Psychological first aid (PFA) is an approach for providing basic psychological support to people in acute distress. It is now viewed as one of the primary early psychosocial interventions during, or immediately following, a crisis. World Vision International, War Trauma Foundation and World Health Organisation have developed a PFA guide for low and middle income countries (LAMIC) following acute emergencies. After the Haiti earthquake, World Vision International (WVI) undertook a pilot orientation to test the draft PFA guide and to provide some basic information on PFA for those assisting in an acute emergency. This paper documents lessons learned from the pilot within the Haiti context, including the use of brief PFA materials. The staff found PFA to be a useful, empowering approach to providing psychosocial support to people affected by the earthquake. One key lesson was that the full version of the draft PFA guide could serve as a comprehensive model (adapted to context), while a shorter version can be used as a generic resource in the immediate aftermath of an emergency. The draft PFA materials designed for LAMIC show promise as a resource for Haiti, and potentially other humanitarian contexts in the future.

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In the aftermath of election related violence in an area of armed conflict in the Philippines, the Philippine Department of Health deployed a psychosocial team to the area to carry out psychosocial interventions. The main intervention was an activity called Psychosocial Processing (PSP) that is briefly described and discussed in this field report.

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This paper explores the question of redressing war related sexualised violence, often referred to as war rape, with refugee women in resettlement contexts using a Canadian case example. The first part of the paper uses theory and research to frame sexualised violence as a tool of war whose practice and impact are shaped by gender and cultural factors. This section highlights how, for survivors, the combination of psychological trauma and socio-cultural factors in post migration environments can create barriers for seeking help, social support, as well as vulnerability to further victimisation and mental health difficulties. The second section provides a case example of a community based mental health initiative in Canada for survivors of war related sexualised violence. The case explores the use of a psychosocial framework that integrates cultural competency, gender perspectives, and community advocacy. Challenges and opportunities of service provision in resettlement contexts are discussed, and recommendations are provided for multicultural mental health practice that is collaborative, community oriented, and sensitive to trauma survivors' needs.

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The earthquake in January 2010 that destroyed Port au Prince, Haiti, has been described as the most devastating humanitarian disaster on record. The author, a mental health professional and a dance movement therapist with more than 12 years working experience in Haiti, encountered numerous anecdotal reports of physical illness and psychological distress amongst rescue and recovery workers, humanitarian aid workers, and others. This field report describes a staff support programme in Haiti that consisted of three phases: 1) psychological first aid; 2) needs and resource assessment and training of a local staff support team; and 3) team building, ongoing training and mentoring. While staff support has been ‘on our radar’ for 20 years, the aftermath of the Haiti earthquake may be a pivotal event in terms of putting the issue front and centre for both local nongovernmental organisations and international nongovernmental organisations. The Haitian experience provides important lessons for the future of staff support in humanitarian situations. The author argues that staff support needs to be an integral part of all international humanitarian programming.

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Rwanda experienced extreme violence and genocide during a three month period starting in April 1994. In the northern regions, there had been ongoing violence since 1990. Many inhabitants still suffer emotionally from the consequences of this era. We performed a quantitative study to measure the effectiveness of sociotherapy; a community based psychosocial intervention carried out in northern Rwanda. This article describes qualitative research methods used to enable and improve this quantitative study, and more specifically how the authors adapted and validated three main outcome measures for use within the local context. Psychological wellbeing was measured by use of the Self Reporting Questionnaire (SRQ-20), social functioning by use of a locally designed questionnaire, and social capital by use of a short, adapted version of the Social Capital Assessment Tool (Short A-SCAT). The collection of context related, qualitative information was essential to create applicable and context appropriate instruments. The authors' experiences underline that for any mental health or psychosocial study, a substantial contribution from qualitative research is essential. In spite of the authors' efforts, it still proved to be very difficult to quantitatively assess issues related to social relations.

