MHPSS Consultation - Africa Room

Good morning friends around the world-we are delighted that you are interested in joining this online platform and would love to hear your thoughts on how to better link the fields of MHPSS and peacebuilding-all your comments are very (very) welcome.

We look forward to hearing from you!

I remember working in the Nyarugusu Refugees camp. On a similar reflection, my office was in the middle of refugees tents where you witness the daily routine of the community members (Refugees). The refugees' community had observed that the MHPSS programme gives potential space for their story.

Another reflection, being in a small office in a marginalised community in Dar es salaam (slum areas). You experience the hustles of the marginalised community. Then you hear at-risk youth observed that the MHPSS programme sustaining their talent and raising their voice in the community.

I will bring more thoughts on the community intervention for MHPSS and Peacebuilding in the coming days. I will be adding past experiences with the voice of the marginalised community. I will unpack with a technical eye and better practices.
 

I'm happy to be here.  I will be learning and exchange thoughts with everyone here. In future, I will remember the moment we had.

Having been part of the south Sudan trauma healing initiative for the past few years, I have come to love the topic of mental health and well-being. It has come to my notice that, this trauma healing initiative should be been implemented right after the signing of peace in 2005 when the comprehensive peace agreement was signed between the south and the North. there is a evidenced existence of historical and recurrent trauma in my country and it is never addressed fully by those implementing partners. I believe, peace building can only sink into the healed minds and souls. peace can be assimilated into daily lives of people if they are healed from the past trauma and their is indication of safe environment. Being part of this group will be of great advantage to me and others who might want to help in my country. I strongly recommend mental health and trauma healing to be integrated into schools curriculum in the country so that people get heal and shift from survival mode to thinking mode.

Theme 1:

Our  experiences 

My name is Eric L.wa Mwenge, resident of Sweden ( but native of the DRC)!  Our regional movement  , namely Mov’humana (movement for humanist actions) operates in three conflict and post conflict areas(Burundi, Rwanda and DRC)! Our members automatically considered that mental health and well- being should not only be a key issue in addressing other community and individual problems but also a cross- cutting question in all intervention, and especially in peacebuilding! 

2. Successes and challenges : 

2.1. our successes : After implementing several narrative theatre forums with different communities as an approach to address traumas collectively and reinforce collective resilience and coping mechanisms, the approach opened an easy way for people and group of people to come together even conflicting communities ! 
2.2. With limited experience the daily is that people who are embarking to the réconciliation route through our movement’s program are exposed to bounce back to their original position or become indifferent towards all the conjugated efforts in peacebuilding ! A more holistic program would be envisaged to be more sustainable ! A part this above challenge, the global pandemic of COVID- 19 had limited community participation in different traditional  meetings! 

3. Networking all the local mental health and psychosocial committees creates energy which is boosted by the synergy of different actors from local to the regional levels! These linked up actors have transforms themselves activists of peacebuilding and social change agents! Instead of being considered MHPSS’s actors our local members are considered as peace makers and social value promoters ! 

Theme 2: Enhancing integration

1. Needed resources : 

- capacity building for local actors in MHPSS approaches ( technical support ) 

- support in organizing meetings ( both locally and regionally) [financial support ]

- Exchange sharing with other actors in other regions and  countries (professional  support) 

2. Cultural considerations to be kept in mind working in the Great Lakes Region : 

- Always use do no harm 

- involve local leaders (in and outside society you operate in)

- Working carefully with sensitive issues although relevant such as the question related to redistribution of resources, gender issues ( the case of lgbt), stigma around individual counseling sessions, trauma healing is so crucial but still not understood the way it is known in Western countries ( need to clarify to a larger population the relevance of such a program), Many ‘humanitarian approaches have left entire populations morally dependent on materialistic aids which develops collective apathy towards MHPSS programs! 

3. Recommendations : 

- Develop a more integrated approach where MHPSS and peacebuilding programs  MUST be  designed, implemented and evaluated by locals (directly)

- Give priority to training programs in MHPSS and peacebuilding 

- Supporting local MHPSS settings financially, technically and professionally.

