Nepal was hit by devastating earthquake on 25th April 2015. Six months after the devastating earthquakes in Nepal the majority of impacted families in the project area of Makwanpur District have chosen to stay in their communities to rebuild. During this time, NGOs and government agencies had provided help to these families by distributing food and essential supplies, coordinating medical health camps and providing in-situ psychosocial support. Although this intervention was short-term in nature a high number of stress-related cases were reported amongst women and older people. It was also believed that more cases remained undetected, especially amongst children. Further, it was observed that the disaster had exacerbated situations of some at-risk individuals who were previously facing difficult situations.
Our partner, ETSC-N, raised concerns that posttraumatic stress could contribute to isolation and exclusion of at-risk individuals as well as elevated stress levels for mothers participating in project activities. Although unconfirmed, the project team perceived distracting level of anxiety in children who accompanied their mothers to attend health literacy classes.
It was expressed that by increasing the ability to address post traumatic stress disorders (PTSD) the project could benefit from:
- Improved delivery of key project processes, such as health literacy classes, by reducing anxiety of participants;
- Improved effectiveness of community groups to work together and to address PTSD cases that could lead to increased health risks of mothers and adolescent girls; and
- Improved the quality of government health services to respond to the complexities of maternal and child health issues
We would like to integrate additional project activities to help build community psychosocial support capabilities. In order to do this we propose a 9-month period of collaboration with skilled psychosocial practitioners and a local NGO (Child Welfare Society). The activities are described below:
- Raises awareness of PTSD amongst WHCs, MSGs, AGGs and health post staff and/or teachers and provide training to members of these groups of techniques and tools to identify, appreciate and engage with issues causing PTSD at household and community levels.
- Work with CBOs and government agencies to strengthen referral systems that deal with PTSD and to increase access of health services toat-risk women and adolescent girls.
- Provide practical guidance to specific group processes in workshops to help identify and integrate practical help and community interventions using creative methods, referrals and counselling, where necessary.
- Facilitate knowledge-sharing workshops between health services and NGOs to strengthen low-intensity approaches to deal with high-risk cases of PTSD, e.g. application of psychological first aid.