Nelden Djakababa, Contributor, Jakarta
In response to the May 27 Yogyakarta earthquake, children were one of the first groups that were of the utmost concern for humanitarian assistance. This is usually the case when disaster strikes. As had been pointed out by one Yogyakarta relief operation leader who had started working one day after the earthquake, children have been suffering as everyone else, but as always, being more vulnerable, they suffer more.
Fortunately due to this kind of concern, many organizations concerned with children's welfare began almost immediately to care for the youngest age groups, to assist them in the transformation from being victims of a disaster to becoming survivors.
The areas of intervention have been varied, from providing basic needs, health and hygiene services, activity and entertainment, education, and also mental health services.
So far, there has been much positive and encouraging news coming from Yogyakarta and its surrounding areas as to these recovery programs, and how they have been helping the children to cope with the disaster's aftermath in psychologically healthy ways and to build resilience.
Formal and non-formal educational settings are very vital in assisting this process.
But on the other hand, how can the success of mental health intervention be measured? How can we be certain that all of the areas needed to be covered are really being addressed?
One of the possible tools that can be used for this purpose is a guideline draft titled The IASC Guidance on Mental Health and Psychosocial Support in Emergency Settings. This draft guideline is currently being developed by the Geneva-based Inter-Agency Standing Committee (IASC) Task Force on Mental Health and Psychosocial Support.
Currently in its fourth draft, the Guideline contains various action plans listing steps that should be taken as a minimum response to a disaster in the psychosocial/mental health domain, and other dovetailing areas.
In developing this guideline, the task force consulted many parties, including non-governmental organization workers who have had experience working in disaster-stricken areas like Indonesia.
At this stage, questions that can be effectively answered only by those working in disaster areas would be: Does a guideline like this relevantly help structure the work in real-life situations? Are the items socially and culturally sensitive enough? Is it flexible enough to be applied to different situations around the world? Is it too global? Is it too specific to certain situations?
At the end of this article, there is a weblink from which the complete 120-page IASC guideline can be downloaded. The site also provides contact information if you have questions and/or feedback concerning the guideline and the task force developing it. The main aim of this article is to start a discussion on this matter.
Education & recovery
Following is an excerpt from a section in the guideline, called Action Sheet 10.2, which focuses specifically on ""How to Organize Psychosocial Support in Educational Settings"": * Establish child- and youth-friendly spaces * Establish non-formal educational facilities for children and young people in cooperation with community members and/or service providers * Spaces should include opportunities for children and young people to learn life skills and to participate in supplementary education, vocational training, artistic, cultural and environmental activities and/or sports. They can also address basic health issues, such as personal hygiene, and protection issues, such as support for separated children and community-based protection measures. * Activities should aim to restore a sense of structure, predictability and normality for children; provide opportunities for expression, choice and social interactions and support; and build children's competencies and life skills. Structured psychosocial activities that address particular issues such as anger management, fears and grief can also be integrated into these activities. * Activities should be participatory and should be active learning and the application of practical skills. Children, parents, and other community members should be involved in the design and the implementation of activities. Adolescents and youth participation in conducting activities for younger children is particularly valuable. Peer-to-peer approaches should also be considered. * Activities should be appropriate to the local context and should utilize local knowledge and skills. Types of activities will vary according to age groups, gender, interests and abilities of the children and young people involved. The space should be accessible to and appropriate for different groups of children, especially marginalized children (e.g. disabled or economically disadvantaged children, or ethnic minorities). Separate activities for adolescents and youth are necessary, as these age groups are often given insufficient attention. * Staff should have strong interpersonal skills, the ability to utilize active learning approaches and experience of working with non-formal education or community programs. A background in formal education is not necessary. * Initiate the provision of basic psychosocial and mental health support for learners experiencing particular difficulties. * Aim to provide additional mental health and psychosocial support to learners experiencing difficulties that educators can help manage. Common difficulties that can usually be managed primarily by the education system include behavioral problems such as fighting, social isolation, unruly behavior, and academic difficulties. Severe mental health problems such as clinical depression should, where possible, be referred to appropriate mental health and psychosocial supports (see point e below). * The kind of support provided will depend on the kinds of problems and the human and financial resources available, but may include: a. Awareness raising/mobilization of community and religious groups, youth, etc. b. Structured groups to help learners build skills to deal with particular problems. c. Support group for parents. d. Structured and informal discussions with learners and/or their families (e.g. school counseling). e. Referral to appropriate mental health and psychosocial supports in the community and through health services, if/when health staff have received training and supervision in the care of severe mental health problems in children. f. Referral to other types of services e.g. legal aid, social services, etc. * Educational personnel such as teachers or school counselors, as well as social/community workers, can be trained to conduct the various activities outlined above. They should have strong interpersonal skills and a background in health or social sciences, and should receive further training. Depending on the activities to be conducted, training topics could include community mobilization and awareness raising; communication and group facilitation skills; dealing with behavioral problems; and when to make referrals to specialized mental health and psychosocial supports. * Provide Support for educators' own mental health and psychosocial well-being. * The training and supervision process should strengthen the abilities of educators to better cope with life during and following the emergency. Relevant topics include the effects of stress in educators, coping skills, supportive supervision and peer group support.available psychosocial support for educators. For instance, bring educators together with a skilled facilitator to start talking about the past, present, and future, or put in place a community support mechanism to assist educators in dealing with crisis situations. This support should be responsive to the different challenges facing male and female educators, and should address diverse coping mechanisms and resources.
Source: The IASC Guidance on Mental Health and Psychosocial Support in Emergency Settings, via www.humanitarianinfo.org/iasc/mentalhealth_psychosocial_support Questions and feedback related to the task force can be emailed to: Mark van Ommeren (WHO, vanommerenm@who.int) and Mike Wessells (Inter Action, mwessell@rmc.edu).
The writer is a psychologist working with Pulih Foundation, Centre for Trauma Recovery and Psychosocial Intervention.
Additional resources for psychological assistance
Yogyakarta
The School of Psychology, Gadjah Mada University (UGM) Team for Earthquake Disaster Assistance: (0274) 550435, (0274) 901124. e-mail: fpsi@ugm.ac.idTanggul Bencana Indonesia (YTBI) has set up a team for trauma healing in the areas of Patalan, Canden, Pundong and Gantiwarno. For more information, contact the Secretariat (CP: Rev. Sundoyo): (0274) 585887, or Nina Nayoan: 0852 17507828. Rifka Annisa Women Crisis Center: (0274) 553333 is working in five areas: Banguntapan, Kotagede, Piyungan, Plered and Pendowohardjo. Also accepts reports of Gender Based Violence incidents.
Jakarta
PULIH Foundation counseling hot line: (021) 7197476, (021)7196426. e-counseling: yayasan_pulih@yahoo.com. Pulih also provides outreach and one-on-one counseling by appointment. For Yogya psychosocial com-munity activities, PULIH is collaborating with Rifka Annisa WCC. The School of Psychology, University of Indonesia Crisis Center: (021) 7873745, (021)7270004/5 ext 1503. e-mail: info@puskapsiui.or.id International Community and Activities Center (ICAC), ICAC House, Jl. Kemang V/22AA, South Jakarta: (021) 7195457.
