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volunteers in Ukraine
Since Russia invaded Ukraine in early 2022, Ukraine’s health system has been operating under severe pressure. It has become increasingly crucial for international organizations to collaborate with local groups in order to respond to the health crises that the war posed. Two organizations that have done this are the World Health Organization (WHO) and Doctors Without Borders/Medicines Sans Frontieres (MSF). Additionally, volunteers in Ukraine are proving crucial.

The World Health Organization (WHO) in Ukraine

Since the beginning of the war in February 2022, WHO has provided medical supplies and cooperated with neighboring countries that welcome and host Ukrainian refugees. The war has sapped Ukraine of resources to devote to health care, and there have been deliberate attacks on health facilities. In collaboration with Ukraine’s Ministry of Health, WHO plans to remain involved in Ukraine for the foreseeable future, giving support to the country’s overwhelmed medical professionals and facilities. It is doing so in several ways. It is building ‘healthcare hubs’ in heavily conflicted areas to treat patients suffering from war-related trauma.

Additionally, WHO successfully appealed for $147.5 million to foster humanitarian efforts, ensure emergency health care and help the country rebuild its health care system. Part of the funding will go to Ukraine directly, while the rest will go to surrounding countries with Ukrainian refugees, such as Moldova, Romania, Poland and the Czech Republic. Through this funding, health care facilities within Ukraine can increase their staff and have access to critical medical supplies such as ventilators, electric generators and ambulances. Between February and June of 2022, more than 1,300 new medical staff received training and the funding helped form more than 40 emergency response teams.

More funding will provide supplies to treat burns and chemical injuries and to handle mass casualties. The war has also led to an increase in psychological illness and distress – symptoms of these medical problems manifest in various forms, including sleeplessness, anxiety, grief and psychological pain. In collaboration with Olena Zolenska, the First Lady of Ukraine, WHO hopes to create a national mental health program.

Medicines Sans Frontieres (MSF) in Ukraine

The work of WHO alone is not enough to combat this crisis. Local organizations are proving essential in providing emergency humanitarian care, and MSF is helping mobilize local relief efforts. When investigating Ukraine’s needs, MSF noted how swiftly Ukraine’s population mobilized to create volunteer networks, NGOs and civil society groups. These quickly formed, efficient, local organizations are the main providers of humanitarian assistance to Ukraine. MSF contributes to these groups by helping them with supplies and logistics to deliver food boxes and medications to remote areas, as well as by helping them coordinate emergency evacuations.

Coordinating Volunteers in Ukraine

One such local volunteer is Dmitry Zakharov, owner of a barbeque restaurant and car wash in Kharkiv, who was interviewed by MSF. Soon after the war broke out, Zakharov transformed his business into a hub for humanitarian aid. He began by distributing free water, and when a nearby meat factory stopped its operations, he gathered up what was left and distributed it to those who needed food. He turned his restaurant into a free medical clinic, and he coordinates volunteer efforts to serve free daily lunches to the community. Another volunteer is Yana Biletskaya, who has coordinated food and medical supply distribution from a massive storehouse near her home.

The need to provide mental health services has dramatically increased. Children and adults suffer from extreme anxiety. In coordination with MSF, volunteer teams provide mental health support in shelters, clinics and metro stations. They conduct individual and group mental health sessions to address issues of fear, stress, worry, hopelessness and panic attacks. While this is a good start, there is still a lot of work to do.

Other Organizations

Many other organizations are aiding these efforts. Team Rubicon coordinates volunteers in over 15 locations in Ukraine, Hungary and Poland. They treat wounds and chronic diseases no matter the condition – whether in a school or community center where hundreds of refugees sleep and live. Medical schools at Yale and Stanford have coordinated donations of medical supplies. Volunteers from the Global Surgical and Medical Support Group, a nonprofit, are training Ukrainian civilians on coping with wounds and fear.

There is a lot that still needs to occur. However, it is encouraging to see so many communities, organizations and volunteers working together, whether on the ground or from a distance, to help Ukraine in this time of need.

– Shiloh Harrill
Photo: Wikimedia Commons

Mental Health in South SudanDecades of war have had a notable impact on mental health in South Sudan. Few resources are available to help those suffering from trauma and stigma deters people from seeking mental health assistance. Despite how dire the situation is, organizations are stepping up to improve mental health within the young nation.

A History of War

Beginning in 1955, South Sudan has fought three civil wars. The first lasted from 1955 to 1972, the second from 1983 to 2005, and the third, starting after the nation’s independence in 2011, lasted from 2013 until 2018 when warring parties agreed to peace deals. The third civil war alone led to about 400,000 deaths and 4 million displacements.

