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Crisis, disaster and trauma

'You are always learning, whether it is good, bad or ugly'

Fadumo Omar Mohamed talks about her experience of working as a Mental Health Activity Manager for Médecins Sans Frontières. Fadumo has previously worked for MSF in Tajikistan and Ethiopia. Her latest assignment took her to Jordan where MSF are treating war-wounded Syrians.

16 February 2017

I joined Médecins Sans Frontières (MSF) in 2013, and spent my first assignment in Tajikistan providing psychological support to Multi Drugs Resistant (MDR) TB patients. There, I saw children and adults given a 50/50 chance that, if you adhere to the medication, you may live. That environment is so different to what I saw in Jordan.

In Jordan, we were treating war-wounded Syrians who had fled across the border. When patients arrived in our hospital in Ramtha, many had severe injuries and we weren't sure if they would make it or not. We saw children, the elderly, men, women, you name it.

Working in Psychological Health Centres in the UK in the past, I had experience of working with patients who are extremely traumatised. I had seen refugees and asylum seekers who had escaped from war zones, fleeing with physical and mental scars. But I had never worked in a context where I was seeing patients arrive straight from casualty.  Working in this environment is certainly very challenging and a real learning curve.

It means that recovery is amazing to witness. After surgery and treatment, there is a transformation as patients begin the healing process. There was a child who had suddenly lost their legs, who was supported to walk with prosthesis. As a psychotherapist, these moments really stay in your memory; making patients feel secure and supporting them to these milestones.

That healing process is not only physical but also mental and emotional. For some patients, they learn to accept their multiple losses; losses of limbs, but also losses of family members, and the loss of their country. There is a permanent change in their life in every sense.

We see patients gain hope as they learn to adjust despite the difficulty that impairs them. You see them laughing and joking – you see that they're human; they are restoring some feeling of normality.

Day-to-day my job involved ensuring that the patient was getting what we planned for them to get, in terms of psychological intervention that would stimulate the patients' wellbeing. We did one-to-one therapy, group therapy, and recreational activities [Fadumo is pictured above, painting].

The activities were important. We had to find a way for them to be engaged in something to normalise their current situation, because staying in hospital or rehabilitation centre for a year or more can be quite traumatic as you are surrounded by pain.

We played games regularly, like card games, darts and chess. We also sung, and brought musical instruments in. Language lessons were popular too. We hired English and Arabic teachers to teach those patients who wanted to read and write, and even helped to enrol children for formal education. That was really important for those who were staying a long time and waiting for other operations.

Sometimes we requested our old patients to be motivators for the new patients. We had a patient who had both arms amputated but he was very strong emotionally after over a year with us. He was a motivator for our other patients who lost an arm or a leg. Others found it very hard to come to terms with these extreme changes in their lives.

In a profession like psychology, you are always learning, whether it is good, bad or ugly. I find myself absolutely uplifted and mesmerised by the resilience of the Syrian patients again and again. Of course, it is hard to see such suffering but it is the reality, and I was privileged to be a part of an MSF team who had the chance to be there to make a difference. 

MSF is currently looking for Mental Health Officers to join its register. Find more information on the recruitment criteria and the application process.