Volume 1, Issue 3 / February 2009
With three-quarters of the refugee population suffering some degree of trauma, JRS has a critical role in providing counseling and psychological services for the mentally vulnerable
Jesuit Refugee Services (JRS), an NGO in Kakuma Camp, takes the lead in advocating for persons with mental illness. “They are persons like any other. I don’t compromise with anyone who discriminates against them. They have a right to live, to associate with other people, and they must be protected against any discrimination,” a JRS supervisor says.
Pointing at their lives in the community, the JRS Supervisor,* who wishes to remain anonymous, says, “There are many myths and mistreatments surrounding people with mental illnesses. Through our advocacy, we guide their parents, guardians, and relatives to understand them and know how best they can be assisted to cope with normal life. We let them know that these mental illnesses are not contagious. When the people who surround them get clear understanding, discrimination is managed.”
According to a JRS counselor, the refugee camp has a profound impact on psychology of those living there: “Three-quarters of the camp population is traumatized or stressed to different degrees.”
According to him, there are various causes of psychological distress. “Many of them lost their beloved ones, others lost their properties and suffered different abuses. Another factor is that some refugees are disappointed when they arrive in the camp and find that what UNHCR-Nairobi promised them before they came to the camp is not true. They lose hope and through their long stay they get stressed and depressed.”
A range of healing services
JRS runs three centers across the camp, in which persons with mental illness are rehabilitated through different social, psychological, and physical activities.
The three centres are open during working days from 8:00 a.m. to 3:00 p.m. JRS staff involve participants in activities such as education, arts and crafts, embroidery, hygiene education, gardening activities, and pottery. They also play games such as football, volleyball, basketball and other imaginary games. Participants are taught songs and traditional dances for entertainment, and they go for walks and rest.
Breakfast and lunch are provided for participants, and sometimes washing cloths, soap, and second hand clothing are distributed.
JRS also offers massage from the Alternative Healing Department. According to the JRS Supervisor, alternative healing massages are offered to individuals suffering from psychosomatic disorder. This is a mental disorder generated by stress which can cause pains in the body. Massage relieves these body pains and facilitates healing.
Counseling is provided for those who seek a safe emotional outlet. A JRS counselor says “We counsel any person who has emotional problems and need to share these problems with another person. When this person shares with us, he or she understands and explores their own problems and gets a solution.”
JRS admits persons with mental illnesses who are referred by the International Rescue Committee (IRC) Mental Health Department. Others are brought to the centre by community leaders and members who identify mentally vulnerable individuals and collaborate with JRS staff to do home visits.
“In our program, we admit anyone who is seven years and above. The person’s mental health status should be ‘mild’ or ‘moderate,'” an assistant supervisor says. “The reason is that they can cope and get full rehabilitation. But when a person’s case is severe, this person cannot change. This case goes to other organizations concerned,” he explains.
Cases of attempted suicide are not accepted for JRS psychological care and counseling. Instead, JRS contacts the community leader concerned and together they refer the case to community security. From that point, the individual’s safety is monitored by security guards.
Some patients are taking treatment for their conditions, as in the case of epilepsy or similar ailments. IRC provides this mediation for patients.
Pointing at the abuses and challenges that exist for mentally ill in Kakuma, the coordinator says, “We work in partnership, but sometimes someone somewhere does not do his duty. This makes us not achieve what we had planned. However, despite the challenges, we get success too. Currently, we have three persons who are fully rehabilitated and now are our staff for NGOs in the camp.”
The JRS supervisor reports that there have been no reports of rights abuses, as staff adhere to the code of ethics and conduct.
Case study: A girl in chains
A small girl is chained by her leg to a post in her home in Kakuma Camp. She is eleven years old and suffers from mental illness.
Her mother explains that her daughter’s illness started in 2005 as a normal sickness, but developed into a more serious problem which continues to affect her today. She was twice admitted to the hospital, where doctors reported that the girl was suffering from chronic malaria.
The girl, whose name remains anonymous, is the eighth born in a family of ten children. She is often chained to a post so she may not cause damage at home. The family explains that this is to minimize her movement. She once set fire to their house and it was totally destroyed in the blaze. She also has a tendency to wander, forcing her worried family has to search the camp.
JRS intervened to assist the young girl. Since then, the girl has attended JRS day care every Monday to Friday. The girl receives well-balanced breakfast and lunch meals each day under JRS care.
Says her mother, “The JRS people have really helped me so much. They take good care of my daughter, and they sometimes provide clothing to her. ”
“They even built my house since the one that I was living in before was burned down by my very daughter who is sick,” she added amid tears.
The girl takes medicine daily, which her mother says has improved her condition. “She can now speak words which are coherent. At one point, she could not utter any coherent words,” her mother stated.
An assistant supervisor at JRS explained that the girl suffers from three ailments, including Attention Deficit Hyperactive Disorder (ADHD), mild mental retardation, and epilepsy.
“We try to engage the girl in games and we allow her to move freely in the compound. We also give her special needs education by giving her a pen and a paper and letting her doodle some drawings,” the JRS staff explained.
On some occasions, the girl may remove all her clothes and throw them away, or even deposit them in the latrine. In that case, the JRS staff must provide her with alternative clothes.
JRS staffs visit the girl and other children at their homes to monitor their treatment by family. According to the JRS assistant supervisor, “The girl has changed and adopted good ways of living, unlike before when she could hold feces with her hand. But now she knows that holding such waste is bad.”
Community appreciation and concerns
Community members, parents, relatives, and leaders appreciate JRS for the initiative and care provided to persons with mental illnesses.
“This is tremendous work JRS does in the camp,” a former Burundian community leader says. “I have seen with my own eyes the importance of interaction with them. When they invite us for annual meetings we do witness that some children with mental illnesses participate in games, and other activities like gardening and they make it. We play with them, laugh with them, and they become very happy.”
One mother whose son has been in the centre since 1997 says that she appreciates donors who fund the program. “JRS staffs do the job. However, without financial support they cannot manage it. Beyond this, I think it will be good if they can consider us for resettlement so that we care for our own people. I know anytime they can cut off the budget as it used to be, then we will suffer more.”
“I think the right way can be to assist us to change this refugee situation to be a durable one,” she concludes. “Twelve years here-sometimes the medicine is out of store and yet we are not able to buy from private pharmacies. Then the process of healing is interfered. Shall we be assisted like this until when?” the mother asks.
Refugees acknowledge the good will of donors but still question the process these donations take to reach them. They say that it passes through many hands and in the end it becomes a drop in the ocean.
*The JRS Supervisor interviewed for this article emphasizes that the views shared here are his personal views and do not represent the official position of JRS.