Harvard Program in Refugee Trauma

HPRT RECOMMENDATIONS : CARING FOR THE PATIENTS AND HEALTH WORKERS TRAUMATIZED BY THE BOSTON MARATHON BOMBINGS

admin — Fri, 26 Apr 2013 11:10:30 +0000

Many of our patients and staff have been deeply affected by this week’s tragic events. The first thing to remember is that we have a common bond with our patients, because we are all affected in one way or another. These few recommendations for dealing with the emotional and physical aftermath of 4/15 in our clinical practice may be helpful to you.

1. In the few days ahead, ask your patients if they have been traumatized by the events. Let them talk and tell you in what way and how they have been coping with the situation. This will give you an opportunity to see if this tragedy is seriously affecting them, bringing back old memories and losses such as 9/11; making their medical problems worse; and/or exacerbating an existing mental health problem (e.g. anxiety, PTSD, depression).

2. Check to see if your patients are having sleep disturbances, especially nightmares. You may want to provide reassurance – see item 4.

3. In all disasters, make sure people feel safe, secure, and know where all their family members are located and if they are OK.

4. Reassure the patients that it is completely normal to have some symptoms of PTSD, such as nightmares, poor sleep, ruminating on the events, worries about their safety, and depressive symptoms such as sadness, despair, and discouragement about the world situation. For the great majority, these symptoms will resolve relatively soon.

5. Recommend to patients the 3 major social instruments of coping: altruism (i.e. helping others), work (or school studies); and spirituality. Do not be afraid or worry you’ll offend the patients by speaking to them openly about their spiritual beliefs and practices.

6. Make sure their kids and teens are OK. Encourage them to check in with their children. It is helpful to turn off the TV news, which is revisiting all the gruesome details of the tragedy over and over again. Stimulating high emotional arousal in young children from TV images of violence is never a good situation. Young children may think the events are recurring, leading to a lot of fear and anxiety.

7. Empathic and sensitive listening is your best therapy. Only a small percentage of patients will need medication or a mental health referral.

8. Most importantly, show solidarity with your patients. This is a situation when the health care practitioner and the patient have shared a tragic and disturbing event. You can express your solidarity with the patient; the patient will really appreciate it.

9. Practice your own self-care since you’ll be experiencing a lot of distress and will need a way of dealing with this yourself.

10. Peer supervision is highly recommended. At periodic meetings with your fellow healthcare professionals (which are not group therapy), discuss those cases related to the tragedy that are bothering you. In this way you can receive and give support to your colleagues. Peer supervision is one of the best things you can do to enhance staff morale and group self-care.

For more information on supporting our patients during this recovery phase, the following website may be helpful.

Psychological First Aid: Field Operations Guide. Agency for Healthcare Research and Quality http://www.innovations.ahrq.gov/content.aspx?id=117

Condolences to those affected by the events at Sandy Hook Elementary School

admin — Fri, 28 Dec 2012 14:27:57 +0000

The Harvard Program in Refugee Trauma (HPRT) and its international faculty sends its condolences to the families and community of Sandy Hook Elementary School and Newtown, CT. This tragedy affected all of us who have worked with survivors of extreme violence over the past 3 decades. We remain committed to serving our society at the time of crisis and are concerned for the mental health of affected families and first-responders six months down the road when natural attention has faded. At this time, HPRT can be called upon if necessary, to lend support.

Prof. Dr. Reverand Frederick J. Streets, an HPRT team member, former chaplain at Yale University has offered the following support:

Parents and other family members will struggle with what to tell their children/siblings regarding the horrific shooting event in Newtown, CT. The shooting was a horrible event.
Being together with other people at a time like this is an important source of support. Relying upon ones religious faith and participating in the life of that faith community by worshipping and praying together and reflecting upon the sacred writings of that tradition can bring immediate and over time long lasting relief of some of the emotional pain caused by trauma.

Parents should not hesitate to get information on the impact of trauma and help should they feel they need it for themselves and their children. Some further points about coping with this trauma:

1) Parents should reassure their children that they are safe.
2) Allow the child to talk about their feelings at any time they wish to. Children depending upon their age may express their feelings in their play and drawings.
3) Some children may have nightmares , want to cling to parents and they may be afraid to leave home and/or to go back to school. Parents should be very patient with their children and reassure them that they are safe.
4) Don’t be afraid to ask your child how they are feeling about what happen.
5) Children, parents, school teachers and staff across the state will identify with this event and may have some of the same reactions as those who were directly impacted by what happen in Newtown.
6) Don’t be afraid to ask for help if you are having difficulty coping with what has happened.
It is also important for parents and other adults to take care themselves during such a stressful time. This will further enable them to be there for others.

