Italy/Norway SIMULTANEOUS TRANSLATION
Pina Deiana: Migratory contexts and MSF interventions for survivors of intentional violences
In the last 10 years, MSF is intervening more and more in migration contexts where people live in transit, waiting for an international protection, hoping to find a safe country to restart their lives. Greece, Italy, Jordan, Lebanon, Libya and other countries along main migratory routes, are some of the places where the migrants, asylum seekers and refugees are stuck for years. MSF is providing medical and mental health care for survivors of intentional violence who are living in places where human rights are often not recognized. This population shows the human suffering and embodies collective traumas caused by global economic interests in a geopolitical chess game fuelled by the conflicts and balances of world powers.
In these non-places where the social structure of the community doesn’t exist, where the rules of civil cohabitation with the host population are based on the categories of known/unknown, internal/external, national citizen/foreigner, the medical paradigm is insufficient to provide an appropriate care to our patients and support them in their rehabilitation process. In these MSF projects, the mental health component is often predominant and more complex than the medical one. Psychologists and psychiatrists have an expertise to treat past individual traumas of patients living in a safe place but, in these situations, an exclusive analysis of the individual symptomatology can often lead to a category fallacy.
The challenge for us is to intervene on the individual level of suffering but also through an acknowledgment of the broader frame where violence occurs.
What MSF psychologists and psychiatrists are witnessing in these contexts is an endless violence with distant origins, often related to national and international political responsibilities. Material persecutors are the last link in a long chain of collective responsibilities. The difficulty of identifying the deepest roots of perpetuating violence leaves patients and clinicians focused on the individual level. The risk of a massive medicalization of suffering is an inevitable consequence of this approach that often leaves the invisible wounds untreated.
The presentation aims to describe these contexts where MSF is frequently the only actor to offer psychological care, as well as its challenges and shortcomings.
Melinda Ashley Meyer: Who shall survive? Empowerment and Resilience: EXIT: Spontaneity training with traumatised communities
We are experiencing the largest refugee crises since World War 2. In 2018, we reached a new record of 68.5 million according to the High Commissioner of Refugees (UNHCR). In 2017 we had the biggest single rise in history of refugees, 2.9 million. In 2015 about 38 million refugees were internally displaced and the majority came from Syria (6.5 million). Being a refugee challenges the organism both physically and mentally. The individual is disconnected, rejected, unsafe, and in doubt about the future. It is estimated that one half of the total refugee population are children. They are the most vulnerable group and the largest concern for the UNHCR. In 2016 over 12,000 children were killed in Syria, an average of 12 per day. The act of war has changed from being one state against another to civil wars where civilians and children often are legitimate targets. They are forced to escape and live in exile.
Expressive Arts in Transition (EXIT) is a quantitative and qualitative research project with 208 unaccompanied minor refugee boys aged 15 to 18.
The EXIT manual is developed for stabilizing people who live under extreme stress and/or have survived human or nature induced trauma. EXIT focuses on training spontaneity, enhancing movement, imagination, engagement, connection, here and now, safety and responsibility. EXIT groups have been implemented in Norway, Germany, Africa, Mexico and South America. EXIT is part of the Certificate Program in Global Health, Peace building and Conflict Transformation at the European Graduate School, campus Malta and at The Norwegian Institute for Expressive Arts, Oslo, Norway.
The results of the research and implementation will be presented. A documentary Film from the program will be shared.