Coping with Crisis

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Coping with Crisis

Issue NO. 1, 2011 www.ifrc.org/psychosocial

Children and emergencies

The world: Disasters and unrest Pakistan: Tough times and glorious games Czech Republic: Rain and tears Israel: Helpers and huggers Contents

Psychosocial support around the world 4 Highlights from the IFRC Appeals and Operational Updates

Focus on Pakistan Moving on 6 The nightmares remain, even when the floods have gone By Majda Shabbir

A tough time 8 4 Psychosocial volunteers recount their experiences By Yasi Qazi, Shahmeer Khan Chandio and Tanzila Qazi

Glorious games 9 No opposing teams, no goals but lots of smiles and laughs By Penny Sims

Rains and tears 10 Czech Red Cross deployed ERU and psyhosocial support to help those affected by the floods 6 By Karel Konečný and Lucie Balarinová Best practices in child protection 12 Experts agree on many issues - and disagree on some By Alastair Ager

Let the old help the young 16 Knowledge and experience are often forgotten in disasters By Emmanuelle Babaud 10 Volunteers help children be children 19 Assisting the displaced in Tunisia By Kathrine Roux

The Hugging Train 20 Magen David Adom in Israel - and in Haiti By Carina Sorensen 16

Editorial board: Nana Wiedemann, Lasse Nørgaard and Carina Sørensen Disclaimer: The opinions expressed are those of the contributors and not necessarily those of the IFRC Psychosocial Centre.

Cover photo: Earthquake in Haiti 2010, Colombia Red Cross plays with the children as part of a PSP program. Photo by Jakob Dall/Danish Red Cross.

2 Editorial

2011 has begun with civil unrest sexual exploitation and abuse. in a number of countries in North At the IFRC Psychosocial Centre Africa and the Middle East. National we have experienced a steep Societies with support from sister increase in requests for materials, societies and the International Red training and advice directly from Cross Red Crescent Movement have National Societies in 2010 and the responded with relief, medical aid beginning of 2011. Entire regions and psychosocial support. Thousands are now engaged in master training of demonstrators staying together of trainers, and numerous National for weeks in one place not knowing Societies have included psychosocial what will happen next, or tens of support in their 5-10 year strategies, communities after the floods, and thousands of refugees in squalor reflecting the three major aims of how Magan David Adom developed camps - some of them having the global Strategy 2020. from a National Society where crossed the border in dramatic The world map you see on the psychosocial support to staff and fashion and uncertain when they following two pages illustrates volunteers was considered unnec- can return to their country of origin how widespread and integrated essary to today having realized the - naturally creates fragile and tense psychosocial support has become benefits and actually being able to situations. as a global Red Cross Red Crescent assist internationally, like in Haiti Psychosocial support is not only activity. It only highlights psycho- after the earthquake. helping individuals but also reduc- social interventions in relation to ing the risk of possible conflicts, and new appeals and on-going interna- Yours sincerely, once again we have been reminded tional operations, whereas activities about the need to be prepared carried out by numerous National for unexpected events. Thankfully Societies domestically are not includ- most of the National Societies in the ed. If they were, the map would region have trained staff and volun- be even more colourful, i.e. the Nana Wiedemann, teers, who have provided support Japanese Red Cross´ deployment of Head of the International Federation every day during the past few a psychosocial support team to New Reference Centre for Psychosocial months. The psychosocial support Zealand after the earthquake would Support. will continue as stated in the appeal have appeared, as well as New with particular attention being paid Zealand Red Cross´ own support. *For further information and other facts please towards assessing the needs of In this issue you can also read refer to the following RCRC brochure which can be vulnerable groups and programming about the Czech Red Cross’ ERU found on the IFRC website: http://www.ifrc.org/ that mitigates the risk of gender assisting after the floods, the Docs/pubs/who/at_a_glance-en.pdf based violence and seeks to prevent psychosocial support to Pakistani

A story from Gaza A mother asks what to say to a child when passing a dead body and the child keeps saying “I don´t want you to die”. A Red Crescent ambulance driver realizes he might need help, when he gets used to picking up injured people, and goes directly for coffee breaks after washing the blood of his hands. A deaf girl talks about the horror of seeing and feeling the shelling and everybody around her being scared but nobody telling her what was going on. Our new video “A story from Gaza” portrays the situation and some of the psychosocial support provided to the occupied area almost a year after the 22 days of military action in 2009. You can order the film from the PS Centre or watch it on the following URL - http://psp.drk.dk/sw40692.asp

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3 Highlights from the world on psychosocial support provided by National and sister Societies, based on the IFRC Appeals and Reports for 2010. Many other National Societies are continuously delivering and expanding their psychosocial support activities.