- Promote a networking approach (see the three levels of social capital ) 

- Identify genuine and innovative models of MHPSS co- created by locals after several years of experience ( ex of CEEDECO whose members were trained by Prof Yvonne Sliep trained since 2005 with the financial support from War Trauma Foundation) but since then this organization had been struggling to adapt their MHPSS to different context and now they developed Mov’humana which a wonderful instrument that can address many challenges of cohabitation and well- being in the Great Lakes region !

Eric L wa Mwenge 

Ceedeco / Mov’humana Project support officer

Tel : +46704121231

ericlwamwenge2000@yahoo.fr

Thank you for your interesting reflection Eric. I have followed your work for a number of years. Can you add some reflection on why you think Narrative Theatre works as a strategy to link MHPSS and Peace Building. We are taking note of your recommendations. 

Greetings 

Yvonne

I have recently joined UNDP with their Peace and Community Cohesion project in South Sudan. Previously I have been working in Social Care and as Psychotherapist in Europe, mainly Ireland. Despite of my short time within this project, it is clear for me that trauma within the community needs to be addressed to allow the success of peacebuilding initiatives. Thus, within our project I am currently coordinating trainings about Trauma Healing and Psychosocial Support, allowing local institutions to develop knowledge, tools, and skills to train more trauma healing and psychosocial support counsellors in their communities, creating a network of trauma awareness and support. During this short time, I have already seen small communities with grievances come together after a training. Thus, sharing their experiences helped them realize they share common problems, common pain, and they realize about the importance of collectively resilience to overcome trauma. Mental health is many times overseen when we talk about development, addressing other basic needs considered more urgent or important. However, the same way you can’t race with a broken leg, you can’t success on peacebuilding if the community is struggling with mental health issues.

Regarding the important topic of self-care, as a mental health professional I have developed my own self-care regime, which has been very important for me to avoid burn-out. Currently, given the hard living conditions of my duty station, my organization also provides self-care allowing periods of Rest and Recuperation each 6 weeks.

Now, giving answer to the guiding questions:

1.1. As I have already mentioned, the way our project is integrating MHPSS into peacebuilding is by addressing the trauma within the communities due to the recent conflict and the ongoing instability and violence. To leave the trauma unaddressed invites a virulent repeat of cycles of violence, and that is why it is so important to address it to work towards peacebuilding and reconciliation.

1.2. The success so far has been seeing communities coming together and sharing their experiences, leaving the trainings with a sense of belonging. The trainings have allowed an open safe space to share experiences and realize they are not alone, normalizing their symptoms and reactions, and, therefore, having a therapeutic impact on the participants. The challenges faced so far are the lack of resources in the area in terms of psychosocial supports. Even if the trauma awareness of the community improves and they have a better understanding of trauma, it is hard to provide the support they need longer term due to the lack of enough psychosocial services and infrastructure (counselling services, community centres, safe spaces…).

1.3. Given the big influence of Peace Committees and different Ministries in the area, we are coordinating the trainings with their collaboration and participation. Thus, as Eric was saying, even though they are working on MHPSS they consider themselves peacebuilding agents, showing the thin connection between both MHPSS and peacebuilding.

2.2. A cultural consideration to have when integrating MHPSS into peacebuilding is being aware of the religious believes in the communities. When conducting the trainings, we had to be culturally sensitive with this and other topics, making sure they understand the content of the training without feeling their believes where disrespected.

2.3. Given that one of the challenges identified after our trauma healing trainings has been the lack of resources to refer people to after identifying a need, it is important to strengthen the networking of already existing services in the area while they continue to grow.

My name is Mandela ‘Ade’ Matur, I am an author, a spoken word poet and professionally a Creative Arts Therapist. I am from South Sudan working with HealthNet TPO as a MHPSS Advocacy Officer. I like to look at the aspect of mental health in peacebuilding from a community perspective and from the context of my country right now.

