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Widener Alumnus Shares Experience of Working as Mental Health Coordinator in Kurdish Iraq

May 19, 2011

Patel in the Kurdish city of Dohuk

In the fall 2009 issue of Widener Magazine, we  profiled alumnus Nishant Patel ’09, a doctoral graduate of Widener’s  Institute for Graduate Clinical Psychology who was then bound for a one-year assignment working as a mental health program coordinator in the Kurdish section of Northern Iraq.  He provided an update on his work in March of 2010, and recently wrote more about his experience in Iraq working with internally displaced persons. He returned from Iraq earlier this month, and will now be working as a mental health coordinator in Jersey City, N.J.

By Nishant Patel, PsyD

“When will the school be finished being built?” A reasonable question, if we were indeed building a school rather than a tent within which to carry out psychosocial activities.

Since May of 2010, I have visited a nearby internally displaced persons (IDP) camp 15 times. The IDP issue in Iraq is a well-documented problem, with over 1.4 million IDPs in the country, according to the United Nations High Commissioner for Refugees (UNHCR). The camp which I have worked with was established in 2006 by Arabs who fled central Iraq due to sectarian violence and war. At its height, there were more than 200 families living in the camp. There are currently 65 families in the camp, while as many have returned to their original neighborhoods. Yet there are also new families that are now settling in the camp from central Iraq.

My initial visit was with several staff members to begin to gauge the needs of the camp members. As we approached the desolate camp area, I noticed that one tent had a UNHCR insignia. We sat under a large tent, which was nothing but a large covering on a wooden structure. We coordinated our visit with the medical mobile team that the organization that I work for funds to visit the camp once a week to deliver medicine and take the blood pressure of residents. A few curious members of the camp came inside while we were waiting for the mukhtar (leader) of the camp. One of the messages that we were told before going into the camp by the mobile team was not to make promises that we could not fulfill. Consequently, we told the mukhtar when we met him that we would like to talk to him before we did anything. One man at the camp started to talk in a forceful way to us, and was then interrupted by another man. Our interpreter, my partner on the initiative to try to provide some service to the members in the camp, told us that the first man said that if all we want to do is to talk, we can leave because there have been many outsiders from international organizations that have come, taken pictures, talked to the camp members, and then left never to return again. Hearing those words made me angry at the rampant exploitation and inaction by international NGOs and governmental agencies, but also made me hopeful because the camp members were so earnest with us about their frustrations.

I was unsure of what we could do at the camp that fit into our organization’s mandate, and I thought we could possibly end up doing more harm than good. My caution came at the heels of reading Crazy Like US: The Globalization of the American Psyche by Ethan Watters, which had a chapter on PTSD and the Tsunami aftermath in Sri Lanka. The chapter poignantly discusses the ill-conceived efforts of well-intentioned western trained mental health professionals. I had to weigh whether our mere presence in the camp could alarm local authorities, and as a consequence endanger camp members. Even if it was safe for the IDPs to talk with us, I was not sure what the best approach would be to help them. I thought counseling would be insensitive and ineffective, especially given that our center provided counseling two years prior to camp members, but ended the effort after the camp members dropped out. To further complicate matters, leaders and other important figures in the camp members’ community could not be incorporated into any plan for the provision of services because such persons were far from the rest of their community, which are mainly in Central Iraq.

After our first visit to camp this time around, we began to meet with families at the camp on an ad hoc basis to conduct an informal needs assessment.  The camp members told us about basic necessities that they were lacking, such as electricity and education for their children. After we spoke to roughly ten families, we began to discuss the idea of organizing psychosocial activities for the children in the camp. The purpose of the activities would be to increase the sense of agency among the children and to provide them with some sense of structure and routine, both which have been severely diminished due to the sectarian violence and relocation they have experienced.

During this period of time, we began to initiate meetings with local and international organizations, as well as universities that we were told either were either currently or previously involved at the camp in one way or another. From these meetings, we sought to gather additional information in the hopes of avoiding any duplication of services. We also had several meetings with the manager of a governmental body that is in charge of IDP issues in Kurdistan. In one meeting, we encouraged the manager to hold coordination meetings with key stakeholders, and most importantly with a committee of camp members to discuss current services. We also strongly advocated for the children to be allowed to enroll in public schools, a right ensured under the Iraqi constitution, and have held initial meetings with UNHCR in order to reach that goal.

I wish I could say that the activities we have pursued  went well. The fact is that none of them had actually taken place when I left Iraq. There were a number of delays in building a tent where we would hold the activities due to weather, unexpected costs, and multiple changes in camp leadership. Thankfully the tent was  completed, and some activities began. Our hope was  to form a council of adults from within the camp that can monitor our activities in order to better inform our work, empower camp members, increase trust and promote sustainability. However, there are many obstacles that we anticipate, the largest of which may be ensuring that camp residents believe our activities are important and valuable.

None of this work falls within the scope of mainstream psychology, yet has the potential of reaching individuals and communities that have traditionally been marginalized to the point where previous healing paradigms have deteriorated. Although we could  not solve all of the problems in the camp (or for that matter build a school), there is a likelihood that we helped to decrease stress and strengthen the resilience of camp residents — a more than worthwhile cause.

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