Australia: On 25 December 2010, tropical cyclone and causing over 222,570 deaths. In Port-au-Prince, Tasha caused widespread rain and flooding. More more than 1.5 million were rendered homeless. than 200,000 people were affected. Ten evacuation By the end of the year 122,149 people have been centres were established to assist affected families, reached with psychosocial support. A psychosocial providing practical and psychosocial support. A support programme was also launched as part of variety of support materials including multime- the emergency response to a subsequent cholera dia resources for young people, children’s activity epidemic. All 102 psychosocial volunteers received booklets and booklets on coping in the aftermath of training in hygiene promotion and cholera preven- a disasters were distributed to affected individuals, tion. Initiatives included prevention campaigning, families and communities. disseminating transmission information, community mediation and facilitating cholera treatment centres, Cambodia & Thailand: Due to rising tension between addressing the fears and stigmatization surrounding the two countries an exchange of heavy artillery the disease. fire occurred on 7 February 2011. More than 25,000 people have been affected. The Thai Red Cross have Kyrgyzstan: Civil unrest in the spring of 2010 caused identified psychosocial support for children as a over 400 casualties and a massive exodus of people. priority while the Cambodian Red Cross is conducting Psychosocial support was a large part of the National a vulnerability and capacity assessment. Society’s operational response. PTSD and other mental health disorders were exacerbated by the China: On 8 August 2010 a massive mudslide caused violence, as was gender-based violence. The Swiss 1,481 casualties and affected another 47,000. Red Cross deployed a psychosocial support delegate Psychosocial support was first initiated in January for two months. 3,399 beneficiaries were reached 2011. Many of the affected families living in crowded with psychosocial support activities including individ- transitional sites are dealing with trauma and ual and group sessions, education, door-to-door emotional duress. 25 local volunteers were trained in visits, trainings, needs assesments, cultural activities, psychosocial support, and carried out door-to-door rehabilitation, children’s activities and referrals. activities, disseminating hygiene knowledge through posters and educational leaflets. Moldova: Due to heavy rain and flooding in July 2010, an estimated 12,000 people were directly Egypt: Civil unrest broke out on 25 January 2011, affected. With the support of the Norwegian with several casualties being reported. Egyptian Red Red Cross, psychosocial support manuals such as Crescent staff and volunteers visited hospitals to ‘Psychosocial Support in Emergencies’ and ‘Assessing provide care and psychosocial support to the injured Vulnerabilities in Emergencies,’ were printed and and affected people. distributed to the National Society branches in order to enhance capacity. Guatemala: On 29 May 2010, Guatemala was hit by tropical storm Agatha, only two days after the Namibia: Approximately 110,000 people were eruption of Pacaya Volcano. Persistent torrential affected by flooding, and Namibian Red Cross volun- rains throughout August and September, as well teers and staff reached out to the most vulnerable. as tropical storms Alex and Mathew, added to the Apart from hygiene promotion activities, 64 volun- turmoil. Volunteers received training in community- teers received training of trainers in gender-based based psychosocial support, providing assistance to violence, while 116 beneficiaries were trained. 300 affected families and volunteers themselves. students have received volleyballs and netballs, and 100 women have been provided with knitting materi- Haiti: On 12 January 2010, Haiti was struck by 7.0 als and tools in the relocation centres as part of the magnitude earthquake, affecting 3 million people psychosocial support programme.

4 Pakistan: 21,837 people were reached with Saint Lucia: During the first week of October 2010, psychosocial support, which has been an ongoing heavy rain caused a flash flood significantly affect- activity since the devastating floods hit last year. ing 400 households. This was further aggrevated by The psychosocial support activities include infor- the onslaught of Hurricane Tomas on 31 October. 200 mal education, group sessions on psychosocial families received food parcels and non-food items, education, sports activities, referrals, individual as well as hygiene promotion, health education and sessions and support to the vulnerable. brochures about psychosocial support from the IFRC ‘Helping to Heal’ series. Philippines: Typhoon Consoon hit the Philippines in July 2010, affecting some 82,000 families. In Tunisia: Starting 17 December 2010, civil unrest swept October 2010, Typhoon Megi – a super typhoon - through Tunisia. The Tunisian Red Crescent established hit the country. The previous year the Philippines a crisis committee where daily meetings were held with was also hit by typhoons twice. Psychosocial staff and volunteers. Volunteers were deployed to crisis support has been provided as part of the health sites providing psychosocial support to families of the and care activities to reach 65,000 beneficiaries, victims and the injured aside from medical and practi- including assessments, health promotion, dissemi- cal assistance. TRCS also responded to the influx of nation of information, education and communica- refugees from the conflict in neighbouring Libya. tion materials. Other countries include: Argentina, Armenia, Romania: Heavy rains and flooding affected more Azerbaijan, Bangladesh, Belarus, Benin, Bosnia and than 12,000 people in July 2010. Romanian Red Herzegovina, Cambodia, Chile, China, Colombia, Cook Cross volunteers provided psychosocial support Islands, Democratic Republic of Congo, Ecuador, El and advice about hygiene and water-borne diseas- Salvador, Ghana, Guatemala, Haiti, Dominican Republic, es to evacuees that housed in provisional camps. Honduras, India, Indonesia, Jamaica, Kazakhstan, Kenya, Kosovo, Kyrgyzstan, Lebanon, Maldives, Russia: On 8 May 2010 two methane blasts in a Moldova, Mongolia, Montenegro, Morocco, Myanmar, coal mine caused 91 casulaties and 129 injured. Nepal, Nicaragua, Pakistan, Palestine, Panama, Peru, The Russian Red Cross provided psychosocial Philippines, Romania, Russia, Saint Lucia, Samoa, support to 247 people from affected families Serbia, South Africa, Sri Lanka, Syria, Tajikistan, Togo, through regular home visits, group sessions and Turkey, Ukraine, Uzbekistan, Venezuela & Viet Nam. community events.

5 Feature: Focus on Pakistan

Moving on

It is not without bumps and challenges to move on after a disaster, despite the relief and psychosocial support provided by the Red Cross Red Crescent Societies and other agencies. Survivors – as well as staff and volunteers – face tough times and set-backs in the process. On the following pages you can read stories about some of the people affected by the terrible floods in Pakistan as well as the challenges faced by those trying to help. You can also read about the activities helping people to move on.

Text and photo by Majda Shabbir, IFRC Communication Officer in Pakistan

“The flood is coming, the flood When she saw the water coming and run by the UN. A psycholo- is coming,” screams little in, she started screaming.” gist visits the camp at least Musaira in her sleep in the The water continued to rise, three times a week, and works middle of the night. Her mother completely surrounding their closely with the children, includ- Gulnara takes her in her arms home, leaving them stranded. ing Musaira, who are suffering and tries to console her. It is six They didn’t want to leave but psychosocial problems after months after monsoon floods had no choice when the water living through the floods. gushed through their village, rose to the point of drowning and eight year old Musaira is them. Better now still having nightmares. The family’s mud house was “I like going to the tempo- Slowly but surely, they are completely washed away. Night rary school here,” says a shy becoming less frequent. Time after night, Gulnara and her Musaira. “They have many play has a way of easing wounds, family kept moving from one activities but I enjoy painting but Musaira’s mother is also relative’s house to another. All and colouring in drawings the taking an active role in her were too full to accommodate most.” Her mother Gulnara is recovery, ensuring she partici- them on a long term basis. also more optimistic. “Despite pates in psychosocial sessions all the hardships we have gone being offered at a Red Cross Fearful and anxious through, I am very happy, as she Red Crescent camp for displaced Gulnara shares that she was is better now,” the mother says persons in Charsadda, Khyber very worried about Musaira who with a glimmer of hope in her Pakhtunkhwa. remained fearful and anxious. eyes. “We consulted several doctors At the same time she admits Washed away for her treatment, borrowing that her daughter is not the fast “Musaira was a normal money to pay the fee but that learner she used to be before child before the floods shook didn’t bring any improvement,” the disaster. The distressed her completely,” says Gulnara she says. Since the family mom hopes to rebuild her own while combing and braiding her moved to this camp two months house again and return her daughter’s hair. “The floodwa- ago, Musaira is better as she daughter to a life that is as ters started entering our house spends time at the child friendly normal as possible. during morning prayer time. space, set up especially for kids,

