Strong plea to address ‘blind spot’ in humanitarian efforts
The commitment to the mind was loud and clear, sent forth with passion from the very heart of the Netherlands, gathering momentum and being echoed and re-echoed from different parts of the world.
Even though the thousands, nay the millions caught up in crisis situations across the world may not have been present, their ‘ state of mind’ was on the minds and in the thoughts of all those who participated at the International Conference on Mental Health & Psychosocial Support in Crisis Situations ( MHPSS) this Monday and Tuesday (October 7 & 8).
The core message was simple – mental health and psychosocial support should be an integral part of the humanitarian response in crisis and emergency situations, as important as water, food and shelter.
It is on behalf of “people whose homes have been destroyed, whose families have been torn apart, who have crossed mountain ranges, deserts and dangerous waters in search of safe havens” that the dynamic catalyst, Dutch Minister for Foreign Trade and Development Cooperation Sigrid Kaag, brought this silent topic to centre-stage at the beautiful Queen Maxima Hall of the KIT Royal Tropical Institute.
“These are people who need our help,” she said, pointing out that “we have long knownabout the mental health consequences of crisis and conflict – consequences that are often and frequently carried inter-generationally. And yet, we have often failed to act on that knowledge”.
To underline how important this need is, the final day of this conference was graced by none other than Queen Maxima of the Netherlands in a simple beige ensemble, serenely smiling and chatting with those around her as photo- journalists seemed to go berserk in capturing her on camera. Princess Mabel van Oranje ( the sister- in- law of King Willem-Alexander and Queen Maxima) who espouses the cause of ‘ Girls Not Brides and VOW – to End Child Marriage’ was also present.
The commitment by international agencies was obvious as well, as seated right in front of the packed hall were United Nations Under Secretary-General for Humanitarian Affairs & Emergency Relief Coordinator, Sir Mark Lowcock; the Director-General of the World Health Organization ( WHO), Dr. Tedros Adhanom Ghebreyesus; and the Secretary-General of the International Federation of Red Cross and Red Crescent Societies (IFRC), Elhadj As Sy.
Among other participants at this twoday conference were most importantly those with ‘lived experience’ who have undergone traumatic experiences including one delegate from Sri Lanka; MHPSS experts including another Sri Lankan; policymakers; ministers; and donors, for it was Minister Kaag’s hope to push this topic to the top of the political agenda of countries.
Impassioned was the plea of Minister Kaag as she said, “Often, we have not addressed the needs of those who sit in the twilight, whose bodies may have healed but still bear scars invisible to the eyes. We also do not know just how many men, women and children face this struggle…….. because mental health is still nota topic that is openly discussed. But we know that the scale of the problem is growing.”
According to the President of the International Committee of the Red Cross (ICRC), Peter Maurer, in conflict areas 1 in 5 lives with some form of mental condition, from mild depression and anxiety, to psychosis. This is three times more than the general population worldwide suffering from these conditions. Just because mental health and psychosocial needs may not be as visible as physical needs, they are no less life- threatening. When not addressed, they have a far-reaching and long-term impact on people, their families, their communities and on the whole society.
The numbers, according to UNHCR (the United Nations Refugee Agency), are disturbing – the world is facing the highest levels of displacement on record.
70.8 million people have been forced from their homes (displaced) around the world
25.9 million of them are refugees
“Grief. Sadness. Loss. What do these words mean,” asked Minister Kaag, creating poignant images through poetry not only during the finale of the conference but also when launching it.
She took up searing quotes to drive home her message. From Primo Levi, the Jewish-Italian writer who endured the horrors of Auschwitz and later wrote that “the sea of grief has no shores, no bottom; no one can sound its depths” to journalist Philip Gourevitch who explored these depths in his haunting book on the Rwandan Genocide, describing the return of survivors to Kigali after the massacres, a place that smelled of death.
“Survivors huddled together in burned-out shops and abandoned shacks, searching for safety and comfort in the ruins. A shadow world of the severely traumatized. Many found it difficult to accept the fact that they were alive. Their bodies were no longer threatened, but their souls remained wounded. And a wounded soul becomes the source of its own affliction. It can make survival feel like a curse. It can make recovery – let alone development – near impossible,” Gourevitch has said focusing on these scenes more than two decades ago.
Looking at the present, Minister Kaag pointed out that “help isbeing provided, but not all the help that’s needed. Humanitarian efforts are focused on providing physical health and safety, first and foremost. The tangible part, food, water and tents and other forms of shelter. This is necessary, commendable work that needs to be continued. However, adequate help in conflict zones is not just about safeguarding life, it is about helping people to liveagain. It is about helping wounded souls heal through therapy, art and music. It is about rebuilding communities, as much as the buildings in which they hope to live”.
And yet, she lamented, out of the total amount that we pledge and spend on development aid, only 0.14% of that small amount in and of itself is dedicated to psychosocial support. But this insignificant allocation of funds is not the only issue.
“The barriers we face are beyond financial. They are also cultural. Countless cultures do not accept what they see as mental weakness – do not acknowledge the needs of people who are suffering on the inside. This is as true in the western world as it is elsewhere. Invisible pain goes unacknowledged. Unacknowledged means unaddressed. If we want to seriously address this ‘ blind spot’ in our humanitarian efforts, we should not just open our wallet, but maybe even more our ability to talk – our mouths. They say talk is cheap – but here talk is priceless. Dignity is priceless. To a large extent, this conference has been about lifting the taboo by sharing knowledge, expertise and, of course, stories – often deeply personal stories from survivors. Lifting the taboo will help lift the burden of trauma,” added Minister Kaag.
Some of the urgent tasks that she foresees are keeping mental health and psychosocial support on the international agenda through continuous political mobilization; implementing action on the work begun at Amsterdam through further discussions at the next International Red Cross/ Red Crescent conference, the UNHCR Global Refugee Forum with the final goal being to take it up at the next UN General Assembly or the world’s forum; integrating mental health needs into the UN’s needs assessments after a crisis; addressing the aftermath of sexual and gender- based violence; and allocating and leveraging additional capacity and financing.
“This is respecting the human part of our humanitarian effort. This should become a guiding principle for new humanitarian response operations. Mental health is now being recognized as not apriority but thepriority. It’s also to be considered a human right. In the past, too often, in the middle or the aftermath of a grave crisis, mental health concerns were met with a ‘never mind’. Going forward from this conference, and in thinking of all the ones we may have lost and all the ones we may never meet, but who we know are out there, counting on our voice, I would like to say: our response will be ‘mind the mind’,” she added.