InAsia

Pioneering Program Addresses Trauma Head-On

February 03, 2021 The Asia Foundation
InAsia
Pioneering Program Addresses Trauma Head-On
Show Notes Transcript

For a decade, the Victims of Trauma Treatment Program has worked with Sri Lanka to heal the psychic wounds of war and natural disaster. When Covid-19 arrived, the pieces were in place to tackle the trauma of lockdowns. Read the InAsia blog piece: https://asiafoundation.org/2021/02/03/pioneering-program-addresses-trauma-head-on/ 

Mahiri (00:03):

My name is Mahiri Ferdinando, and I manage the Mental Health and Psychosocial support program of the Asia Foundation, Sri Lanka office.

John (00:11):

Another voice from the field this week on In Asia, from the Asia Foundation. I'm John Regar.

Tracy (00:16):

And I'm Tracy Yang. Hardship and suffering have been woven into the tapestry of Sri Lanka for decades. So writes today's guest in this week's blog, 30 years of ethics civil war, the Asian tsunami, the Easter Sunday bombings in 2019, and now COVID-19 have tested the psychological resilience of all Sri Lankans.

John (00:37):

Joining us now is the director of the Asia Foundation's Victims of Trauma treatment program. A first of its kind initiative with a lot of moving parts that for nearly a decade has been helping to develop mental health and psychosocial support services for the people of Sri Lanka. Mahiri Ferdinando, welcome to In Asia.

Mahiri (00:55):

Thanks Tracy and John.

John (00:57):

Where are you joining us from today? Where are you?

Mahiri (00:59):

I'm in Columbus, Sri Lanka.

Tracy (01:01):

Yeah. And I can hear the chirping. Is that birds?

Mahiri (01:04):

Squirrels.

Tracy (01:05):

Oh.

John (01:05):

Squirrels.

Tracy (01:07):

I don't assume squirrels live in Sri Lanka for some reason.

John (01:10):

Yeah. I didn't think of that either.

Mahiri (01:12):

Loads of them, we have so many.

John (01:13):

Well, Mahiri thanks so much for being with us today.

Mahiri (01:16):

Very happy to be here.

Tracy (01:18):

So Mahiri, paint us a picture of the social landscape for Sri Lanka. Why did a program to help victims of trauma need to be a part of the national agenda?

Mahiri (01:29):

Sri Lanka is a beautiful island in the Indian ocean. However, it has had its fair share of human suffering, be the civil ethnic war, the Asian tsunami, the April 2019 Easter Sunday attacks, and now the COVID-19. The reason that we got into this work is because there was a war going on, there was active combat going on. And there was a lot of suffering and pain going on. And so the Asia Foundation began to work with the families and individuals who'd lost loved ones, who've lost limbs, who hadn't been going to school and different kinds of human suffering and just provide them with some support. And when we began work, we began working with the NGO partners who were in these areas, like the Family Rehabilitation Center in Shantia and providing people with just someone to talk to, tell what they were going through.

John (02:34):

Say a little bit more about the conditions that made this program a vital contribution to Sri Lanka. Was there a clear and present need for mental health services in Sri Lanka? And how did you go from working in the north to having a national presence?

Mahiri (02:52):

Sri Lankans are resilient and we draw strength from each other. If there is a problem in the home or the community, we reach out to a family member, to a religious leader. What happened with ethnic conflict was that these social networks were destructed and broken. Children were born into war, who didn't know what peace looked like. The residues of war and conflict were wide spread and not limited just to the north and the east. So while we began working with non-governmental partners who work predominantly in the north and the east, today the program is actually a national program that works with three key ministries.

Tracy (03:37):

The Sri Lankan government was apparently quite proactive about mental health services, calling for a core of government counselors back in 2005. Tell us how you supported their efforts to recruit and train psychosocial counselors.

Mahiri (03:52):

Today we have approximately 420 counselors. When they were recruited, there was no clear cut plan on how this personnel, who are arts graduates mostly, how they were supposed to perform that task because there was no professional training. And that's where the Asia Foundation came in. Building on our work and experience with non-governmental partners, we built this experience into the state sector. The first training that we did was on the role and the scope of the counselor. Who am I? What do I do? How do I respond to a situation? How do I work with the client, working with children, working on couple's therapy? How would you start a case and finish a case when you work with the client? We build the curriculum together with the ministries. Counselors themselves, some of them are part of the drafting of the curriculum. And so it's a very participatory approach that we've tried to employ.