6 7 Focus on Pakistan A tough time

By Yasir Qazi, Shahmeer Khan Chandio and Tanzila Qazi, psychosocial volunteers of the Pakistan Red Crescent Society.

e are psychosocial W volunteers of the Pakistan Red Crescent Society, working in Sindh for the flood affected. We are part of a team of 18 volunteers in Dadu, one of the districts where houses, land, crops and cattle were destroyed by the high levels of water. Villagers here lost everything, have no safe water to drink and no food to eat, so they are desperate to get help. We combine psychosocial support with community-based health first aid. Each day we go to the affected areas to offer psychosocial support to adults, to conduct play activities with the children and to demonstrate the use of water purification. Our PSP project incorporating hygiene promotion in Sindh province. Volunteer field officer Saba demonstrates team works in 13 villages as how to purify water using the tablets the women will receive from the Red Cross the following day. This will part of a Danish Red Cross enable them to make the contaminated water safe. Photo by Olivier Matthys / IFRC project supported by ECHO.

30 minutes to leave safe ground nearby, the water in need. They had tears in their In the early days of our work, almost caught up with them. It eyes too from listening to the we and other Red Crescent was extremely scary for all. The story of villagers. Even though volunteers were the first to immensity of the flooding made these are difficult times, we are reach Dhani Bux Bughyo, a his family members urge him to happy to be part of a project village in Dadu, where we met shoot them, so they wouldn’t providing some help and support disheartened, sad and upset have to face the devastation. to the affected. villagers who had not eaten for We had tears in our eyes when This is a miserable time for many days. he told us his story, and we many in Pakistan. Many of those We offered psychological thought that had we been in his affected by the floods have to first aid to as many as possible. shoes, we would have felt the live under open skies. They need Among them a man of about same. The man felt comforted by help to rebuild their houses, and 50 years of age. He had lost his sharing this experience with us. at the village level support is house, land and all his animals. needed to rebuild medical He cried while recounting the Under open skies facilities, schools, bridges and deplorable moment when he Nearby another team of canals. In the process, it should was told that the water was Pakistan Red Crescent volunteers not be forgotten that hearts and coming. There were only 30 were carrying out an assessment, minds need mending as well, and minutes to leave the village, and while at the same time offering that support and comfort can go as he took his family of five to a psychological first aid to those a long way.

8 PSP project in Sindh province, run by the Danish Red Cross and PRCS. A young gril waves goodbye, showing her handiwork from the art class. The activities help children recover from the trauma of the floods. Photo by Penny Sims / IFRC

t is 11:15 in the ling and toys I morning at M. to encourage Ibrahim Channa children to play village school, and in the communi- a mass game of ties. football has just broken out. There Scared to leave is no opposing the house teams, no clearly “The floods defined goals or affected people positions, but in different ways. there is what is Those haunted by most needed: one nightmares and football, and a sounds react very roar of exuberance strongly. In one as every child in Glorious case, a woman the school chases was so convinced it with urgent the floods would intent. The team return she would sweeps across games not allow anyone the playground, from her family around the corner out of the house,” and back up to the says Dr. Solangi wall. It doesn’t and continues: matter where the goal is, it’s a “We teach people relaxa- glorious game. By Penny Sims, British Red Cross tion techniques to help them Next there is cricket, volley- cope. This can be simple ball and games and exercises. things, like breathing exercis- In another area, a volunteer ed in order to plan for aid, but es, and we teach ways to deal shows children how to make also the psychological impact of with their thoughts. It’s also colourful butterflies from the floods. People are telling us important to reassure people, scraps of paper. they have nightmares; they are to let them know it’s normal haunted by the sounds of the to feel this way, but that it will Haunted by sounds floods coming in their dreams. eventually pass.” The games are part of the It has affected the way people Red Cross Red Crescent psycho- live, and how they recover”, he Art and toys social support programme explains. The volunteers of the (PSP), which accompanies the German and Danish Red psychosocial progamme talk to distribution of aid in the KN Cross Societies have entered those affected, and they Shah region of Sindh province. into a partnership with the arrange activities. They “We plan to support 63,000 Pakistan Red Crescent Society. provide sports equipment to people in this region,” says The German Red Cross looks the local schools, and arrange Dr Zeeshan Solangi, who is a after the distribution of aid, with the teacher for the consultant for the psychosocial such as shelter kits, water children to have regular support programme. purification tablets, and other playtimes. Another volunteer “When we came to assess items. The Danish Red Cross creates art with the children, the situation in this area, we and Pakistan Red Crescent showing them ways to make did not only look at the physi- provide first aid training, toys from simple things like cal needs of the people affect- hygiene promotion, counsel- paper, paint and sticks.

9 Rain and tears

Images of raging waters, flooded houses and boats evacuting people are still transfixed in our minds. So are the cloudy skies which preceded the “rain of tears” as our eyes watched the havoc caused by the floods. We must not forget another image, that of the professional and volunteer rescuers who help people to cope during the aftermath of a disaster. Among such dedicated people are the members of the Emergency Response Unit of the Czech Red Cross.

