Adaptive Coping During Protracted Political Conflict, War and Military Blockade in Gaza

Identifying culturally-relevant concepts and coping mechanisms can help protect civilian wellbeing. This study explores how seven professional Palestinian university graduates in the Gaza Strip (occupied Palestinian territories) cope with war, military occupation, military blockade and the challenges of living in a conflict-affected area. Participants were interviewed to determine whether culturally specific modes of coping were used. Thematic analysis was applied. The use of resistance and more specifically, sumud , being steadfast and persevering, were identified alongside the motivation to persevere and other adaptive responses to living conditions. Coping strategies identified in this study include adapting, problem-solving, accepting reality, exercising patience, utilising social support, and faith in God (iman) and religion. The implications of this study and the relevance of the findings to mental health and disaster relief are considered

Psychosocial Capacity Building in Response to Cascading Disasters: A Culturally Informed Approach

The dominant paradigm guiding mental health professionals responding to major disasters is the field of \u27disaster mental health\u27, which historically focused more on psychological factors than social factors, privileging individual over collective interventions. However, resilience to complex events is a result of multiple drivers, such as social networks and local culture, that must be considered together in the assessment and planning process. This paper adopts a multi-disciplinary perspective for disaster response, applying a social-ecological approach to disaster risk reduction which has been developed through practice and a review of the literature. In particular, we investigated how psychosocial healing, collective efficacy and social justice as intertwined aspects of the recovery process may inhibit the escalation of cascading disasters. The article argues that psychosocial capacity building can be used in disaster preparation as well as to respond to cascading events, as the escalation of secondary emergencies caused by the loss of vital services can heavily influence collective behaviors, and hinder the response capacity of emergency services. Our research suggests that adopting a multi-systemic approach, drawing on local cultural practices, can deepen the capacity of local people to take control over their own process of healing and psychosocial restoration, enhancing a sustainable recovery process. The conclusions suggest some possible applications for responders, utilizing groups and activities, and raise questions for researchers in the field

Provision of antiretroviral treatment in conflict settings: the experience of Médecins Sans Frontières

ABSTRACT: INTRODUCTION: Many countries ravaged by conflict have substantial morbidity and mortality attributed to HIV/AIDS yet HIV treatment is uncommonly available. Universal access to HIV care cannot be achieved unless the needs of populations in conflict-affected areas are addressed. METHODS: From 2003 Médecins Sans Frontières introduced HIV care, including antiretroviral therapy, into 24 programmes in conflict or post-conflict settings, mainly in sub-Saharan Africa. HIV care and treatment activities were usually integrated within other medical activities. Project data collected in the Fuchia software system were analysed and outcomes compared with ART-LINC data. Programme reports and other relevant documents and interviews with local and headquarters staff were used to develop lessons learned. RESULTS: In the 22 programmes where ART was initiated, more than 10,500 people were diagnosed with HIV and received medical care, and 4555 commenced antiretroviral therapy, including 348 children. Complete data were available for adults in 20 programmes (n = 4145). At analysis, 2645 (64%) remained on ART, 422 (10%) had died, 466 (11%) lost to follow-up, 417 (10%) transferred to another programme, and 195 (5%) had an unclear outcome. Median 12-month mortality and loss to follow-up were 9% and 11% respectively, and median 6-month CD4 gain was 129 cells/mm 3.Patient outcomes on treatment were comparable to those in stable resource-limited settings, and individuals and communities obtained significant benefits from access to HIV treatment. Programme disruption through instability was uncommon with only one program experiencing interruption to services, and programs were adapted to allow for disruption and population movements. Integration of HIV activities strengthened other health activities contributing to health benefits for all victims of conflict and increasing the potential sustainability for implemented activities. CONCLUSIONS: With commitment, simplified treatment and monitoring, and adaptations for potential instability, HIV treatment can be feasibly and effectively provided in conflict or post-conflict settings