South Sudan Conflict has destroyed so much more than infrastructure, livelihoods, and human security. It goes deep into the fabric of society, destroying link after link of the solid chain. And with the different ongoing community conflicts, people continue to experience negative emotions of fear and insecurity, making it difficult for true emotional healing to take place. Once these feelings of hatred, fear, and mistrust are not prevented, it becomes easy for them to spiral into deeper cycles of violence. By understanding this interconnection between conflict and emotional wellbeing, I suggest that mental health interventions should simultaneously work towards conflict transformation. Communities and different cultures interpret the manifestations of trauma according to their own understandings of illness. And in order to respect these interpretations, approaches that seek to improve mental health by working with rather than against these cultural beliefs need to be adopted.

And that starts by recognizing that instead of imposing different mental health programs upon communities, the communities themselves should have the capacity to develop and implement techniques aimed at addressing the effects of trauma. This has provided an alternative to western psychiatry methods that frame suffering as a scientific problem that needs solving without acknowledging traditional, cultural and religious aspects that may be relevant to societal cultures. Although medical interventions have their uses, a greater emphasis on non-medical approaches can benefit traumatized individuals, families and communities. And this is something we have been working on as HealthNet TPO, to be able to make this healing community based. (I will highlight our work sometime within the week)

So, in order for populations traumatized by years of repression and war to recover, they require feelings of safety, calm, empowerment, connectedness, and hope. To help achieve this outcome, MHPSS programs need to put more emphasis on the social aspects at both the individual and community level. Focusing a lot of efforts too at the individual level would also negate inherent human resilience; that is why collective psychosocial interventions can go a long way in restoring damaged social strand, especially when paired with economic development. It is very important to recognize how witnessing and experiencing violent conflict and its vast social, economic, and political consequences have a harmful effect on the well-being of and the relationships among communities.

Basically, any attempt to address mental health in a community setting that has been affected by years of war to achieve peace must take some of these realities into consideration, working carefully to convey the relationships between diseases, treatments, institutions, social structures, and the people they seek to assist. With careful planning, programs can potentially develop appropriate forms of structuration capable of reshaping biases in a way that creates new identities based on ideas of cooperation, forgiveness, peace and healing. If successful, these systems can lead to greater mental health and the transformation of conflict bringing about changes in the individual, the communities and the context itself & restoring peace within and between individuals, communities and society.

Mandela 'Ade' Matur Welcome, brother. I'm looking forward to learning about your journey and your perspective on better practices. 

Mandela 'Ade' Matur Thanks for your thoughts and perspective. Considering of context and initiative have done on the ground for the South Sudan Context for some time. Do you see the integration of MHPSS and Peacebuilding will sustain community engagement and transform the current situation into a better and different story?

There is so much exciting input happening here, thank you everyone!!!!

Thank you Angi and others for sharing resources. In this way the platform is more than a discussion forum but also building networks and capacity building. 

What recommendations would you like to make to UNDP regarding the integration of MHPSS into peacebuilding?

I will give my recommendation for the case of South Sudan. for the effective integration of MHPSS into peacebuilding, I see there is need for MHPSS to be first prioritize because, our people are stuck in the survival brain due to the long history of war in the country and the continuous cycle of victimization and aggression which makes it hard to give room for the cycle of healing which is the genesis of peacebuilding process. Having said that, i recommend that:

1. launching a countrywide MHPSS program that will be done across the country and to the people at the grasssroots

2. integration of the MHPSS into educational curriculum for the healing process to be understood.

3. grassroots consultation with the people on what they need to be done in the integration of MHPSS into peacebuilding.

4. UNDP should scale up the funding of the MHPSS projects across the country and allow the citizens to do it by themselves. good funding should be allocated for MHPSS for south sudan.

5. develop MHPSS radio dramas together with peace building dramas for listening across the country.

6. training of more trauma facilitators across the ten states of South Sudan who can do door to door facilitation of trauma sessions and peace building.