By Karel Konečný and Lucie Balarinová, Emergency Response Unit of the Czech Red Cross

ffering psychosocial first aid on ensuring efficient logistics for nators and team leaders. Here are Owas and is one of the main covering critical areas, enabling the some to the conclusions: emergency response activities of the deployed forces to cover a large Czech Red Cross. We understand it area in a short amount of time. 1. Volunteers as an immediate response including Part of the efficiency was due to Volunteers must be self-suffi- meeting basic needs for survival, as good pre-planning of routes, teams cient and always responsible for well as access to practical informa- assigned to specific areas - no more their actions in every situation. tion and securing contact with close than one team per area, the teams They should only help if they feel relatives. Everything is done with communicating amongst each other, capable of doing so and have a the necessary respect, empathy and lunch and other necessary items support base, in other words a concern for those involved, and with being provided for and pre-assigned strong circle of family and close reflection for how things could be roles for each team member to avoid friends. improved. The Emergency Response duplication of efforts. Last but not Although volunteers should be Unit (ERU) of the Czech Red Cross, least, much focus was put on good able to rely on themselves, they together with co-workers and other and constant communication. must also be able to trust their non-govermental organizations, colleagues in the team as much as provide help at critical places in Large scale floods possible and not feel that all the cooperation with the Integrated Last year we were hit by several responsibility lies on their shoul- Rescue System of the Czech large-scale flash floods in different ders. Republic. parts of the country during a short Volunteers must also be three month period. prepared for the fact that their First experience ERU-CRC members helped in two assistance may at times be refused, The first real experience for the of these events, managing evacua- and should not take that to heart. ERU came with the floods in north- tion centers, distributing humanitar- Respecting the rules of the organi- ern Moravia – Novojicinsko in 2009. ian assistance and managing provi- zation is likewise important as they Our people coordinated and provid- sional treatment places. Psychosocial are representing the RCRC when on ed medical and psychosocial first aid. support was conducted under the duty. Teams of the Red Cross were guidance of fire department psychol- Furthermore, volunteers going through the terrain, monitor- ogists, which helped us reflect on must remember to communicate, ing the needs of affected people, the effectiveness of the assistance since good communication is key treating acute injuries and offer- provided. element to delivering effective aid, ing psychosocial first aid. At first, Once interventions had finished, for example through coordination, medical first aid appeared to be all the participating members under- but volunteers must also be able most valuable as it “opened the went specialized supervisory care. to listen to their own needs and door” to following supportive inter- body and be able to say STOP when views, often provided repeatedly. First learnings neccessary. If necessary, a professional crisis Experiences from the first couple intervention team was called in for of years working with ERU and 2.Coordinators the more acute cases. psychosocial reports were collected What was said of the volun- Great emphasis was placed for volunteers, emergency coordi- teers, also applies to the coordi-

10 Clockwise from top left: (1) Floods at Jesenik 2009 – Jan Bozovsky, member of ERU checks remote parts of the small village Tomikovice, near Jesenik city. Photo by Dan Rother. (2) Floods at Troubky 2010 – ERU briefing with Karel Konecny (starting from the right), Lucie Balarinova, Marek Balicki, Roman Vana, and Jana Zaplet- alova in centre. Photo by Ladislav Bohac. (3) Floods at Liberecko 2010 – CRC Rescuer at Raspenava, one of the most damaged villages. Photo by Karel Konecny (4) Floods at Liberecko 2010 – the aftermath of the floods at Chrastava. Photo by Karel Konecny. nators. Moreover, it is important to the ERU team leaders. They are with empathy, selflessness and for coordinators to create a good spearheading the operations and modesty. Secondly, they must be atmosphere for the team, paying should therefore be an inspiration fortified with a professional ability attention to everyone’s psychologi- for the team. They must prepare to communicate and cooperate cal, physical and spiritual needs. carefully and evaluate, collate and with people to stay focused and They are responsible for setting apply experiences learned for the reach the same objectives. the schedule and holding regular next crisis event. This should be We consider this a cornerstone meetings with relevant govern- done in cooperation with relevant for successful and effective help, ment agencies and NGOs (if possi- government agencies and NGOs. but it would not be possible ble once per day) for effective without the many staff and volun- coordination and keeping updated. The greatest capital teers who have dedicated Coordinators must also be able The understanding of an themselves to their tasks. to delegate tasks and foster self- intervening professional embark- Therefore, on this occasion, we reliance and responsibility in staff ing on a mission to help others will would like to thank all participating and volunteers. Team-building always be enriched with something CRC members, collaborating and confidence can be boosted intangible – the stories of affected partners from NGOs and the by encouraging interaction inside people, the unique atmosphere of government/IRS staff for their the team, reminding the team to the scene and daily “little things” cooperation – they are our founda- respect themselves and others, as requiring a completely different tion. well as showing appreciation and type of attention. giving praise. It is also important to Coping with the consequences Karel (konecny.karel@cervenykriz. maintain focus and understand the of the floods has required, and eu) is Chief of the Emegency Rescue needs of those affected. will still require, a lot of financial Unit of Czech Red Cross. Lucie resources and material aid. But (balarinova.lucie@cervenykriz. 3. ERU team leaders the greatest capital will always eu) works as the Project holder for What applies to the volunteers be a willing human being that Emergency Rescue Unit of Czech and coordinators, likewise applies is equipped first and foremost Red Cross.

11 Best practices in child protection

A recent study amongst leading international experts on child protection in emergencies has identified a number of core themes that are widely seen to define ‘best practice’ in programming. The study also indicated, however, some key areas where opinions remain divided, and that documents seen by some as defining best practice are unknown by many and not used by most.

By Alastair Ager, Professor at Columbia University, USA

here is increasing interest in who has participated in group expert opinion as a product Tthe evidence base for effective discussions knows how difficult it of diverse experience, and interventions addressing the needs can be to negotiate real ‘consensus’ provide a formal structure for of children in emergency settings. among experts. Individual reflecting on that experience and Many agencies are interested in personalities inevitably shape such considering areas of agreement documenting ‘what works’, and discussions, and those responsible and disagreement. In particular, there have been a number of recent for note-taking and writing-up duties consensus methods seek to control initiatives to support more thorough have particularly strong influence in the effects that can often bias research and evaluation work in the final outcomes. processes of expert discussion. Such field, including new inter-agency effects include the potential for endorsed guidelines on evaluation of Finding consensus undue influence of those drafting psychosocial programming . In recent years a number of conclusions, and the premature But what of the ‘evidence’ ‘consensus methodologies’ have loss within discussions of ‘minority’ of the opinions of experienced emerged as tools to establish opinions. practitioners, shaped by exposure expert agreement on issues of One of the most powerful to programming across diverse practice, especially where evidence consensus methods is the ‘Delphi’ settings and circumstances? Many from formal research studies is review process. This involves inter-agency processes seek to learn inadequate and/or inappropriate to consulting a panel of experts over from such experience in negotiating inform judgments. a number of phases of a review, guidelines and principles. But anyone Consensus methods respect during which expert opinions are

12 A young girl stands in the rain at a Red Cross Red Crescent camp in Charsadda, Pakistan. We must establish a The camp houses 150 families left homeless by the monsoon floods ‘culture of learning’ in July 2010 and offers shelter, food, health among agencies. care and a child friendly In enabling community mobili- space. “ zation, it is vital to identify and include” different community sub-groups. Programming should be inclusive and reach out to a range of affected children. Effective reintegration programs support former children associated with fighting forces and also other vulnerable children.