Even after the agreement, violence remains common. Communities continue to fight “over land, cattle and grazing” and the fact that “political and military leaders” provide locals with weapons further exacerbates the violence. The violence between South Sudanese communities has led to “hundreds of thousands” of deaths and displacements across the country, adding to the nation’s collective trauma.

Mental Health in South Sudan

Information on mental health in South Sudan is limited, but South Sudan Health Cluster estimates indicate that about 5.1 million of the nation’s 11 million people are affected by the war. Specifically, 204,000 suffered severe mental health conditions and 1,020,000 experienced “mild to moderate mental health conditions.” These conditions include post-traumatic stress disorder (PTSD), anxiety and depression.

In 2015, the South Sudan Law Society and the United Nations Development Programme conducted a study that found that out of a group of 1,525 individuals across six states, about 41% met the criteria for PTSD. Despite how widespread mental illness is in the country, less than 1% of people are receiving the necessary treatment, according to the World Health Organization in 2017.

The Complex Mental Health Situation

There are only three practicing psychiatrists and 29 practicing psychologists in the entire country, all of whom are positioned in the capital city of Juba.

Furthermore, stigmas and taboos stand as barriers to addressing mental health in South Sudan. Many believe mental illness “runs in the family,” so if one member is diagnosed, then the rest become social outcasts. In fact, “Most communities believe in supernatural possession or punishment by higher powers, as opposed to accepting a mental illness diagnosis,” South Sudanese psychiatrist Dr. Atong Ayuel tells Al Jazeera. A possession is preferable to mental illness, so people seek assistance from religious institutions instead of mental health care practitioners.

Some believe faith is the cause of their recovery rather than treatment. Paradise Akaag Henry, a schizophrenic patient under Dr. Atong’s care tells Al Jazeera the reasons for her recovery. “First of all Jesus, and then Dr. Atong.”

Mental Health and Poverty

Mental illness and poverty are linked in several ways. Those living without treatment may not function well in their community and receive “limited employment opportunities,” pushing them further into poverty. Adolescent pregnancy and domestic violence rates tend to increase in circumstances of poverty.

In Glasgow, Scotland, a study found that 7.3% of 4-year-olds born into poverty showed “abnormal social, behavioral and emotional difficulties” compared to 4.1% for those not born into poverty. This prevalence increased by age 7 to 14.7% for impoverished children and 3.6% for wealthier children.

Also, the stresses from poverty, like long work hours, can affect cognitive function, which can lead to poor decision-making and increased susceptibility to mental illness.

A 2013 research study published in the journal Science found that the psychological burden created by poverty is the equivalent of “losing 13 IQ points.”

Action to Improve Mental Health in South Sudan

To fight mental illness in South Sudan, Médecins Sans Frontières (MSF), a nonprofit organization started in 1971 by medical professionals, “launched an emergency intervention in Tambura County in December 2021″ after large-scale violence plagued the area.

MSF Mental Health Activity Manager Ariadna Alexandra Pérez Gudiño and a group of four counselors from Tambura set up “community-based mental health services” across displacement camps. These services included “one-to-one counseling sessions, referral pathways for those in need of further treatment or medication and group psychosocial health sessions.”

Psychosocial group sessions included creative activities such as dancing, singing, creating jewelry and drawing. The psychosocial activities are particularly helpful as the sessions give residents an opportunity to process their trauma together. Between January and July 2022, MSF held “more than 11,500 individual and group” sessions across seven projects taking place throughout South Sudan. In June 2022, with the situation improving, MSF handed over its mental health programs to local health care workers.

Healthnet TPO

Healthnet TPO, established in 1992 by MSF, aims to “bridge the gap” between emergency aid and “long-term structural development.”

Its program, called Leaders of Peace, works to provide psychosocial and self-care services for women subjected to gender-based violence, alter society’s attitude toward women to improve gender equality and increase women’s participation in “leadership, decision-making and peacebuilding processes.”

The specifics include establishing community-based mental health programs across 50 communities in five South Sudanese states and placing 50 trained individuals in 50 women groups to manage gender-based violence cases, community engagement, mobilization, mental health advocacy and more. These individuals will also “strengthen different community groups” and advocate for mental health services and the passage of gender-based violence laws. The program will last from 2021 to 2025.

Through continued mental health efforts, the conflict-affected nation of South Sudan can move past its collective trauma and look to a brighter future.

– James Harrington
Photo: Wikimedia

refugees in greece
Marietta Provopoulou came home to find living conditions on her own soil worse than those of the African village in which she worked. After a decade of working with Medecins San Frontieres, or Doctors Without Borders, she took her work home to Greece to head MSF in Athens-mainly on the issue of migrant detention.

Upon discovering the conditions of migrant detention camps in Greece, Provopoulous commented that she didn’t even think such conditions were possible on the European continent. Further, other MSF members denounced the Greek government for its treatment of migrants, calling it a violation of national, European and international standards, and harmful to people’s health and dignity.

