outlook—have changed dramatically.
After the incident, Hervé was taken to the hospital where doctors said they needed to amputate the lower part of his leg. At first, Hervé refused.
“I was so afraid of losing my leg and of the consequences it would have on my life,” Hervé explains. “I thought I would become a burden to my family and I didn’t want that.”
With Hervé refusing surgery, the hospital was prepared to discharge him despite the life-threatening risks of his injury. But his leg had become infected and the need to amputate was increasingly urgent. It was then that Humanity & Inclusion’s team learned of Hervé’s case and intervened.
Over the course of a week, Humanity & Inclusion’s mental health specialists counseled Hervé and helped him to overcome his fears, while educating him on the severity of his situation. With his newfound understanding and psychosocial support, he made the life-saving decision to undergo the operation.
After his amputation, Humanity & Inclusion’s team provided Hervé with a wound dressing kit and he regularly received care from physical therapists and mental health specialists to aid in a smooth recovery. His transportation costs to and from therapy were also covered by Humanity & Inclusion to ensure access to the care he needed.
When the time finally came for Hervé to take the next step in his recovery, Humanity & Inclusion took him to Bangui to be fitted for an artificial limb at ANRAC, the only fitting center in the Central African Republic. One week in June, Hervé spent every morning testing models and having molds made at the center, all leading up to the moment where he can finally begin to walk with his new prosthetic.
“I’m so happy,” Hervé says. “It has been so difficult to get around without a prosthetic. I hope, for myself and my family, that I will be able to walk normally again soon so that I can go back to living the way I used to. I see that little by little, I’m becoming mobile again and for that I thank HI.”
After his injury, Hervé’s job opportunities were limited. For now, he's shining shoes along the main road in the city for very little income. But with his newfound mobility, Hervé is eager to start a new job as a mobile pharmaceutical vendor, walking tall around the neighborhoods of Bambari.