Survivors of the war in the Northern Kosovo: violence exposure, risk factors and public health effects of an ethnic conflict.

The aim of this population-based study was to assess the long-lasting effects of ethnic conflict on health and well-being (with a focus on injury and persistent pain) at family and community level. The possible risk factors for victimisation during the conflict and factors contributing to healing, have also been investigated.

Survivors of war in the Northern Kosovo (II): baseline clinical and functional assessment and lasting effects on the health of a vulnerable population

This study documents torture and injury experience and investigates emotional well-being of victims of massive violence identified during a household survey in Mitrovicë district in Kosovo. The victims reported a high prevalence of severe pain and emotional disturbance. They showed high BMI and a reduced level of physical fitness.

Using international jurisprudence on rape as a form of torture or other ill-treatment

This report hopes to provide a useful resource for those seeking to build upon these developments, helping to translate them into change for individuals and communities. It does so by focusing on one strategy which has been fruitfully used both to bring rape within the international legal framework, and to seek justice in individual cases: making the link between rape and torture and other prohibited ill-treatment.

Denial and silence or acknowledgement and disclosure

Disappearances are a worldwide problem. Over the last few decades the world has been shocked by accounts of tens of thousands of people who are known to have disappeared in Cambodia, Latin America, Iraq, Rwanda, the former Yugoslavia, Chechnya and others.Forced disappearance have an effect on the individual, his/her family and the community as a whole. The problems that family members of disappeared persons face are complex and can be overwhelming.

Justice Denied: The experiences of 100 torture surviving women of seeking justice and rehabilitation

The case histories of 100 women survivors of torture from 24 countries who sought asylum in the United Kingdom were reviewed in order to assess their experiences of torture and ill treatment and of accessing justice and rehabilitative help and support in their countries of origin.

Statement of Good Practice

The Statement aims to provide a straightforward account of the policies and practices required to implement and protect the rights of separated children in Europe

Handbook on Direct Assistance for Victims of Trafficking

Handbook on Direct Assistance for Victims of Trafficking IOM has had some 13 years of experience in implementing counter-trafficking activities and has provided assistance to over 14,000 victims of trafficking in all regions of the world. This Handbook summarizes and systematizes this experience. IOM recognizes that each victim is unique and requires and desires different assistance. As well, the nature of trafficking is different around the world and is ever evolving, requiring changing responses

Handbook for the Protection of Internally Displaced Persons

The focus of the Handbook is on the protection of IDPs and other affected populations in situations of internal displacement in complex emergencies. Much of the guidance provided may be relevant as well during natural disasters, when internal displacement and protection risks also often arise.

Implementation Guidelines for Psychosocial Support in Disasters

This guideline aim to provide guidance to field relief workers and volunteers. Being a reference work prepared based on the experiences and assessments of our specialists, these guidelines draw the general framework of psycho-social support and provide information on the psycho-social support practices, human resources, volunteers and vulnerable groups.

Children and transitional justice – Truth-Telling, Accountability and Reconciliation

The damage to the lives of children caused by the worst impacts of armed conflict cannot be fully repaired, but much has been done to protect children and enable them to better protect themselves.

Psychosocial Healing – A Guide for Practitioners

This guide for practitioners describes the use of trauma healing and related psychological and social-support activities as contributors to the development of a stable, peaceful andfunctional society in a post-conflict environment. We describe this type of work as psychosocial trauma healing for post-conflict social reconstruction. For convenience, in this guide we generally use the shorter terms psychosocial healing.”

Development of the rapid assessment tool for mental health and psychosocial support in the philippine health emergency setting

This covers a wide-range of interventions and services and should be preceded by careful assessment and planning within the local context, which would include the local perceptions of distress and illness, coping mechanisms, and the mapping of the community’s capacity to cope. In the Philippines, the National Disaster Coordinating Council MHPSS Sub-committee saw a need to develop a Rapid Assessment Tool for Mental Health and Psychosocial Support in Emergency Settings (MHPSS-RAT) which will provide immediate assessment of thevulnerable population and relevant resources in the first twenty-four hours of onset in mass emergencies and disasters.

Psychosocial support to learners

In the “GUIDEBOOK for planning education in emergencies and reconstruction” chapter 4. To provide educational, psychological and social opportunities which support the well-being of children affected by the trauma of conflict or natural disaster.

