• Against the Odds: Psychomotor Development of Children Under 2 years in a Sudanese Orphanage.

      Espié, E; Ouss, L; Gaboulaud, V; Candilis, D; Ahmed, K; Cohuet, S; Baubet, T; Grais, R; Moro, M-R; Epicentre, Paris, France. (Oxford Journals, 2011-01-06)
      Providing abandoned children the necessary medical and psychological care as possible after their institutionalization may minimize developmental delays. We describe psychomotor development in infants admitted to an orphanage in Khartoum, Sudan, assessed at admission and over an 18-month follow-up. Psychological state and psychomotor quotients were determined using a simplified Neonatal Behavior Assessment Scale (NBAS), the Brunet-Lezine and Alarm distress baby (ADBB) scale. From May-September 2005, 151 children were evaluated 2, 4, 9, 12 and 18 months after inclusion. At admission, ∼15% of children ≤1 month had a regulation impairment according to the NBAS, and 33.8% presented a distress state (ADBB score >5). More than 85% (129/151) recovered normal psychomotor development. The results of the program reinforce the importance of early detection of psychological disorders followed by rapid implementation of psychological case management to improve the development of young children in similar institutions and circumstances.
    • Conflict in the Indian Kashmir Valley I: exposure to violence.

      de Jong, K; Ford, N; Kam, S; Lokuge, K; Fromm, S; van Galen, R; Reilley, B; Kleber, R; Médecins Sans Frontières, Plantage Middenlaan 14, 1018 DD Amsterdam, the Netherlands. kaz.de.jong@amsterdam.msf.org. (2008-10-14)
      ABSTRACT: BACKGROUND: India and Pakistan have disputed ownership of the Kashmir Valley region for many years, resulting in several conflicts since the end of partition in 1947. Very little is known about the prevalence of violence and insecurity in this population. METHODS: We undertook a two-stage cluster household survey in two districts (30 villages) of the Indian part of Kashmir to assess experiences with violence and mental health status among the conflict-affected Kashmiri population. The article presents our findings for confrontations with violence. Data were collected for recent events (last 3 months) and those occurring since the start of the conflict. Informed consent was obtained for all interviews. RESULTS: 510 interviews were completed. Respondents reported frequent direct confrontations with violence since the start of conflict, including exposure to crossfire (85.7%), round up raids (82.7%), the witnessing of torture (66.9%), rape (13.3%), and self-experience of forced labour (33.7%), arrests/kidnapping (16.9%), torture (12.9%), and sexual violence (11.6%). Males reported more confrontations with violence than females, and had an increased likelihood of having directly experienced physical/mental maltreatment (OR 3.9, CI: 2.7-5.7), violation of their modesty (OR 3.6, CI: 1.9-6.8) and injury (OR 3.5, CI: 1.4-8.7). Males also had high odds of self-being arrested/kidnapped (OR 8.0, CI: 4.1-15.5). CONCLUSION: The civilian population in Kashmir is exposed to high levels of violence, as demonstrated by the high frequency of deliberate events as detention, hostage, and torture. The reported violence may result in substantial health, including mental health problems. Males reported significantly more confrontations with almost all violent events; this can be explained by higher participation in outdoor activities.
    • Mental disorders, disability and treatment gap in a protracted refugee setting

      Llosa, A E; Ghantous, Z; Souza, R; Forgione, F; Bastin, P; Jones, A; Antierens, A; Slavuckij, A; Grais, R; Augusto E. Llosa, PhD, Epicentre, Paris, France; Zeina Ghantous, MPH, Médecins Sans Frontières, Geneva, Switzerland; Renato Souza, MD, Médecins Sans Frontières, Geneva, Switzerland, and Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil; Fabio Forgione, MSc, Pierre Bastin, MD, Alison Jones, MSc, Annick Antierens, MD, Andrei Slavuckij, MD, Médecins Sans Frontières, Geneva, Switzerland; Rebecca. F. Grais, PhD, Epicentre, Paris, France. (2013-09-12)
      Studies have shown high levels of distress and mental disorder among people living in refugee camps, yet none has confirmed diagnosis through clinical reappraisal.
    • Offering mental health services in a conflict affected region of Pakistan: who comes, and why?

      Shah, Safieh; Van den Bergh, Rafael; Van Bellinghen, Benedicte; Severy, Nathalie; Sadiq, Sana; Afridi, Sher Ali; Akhtar, Asma; Maïkére, Jacob; Van Overloop, Catherine; Saeed-Ur-Rehman; et al. (2014-06-25)
      North West Pakistan is an area ravaged by conflict and population displacement for over three decades. Recently, drone attacks and military operations have aggravated underlying mental disorders, while access to care is limited. Among patients attending a mental health clinic integrated in district hospital conducted by psychologists; we describe service utilization, patient characteristics, presenting complaints, morbidity patterns, and follow-up details.
    • Perceptions and Health-Seeking Behaviour for Mental Illness Among Syrian Refugees and Lebanese Community Members in Wadi Khaled, North Lebanon: A Qualitative Study

      Al Laham, D; Ali, E; Mousally, K; Nahas, N; Alameddine, A; Venables, E (Springer, 2020-01-21)
      This is a qualitative exploration of the perceptions of mental health (MH) and their influence on health-seeking behaviour among Syrian refugees and the Lebanese population in Wadi Khaled, a rural area of Lebanon bordering Syria. Eight focus group discussions and eight key informant interviews were conducted with male and female Syrian refugees and Lebanese community members from March to April 2018. MH illness was associated with stigma, shame and fear among both populations. Beliefs surrounding mental illness were strongly linked to religious beliefs, including Jinn. Religious healers were considered the first line of help for people with mental illnesses, and were perceived as culturally acceptable and less stigmatizing than MH professionals. It is essential for MH professionals to build trust with the communities in which they work. Collaboration with religious healers is key to identifying MH symptoms and creating referral pathways to MH professionals in this context.