MdM in Palestine

MINIMIZING THE IMPACT OF THE ISRAELO-PALESTINIAN CONFLICT ON THE PHYSICAL AND MENTAL HEALTH OF THE PALESTINIAN POPULATION

MdM is implementing health programmes in the Northern West Bank since 1999 and in the Gaza strip since 2002. The increasingly recurrent violent acts of settlers in the West Bank and Israeli military operations such as the current “Protective Edge” operation continues to negatively impact the well-being of Palestinian populations. Therefore, in 2014, MdM remains committed to strengthen emergency response capacities and to improve mental health care for Palestinians

 

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In the Northern West Bank, mental health and psycho-social support

Present in the West Bank since 1999, MdM puts in place programmes aiming to improve access to mental health services for Palestinians living in Nablus governorate and the Northern West Bank, as well as limiting the impact of settlers’ violence on the well-being of the population.

Mental health as part of national services to Palestinians

The Palestinian health system is performant. However, mental health is insufficiently developed. Indeed, there are not many health structures that provide mental health services and medical staff is little informed on what mental health is and not sufficiently trained to identify people in need of such services.

From 2010 to 2012, MdM worked to integrate mental health services into 10 primary health care centres in Nablus governorate. Following this first initiative, MdM France (MdM F) and MdM Switzerland (MdM CH) elaborated a three-year project in close collaboration with the Palestinian Ministry of Health and Ministry of Education, and with a local partner, the Palestinian Counseling Center (PCC), to improve the access and the quality of mental health services to the population of Nablus governorate, with a special focus on children and teenagers.

In this regard, several activities take place:

  • A health centre offering specialized services to children and teenagers has been established. Its doors will open in September 2014. MdM will support this centre and train the staff;
  • Doctors and nurses of Primary Health Care centres located in 25 villages are trained to identify mental health needs in patients and refer them to appropriate structures. Eighty-five medical staff are currently being trained;
  • Counselors in 25 schools are trained to identify children and teenagers in need of specialized consultations in mental health and refer them to the relevant structures;
  • Awareness sessions are organized in local communities in order to sensitize people on what mental health is and fight prejudices and stigmas. Seven or eight sessions are organized in villages and leaflets on mental health are handed out;
  • A referral system for mental health services is being designed and implemented at a national level. This is done in close collaboration with the Ministry of Health;
  • The Palestinian Council Center’s advocacy strategy is supported and reinforced.

Preventing and limiting the consequences of settlers’ violence on Palestinians’ psychosocial well-being

In 2013, the Office for the Coordination of Humanitarian Affairs (OCHA) reported Nablus governorate as one of the areas most prone to settlers’ violence, as this governorate concentrates a high number of Israeli settlements. These acts of violence, whose number has increased over the past 3 years, have strong material, human and psychological consequences for the inhabitants of the neighbouring villages.

MdM works in 27 villages in the Northern West Bank that are particularly exposed to settler’s violence. The project that is being put in place aims to prevent and limit the impact of settler’s violence on Palestinians psychosocial well-being. In this regard, different activities are being carried out:

  • MdM works to reinforce the capacity of communities to protect themselves from violent acts. In each village, a Community Eyes Watch (CEW), a committee composed by volunteers and linked to municipalities, is created. Their role is to alert local authorities and protection NGOs when acts of violence occur. In the long-term, it is expected CEWs to be recognized by the local authorities as interlocutors and actors with whom to work when settlers’ violence happens;
  • Within the 72 hours after an act of violence against Palestinians and their property, MdM teams go assess the situation and perform Psychosocial First Aid (PFA). This consists in listening to the victims and normalizing their emotions. Two weeks after this first intervention, MdM returns to check how people are and identify people who would need more serious follow-up

 

Group support sessions are organized in local communities to help Palestinians deal with situations of violence and stress;

  • After an act of violence, MdM assesses the situation on the field and identifies psychosocial and protection needs. Results are shared with other major international and national organizations working in the protection of populations for them to intervene in their field of expertise (livelihood, legal aid, protective presence, mental health, etc.);
  • In order to address the roots causes and obtain long-term changes for Palestinians, MdM leads advocacy activities. The impact of settlers’ violence on the psychosocial well-being of Palestinians is documented and findings are shared with different actors that can positively influence the course of events.10352029_766333610092614_8546024482738625693_n

In the Gaza Strip, emergency preparedness for health care structures and first aid trainings for civilians

Since its creation in 1948, the Gaza strip has faced many phases of instability: occupation, wars and a continuous blockade since 2006. The recurrent wars combined to a permanent crisis have impacted the population and the infrastructures. Today, the Gaza strip has been the scene of another Israeli operation entitled “Protective Edge”. Since July 8, 2014 more than 2,000 people were killed, more than 11,000 were injured and over 300,000 were displaced.

Present in the Gaza strip since 2002 and with the experience the organization has both internationally and in France, MdM has set up programmes aiming to improve the quality and access of health services for Palestinians and limit the impact of the conflict on their health.

MdM supports local health structures. In 2009, emergency rooms were created in 11 primary health care structures and drugs have been supplied and upgraded until the beginning of the war in July 7th, 2014. As it was the aim of this previous MdM programme, these emergency rooms have been receiving an increasing number of emergency cases, thus reducing the overload in hospitals. From January 2013 to May 2014, more than 81,000 patients were treated including 123 critical cases. In these facilities, an average of 1,301 consultations per month was provided.

MdM also trained 4436 medical staff and community volunteers to basic first-aid techniques, pursuing the aim to decrease hospitals’ overload. From 2012 to April 2014, they have treated more than 1,650 emergency cases mostly for wounds, burns, fractures, convulsions, and cardio-pulmonary resuscitations.

In 2013, an Emergency Preparedness Plan (EPP) was designed in coordination with the Ministry of Health whose aim is to help coordinate actors in time of crisis to better respond to emergencies and bring appropriate aid to the population. MdM also encourages the implementation of emergency committees in villages:  vulnerable communities, such as fishermen and farmers, received Basic Life Support training and First Aid kits.

Emergency Medical Service (EMS), comprising ambulances have been provided with medical equipment and communication devices.

On July 2014, a Sexual and Reproductive health project intending to improve women’s access to family planning and to defend women’s rights in partnership with Culture and Free Thought Association (CFTA), was due to start. However, the Israeli military operation has delayed its start.

Likewise, routine activities were suspended for security reasons. During the fifty days of the war, MdM focused on bringing an emergency response to vulnerable people and health infrastructures within the Gaza strip by providing drugs and medical supplies to Gaza’s central pharmacy (belonging to the Ministry of Health) and supporting the psychological counselling hotline of our Palestinian partner SAWA. Since August 12, two mobile clinics were launched providing Primary Health Care and mental health services, and hygiene awareness sessions to displaced Palestinians living in public schools. Another two clinics have been set up next to damaged health facilities during their rehabilitation and until they are functional again.