Dec 29, 2015

CNMH earthquake response project report 2015

Chhahari Nepal for Mental Health

Earthquake Response Project Report

Chhahari Nepal for Mental Health (CNMH) initiated immediate relief measures in response to the destruction and damages caused by the earthquakes in the months of April and May, 2015. The first priority has been to locate and access the safety of CNMH's clients and their families. CNMH is now widening its scope to initiate a rapid assessment of other people on the streets who may be suffering from trauma, stress and/or mental health problems as a direct consequence of the earthquakes. The objective of this Earthquake Response Project is to identify these individuals, re-connect them with their families and provide psycho-social and treatment support where necessary.

This report summarizes the findings of a project that focused on locating, and offering support to, mentally distressed men and womenafter the earthquakes in Nepal in April and May 2015. The location of this project was in the areas around Lalitpur (Lubhu, Bugmati, Khokana and Bagdole) as these areas were adversely affected by the earthquakes, but were not areas in which Chhahari Nepal for Mental Health (CNMH) had previously worked. The project lasted for one month

Three days after the first earthquake, CNMH began to locate clients, ensure their safety, then investigate and address their wider needs. The main task was to find individuals who were living on the streets in areas that had been devastated by the earthquakes who had not yet gained access to Chhahari's services, and build positive working relationships with them. While locating these new clients and their carers the focus has been on areas in the Lalitpur district that were not previously covered by CNMH.

Two Earthquake Response Officers (EROs) were assigned to complete this essential work. Both EROs had been volunteering for Chhahari prior to the earthquake, so were familiar with the organisation's work and approach. While visiting many different locations around the Lalitpur area many mentally distressed women and men were found to be living in a miserable state with various mental, as well as physical, health problems. In the field visits 21 vulnerable people were located who had not yet accessed CNMH's services (14 men and 8 women) in the areas around Lalitpur. Estimated ages ranged from 16 to 50 with most of them falling in the 20-40 age range. The EROs focused more on the areas such as Lubhu, Bungmati, Khokana and Bagdole as these were new areas for CNMH and had been badly affected by the earthquakes.

Of the 21 mentally distressed women and men who were identified during our field visits, only 4 had family support while 17 were mentally distressed women and men who live on the street.

CNMH's two EROs received extensive training relating to post-earthquake trauma counselling. This training was very helpful during the project, but also helped greatly in their own personal lives.

Initial support for individuals focuses on assessing their current living conditions, assessing needs and setting priorities for support work. The next step is tracking down their families and, where necessary, reuniting individuals with their families. Reconnecting mentally distressed people with their families/carers is essential for ensuring that basic needs for food, shelter and clothing are met, but also for meeting social, medical, educational and economic needs. CNMH often finds this partnership approach with carers and family members to be extremely effective in supporting individuals with mental health issues.

Through the undertakings of this project, it is identified that the community is provided with training courses related to trauma counselling and mental health support.Likewise, it is also noted essential that after building positive relationships and rapport with new clients, it is necessary to provide them with medical treatment. Similarly, to encourage new clients and their carers to attend the day-care centre (Welcome Centre) and to allow individuals to express themselves through creative tasks (music, arts, cooking), build self-esteem (using meditation and field excursions) and support increased interaction with others. Previous experience has demonstrated the huge contribution Chhahari's Welcome Centre makes to helping people to improve their mental health.

During the implementation of this project, the urgent need is identified to locate individuals with mental health issues who are living on the street and their carers and reunite them.

case study:  

Rita is a 35 year old woman from Khokana who lives with her family. She is married and has two children. During the earthquake Rita was working in the field alone, away from friends and family members. According to her father-in-law, Rita did not return to her work for weeks after the earthquake and was showing signs of shock, mood swings and helplessness. She was traumatized by what had happened, and had refused to enter her house for several days after the earthquake due to her fear of aftershocks.

It was suggested that CNMH could provide local people with information on mental health issues and how to deal with trauma.

The most pressing need for this client is for psycho-social trauma counselling to help her to come to terms with what happened. Also there needs to be increased awareness, as well as acceptance, in this area regarding mental health issues and mental distress.

sharing
sharing
Sep 28, 2015

CNMH Earthquake Response Progress Report - Phase III

Uncertainty
Uncertainty

Chhahari Nepal for Mental Health (CNMH)
Earthquake Response Progress Report – Phase III

After the completion of two phases of Post-Earthquake Response Activity project, we now process towards the phase III. This is the final phase of this project and mainly focuses on the completion and some ongoing activities of phase I and phase II. In phase I, we emphasized on assessing our clients living condition and to what extent earthquake affected them be it physically, mentally, financially and socially. As we worked upon phase I, we identified the need of the development of another phase; and in phase II, we worked on locating new clients and re-connecting them with their family/relatives. Under all phases we work in co-ordination with the community and other likeminded organizations. CNMH is also participating in the UN Mental Health Cluster meetings led by UN and MoHP(Ministry of Health and Population).