Thanks

Hello everyone I am Mathew Mutiso ED- Coalition Action For Preventive Mental Health Kenya.(CAPMHK) We are an ecosystem accelerator for Mental Health investment in Kenya. Our coalition is made up 128 CBOs and NGOs in Kenya with different initiatives and programs from LGBTQ, Social Justice, Youth, Vulnerable populations, Men, Street persons, Children, Workplace, PPD.

The context of sharing of experiences, lessons learned, and good practices on integrating MHPSS into peacebuilding in the African region is often skewed towards a perspective of known traditional conflicts of war like situations example South Sudan, Somalia, Congo, Rwanda, Uganda, Chad etc

Since there is room open for any input on this conversation that can be framed around two main themes as per the guiding questions. Allow me to paint a perspective of a relative known and peaceful country like Kenya but peace and social cohesion is threatened by cultural practices like early marriages, FGM, income inequalities and injustices that affect youth between 10-24yrs and compound mental health stressors and risk and exacerbate conflict and disharmony among communities and families. 

"For peace is not merely the absence of visible conflict. Only a just peace based on the inherent rights and dignity of every individual can truly be lasting" - Barack Obama 

Theme 1: Your experiences 

1. How do you/your projects integrate/partner/collaborate with the other field?

Our Coalition has five thematic areas: Advocacy, Capacity building, Research, Sub-granting, Networking and Collaboration- One project we did is Post Partum Depression awareness campaign for teen mothers. We realized that the need for integration of perinatal mental health to antenatal care has a huge possibility of reducing adverse childhood experiences, poor birth outcomes , children cognitive development. Its also would help with the integration of into primary health care and reduce infant mortality-infanticide ,  

2.What have been your successes and/or challenges in linking your work with the other field?

Our biggest challenge has been on reducing stigma associated with teen pregnancy and the language of Unwanted pregnancy that breaks families, Discussion of early marriages and how they create mental health stress to teenage girls and put their kids at risk of ACEs or even psychosis for the mothers. Success has been seen when teen mothers understand learn basic hygiene, lactation, acceptance, reconciliation with families and going back to school

3. What context/regionally specific elements are you considering and including in your programming on linking MHPSS and Peacebuilding?

Programs that touch on early marriages, unplanned teen pregnancies and FGM should incorporate and link MHPSS in their delivery. Income generating activities , agribusiness ,table banking and micro finance

Theme 2: Enhancing integration

1. What resources would your organization need to be better able to work in a way that integrates MHPSS into peacebuilding?

Funding - Our program was piloted in 5 counties in Kenya. Our target was 47 counties. Covid19 increased teen pregnancies cases by 40% country wide. 

Capacity building on similar content creation ,dissemination and compilation- We used different psychologist in different counties we would prefer to have had the same manual and program for the entire program. 

Monitoring and Evaluation - We lacked tools for documentation, Data collection that we could use to inform policy and advocate for budgetary allocation especially for CHV-within the counties who mostly work with teen mothers. ( Health in Kenya is a devolved function) 

2.What are the regional and/or cultural considerations that need to be kept in mind when integrating MHPSS into peacebuilding?

-Consider Language and local dialect translations

-Consider Negative social economic effects of early marriages, 

- Consider boy/girl sexual education and empowerment 

- Community based structures like the elders court, women forums should be incorporated 

3.What recommendations would you like to make to UNDP regarding the integration of MHPSS into peacebuilding?

Without peace there can not be development, culture and social inequities perpetuate and contribute to Mental Health issues for teens. Peacebuilding should be looked at from a holistic perspective and from different context of what contributes to disunity among communities. 

Theme 1: Experience

When there was influx of refugees in Uganda, there was an overwhelming number of unaccompanied children, there was some relief support but the aspect of trauma healing for the children was a challenge that is when we stepped in to fill the gap. We engage unaccompanied refugee children in social and musical activities to heal them of trauma, develop their skills and give them voice to advocate for peace. We are a multi sector organization with a specific focus on vulnerable children and women and on peace building.