            Something else that we've done is we've found out that counselors in our country don't have a place to talk about the cases. There is no avenue for systematic clinical supervision. And so, one of the things that we've done through the VTTP is to introduce peer support to the government counselors attached to social services or the women's ministry. And there's a methodology on how this discussion takes place. And something that we are really, really proud of and really grateful for is that in 2015, both the ministry of social services and the ministry of women and child affairs mandated that every counselor goes through peer support at least once a month.

John (05:38):

Mahiri, you've put together a lovely photo essay about the VTTP for this week's blog. And the diversity of people involved in the program is quite remarkable, from health care professionals, to community volunteers who are the people that make the VTTP work?

Mahiri (05:52):

That's a really important question, John, because the people are what make the program work. Being survivors themselves through our grassroot level action committees or community leaders, various mental health and psychosocial support professionals, ministry officials, subject specialists, it's this whole team that needs to work together. And every entity is equally important to make the work successful. The Asia Foundation is well positioned for this task or into a strong relationship with-

Tracy (06:27):

Hold on, I hear your...

Mahiri (06:29):

Ah, that's a chumpa. That's the bread delivery from house to house and everywhere on the island, it has the same music.

John (06:41):

All right. Where were we Tracy?

Tracy (06:44):

So the VTTP has a lot of moving parts as we said up top. And another one of those elements is training nurses for the National Institute of Mental Health. Tell us about your training of trainers program to train nurses to be master trainers.

Mahiri (07:02):

We began the National Mental Health Nursing program, which covered nurses who were attached to acute psychiatric wards across the island. Something that we found out while working with nursing personnel is that there were no real role models or mentors to this personnel. So while the initial program was facilitated by doctors, psychiatrists, or registrars, we began to build in a training of trainers models with nursing personnel so that nurses would train nurses. And I think that was a really nice transition rather than doctors training nurses. It was nice to see nurses training nurses, and we have this training of trainers group or the TOT group. When the COVID-19 hit, we had some of our TOT nurses be part of the 1926 phone line.

John (07:59):

The 1926 phone line is a crisis helpline, basically.

Mahiri (08:03):

That's right. I think the helpline became really important with the COVID-19, recording over 12,000 calls. There's a great group of nurses at DNA image who have been part of this master trainers.

John (08:16):

There's a picture of one such trainer in your photo essay this week. And she looks dedicated and a little bit stern.

Mahiri (08:24):

Yes. I think you're talking about Pewmina's fueled me. She amends the training center. Nurses can be a bit stern because they actually manage the wards. And sometimes their workload is much that it's difficult for them to even share a smile. So some of our work with them, how we help them to manage their time, how we help them to build better relationships with the patients and also how we give them a little time for their own self care, because it's a stressful job.

Tracy (09:01):

So Mihiri, you've taken us through the ins and outs of the Victims of Trauma treatment program. Can you say a bit about what the impact would be of not addressing mental health?

Mahiri (09:12):

There is no health without mental health. Each of us, we have bad days and we have good days and some of us have the capacities to deal with it and move on. But sometimes life sort of dishes you a curved ball. And if you don't really get the support that you need psychologically, mentally, you might not be able to be the best person you could be. Maybe a decade back when you looked at mental health and psychosocial support, nothing much was known about it in Sri Lanka, leave alone the Asia Foundation International. The Sri Lanka office is probably the first office to begin a program and a mental health and psychosocial support. And we see it as part and parcel of living that good life. It's like that beautiful tree that has its roots deep in the ground and has the leaves and the fruits. And it's this flourishing beautiful tree. And our dream is that people live this well, beautiful, flourishing life even when disaster strikes.

John (10:23):

Mahiri Ferdinando, thank you so much for joining today.

Mahiri (10:26):

It's been a pleasure, John and Tracy. Thank you for having me on the show or what is it, a podcast?

John (10:32):

It's a show, show is fine.

Mahiri (10:33):

Okay.

John (10:35):

And that brings our show for this week to a close. Mahiri and her partner Gamino Amarasing have put together a photo essay that gives a nice feel of the program. And you can see that in this week's In Asia blog. Until next time, I'm John Regar.

Tracy (10:49):

And I'm Tracy Yang.

John (10:50):

Thanks for listening.