Under phase III, CNMH is providing monetary support to help clients and carers continue with their medication, treatment and temporary shelter with regular follow-up. We are in the process of providing monetary fund to the clients for their monthly medical cost; and covering 50% of treatment cost of the carers. These carers are undergoing certain medical treatment like cataract treatment, hemorrhoids, and bed sore. This monetary fund is provided only for a period of 5 months. And for this we have signed an agreement letter between the carers, clients and organization. This agreement letter is considered to be of importance; as for the clients and carers to understand that this support is for a certain time period.The bills provided by the hospitals, clearly mentioning the patients name and amount; are collected as for our record.

Likewise, the client's families who have lost their houses or who have suffered from damaged houses are provided with monetary support.

We continue to work and proceed with one of the activities of phase II; that is to locate new clients and re-connect with their family/relatives. For this activity to be carried out, we have employed two EROs (Earthquake Response Officers) who actively participate to identify and investigate people suffering from mental health problems, majorly affected due to the earthquake. The EROs shall also seek to locate and reconnect these individuals with their families. Until date, we have located 21 new clients post- earthquake period. And under phase III, we continue to work with these clients and support them.

After, the assessment and evaluation was done by the EROs during phase II, a report was prepared by them which highlighted the findings and experiences focusing on locating mentally distressed men and women as a post-earthquake response. This report can be found in our website.

Similarly, the clients and carers are also supported through our weekly Welcome Center sessions and Carers Workshop Sessions. Carers Workshop Sessions takes place once in every 2 months in collaboration with ECTC (Elijah Counselling and Training Cenre) specially designed for the carers only who care for the mentally ill .We have realized that it is essential to have a carers support group for awareness and guidance whilst they themselves support mentally ill person/s.

There are some aftershocks felt across Nepal until date. And a sense of fear and stress still exists amongst the people. Therefore, under this phase CNMH is participating in various psycho-social trainings on stress management, peer support; counseling and community based psychosocial support; to continue to develop in post-earthquake response activities with mentally distressed group.

Fearful
Fearful
Enjoyment
Enjoyment
Sharing
Sharing
Creativity
Creativity

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Jun 30, 2015

CNMH Earthquake Response Report

clients living condition
clients living condition

A 7.9 Richter scale earthquake hit Nepal on April 25th causing the greatest destruction the country has faced in 80 years followed by a second strong shake of 7.3 Richter scale on the 12th of May, affecting 8 million people. Communities that were living in poverty even before the earthquake have been hit hard and men, women, children, people affected by mental health are most vulnerable in this time of emergency.


CNMH is working in the district of Lalitpur in Kathmandu valley facilitating appropriate support and treatment for homeless and mentally ill people, so that they can be accepted back into society. Before the earthquake, CNMH was working with 91 clients (50 men and 41 women) on the streets, working closely with 52 of individuals and has located families in 30 cases.


Chhahari Nepal for Mental Health (CNMH) went into action on the third day after the disaster struck to investigate and identify our clients’ need. The sporadic location of our clients and their displacement since the quake has made it difficult for us to locate them for assessment. However, out of 52 clients who we are working with; at this time we have managed to visit and provide basic help and psychosocial counseling to 42 clients including 10 new clients who were on the streets after the earthquake. Upon certifying the safety of our clients (few had minor injuries), our team started providing relief which included food and non-food iteams as well as psycho social counseling to carers as well.


Chhahari initiated a Post-Eathquake Response Activity project, which is divided into III phases. In phase I, we emphasize on assessing our clients living condition and to what extent earthquake affected them be it physically, mentally, financially and socially. Likewise, during this phase CNMH was also involved in distribution of relief materials like food, tarpaulins, blankets, sleeping bags, clothes, hygiene kits, first-aid kits and home prepared hot meals mainly to our clients.


As we worked upon phase I, we identified the need of the development of another phase; and in phase II, we mainly carry out the objectives of locating new clients and re-connecting them with their family/relatives. Likewise, this phase was also designed to carry out the process of working in co-ordination with the community in accessing clients’ living condition. Under this phase, CNMH plans to provide funds to help clients continue with the medication and to provide monetary support for carers treatment. However, we also identified the need for various psycho-social training programmes on stress management, peer support, counseling and community based psychosocial support, to be provided to the staffs and volunteers; to continue to develop in post-earthquake response activities with mentally distressed group. We plan to get more professional help to support staff and built their capacity.


In this way, as we process towards the phase II, we plan to work on these activities in order to extend and build-up the activities for phase III.

hot meals feeding day
hot meals feeding day
hot meals on the street
hot meals on the street
hot meals on the street
hot meals on the street
providing temporay shelter
providing temporay shelter
HOPE FOR NEPAL
HOPE FOR NEPAL
clients enjoying our welcome center sessions
clients enjoying our welcome center sessions
 
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