From a traumatic situation, today we have these children as advocate and ambassadors of peace in the community

Our work has extended from Refugee camp in Uganda to South Sudan. We have number of activities that contributes both to peace and Mental Health and Psychosocial Support such as music, culture and heritage, entrepreneurship skills development and offering start up business capitals for women

What have been your successes and/or challenges in linking your work with the other field?

We have become central of hope for our local community in Bidibidi. From working with 10 children, we now have 155 children in Bidibidi and our work has extended to South Sudan where we have 78 children in Juba, and 75 in Western Equatoria State. Our challenge has been funding to have more impact of our work in South Sudan.

What context/regionally specific elements are you considering and including in your programming on linking MHPSS and Peace building?

There should be more recreation center, more resources put to entrepreneurship skills development and empowerment of women to start up business of their own. Empowerment of local community to produce and create market for them

What resources would your organization need to be better able to work in a way that integrates MHPSS into peacebuilding?

We would need more social structures built for youth, more child friendly spaces, music equipment, art such as painting and drawing to be enforced

What are the regional and/or cultural considerations that need to be kept in mind when integrating MHPSS into peacebuilding?

The negative stereotype on girls and women being at the receiving end not as the decision makers

What recommendations would you like to make to UNDP regarding the integration of MHPSS into peacebuilding?

Peace can only be achieved with the availability of everything that makes human happy and fulfilled. There is need to focus more on building peace from the grass roots and this can be achieved by embracing the grand bargain policy and localization. Supporting grass roots actors to be able to serve at the local level and influencing government to welcome the localization agenda

Thank you for sharing your ideas, resources and recommendations Mathew. People on this continent are so active,

Mathew you and others also make the important point of lack of monitoring and evaluation knowledge and tools. In relation to MHPSS the individual is often the unit of analysis but that is quite Western orientated. It would be interesting to hear your thoughts on communities and even organisations being the unit of analyses. So indicators of change would take a contextual and holistic approach.

Dear colleagues,

Thank you for your contributions so far. We are glad to inform you that the closure of the room has been extended to 9 November, in order to allow your widest participation possible.

As such, we encourage you to continue sharing your regional perspectives and experiences, and involve other colleagues if possible.

Warmly,

Rita

I am Shillah Mwavua a clinical psychologist working in the public sector in Nairobi Kenya. I am a trainer , mentor , researcher and practitioner .Yes i have a self care routine that is embedded in day to day activities.  

Theme 2: Enhancing integration

1. What resources would your organization need to be better able to work in a way that integrates MHPSS into peacebuilding? As a trained practitioner time is the most prized resource ,and being in public sector there are many opportunities of intergrating MHPSS into peace building in terms of direct service delivery to those who have been affected with mental illness resulting from conflicts /Violence. Having clear referral pathways for those who have been displaced and empowering community mental health champions to identify ,link and support those who may require MHPSS. Therefore to us strong partnerships and collaborations with partners who are skewed towards service delivery and strengthening of referral pathways  is very important.
2. What are the regional and/or cultural considerations that need to be kept in mind when integrating MHPSS into peacebuilding? Language and socio-cultural  beliefs and structures of all the communities involved are very critical especially when it comes to MHPSS interventions. Some intervention that work well in one community may not augur well in another ( Cultural idioms) Their understanding and practises towards mental health are also very critical as they will help design and intergration of the same.
3.  What recommendations would you like to make to UNDP regarding the integration of MHPSS into peacebuilding? awareness creation and advocacy on the importance of mental health, (clearly differientiate Mental health and mental illness) state clearly the role of MHPSS in peace building -•It restores the social fabric that binds and supports people within their communities, •Is essential for breaking cycles of violence and building sustainable peace. Demystify myths and facts about mental health. People need to understand the prevalence of mental health disorders resulting from conflicts zones and why MHPSS  important for survival 

Thank you for sharing your experiences and innovative ideas on the platform yesterday. Such a rich discussion. One of the themes briefly touched on was indicators of change. We would love to brainstorm a bit more on this topic. In very concrete ways, how would you know an individual, family, community has more peace of mind? How would you know there is true ownership of taking on board promoting peace and psychosocial support, especially on a community level? 