Emergency mental health and psychosocial support

Public health guide for emergencies Chapter 5. This chapter is as a guide for setting up mental health and psychosocial programmes for vulnerable populations in developing countries who are or have been exposed to crisis events. It describes the psychological problems of people exposed to violence, disaster or critical incidents and provides guidelines for planning emergency mental health programs.

From Violent Policies to Policies for Violence Prevention:Violence, power and mental health policy in 20th century South Africa

Strategies for the use or containment of violence have played a greater role in the dynamics of South Africa than in many other societies. As a result, references to the violent practices and policies of the past are prominent in the popular and political rhetoric of 1990s, and contemporary efforts to deal with the problem of violence are shadowed by what went before them. New policies should therefore be formulated with reference to what these historical strategies may teach us about the management of violence in the present.

Disabilities among Refugees and Conflict-Affected Populations

Reveals a disparity between refugee camps and urban areas: in camps there is a greater awareness about the needs of the disabled and better services than in urban environments, where refugees with disabilities are unable to access services offered by the host government and virtually no one is providing special assistance to them. The Women’s Refugee Commission also found greater discrimination and stigmatization towards the mentally disabled population; assistance programs, when available, tend to focus on those with physical and sensory disabilities.

Rehabilitation as a form of reparation under International law

The Basic Principles and Guidelines on the Right to a Remedy and Reparations for Victims of Gross Violations of International Human Rights Law and Serious Violations of International Humanitarian Law (Basic Principles) further clarify this right. These Principles indicate the types of reparation that may be needed, depending on the particular circumstances of the case, to afford adequate and effective reparation to victims, explicitly recognising five forms of reparation for such violations: restitution, compensation, rehabilitation, satisfaction and guarantees of non-repetition.

Physical forensic signs of sexual torture in children

A guideline for non specialized medical examiners: Proper forensic documentation of sexual torture in children is crucial. Informed consent for examination and documentation must be sought from the child/accompanying person and the examination conducted in a sensitive and respectful manner. Time should be given to the child to relate the history of torture and the examiner should start with open ended questions. The history of torture should be recorded verbatim as much as possible.

Children, torture and psychological consequences

Deliberate infliction of pain and suffering or intimidation or coercion on children to obtain a confession or information, for punishment of real or perceived offences on the basis of discrimination about race, ethnic or political affiliation, is practiced in many places around the world. Impact of torture on children may vary depending on the child’s coping strategies, cultural and social circumstances.

Torture in children

Torture in children happens during peace times and during political violence and war conflicts. The majority of torture victims happen during peace times. The high-risk groups are impoverished children living in the street, children deprived of parental care, children in conflict with the law, and children in detention. During political violence and war the high risk children are the children detained during political violence, child soldiers, children internally displaced in refugee camps, detained children during the war against terrorism and children tortured by peacekeeping forces.

Child soldiers as zones of violence in The Democratic Republic of Congo: three cases on medico-legal evidence of torture

This article sets medico-legal light on torture of three former child soldiers by comparing torture methods, consequences of torture and medical observations. It is focused on these child soldiers as representatives of the many abuses of children as soldiers in armed groups.
(This is not an open-source article, but it is an important publication.)

Household exposure to violence and human rights violations in western Bangladesh (I): prevalence, risk factors and consequences.

The ruling parties in Bangladesh have systematically used violence against political opponents and criminals. It is essential to 1) determine the magnitude and burden of organized crime and political violence (OPV) and human rights violations in the affected community, and to 2) identify the risk factors and key indicators for developing effective health intervention and prevention measures. The level of violence and human rights violations is high. The affected population suffers from violence-related injuries and traumas, which could be a factor contributing to poverty. Victimisation is not random.

Where there is no Psychiatrist

Attitudes towards mental illness have changed, with more people coming forward for treatment. Despite this positive development, access to mental health care in low-income countries is still extremely poor and there is a serious shortage of mental health care workers. However, most of these countries have large numbers of community workers who could be deployed to deliver mental health care if they had the necessary knowledge and skills. Where there is no Psychiatrist might go some way in Providing such knowledge and skills.

Psychosocial intervention and post-war Reconstruction in Angola: interweaving Western and traditional approaches

The intra-state wars that now comprise the dominant form of armed conflict in the world cause immense physical, psychological, and social damage, and create profound obstacles to peace. Worldwide, approximately a quarter of a million children participate in military activity, often as the result of victimization, coercion, or economic desperation. Many have killed or witnessed tortures, executions, and deaths. In Angola in 1994, there were over 9,000 child soldiers, most of whom had been forcibly recruited at age 13 to 14 years.