Afetações psicológicas de crianças e adolescentes expostos ao conflito armado em uma zona rural da Colômbia

Determinaram-se as afetações psicológicas de 284 crianças e adolescentes expostos ao conflito armado em uma zona rural colombiana, selecionados mediante uma amostragem aleatória. Os instrumentos aplicados foram: a Lista de checagem de comportamento infantil, a autoavaliação de comportamentos de jovens, a Lista de sintomas pós-traumáticos, a Escala de estratégias de enfrentamento para adolescentes e a Escala de resiliência para escolares. 72% da população apresentou afetações psicológicas: 64.4%, condutas internalizadas, 47%, condutas externalizadas. 32%, problemas somáticos; 56%, se encontrava em risco de estresse pós-traumático, e 93% consumia álcool de forma moderada. A estratégia de enfretamento mais utilizada era deixar que as coisas se resolvessem sozinhas. Foi encontrada uma alta necessidade de atenção em saúde. Ser homem constituiu um fator de risco de depressão, agressão e problemas sociais. Ao mesmo tempo que ter até doze anos e estar cursando uma série escolar baixa, foi para os sintomas somáticos em adolescentes. Os resultados evidenciaram a afetação da saúde mental dos participantes.Se determinaron las afectaciones psicológicas de 284 niños y adolescentes expuestos al conflicto armado en una zona rural colombiana, seleccionados mediante un muestreo aleatorio por afijación proporcional. Los instrumentos aplicados fueron: la Lista de chequeo de comportamiento infantil, el Auto-reporte de comportamientos de jóvenes, la Lista de síntomas postraumáticos, la Escala de estrategias de afrontamiento para adolescentes y la Escala de resiliencia para escolares. El 72% de la población presentó afectaciones psicológicas: el 64.4%, conductas internalizadas, el 47%, conductas externalizadas en rango clínico. El 32%, problemas somáticos; el 56%, se encontraba en riesgo de estrés postraumático, y el 93% consumía alcohol en grado moderado. La estrategia de afrontamiento más utilizada era dejar que las cosas se arreglaran solas. Se encontró una alta necesidad de atención en salud. Ser hombre constituyó un factor de riesgo de depresión, agresión y problemas sociales en los niños. A su vez, tener hasta doce años y estar cursando un grado escolar bajo, lo fue para los síntomas somáticos en adolescentes. Los resultados evidenciaron la afectación en la salud mental de los participantes.Psychological effects were determined in 284 children and adolescents exposed to armed conflict in a rural area of Colombia, selected through random sampling proportional allocation. The instruments applied were: The Child Behavior Checklist, the Youth Behavior Self-report, the Trauma Symptoms Checklist for Children, the Coping Scale for Adolescents and the Resilience Scale for School Children. Findings showed that 72% of the population suffers from psychological problems, 64.4 from internalizing behavior and 47% from externalizing behavior within clinical range. It was also found that 32% had somatic problems, 56% were at risk for PTSD and 93% had moderate alcohol consumption. The most frequently used coping strategy was to leave things get fixed by themselves. There was a high need for health care. Being male constituted a risk factor for depression, aggression and social problems in children. In turn, being up to12 years old and a student of a lower grade were risk factors for somatic symptoms in adolescents. Results clearly revealed the impact on mental health of the population under study

Growing the sheltering tree: protecting rights through humanitarian act

xvii, 219 hal.; 23 c

Sick or Sad? Supporting Palestinian Children Living in Conditions of Chronic Political Violence

NoIn this article we reflect on the relatively recent emphasis on Palestinian children's mental health and well-being in the context of exposure to chronic warlike conditions, as we position this trend within the larger framework of the generations-long history of political turmoil and suffering. We describe how a process that started with no attention to psychosocial health of children in relation to exposure to dispossession, expulsion, occupation, repression and military attacks, proceeded with a focus on presumed mental disorders, and the more recent approach of designing context appropriate and community-based psychosocial interventions