Long-term strategies are required for youth who have missed education and who need to become economically active.

We need strict ethical protocols for collecting information from children. We need to provide ‘girl friendly’ reproductive health and GBV services. refined to produce consensus agreement across the panel. Our We need to develop an evidence-base of what team at Columbia University recently constitutes effective child care and protection reported on a Delphi review that we conducted with leading child We need to put strategies in place to prevent the protection experts working in separation of children. the field of humanitarian support in emergencies. The study was There is a need for planned reintegration from a long- conducted as part of the Program term perspective with recognition of ongoing needs. on Forced Migration & Health’s Care and Protection of Children in Crisis- Efforts to support children formerly associated Affected Countries (CPC) Initiative with fighting forces are most effective and funded by USAID’s Displaced sustainable when based on their strengths and Children and Orphans Fund, the Oak resources. Foundation and the United States Institute for Peace. Child protection must be addressed and prioritized within military and peacekeeping operations. Our Delphi process Specific strategies need to be put in place to engage Potential expert participants girls in education and training activities. were defined with respect to four criteria that ensured that we were consulting with senior people with Table 1: Statements receiving 100% support from experts experience across a range of crisis settings. They were either people holding the most senior position governmental organization (IGO) relevant websites. After exten- in child protection within a leading or international non governmental sive web-searches and telephone donor agency working in the field of organization(INGO) working in the research we identified seventy-seven child protection in a crisis; or those field of child protection in a crisis; or, potential participants meeting these holding the most senior position finally, were people who had been criteria. Of these, thirty-eight agreed within an international network/ contracted by a leading IGO/INGO to participate within the study, thirty forum regarding child protection for technical/advisory work resulting of which completed all phases of the in crisis situations; or those in the production of five or more review. holding the position of Senior Child technical reports. Protection Adviser or equivalent or We defined ‘leading agencies’ Best practices above within specialised children’s as those posting positions and In Phase 1 of the review, services within a leading inter- projects on the ReliefWeb and other participants independently stated

13 Table 2: Documents Suggested By Experts as Representing Best Practice (and percentage of experts who were aware, owned and used the document respectively)

what they considered principles accordingly. the well-being of children linked to of best practice in the field. A a wide range of social, cultural and consolidated listing of 91 statements Key areas of agreement economic factors. Crises may directly was compiled from responses The review produced a listing of expose children to trauma and received. In Phase 2 this listing was 55 statements that 90% or more of loss, but the erosion of community presented to all participants with the our experts were in clear agreement resources also undermines request to rate level of agreement with. The 13 statements that got well-being. with each statement. Participants 100% agreement are shown in Table Promoting child well-being were, additionally, requested to rate 1, and give a flavor of the sorts of may, in the short-term be guidelines cited during Phase 1 issues in this larger list. A number through direct service provision, responses as constituting existing of statements reflect principles but experts were clear in their statements of best practice. that have become established in focus on utilizing, and where The opportunity was provided to guiding humanitarian efforts more necessary re-building, community give a brief commentary regarding widely, including those related to capacities and institutions. Some the rating of any item. In Phase 3 the ‘do no harm’ principle, agency forms of specific intervention are consensus ratings - and collated coordination, staff codes of conduct commended, including reproductive participant commentaries with and community participation. health services for girls, livelihoods respect to each statement - were Others, however, reflect particular programs for youth, documentation shared with all participants, with the understandings of the particular and tracing for separated children invitation to amend or affirm ratings needs of children. Participants saw and demobilization, disarmament

14 and reintegration provision for vocabulary of development” and Documenting best practice war-affected youth. But the greatest “Vulnerability is a product of situa- The findings regarding ratings of emphasis is given to the manner in tions, not individuals”. existing practice guidelines make which interventions are planned and The adoption of a ‘rights-based sobering reading for those involved implemented. Active participation approach’ also produced contrast- in dissemination of documentation of children and youth and the wider ing reactions. Some saw this as within the humanitarian sector. community are considered crucial, the foundation of best practice, Although the documents listed in and the inclusivity of programming is while others suggested “Narrow Table 2 do not include materials consistently emphasized. definitions happen too often. It can produced since 2006 (which was the inspire unbalanced approaches, year when elicitation phase of the Key areas of disagreement and can undermine capacity- Delphi review began), two key facts Of equal interest are the building” and “…only if done identify the challenge of knowledge statements reflecting what some without imposing rights or taking a sharing in the field. Firstly, even experts suggested as clear best moralistic stance, demeaning local senior practitioners were unaware practice, but with which others practices.” of many documents cited by others actively disagreed. These are A third issue producing widely as representing best practice, potentially key areas of debate differing views concerned the pointing to the importance of more in the development of the field suggestion that ‘Interventions need active and effective dissemination of working with children in to be scalable’. of such materials. Secondly, a crisis. Three of these issues are “The fact that interventions minority of participants made active considered here: vulnerability, can’t be applied beyond a small use of such documentation in their right-based approaches and scale. group should not necessarily work, suggesting that in developing First, while some experts preclude those interventions being materials greater attention should favoured interventions targeting carried out” argued some. However be made to facilitating utilization. the most vulnerable, others were others - concerned at equity and concerned at the danger of stigma efficiency - argued that “Great and community disruption when interventions that do not reach the Alastair Ager is Professor of Clinical inclusion criteria for programs vast majority cannot be consid- Population & Family Health with the are based on specific needs or ered effective practice”, drawing Program on Forced Migration and exposure to specific experiences. parallels with water & sanitation Health and Executive Director of the These concerns were expressed in provision, food distribution and Global Health Initiative, Mailman such comments as “‘vulnerable’ is emergency health care where School of Public Health, Columbia about the worst word to enter the effective coverage is a key concern. University, USA.

