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Early rehabilitation in conflicts and disasters

LATHIA, Charmi
SKELTON, Peter
CLIFT, Zoe
Eds
January 2020

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When emergencies strike, there is a huge surge in the need for Early Rehabilitation. Early Rehabilitation for patients with traumatic injuries in conflicts and disasters is now recognised as being an integral part of a patient’s recovery. However, the majority of rehabilitation professionals in countries that experience such emergencies do not have all the skills needed to treat all of the injuries. HI, in collaboration with leading organisations (ICRC, MSF-France, CBM, Livability & the WHO), has created this educational resource package to fill this gap

Each chapter of this handbook has been written by experts in their field. It includes pictures and evidence based treatment protocols to help rehabilitation professionals around the world to delivery high quality early rehabilitation intervention. Chapters included are:

  • Key Challenges in Delivering Early Rehabilitation in Conflicts and Disasters
  • Early Rehabilitation Patient Assessment and Treatment - the Basics
  • Early Rehabilitation of Fractures 
  • Early Rehabilitation of Peripheral Nerve Injuries
  • Early Rehabilitation of Amputees
  • Early Rehabilitation of Acquired Brain Injuries
  • Early Rehabilitation of Spinal Cord Injuries
  • Early Rehabilitation of Burns

Videos accompany each of the chapters. The handbook contents are directly linked to modules taught on disasterready.org where there are additional accompanying resources designed to be used in conflict and disasters settings

Combating PTSD in the Military

Bradley University
October 2019

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PTSD in veterans is a serious issue, but many former service members and their loved ones do not know how to identify the condition or seek treatment. Because PTSD affects mental health and can be hidden, it can be difficult for health practitioners and other individuals to gauge its severity. Additionally, PTSD in veterans is often misunderstood by the public to be a condition that only affects combat veterans or those who have encountered violence firsthand. And even those who understand PTSD in veterans and its potential long-lasting harms still may not know all of its wide-ranging symptoms.

Included here are tips, tools and resources that can help friends and families of veterans who may be suffering from PTSD. 

Impact of parenting a child with cerebral palsy on the quality of life of parents: A systematic review of literature

RAMANANDI, Vivek
et al
2019

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This article reviews the literature on the effects of parenting children with cerebral palsy, and summarises the related factors. A systematic search of online databases was conducted and, based on the reference lists of selected articles, further studies were identified. Thirty-six articles that met the inclusion criteria were analysed.

 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Psychosocial disability in the Middle East

BOLTON. Laura
May 2018

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A K4 helpdesk report, commissioned by DFID (UK), provides a rapid review of literature to provide best estimates of psychosocial disability in specific countries in the Middle East.

Topics discussed include:

Prevalence and different forms of mental health conditions and psychosocial disability

Factors influencing prevalence

Differences across demographics

Provision for those with psychosocial disabilities

Road traffic injuries and rehabiliation. Factsheet.

HANDICAP INTERNATIONAL
March 2017

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The rate of road accidents is increasing globally and the resulting deaths, injuries, physical disabilities and psychological distress are creating a tremendous negative economic impact on victims, their families and society in general, especially in low and middle income countries. Common impairments and activity limitations from road traffic injuries are musculo-skeletal injuries, spinal cord injuries (SCI), traumatic brain injury and psychological distress and depression. Different examples of rehabilitation across the care cycle are provided. A case study of brain injury in Laos is provided. 

Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds

CREPET, Anna
RITA, Francesco
REID, Anthony
et al
January 2017

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While the medical conditions of newly migrated asylum seekers to Sicily were being addressed, the mental health of those who may have experienced trauma before, during, or after their migration was not addressed. "Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014–15." 

Not forgetting severe mental disorders in humanitarian emergencies: a descriptive study from the Philippines

WEINTRAUB, Ana Cecilia Andrade de Moraes
et al
November 2016

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"In response to the Typhoon Haiyan in the Philippines, Médecins Sans Frontières-Operational Centre Brussels (MSF-OCB) decided to concentrate its efforts in the severely affected area of Guiuan and its four surrounding municipalities. The MSF-OCB intervention included a comprehensive approach to mental health, including care for people with pre-existing and post-disaster severe mental disorders. Based on this experience of providing MH care in the first five months after Typhoon Haiyan, we report on the monthly volume of MH activities and beneficiaries; sociodemographic and care seeking characteristics of beneficiaries receiving MH counselling/care, stratified by the severity of their condition; profile and outcomes of patients with severe mental disorders; prescribing practice of psychotropic medication; and main factors facilitating the identification and management of individuals with severe mental disorders"

International Health, Vol.8, No.5, pp. 336-344

Doi: 10.1093/inthealth/ihw032

Problem Management Plus (PM+) Individual psychological help for adults impaired by distress in communities exposed to adversity

WORLD HEALTH ORGANIZATION
2016

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With this manual, the World Health Organization (WHO) is responding to requests from colleagues around the world who seek guidance on psychological interventions for people exposed to adversity.