Trauma, Peacebuilding and Development: An Africa Region Perspective

Armed conflict and its aftermath impose an enormous burden of psychological and social suffering on affected populations. During the 1990s and early in the 21st century, this suffering was conceptualized in terms of a trauma paradigm, which held that life threatening experiences cause individual traumatic reactions such as Post-Traumatic Stress Disorder (PTSD) and also collective maladies such as collective trauma. In many regions, practitioners who adhere to a trauma paradigm assume that unhealed traumas may contribute to ongoing cycles of violence and thwart peacebuilding efforts, and they seek to alleviate trauma through individualized approaches such as trauma counseling .

Do No Harm: Challenges in Organizing Psychosocial Support to Displaced People in Emergency Settings

Psychosocial assistance in emergencies plays an important role in alleviating suffering and promoting well-being, but it is often a source of unintended harm. A prerequisite for ethically appropriate support is awareness of how psychosocial programs may cause harm. This paper underscores the importance of attending to issues of coordination, dependency, politicization of aid, assessment, short-term assistance, imposition of outsider approaches, protection, and impact evaluation.

Sexual violence against women and girls in war and its aftermath: realities, responses, and required resources

Addressing GBV requires coordinated, inter-agency, and multi-sectoral strategies that aim for prevention through policy reform and implementation of protective mechanisms and building the capacity of health, social welfare, legal and security systems to recognize, monitor, and respond to GBV; in addition to ensure rapid and respectful services to survivors (34 pages, .pdf. for historical reference).

Women’s Health and Human Rights in Afghanistan

The current health and human rights status of women described in this report suggests that the combined effects of war-related trauma and human rights abuses by Taliban officials have had a profound effect on Afghan women’s health. Moreover, support for women’s human rights by Afghan women suggests that Taliban policies regarding women are incommensurate with the interests, needs, and health of Afghan women (8 pages, for historical reference)

Rapid Assessments of Mental Health Needs After Disasters

Screening for PTSD among survivors of disasters in developing countries, especially in acute situations, has faced a number of common criticisms; psychological trauma is a western concept that may be unfamiliar to other cultures. PTSD has limited diagnostic validity because culturally diverse communities do not have equivalent terms for the constellation or for the individual symptom domains of the disorder (4 pages).

Association of Combatant Status and Sexual Violence With Health and Mental Health Outcomes in Post Conflict Liberia

Former combatants in Liberia were not exclusively male. Both female and male former combatants who experienced sexual violence had worse mental health outcomes than noncombatants and other former combatants who did not experience exposure to sexual violence.

Mental Health Problems Among Adults in Tsunami-Affected Areas in Southern Thailand

Among survivors of the tsunami in southern Thailand, elevated rates of symptoms of PTSD, anxiety, and depression were reported 8 weeks after the disaster, with higher rates for anxiety and depression than PTSD symptoms. Nine months after the disaster, the rates of those reporting these symptoms decreased but were still elevated. This information is important for directing, strengthening, and evaluating post tsunami mental health needs and interventions.

School-Based Mental Health Intervention for Children Affected by Political Violence in Indonesia

In this study of children in violence-affected communities, a school based intervention reduced posttraumatic stress symptoms and helped maintain hope, but did not reduce traumatic-stress related symptoms, depressive symptoms, anxiety symptoms, or functional impairment (9 pages).

Torture in South Africa. Exploring torture and cruel, inhuman and degrading treatment or punishment through the media.

In the absence of official records, this report uses media reports to explore torture and CIDT in South Africa today. There are multiple methodological problems associated with such a method. While victims of alleged torture usually complain to official mechanisms, the media often provides a more immediate avenue of complaint, and it may become a prompt for official action

Health Challenges for Refugees and Immigrants

This Refugee Reports focuses on refugee health in the United States, beginning with an article about the general healthcare challenges facing refugees and immigrants. John Poon provides a case study of Afghan refugees trying to gain access to necessary health services. José Quiroga discusses the physical and mental health needs of torture victims. Several reports feature the important mental health issues facing newcomers as well as refugee-specific information about vaccinations and civil surgeons.

Because I am a Girl: the State of the Worlds Girls reports

The public images of war focus almost exclusively on young men  armed forces, suicide bombers, young men throwing stones at soldiers. The fact that girls remain invisible casts a long shadow on their involvement in war, particularly as the changing nature of war and conflict means that increasingly, civilians are affected as war is played out closer to people’s homes.