Dear all, 

I hope everyone is well and in good health (starting out to sound like an email lol). I would like to thank the organisers and especially Yvonne for inviting me to the last week's meeting. I was extremely delighted at the content and the level of engagement. I felt at home listening to engagements about two very important topics. 

I would like to address for now Theme 2 (point two may seem controversial but it is definitely worth noting).

3. What recommendations would you like to make to UNDP regarding the integration of MHPSS into peacebuilding?

• Awareness on the importance of understanding the overall impacts of trauma on one's mental health. Whether the trauma stems from war related trauma, sexual, domestic or intimate partner violence. More importantly helping people understand even in the context of domestic, intimate partner or other interpersonal violence incidents do not always need to involve physical assault or aggression. Unfortunately, this is what most people associate with violence without understanding the impacts of verbal, emotional and even financial abuse. Within our African context, we really need to understand how violence in different forms impacts our mental health, physical health, substance abuse and dependency and issues with law.  As well as how it affects both your relationships with people closest to us (family, neighbours, peers) and others in the larger community ultimately affecting peace building prospects; especially in relation to the continued cycles of violence. 
• There is also a need to highlight  women's roles in the perpetuation of violence affecting mental health outcomes and peacebuilding efforts on individual, community and societal levels. We have for the longest time seen and promoted women as the healers and protectors of children and other women in society all over the world but in Africa especially. There is an amazing Swahili saying "Mama ni mama " and in a religious perspective (Islamically at least) "heaven lies beneath the feet of the mother". These terms are beautiful and admirable but very little attention is ever paid to the trauma women inflict on their children and other women causing them mental health issues as well as making them vulnerable to violence by men. There is an unspoken power that women have that is ignored, a power that for generations has made the vulnerable (women and children) easy targets for violence ultimately encouraging and normalising violence. If this is not properly affected, I really do not see the prospect of achieving and building peace within our society. We cannot talk to men about the violence that they inflict on women, children and even other men, without  addressing and helping women see their hand in violence.  As well as helping them heal from whatever traumas they've endured. Like Mike said in the meeting "Hurt people hurt people". Damaged/ hurt people want to have power over others that they never previously had and in the case of women having power and control over children both male and female gives them the greatest power, because they have power over generations of people, often manifesting itself in physical, verbal abuse and even psychological manipulation.
• Religion also needs to be included in programmes that integrate  MHPSS into peacebuilding. Largely, because African's although culture is important religion plays a major role in decisions taken that affects their mental health and even as seen across the continent affects peacebuilding. Religion cannot be sidelined with the view that it is a destructive force rather we need to revisit and reimagine religion.  In terms of working with religious leaders who are now more than ever understanding and see the links between  violence and mental health issues, and decisions taken based on the impacts of trauma and mental illness. Covid- 19 especially in African countries have help many religious leaders understand the gravity of mental health and are beginning to take it more seriously. I am currently working with a religious leader who pre-Covid would do counselling with people and after the pandemic hit having gone through mental distress himself realised the gravity of mental distress. The experience helped him understand issues of violence (self-inflicted and interpersonal). The fact that our people are deeply religious and there maybe a point where people understand mental health issues and links to peacebuilding, very little may change because of our religious underpinnings. People even when they know something is wrong they go back and check with religious leaders to see if their decisions are correct with some being spiritually blackmailed causing internal conflicts (moral anxiety), which often results in the normalisation of violence ultimately affecting any prospects of achieving peace within homes, communities and even between societies. Religious leaders need to be engaged. 

I will leave it there other wise I'll go off on a tangent.  I hope these help especially the last two points. Thank you again.

Dear all, thanks a lot for participating in the consultation room  and/or SparkBlue. As Friederike stated in one of the groups, we need to develop a common set of indicators in order to assess whether an integrated approach indeed contributes to more sustainable outcomes for each field. I would like to know if already such indicators are developed and used. I hope that you want to share that with us and also how these indicators are developed and how it works out in practice. Please let us know.