Greece is often utilized as an entry hub for migrants around the world- from Asia, Africa and the Middle East. Due to pressure from the European Union to halt the influx of immigrants, the ultra-conservative Greek government instituted its migration policy, Operation Xenious Zeus.

The policy was launched two years ago- a harsh policy that systematically detains refugees in Greece. According to MSF, undocumented migrants are routinely detained when apprehended on territory without valid documentation. Migrants, whose forced return does not occur within the initial detention period, are at risk for repeated detentions. The estimated number of migrants and asylum seekers in Greece’s detainment camps has exceeded 6,000.

Detention is frequently being used worldwide as a means to manage and restrict migrants and pressure them to return to their home soil. However, in most cases, particularly in Greece, the physical and mental health of detained migrants is largely neglected, if not abused.

In the MSF’s Invisible Suffering, a report on the condition of detention camps in Greece, it is noted that detainment has caused suffering directly linked to various health problems that require medical attention. Among these include scabies, dental problems, respiratory ailment, even tuberculosis. Mental illness is also a grim consequence; there have been several cases of suicide and incidents of detainees sewing their mouths shut as a form of protest.

Above all, the living conditions are inhumane and unsanitary. One such camp located on the Turkish border was described as having human excrement seeping through cracked pipes between the building’s floors. Detainees are crammed in dilapidated, perilous quarters. Suffering from overcrowding, filth and neglect, these migrants feel less than human. One young boy was recorded saying, “I have come for peace. I am not a criminal. I thought it was better for me to jump off the roof than to stay here.”

Despite recent international criticism, the Greek government is steadfast in its rigid policies. They have thus far shown no intention of loosening their tight reigns. It may take an international effort to bring humanitarian justice to Greek migrants.

– Samantha Scheetz

Sources: IPS, Medecins Sans Frontieres, The Guardian, NPR
Photo: Greek Independent News

ebola
An outbreak of Ebola has been linked to more than 330 deaths in Guinea, Sierra Leone and Liberia, according to the latest numbers from the World Health Organization.

The outbreak, which is ravaging West Africa, is “completely out of control,” says a senior official of Doctors without Borders, who also notes the organization is stretched to its limit in response to the epidemic. Bart Janssens, the director of operations for MSF in Brussels, reported that the epidemic is now in its second wave and, more than ever, the international organizations and governments providing aid need to send in more health experts, as well as increase the public educational messages regarding how to stop the spread of the disease.

The outbreak, which began in Guinea earlier this year, appeared to slow before ravaging in recent weeks, including spreading to the Liberian capital. With multiple locations of breakout and movements across several nations, the outbreak shows no signs of slowing. Janssens noted, “I’m absolutely convinced that this epidemic is far from over and will continue to kill a considerable amount of people, so this will definitely end up the biggest ever.”

This is the highest number of deaths associated with the Ebola virus, which is considered one of the most virulent in the world. At this point, Liberia has declared a national emergency.

With a real political commitment from the governments of the infected nations and a more effective response, the epidemic could perhaps be controlled. However, currently the Ebola outbreak is the worst it has ever been, “It’s the first time in an Ebola epidemic where [Doctors Without Borders] teams cannot cover all the needs, at least for treatment centers,” Janssens said.

The underdevelopment of these countries plays an important role in the spread of the virus. “The affected countries are at the bottom of the human development index,” Janssens noted. “Ebola is seriously crippling their capacities to respond effectively in containing the spread.”

— Elizabeth Malfaro

Sources: CBS News, USA Today
Photo: CNN

Doctors Without Borders and Measles in the Democratic Republic of Congo
There has been a threat from measles in the Democratic Republic of Congo (DRC) since 2010. Three months ago, the disease reached epidemic levels. Although much is being done to combat the spread of measles, tens of thousands of people are still affected.

Over the past year, Doctors Without Borders has inoculated nearly half a million children against measles, having to treat nearly 20,000 for the disease itself. Mortality rates can vary from 15 to 25 percent; the manager of a medical team “counted 35 dead in one village…traveling from village to village, we hear just one word: measles.”

Perhaps the most awful thing about measles outbreaks is that the disease itself is extremely treatable. Vaccines can be purchased for a pittance, but the problem in the Democratic Republic of Congo lies in getting the medicine to those who need it. Without modern infrastructure extending navigable roads to many villages, the vaccine cannot always be kept cold in transit. One health center “has only two refrigerators and one broken motorcycle to serve an area half the size of Switzerland.”

Doctors Without Borders put out the alert back in December, hoping that increased attention to the epidemic would bring more donations, and therefore more treatment. Tens of thousands of lives can be saved for barely a few dollars each. The only thing standing between those who are suffering and their good health is the vacillation of foreign donors.

Jake Simon

Source: Doctors Without Borders