Valentina is a volunteer for the Red Cross in Belarus. Here she taking care of children from a children’s home. Photo by Jakob Dall / Danish Red Cross

15 Let the old help the young

Can our children handle tomorrow’s emergencies? That is a question the French Red Cross, the Belgian Red Cross, the Bulgarian Red Cross, the Finnish Red Cross and the University of Paris (referred to as the “University of Paris 5”) have been trying to answer through a project funded by the European Commission.

By Emmanuelle Babaud, psychologist, French Red Cross

hildren’s preparedness is educate their parents afterwards. emergencies, so factors like social Cone of the topics which This kind of process produces a support, trust and some kind of the European Commission has role inversion, which is not neces- parenting seem to be essential special focus on. So during the sarily in the children’s best inter- in order to reinforce children’s Second Civil Protection Forum the est – or in the best interests of the coping capacities and resilience. question was not only if children parents for that matter. can handle future emergencies Supporting parents but also who do they first and A different approach So how does one help adults foremost rely on and how can they This project’s approach is a to strengthen their capacity to be assisted? different one and aims to reinforce protect their children? Risk prepar- In order to find the answers, confidence in children as well as in edness is sometimes considered an one has to take into account the adults by enhancing their capac- issue exclusive for specialists, such cognitive and emotional develop- ity to protect their children. The as fire-fighters or rescue workers. ment of children, so not to place protection adults can offer during This project, on the contrary, too heavy a burden of responsibil- emergencies is indeed impor- enables parents, grandparents ity on the children themselves. tant for several reasons. From an and teachers to link appropriate Some risk education programs emotional point of view, children questions with risk preparedness. target children hoping they will can easily be overwhelmed facing The project’s objective is to

16 Two generations of a family, in the Abu Monaiser Area of Abu Ghraib district 30 kilometres west of Baghdad. November 2002.

develop pedagogical resources for children and adults perceive risks? and children. risk education, for both children What are the educational practices and adults. The aim is to reinforce of the adults concerning risks? And Who plays a role? communication and interac- thirdly, what beliefs are related to The results of the study, tions within a community and education? Our objectives were to analysed by the “University of particularly to enable caregivers understand how to support adults’ Paris 5”, showed that those and educators to talk to children educational practices and to questioned had a very high risk and address the issue of risk. The discover which interactions should perception, involving numerous intergenerational dimension is be reinforced between different dangers. Even situations where important, considering that elderly community members in order risks seemed to be fewer or less people represent a community’s for risk preparedness to be more serious were perceived as risky. collective memory. Those sharing their experiences may reinforce the feeling of belonging, for all community members.

The right messages Educating children about risks and preparedness are not easy subjects to deal with. In fact, many adults are not sure how to address them at all. They may consider whether they in fact frighten the children unnecessarily. The pedagogical resources developed in the project support the educational practices of adults. With regards to how to communicate about risks, some research- ers have shown that the use of distressing images can reinforce people’s belief that disasters are too catastrophic for personal action to make a difference. Such communication may even inhibit Daniel is a four-year-old boy who is HIV-positive. His mother died of AIDS and his father is missing. Grandmother the motivation to prepare and plan Agnes and grandfather Samuel care for the little boy. Photo by Brendan Bannon / IFRC. ahead, if an overwhelming sense of hopelessness takes over. efficient. The practical knowledge of This project is aimed at The study was carried out in grandparents with regards to trying to make people change Belgium, Bulgaria and France. risks turned out to be under- their behaviour about risk issues Questionnaires were developed estimated in all three countries. through reinforcing positive for children between the ages of 8 This shone through in all catego- messages, like the possibility of to 11, their parents, grandparents ries of participants: children, helping each other and strength- and their teachers. The dimen- parents and teachers. Only grand- ening trust within the community. sions analysed for all categories of parents had actually considered participants were risk perception that they could play a role in risk How do we perceive risks? and practical knowledge related situations. In this context, we decided to to risks, links between different It is noteworthy that one’s carry out a study to try to answer members of a given community practical knowledge about risks the following questions: How do and beliefs regarding education seems to be less valuable to

17 “Grandparents, who often believe that they have some practical knowledge that could be shared, are not always recognized as having valuable input. Their role within children’s supervision is not clear, and this is an area where clarity can and should be developed.”

respondents than their possibil- defined, and this is particularly recognized as having valuable ity of calling for help, and this so in France and Bulgaria. input. Their role within children’s applies to children in particu- supervision is not clear, and this lar. Participants, regardless of The need to be reassured is an area where clarity can and country, did not have the feeling Regarding people’s beliefs should be developed. The study of being in control when faced about education, the study certainly shows that the grand- with risks and were more likely to showed in all three countries parents’ role is underestimated call for help, rather than knowing that children have the need for and not as valued as it could be. how to react and deal with it. supervision, in other words: Furthermore, it also shows that to have someone listening if people perceive risks, they Who is trustworthy? to them and to be reassured generally do not believe they Regarding links between when needed. These results are can control them. It is precisely different members of the based on both the adults’ and such perceptions that must be community, the study showed children’s answers. changed, because there are steps that in all three countries, grand- Adults consider that children individuals and communities can parents, parents and neighbours need to be supervised and the take to safeguard their safety, as are considered to be more trust- children themselves are not well as responses that can drasti- worthy than teachers and rescue convinced that they can only rely cally mitigate the impacts of workers. Teachers do not share on themselves or each other. threatening events. this point of view and express Adult responders, in general, the opposite, that teachers and did not think of fear as a good From old to young rescue workers are in fact more underlying principle for facili- Self-protection is defined as trustworthy. tating education. Indeed, they the behaviour that each citizen, Most children questioned thought that fear itself would family or community chooses to are of the same opinion as the not make people understand the adopt to prevent, be prepared teachers; a teacher is better dangers nor make them change for, respond to and recover able to help a child confronted their behaviour. More children effectively from emergencies. A with a risk than a grandparent is. rather than adults think that fear key element in good self-protec- In Bulgaria, parents seem to be can make people act differently. tion is that trans-generational more trusting regarding teach- bonds between the young and ers, even if teachers seem to be The need to recreate trust the old are actively supported, less so with parents. The findings confirm the need through good communication, Children’s needs of being to recreate trust between differ- the handing down of knowledge supervised in their daily activi- ent members of a community: through the different genera- ties were confirmed by the between children and parents, tions, and the role to be played study. In all three countries, parents and grandparents, and by the adults in education – all children expressed the view parents and teachers. If they so that effective prevention and that they could not always help do not trust each other, who is preparation can be accom- each other and that the help of left for children to trust in a risk plished. an adult was often necessary. situation? Grandparents, who The role of grandparents when often believe that they have Visit the project’s website at: it comes to supervising children some practical knowledge that www.autoprotectionducitoyen. does not seem to be clearly could be shared, are not always eu/enfants