The psychosocial impact of war, HIV and other high-risk situations on girls and boys in West and Central Africa.

The psychological and physical suffering of children expressed in the testimonies makes for disturbing reading. But the findings need to be understood for what they are: reports on children in extreme situations where traditional and modern protection mechanisms of states, families and communities have failed .

Nowhere to turn: failure to protect, support and assure justice for Darfuri women

This report amplifies the voices of some 88 women in the Farchana refugee camp, some of them breaking their silence for the first time. They spoke about the sexual violence visited upon them both in Darfur and in the environs of the refugee camps in Chad, and about their lives and difficulties in the camp. The report reveals the profound stigma and physical violence to which many women have been subjected as a result of sexual assault.

Women, girls, boys and men different needs equal opportunities. Gender Handbook in Humanitarian Action.

This handbook offers practical guidance on identifying and addressing the differing needs and situations of women, girls, boys and men; in other words, being sensitive to gender issues in humanitarian crises. The IASC Guidelines for Gender-based Violence Interventions in Humanitarian Settings serve as a complement to this handbook and should be used in conjunction with it.

Stakeholder perceptions of mental health stigma and poverty in Uganda

According to a range of mental health stakeholders in Uganda, there is a strong interrelationship between poverty, stigma and mental illness. These findings re-affirm the need to recognize material resources as a central element in the fight against stigma of mental illness, and the importance of stigma reduction programmes in protecting the mentally ill from social isolation, particularly in conditions of poverty.

Women war survivors of the 1989-2003 conflict in Liberia: the health consequences of sexual torture

Levels of psychological trauma are very high resulting in a large percentage of women not being able to work. The stigma and shame of women’s experiences and their reproductive health problems has further impact on their identities and a gendered understanding of trauma is proposed. However, Liberian women demonstrated resilience; contributing to peace processes, taking up male roles and bringing the first ever woman Head of State to power .

Human Rights, Health and Poverty Reduction Strategies

The booklet aims to provide policy-makers with guidance, suggestions and real life examples to help demonstrate how human rights can and have been applied to pro-poor health policies and initiatives, and how they can enhance the effectiveness of a Poverty Reduction Strategies.

Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese nationals, refugees and Ugandans in the West Nile

Symptoms of PTSD in war-affected Sudanese populations can be partly explained by traumatic event exposures. The high prevalence of violence and symptoms of PTSD in refugee populations highlight the need for better protection and security in refugee settlements. Humanitarian agencies must consider the provision of mental health services for populations affected by war and forced migration.

The mental health disaster in conflict settings: Can scientific research help?

What gains have been made in the fight against traumatic disorders and other mental health problems in conflict areas? What do we know about the impact on individual, family and community functioning? Given what we know about the effects of trauma, it is likely that we will also see a rise in substance abuse and suicidality, violence, and a worsening of physical health.

Mental health and conflict

This note discusses the relevance and design of mental health care interventions in post-conflict situations. Mental health disorders and psychosocial problems arising from conflict need to be addressed as part of post-conflict reconstruction and reconciliation efforts. The note presents a conceptual framework for mental health interventions in post-conflict settings and illustrations from West Bank-Gaza, Bosnia, Burundi and Uganda (4 pages, .pdf, for historical reference).

The trauma of ongoing conflict and displacement in Chechnya: quantitative assessment of living conditions, and psychosocial and general health status among war displaced in Chechnya and Ingushetia

The study demonstrates that the health needs of internally displaced in both locations are similarly high and equally unaddressed. The high levels of past confrontation with violence and ongoing exposure in both locations is likely to contribute to a further deterioration of the health status of internally displaced. As of March 2007, concerns remain about how the return process is being managed by the authorities.

Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord’s Resistance Army in Northern Uganda

Abduction and forced conscription of civilians has affected the psychological well-being of a significant number of northern Ugandans. The sources of psychological trauma are multiple, ranging from witnessing to being forced to commit violent acts, and compounded by prolonged exposure to violence, often for months or years. Community-based mental health care services and reintegration programs are needed to facilitate the reintegration of former abductees back into their communities .

A Practical Approach to Gender Based Violence: A Programme Guide for Health Care Providers and Managers

A sizeable proportion of women, worldwide, have experienced GBV. However, many women will not mention violence unless asked directly. Yet, few health care providers have been trained to address these difficult issues with their clients and few clinics have activities that specifically address the needs of victims of GBV. To help break the silence we are embarking on an innovative strategy to assist survivors of violence by integrating the assessment and treatment of GBV into Reproductive Health services.

