14 October, 2016
From the 27th to the 30th September 2016 there was a training workshop on the Teaching Recovery Techniques manual, which was developed by the Children and War Foundation. The workshop was organised by the Syrian American Medical Society (SAMS) Foundation, A Syrian-American non-profit medical organisation with its headquarter in the USA. The training was delivered by Dr. Masa Al-kurdi, a trainer from the Foundation, and her co-trainer Ms. Lamia Al Gorra. The training was held in the suburbs of Thessaloniki in an area called Sindos, closely situated to the refugee camps where later implementations of the program would take place.
About the Refugee Camps:
The three selected refugee camps, situated near Sindos area are called – Karamenlis, Frakapour and Iliadis. Each camp has around 600-800 refugees, mostly families with young children. In partnership with the Greek government, SAMS is the official medical provider for these camps. They have set up primary healthcare clinics in each camp, and their medical staff are volunteers that visit from abroad on a periodic basis to provide medical treatment to refugees. Patients needing referral for more specialised care, are referred to state-run health care clinics and hospitals. While mental health and psychosocial interventions are not yet delivered by SAMS in Greece, they are in the planning process to make these available and the first step of this plan was the TRT program.
The Recruitment Process:
Through SAMS medical and translator volunteers, a call for TRT volunteers from the camps was made in August 2016. The call for volunteers was first through word of mouth, and then a small flyer was circulated outlining the TRT program. Interested participants were interviewed and their names were registered for the training. Shortly after, the TRT manuals were distributed to participants, ahead of the TRT training. Early in September, SAMS registered 24 participants to take part in the training. But due to the changing nature of the refugee situation in Greece there was a high drop-out rate and only 13 participants were available for the TRT program. Two days ahead of the training Dr. Masa and Dr. Aula Abarra, made field visits to the camps and recruited more participants and registered a total of 20 participants to attend the TRT training.
Participants are all refugees in one of the named camps and are either Syrian or Syrian-Kurdish and have experienced multiple displacement inside Syria, Turkey and now Greece. Prior to being situated in the camps, they had crossed the sea from Turkey and made their way to the Macedonia border. At the time of their arrival the border was closed and they remained there until relocation to a temporary camp until the current camps were ready to host refugees. Most of the participants have been refugees in Greece for approximately 8 months.
There was a total of 16 male and 4 female participants aged 19-45 years. It was extremely difficult to recruit female participants because most of the refugees in the camps had young children to look after so could not attend four full days of training. A total of 6 participants dropped out of the training by the second training day: two of which felt the training was too much to handle emotionally, two trainees had been relocated outside of the camp as part of the asylum process and the logistics of their participation in the program became impossible, and the remainder two had family obligations.
The remainder 14 participants were as follows: 3 participants from camp Illiadis (all males); 3 participants from camp Karamanlis (1 female, 2 males); and 8 participants from camp Frakapour (5 males, 3 females). None of the trainees had any prior training or work experience in the field of mental health, but had all completed their schooling and were from various professional backgrounds including teaching, banking, fashion design, construction etc.
Participants were picked up from their camps by SAMS medical volunteers and were brought to the training location. The training was held in SAMS living quarters, postgraduate housing, and the cafeteria area was turned into the training room. The training was held for four consecutive days from 9am until 5.30pm.
The first three days of the training were spent on the TRT manual. The final training day was spent on training the team on the implementation plan and the pre-post survey assessment tools. Despite not having any previous knowledge or experience in the field, the participants grasped the concepts extremely well. During practical exercises all participants demonstrated their ability to practise the techniques on one another and to demonstrate their skills in front of the trainers. All participants were provided with comprehensive feedback on program delivery with the children and parents.
Participants were very pleased to be selected for the TRT program, and they gave feedback that the training was beneficial to them personally. They felt that the training boosted their morale and empowered them to make a difference in their community. Some said that the training made them feel “human again”. Having a purpose to wake up early and to have an objective for the coming weeks made them feel that they were more than “just refugees”. They expressed excitement to begin implementation and insisted to begin implementation immediately after the training.
The Implementation Plan:
Due to the changing nature of the refugee situation in Greece the implementation of the TRT sessions with the children would be implemented every 5 days, instead of every 7 days. Therefore, the first cycle is estimated to last 4 weeks in duration. This will minimise the risk of trainee or children drop-out.
Trainees will work in teams of two to deliver the TRT program. There will be a total of 8 children groups engaging in the TRT program. Implementation will be as follows:
- Camp Karmenlis: Two groups of children, 15 children in each. Age groups: 8-10 years and 11-14 years. Total number of children = 30.
- Camp Iliadis: Two groups of children, 15 children in each. Age groups: 10-11 years and 12-14 years. Total number of children = 30.
- Camp Frakapour: Four groups of children, 15 children in each group. Age groups: two groups of 8-10 years, one group 12-14 years and one group 15-18 years. Total number of children = 80.
The first parent session is to take place on the 9th and 11th October 2016. The first children session is planned on the 12th and 13th October. After the completion of the five children sessions, a second parent session will be held. The pre-survey is to be collected before the children sessions begin. The post-survey will be collected approximately 10-14 days after the children sessions have been completed. In the event where someone has to be absent from one of the sessions, another trainee will fill the place so there will always be two people implementing the sessions at all times.
One person from each camp was assigned to be the point of contact for logistics follow-up with SAMS organisation. A group whatsapp to include all the trainees and both trainers was established – this to ensure continuous supervision and support to the team during implementation of the first cycle. Once the implementation is complete, a certificate of TRT training completion will be awarded to the trainees.
Children requiring further specialist mental health treatment will be referred to the mental health clinic provided by Refugee Trauma Initiative (RTI), a British organisation who has clinics in some of the camps. Mental health support will be offered to trainees as part of a ‘helping the helpers’ approach by RTI.
Reported by: Dr. Masa Al-kurdi