18 Volunteers help children be children

By Katherine Roux, IFRC communication delegate in Tunisia

itting quietly under the shade the Tunisian Red Crescent and shoes they are wearing, are taken Sof a tree, two volunteers from UNHCR. off them. The adversity that these the Tunisian Red Crescent play While his wife, Mariam, sits people have had to overcome can games with a family recently solemnly on a chair nearby, her be read in their faces. arrived from the Libyan town of children enjoy the attention of Yet despite the trauma Zawiya. two Red Crescent volunteers, this family has endured on the Of the thousands of people who show them how to do some journey into Tunisia, the psycho- fleeing the violence and arriving puzzles. They tickle Abderaham, social support provided by the in Tunisia, this family is particu- and talk about Houyim’s love of Tunisian Red Crescent creates a larly special because they have books about princesses, or amira semblance of peace. The volun- three children: Hannah, age as it is known in Arabic. teers help the children maintain a eight, Houyim, age seven, and sense of normality and remember three-year-old Abderahman. Stripped at checkpoint that they are children, which is With the escalating violence Almost every person fleeing crucial in moments of uncertainty in Libya, their father, Ali, was Libya – Mariam and Ali included and stress. afraid he would be forced to – has the same story to tell: they “It makes them feel better fight. In order to protect his wife leave because of the violence and here, just to see someone smile,” and children, he fled with the at the checkpoint, before cross- explains Mohamed Driss family to Tunisia. They have now ing the border into Tunisia, all Chalouah, a volunteer with the arrived safely in the camp run by their money, mobile phones, and Tunisian Red Crescent, as he the local authorities, the IFRC, sometimes even the clothes and points to his heart.

19 The Hugging Train

After the earthquake that hit Haiti in January of 2010, the Magen David Adom were one of many National Societies to deploy delegates to provide medical and paramedic support to the victims and survivors. Being able to attend to the physical needs was an extremely important task, but something far less visible yet just as tantamount to the success of the team was the ability to provide emotional care, not only for the survivors, but also for themselves and their team members. What were the secret ingredients behind their strength?

By Carina Sorensen, IFRC Psychosocial Centre

edestrians walked languidly were completely unperturbed by civilian clothing, a backward cap Pabout in the sweltering heat in the impatient traffic and honks and kaki jeans were accessorized the bustling city, their skin glisten- that pierced the air, as they with a rifle strewn across the back ing in the sun and shadows trailing zig-zagged between the cars to get – not an ordinary sight in an OECD behind like long veils extending to the other side. country, of which Israel became a their stature. By the coast, barely I couldn’t help but think that member state last year. clad children, men and women this could have been like any other reveled blissfully in the undulating coastal metropolis, perhaps Los “MDA in Australia” waves. Angeles, Miami, or Sydney but this The intense security situa- As I approached the main city was above and beyond unique tion is known to the world but business district, suits and ties for various reasons. The unavoid- my quest was not to fall prey to flashed past, while others sat on able sights of guns and uniforms partisan politics – rather, I wanted steps, with the occasional smoke certainly stuck out. The teenage to get to the heart of something ring rising into the sky. A group of girls and boys who only a few years far more universal. energetic youth chatted cheerfully earlier had been playing with toys, After several twists and turns, amongst each other, one giving were now carrying far more serious a dead end, and misguided direc- a friendly push to the other, and and lethal equipment. Even in tions from well-intentioned pedestrians, I finally managed to find my way to the headquarters of Magen David Adom (MDA), the National Society of Israel, located in Tel Aviv. I sensed I had been heading the right direction,

Red Cross medical teams from Norway, Canada, Israel and Haiti are in action at a policlinic, sergical rooms and specially trained volunteers attending to both patients as well as hospital personells psycological needs after the earthquake. Photo by Olav A. Saltbones / Norwegian Red Cross

20 In a mobile surgical hospital in Port au Prince, Asaf Chen of Magen David Adom, Israel’s equivalent of the Red Cross, prepares Mitch Leanord for surgery to amputate his leg. Leanord lost his three children and his wife to the quake. Photo by Talia Frenkel / American Red Cross

as I noticed several ambulances bereaved in emergencies. itarian spirit. He informed me of in the vicinity, carrying MDA MDA’s activities, and in particular emblems. I also took note that Ready for Haiti about the latest developments each ambulance had, for example, MDA delegates in Haiti were with MDA´s psychosocial portfo- “Magen David Adom in Australia” therefore particularly well- lio. I was later able to discern or “…in United Kingdom” written equipped to address both the that Chaim’s infectious smile and across each side. I wondered why, physical and emotional needs of heartfelt laugh were extraordinary but I was actually more curious the victims of the earthquake. assets during times of crisis, giving as to the existence of these The fact that the MDA is unique him the tools to remain resilient ambulances in the first place. in this regard, is a reminder that and to pass on his resilience to the decentralized organizational others. He recounted how impor- Volunteer paramedics structure of the Red Cross Red tant it was to keep up the spirit In my home country of Crescent movement means that in times of extreme hardship, and Denmark, Red Cross ambulances each National Society can exercise how this had helped him during his do not exist. I was later to find considerable flexibility in how staff tough experiences as a paramedic out that this was an integral and volunteers should be trained. in Haiti, shortly after the earth- component to why the MDA is A cookie-cutter approach is not quake, where he was one of five so well suited to deliver psycho- feasible, given that countries and Israelis to participate in the IFRC’s social support as part of any peoples experience unique circum- disaster response. emergency response interven- stances. Thus, National Society tion. staff and volunteers decide for Loudest bunch Unlike most other National themselves what the most press- With a cheeky twinkle in his Societies, one of the most impor- ing concerns are and how they can eyes, he proudly confessed that tant functions of the volunteers best deliver upon those needs. the MDA team was the loudest of MDA is to assist and act and most rambunctious bunch as paramedics when medical Emotional assets of the lot, laughing so loud that emergencies arise. I had met one Chaim, the psychosocial coordi- some delegates asked them to such volunteer, who informed nator of MDA, ushered me into his move their tent as far away as me that he had received full office. A jolly and cheerful man, possible. Despite the seriousness training and had often attended he epitomized hospitality and of the extremely desperate situa- to wounds, injuries and the kindness, but above all the human- tion and being amidst one of the