Children and armed conflict

The report includes information on compliance with applicable international law to end the recruitment and use of children in armed conflict and other grave violations being committed against children affected by armed conflict; information on progress made in the implementation of the monitoring and reporting mechanism and action plans to halt the recruitment and use of children, as well as progress made in mainstreaming children and armed conflict issues in United Nations peacekeeping and political missions.

Children in Emergency and Crisis Situations

Commission Of The European Communities, 2008. A framework for community humanitarian actions covering children in crisis situations with focus on separated and no accompanied children, child soldiers and education in emergencies. This general framework will be implemented according to the specificities of each crisis situation taking into account the available resources and the presence of competent partners in the field.

Manuals to help children cope with their reaction to war and disasters

The Children and War Foundation has developed five manuals to help children cope with their reactions to war and disasters. They have developed five manuals to help children cope with their reaction to war and disasters.
To get access to the manuals, please contact the foundation directly by e-mail: contact@childrenandwar.org or by phone: +47 920 00 920

Long-term consequences of falanga torture

The aim of this article is to present an overview of the literature on falanga,mainly focusing on the clinical aspects and to highlight possible lesions caused by this specific form of torture that may influence the overall management of the condition.

Study Group Guide for Psychotherapy with Torture Survivors

Andrea Northwood, CVT. This guide was developed over the course of several study groups. It contains the curriculum used for the nine group meetings, each of which focuses on a core component of psychotherapy with survivors of politically motivated torture who are living in exile. While it is useful to have case material from which to learn, it is not necessary to be doing clinical work with torture survivors in order to use this curriculum.

The mental health of children affected by armed conflict: Protective processes and pathways to resilience

This paper examines the concept of resilience in the context of children affected by armed conflict. Resilience has been frequently viewed as a unique quality of certain invulnerable children. In contrast, this paper argues that a number of protective processes contribute to resilient mental health outcomes in children when considered through the lens of the child’s social ecology.

Collective trauma in northern Sri Lanka: a qualitative psychosocial-ecological study

Complex situations that follow war and natural disasters have a psychosocial impact on not only the individual but also on the family, community and society. Just as the mental health effects on the individual psyche can result in non pathological distress as well as a variety of psychiatric disorders; massive and widespread trauma and loss can impact on family and social processes causing changes at the family, community and societal levels.

Security Council Cross Cutting Report Children and armed conflict

These reports track Security Council involvement with children and armed conflict over the years, highlighting trends since the issue first emerged as a separate thematic agenda item in 1998. The present report covers relevant developments at the thematic level during 2014 and into the first half of 2015 (40 pages).

Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo

Little is known about the impact of psychological support in war and transcultural contexts and in particular, whether there are lasting benefits. This article present an evaluation of the late effect of post-rape psychological support provided to women in Brazzaville, Republic of Congo.

Guidelines for medico-legal care for victims of sexual violence

Health professionals can use the guidelines as a day-to-day service document and/or as a tool to guide the development of health services for victims of sexual violence. The guidelines can also be used to prepare in-service training courses on sexual violence for health care practitioners and other members of multidisciplinary teams.

The relationship of SGBV to Sexual-risk Behavior among Refugee Women: The Mediating Role of Depression

This study investigated the relationships of SGBV, learned helplessness, depression, and sexual-risk behaviors among refugee women in Botswana utilizing a cross-sectional research design and the theory of learned helplessness. A total of 402 female refugees who were at least 21 years old residing at the Dukwi refugee camp participated in this investigation within a three-month period.

Shattered lives – Immediate medical care vital for sexual violence victims

Finding immediate care is critically important after a sexual assault. The provision of medical care within days after rape is vital to limit serious consequences for the victims: treatment to prevent HIV infection has to start within three days, emergency contraception is possible within five.

Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Action

This Thematic Area Guide (TAG) is excerpted from the comprehensive Inter-Agency Standing Committee Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Action: Reducing risk, promoting resilience and aiding recovery (IASC, 2015). The purpose of this TAG is to assist water, sanitation and hygiene (WASH) actors and communities affected by armed conflict, natural disasters and other humanitarian emergencies to coordinate, plan, implement, monitor and evaluate essential actions for the prevention and mitigation of gender-based violence (GBV) across the WASH sector.