Some may ask themselves where was G-d or why does G-d allows tragic events to happen. I believe that G-d has given us free-will. Christians are celebrating Advent and the coming of Christmas. Yet, within the first two years according to the story of the life of Jesus , King Herod ordered children up to two years old be killed. Such evil and violence has been with us for a long time. I think G-d cries when we inflict such suffering upon others. All of our religions remind us that evil will not prevail and that goodness and justice will triumph. We are all responsible for making this happen.

Frederick J Streets, former Chaplain of Yale University, is a member of the faculty at Yale Divinity School, a clinical social worker and Acting Pastor of the Dixwel Avenune Congregational Church, New Haven, CT.

Sandy Hook remains in our prayers.

Sincerely,

Richard F. Mollica

Sven-Erik Baun Christensen

admin — Sun, 14 Oct 2012 16:14:47 +0000

Sven-Erik Baun Christensen, Librarian, M.L.I.S.

Head of Documentation

RCT, Rehabilitation and Research Centre for Torture Victims, Copenhagen, Denmark

Born 1947.

Librarian DB (1975); Master of Library and Information Science (1994), Royal Danish School of Librarianship and Information Science.

Before coming to RCT in 1998 I worked in two different University Libraries for over 20 years, with a short spell in the Library of the Danish Parliament in between. Though I was not unfamiliar with human rights work when joining RCT, as my wife has worked in that field for decades, I was still heavily affected by learning in detail about the sufferings of survivors of torture, and the scale of the problem of torture worldwide. The founder of RCT, Dr. Inge Genefke stated from the very beginning that in order to fight torture and help its victims ‘we must know what we know’ – that is, try to gather all knowledge about torture, organise it, and disseminate that knowledge to all who need it in their work. It is a privilege, I feel, to be a part of that effort.

Sarah Y. Berkson

admin — Sun, 14 Oct 2012 16:10:59 +0000

Sarah Y. Berkson, BA, is a research fellow at the Harvard Program in Refugee Trauma (HPRT). Sarah joined HPRT in 2011. She has collaborated on the curriculum development for, the teaching of, and the evaluation of HPRT’s Cambodian Health Promotion Program. She collaborated on HPRT’s Diabetes Outreach. For this project, she conducted home visits with a Cambodian nurse for Cambodian patients with poorly controlled diabetes. She also helped co-facilitate a Cambodian diabetes education group.

Sarah graduated from Johns Hopkins University with a BA in psychology and public health, served in Peace Corps Mali, and is currently a physician-in-training at Albert Einstein College of Medicine in Bronx, NY. She is a poet and aspiring psychiatrist.

Ranieri Guerra

admin — Sun, 14 Oct 2012 16:05:52 +0000

Ranieri Guerra, MD, is the Director of URE, External Relations Office, the President’s cabinet for the Istituto Superiori di Sanità, the National Institute of Health of Italy in Rome. His role at ISS includes management activities on Health system reform, equity and impact assessment, capacity building and institutional development at central and intermediate level (MoH, subnational) especially in public-private systems. Also, his curriculum vitae includes significant experiences dedicated to the integration of NGOs’ participation in national health programmes, monitoring and evaluation of health activities, epidemiological research applied to health system management, strategic planning, telematics in health, health systems design and appraisal, training in public health, multi-sectoral HIV/AIDS responses and poverty diseases within national frameworks, poverty reduction strategies programme’s development, Health projects appraisal and performance based assessment, quality, certification and accreditation of health institutions, continuing medical education. Dr. Guerra has published widely on health strategies topics and has preformed an intensive working experience in many developing and transitional Countries. Since 2000, Dr. Guerra has worked as a consultant and team leader for UNICEF, UNDP, WHO and the Italian Ministry of Foreign Affairs on projects in Palestine, Eritrea, Uganda, Rwanda, Burundi, Swaziland, and China.

Nasir Warfa

admin — Sun, 14 Oct 2012 15:57:48 +0000

Nasir Warfa, PhD, is senior lecturer (associate professor) with Queen Mary University of London (QMUL), UK. Dr Warfa is also the deputy director and co-ordinator for QMUL’s MSc courses in Psychological Therapies and Transcultural Psychiatry. His research interests include qualitative and quantitative investigations and evidence synthesis with a particular focus on the social and psychological wellbeing of refugee populations and ethnic minority communities. For many years, Dr Warfa has taught on migration and mental health at Queen Mary University, and as a guest lecturer with University College London, University of Kent and Brunel University. In 2010, Dr Warfa was nominated for Queen Mary University of London’s Draper Award for Excellence in Teaching. He joined the Faculty of the Harvard Programme in Refugee Trauma: Global Mental Health, Trauma and Recovery in November 2011.