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In refugee settings, alcohol and other psychoactive substances can potentiate many underlying problems and contribute to the erosion of social relations and community structure. Interventions to minimise harmful use of alcohol and other psychoactive substances can lead to positive changes, but must be customised to the specific needs of each setting. Rapid assessments with appropriate tools, understanding the situation, partnership with workers and refugees, as well as inclusive approaches are all essential. Based on field experience in two refugee camps, these elements are discussed and recommendations are proposed for integrated interventions for alcohol and psychoactive substances.

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Cet article examine la question de la réparation des violences sexuelles liées à la guerre, communément appelées viols de guerre, avec des femmes réfugiées en milieux de relocation, à l’aide d’un exemple canadien. La première section de l’article emploie la théorie et la recherche pour défi nir la violence sexuelle comme un outil de guerre dont la pratique et l’impact sont façonnés par le genre et les facteurs culturels. Cette partie montre comment pour les survivantes, le traumatisme psychologique combiné aux facteurs socioculturels peuvent, en situation post-migratoire, créer des obstacles à une demande d’aide, de soutien social, et renforcer la possibilité de victimisation et de diffi cultés d’ordre mental. La seconde section présente le cas d’une initiative de soins de santé mentale de proximité au Canada pour les survivantes de violence sexuelles liées à la guerre. Le cas examine l’emploi d’un encadrement psychosocial intégrant la compétence culturelle, le point de vue du genre et la mobilisation communautaire. On y discute les défi s et les opportunités liés à l’offre de services dans des milieux de relocation, des recommandations sont faites pour des pratiques multiculturelles dans la santé mentale, qui soient basées sur la collaboration, axées sur les communautés et sensibles aux besoins des personnes ayant survécu à un traumatisme.

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The abuse of alcohol and other drugs (AOD) is evidently a significant, but often neglected, problem in refugee camps. There are some differences compared with AOD problems in developed countries (notably fewer affected women), but also many similarities. Alcohol is the major problem in terms of behaviour and is often manufactured and traded by refugees themselves. Not all AOD users are AOD abusers, but identifying abusers may be worth the effort if it can be shown to reduce, rather than increase, the healthcare workload. If staff can be engaged, there are several techniques for engaging and managing abusers. The nonspecific effects of interventions may be considerable.

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Many populations that are displaced by conflict experience health and social problems connected to alcohol use. Screening for high-risk alcohol use and brief intervention is a core public health strategy for decreasing the harm related to alcohol use. Experience among populations displaced by conflict is, however, limited. The authors conducted a pilot project in a long standing Burmese refugee camp in Thailand, using the Alcohol Use Disorders Identification Test (AUDIT) as a screening instrument. The intervention was piloted through the existing primary health care system. Screening and brief intervention for high-risk alcohol use was feasible in this refugee camp setting. More work is required to assess the effectiveness of this intervention in settings of forced displacement, as well as the feasibility of incorporating such interventions into community mobilisation strategies and measures, addressing the drinking environment more generally.

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Este estudio explora la cuestión de cómo tratar la violencia sexualizada en tiempos de guerra, también conocida como violación de guerra, con mujeres refugiadas en contextos de reasentamiento. Lo hace por medio de un ejemplo canadiense. La primera parte del estudio se basa en teoría e investigación para defi nir la violencia sexual como una herramienta de guerra cuya práctica e impacto son formados por género y factores culturales. Esta parte describe cómo la combinación de trauma psicológico y factores socioculturales en contextos posmigratorios es una posible barrera para las sobrevivientes para buscar ayuda y apoyo social, y cómo las hacen vulnerables a más victimización y problemas de salud mental. La segunda parte describe una iniciativa comunitaria de salud mental en Canadá para sobrevivientes de violencia sexualizada en tiempos de guerra. Se explora el uso de un marco psicosocial que integra competencias culturales, perspectivas de género y abogacía comunitaria. Se discuten los desafíos y oportunidades en cuanto a la prestación de servicios en contextos de reasentamiento, y se dan recomendaciones para una práctica multicultural de salud mental que sea colaborativa, orientada en la comunidad y sensible a las necesidades de las sobrevivientes del trauma.

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