21 Ron Rosenthal is one of the MDAs volunteer ambulance-drivers that are usually some of the first to help at the scene of an accident. Photo by Jakob Dall / Danish Red Cross

world’s most devastating disasters, having to inform the boy about her aid first became clear during the the team was able to maintain death. The drawing the little boy suicide bombings that started in emotional strength and a sense had created contained a depic- the 1980’s. Back then, this kind of of camaraderie. The support they tion of his mother without a leg, psychosocial support was regarded provided to each other alleviated himself on one side and an MDA primarily as a service provided to the emotional turmoil of witness- team-member with a very promi- survivors and the bereaved, not as ing the despair and anguish the nent heart on his chest. This was part of a more holistic approach in Haitians were going through. just one of the many devastating which staff and volunteers are also moments the delegates were faced included as a target group. with on a daily basis. It was deemed that if staff and volunteers could not cope, then Old society - new they should not engage themselves activity with such work. Their emotional The MDA is one needs were not discussed. One of the world’s oldest reason for this, Chaim conjectured, National Societies, was the fact that the former direc- having been around tor-general of MDA had a military even before the background. creation of the state of Israel itself. Established Skeptic staff in 1930, it is the Times have changed and now all primary and only public 1,500 staff and 10,000 volunteers ambulance service in receive training in psychological first the country, while the aid, while a peer support system and ICRC heads the opera- crises intervention team are still in tion in the occupied their initial stages. One of the most territories. significant obstacles to incorporate Despite MDA’s and expand psychosocial support longevity, psychoso- was the skepticism of the staff, Chaim Rafalowsk in his office. Chaim is EU projects and Disaster Manage- cial support was only since many initially felt that it could ment Coordinator for MDA. Photo by Carina Sorensen / PS Centre. formally introduced in undermine their profession. the latter part of 2006, As Chaim cited, “I chose to subsequent to the second become a paramedic, not a social Devastating drawing Lebanese war, when the IFRC worker”. What started out as being Chaim recounted how a woman Reference Centre for Psychosocial imbued with contention eventually had to have her leg amputated. Support in Copenhagen was became known and accepted as the Meanwhile her young son had to approached for assistance to help “hugging train” as MDA staff and be kept occupied, so they provided create a psychosocial programme. volunteers began to realize the paper and pencil for him to draw. value of building upon their own Shortly after the mother died. After suicide bombings resilience and supporting each other Chaim recalled the heartache of The need for psychological first to the utmost.

22 Advertisement The IFRC Psychosocial Centre was established in 1993 and is a delegated function of The Seven Fundamental Principles the International Federation of Red Cross and Red Crescent Societies, hosted by Danish Proclaimed in Vienna in 1965, the seven Fundamental Red Cross and situated in Copenhagen, Denmark. Its primary function as a “Centre of Principles bond together the National Red Cross and Red Excellence” is to develop strategically important knowledge and best practice which Crescent Societies, The International Committee of the will inform future operations of the Federation and National Societies. Red Cross and the International Federation of the Red Cross and Red Crescent Societies. They guarantee the The centre was established to promote, guide and enhance psychosocial support initia- continuity of the Red Cross Red Crescent Movement and tives carried out by Red Cross and Red Crescent National Societies globally. The its humanitarian work. International Federation Psychological Support Policy Paper, adopted May 2003, established the basis of Red Cross and Red Crescent intervention both in emergency Humanity response operations and in the implementation of long-term development programmes. The International Red Cross and Red Crescent Movement, Within this policy, the mandate of the Psychosocial Centre is to mainstream psychoso- born of a desire to bring assistance without discrimination cial support in all National Societies. As stated in the consultation on National Society to the wounded on the battlefield, endeavours, in its inter- centres and networks commissioned by the Governing Board of the International national and national capacity, to prevent and alleviate Federation in March 2007, the centre provides a potentially flexible and creative struc- human suffering wherever it may be found. Its purpose ture to develop and disseminate expertise. is to protect life and health and to ensure respect for the human being. It promotes mutual understanding, friend- ship, cooperation and lasting peace amongst all peoples.

Research partners: Hosted and supported by: Impartiality It makes no discrimination as to nationality, race, religious beliefs, class or political opinions. It endeavours to relieve the suffering of individuals, being guided solely by their needs, and to give priority to the most urgent cases of And supported by: distress.

Neutrality In order to continue to enjoy the confidence of all, the Movement may not take sides in hostilities or engage at any time in controversies of a political, racial, religious or ideological nature. Read more about the principle of Neutrality.

Independence The Movement is independent. The National Societies, while auxiliaries in the humanitarian services of their governments and subject to the laws of their respective countries, must always maintain their autonomy so that they may be able at all times to act in accordance with the principles of the Movement.

Voluntary service It is a voluntary relief movement not prompted in any manner by desire for gain. Read more about the principle The Psychosocial Centre of the International Federation of Red of Voluntary service. Cross Red Crescent Societies c/o Danish Red Cross Unity Blegdamsvej 27 There can be only one Red Cross or one Red Crescent PO. BOX 2600 Society in any one country. It must be open to all. It must 2100 Østerbro carry on its humanitarian work throughout its territory. Copenhagen DENMARK Universality The International Red Cross and Red Crescent Movement, Tel: +45 3525 9200 in which all Societies have equal status and share equal E-mail: [email protected] responsibilities and duties in helping each other, is world- Internet: http://www.ifrc.org/psychosocial wide.