Dr Warfa makes regular contributions to national and international conferences and summer schools, including the well-established summer School on Migration and Psychological Medicine at Karolinska Institute organised by Professor Solvig Ekbal. He currently manages the UK website on health of migrants and ethnic minorities which received financial support from the EU’s Directorate-General for Health and Consumer Protection. 16 other partners from Austria, Belgium, Germany, Greece, Hungary, the Netherlands, Poland, Portugal, Sweden, Turkey, Switzerland, Norway, Romania and Denmark are also taking part in this project (http://mighealth.net/index.php/Main_Page, for more information).

Dr Warfa has co-published many peer-reviewed articles and book chapters on refugee mental health. His latest paper, titled “Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study”, can be accessed from the following link:

http://www.biomedcentral.com/1471-2458/12/749/abstract

Elizabeth DiStefano

admin — Sun, 14 Oct 2012 15:55:41 +0000

Elizabeth DiStefano, MBA, is HPRT’s financial manager.

Carol Landau

admin — Sun, 14 Oct 2012 15:52:46 +0000

CAROL LANDAU, Ph.D. is a clinical psychologist and Clinical Professor of Psychiatry & Human Behavior and Medicine at Alpert Medical School, Brown University. For over 25 years, she has served as the Co-Director of Psychology and Psychiatry in Primary Care in the Division of General Internal Medicine at Alpert Medical School, developing innovative curricula for residents in internal medicine. Dr. Landau has a practice in psychotherapy and consultation and was a co-founder of Women’s Health Associates, a Brown-affiliated multidisciplinary group practice. She also serves on the Advisory Committee of Brown’s Office of Women in Medicine and Science. She is the author of three books on women’s mental health and has published more than 50 academic papers and chapters on curricular development, women’s health and depression. Dr. Landau has received numerous awards for her teaching and writing. She serves as an expert in behavioral medicine and women’s health for numerous advisory boards and websites, including iVillage.com, the visualMD and Healthywoman.org. Her website is www.carollandau.com

Annegret Klaua

admin — Sun, 14 Oct 2012 15:49:17 +0000

Annegret Klaua is HPRT’s Program Manager and Clinical Research Coordinator. She has always had a strong interest in human rights, which in recent years broadened to include trauma studies and issues of global and environmental health. Annegret is trained and certified as a rape crisis counselor by the Boston Area Rape Crisis Center whose Medical Advocacy program she joined as a volunteer in 2008. A year later, she was a summer intern with the organization’s legal and case management teams, received the Melissa Gosule Award for outstanding volunteer service, and became a peer supervisor in Medical Advocacy in 2011. Annegret helped organize the 2009 International Women’s Day Film Festival in Cambridge and Boston, MA, and previously worked as a graduate assistant at the Center for German and European Studies at Brandeis University.

Annegret is also a classical violinist and currently performs with the Boston Classical Orchestra, Boston Modern Orchestra Project, the Boston Lyric Opera, and the Rhode Island Philharmonic Orchestra. She directs the chamber music group Ensemble 451 and, aside from classical music, enjoys playing traditional Venezuelan music with Las Paraulatas Bostonianas. In addition, she is an experienced teacher and is on the faculty at the Winchester Community Music School and the Governor’s School of North Carolina. In the past she taught at Bridgewater State University, Brandeis and Indiana Universities, and the Brevard Music Center. She received her Bachelor and Master of Music degrees from Indiana University, an Artist Diploma from the Hochschule für Musik in Dresden, Germany and a Master’s degree in musicology from Brandeis University.

Annegret loves walking and riding her bike to work, traveling, cooking, and photography. She feels fortunate that her travels have taken her to five continents and hopes to always be able to explore different cultures, languages, foods, and nature.

Abdelraham Abudoam

admin — Sun, 14 Oct 2012 15:37:28 +0000

Dr. Abdelrahman Ahmed Abudoam, Sudanese and father of 4 grown children, is an Associate professor of Psychiatry Faculty of Medicine at the International University of Africa. He is a consultant psychiatrist at Taha Baashar Psychiatric teaching hospital Khartoum North and the Director of the Institute of Disaster Management & Refugee studies at the International University of Africa. Furthermore, Dr. Abudoam is the Deputy Chair of the Sudanese Psychiatrists Association and a member of the MoH Advisory Board of Psychiatry. He is a former advisor to the Minister of Humanitarian Affairs, the Qatar Charitable Society Doha, and a former commissioner of voluntary agents. Dr. Abudoam is the author of three books on voluntary work and refugee studies.