The manual describes a scalable psychological intervention called Problem Management Plus (PM+) for adults impaired by distress in communities who are exposed to adversity. Aspects of Cognitive Behavioural Therapy (CBT) have been changed to make them feasible in communities that do not have many specialists. To ensure maximum use, the intervention is developed in such a way that it can help people with depression, anxiety and stress, whether or not exposure to adversity has caused these problems. It can be applied to improve aspects of mental health and psychosocial well-being no matter how severe people’s problems are.

Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq : a randomized household cluster survey

LAFTA, Riyadh
et al
August 2015

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“The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad.” The quantitative study shows the methodology used in the collection of data, the findings discovered through evaluation of the data gathered, and interpretation of how to best use those findings to serve specific populations”

 

 PLOS ONE, 10(8)

Participation and quality of life outcomes among individuals with earthquake-related physical disability: A systematic review

NUNNERLEY, Joanne
DUNN, Jennifer
McPHERSON, Kathryn
et al
May 2015

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A literature review to evaluate quality of life and participation outcomes of individuals with earthquake-related physical injury. A systematic review was performed searching MEDLINE, Embase, PsychINFO, CINAHL and AMED electronic databases from 1966 to January 2014. Studies that measured quality of life or participation outcomes among individuals who acquired a physical disability as a result of an earthquake injury were included, with no limits on research design. The search yielded 961 potentially relevant articles after removal of duplicates. Of these, only 8 articles met the inclusion criteria. Seven papers were reviewed from the following 5 earthquakes: 2001 Gujarat earthquake, India; 2008 Wenchuan earthquake, China (also known as the Sichuan earthquake); 2005 Kashmir earthquake, Pakistan (27); 2009 Padang earthquake, Indonesia; 2010 Port-au-Prince earthquake.

Journal of Rehabilitation Medicine, vol.47, no.5, 2015, 385-393

10.2340/16501977-1965

Disability associated with exposure to traumatic events : results from a cross-sectional community survey in South Sudan

AYAZI, Touraj
et al
May 2013

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"There is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting. We conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire (HTQ) was applied to investigate exposure to trauma events. Disability was measured using the Washington Group Short Measurement Set on Disability, which is an activity based scale derived from the WHO’s International Classification of Disability, Functioning and Health. The estimated prevalence of disability (with severe difficulty) was 3.6% and 13.4% for disability with moderate difficulties. No gender differences were found in disability prevalence. Almost all participants reported exposure to at least one war-related traumatic event. The result of a hierarchical regression analysis showed that, for both men and women, exposure to traumatic events, older age and living in a polygamous marriage increased the likelihood of having a disability. The finding of association between traumatic experience and disability underlines the precariousness of the human rights situation for individuals with disability in low-income countries. It also has possible implications for the construction of disability services and for the provision of health services to individuals exposed to traumatic events"
BMC Public Health, 13:469

Infertility : why can’t we classify this inability as disability?

KHETARPAL, Abha
SINGH, Satendra
2012

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"Disability is a complex phenomenon. It reflects an interaction between features of a person's body and features of the society in which he or she lives. International Classification of Functioning, Disability and Health (ICF), lays stress on the functional as well as the structural problem of a person. All the definitions of disability also include the disorders of the reproductive and endocrine system. So infertility and impotency should also be included in the category of disability. It affects the participation in areas of life and can have a disabling affect on an individual"
Australian Medical Journal, Vol 5, No 6

Disability and health related rehabilitation in international disaster relief

REINHARDT, Jan
LI, Jianan
GOSNEY, James
et al
August 2011

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Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention. The objective was to examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability. A qualitative literature review and secondary data analysis were carried out. 

 

Global Health Action

http://dx.doi.org/10.3402/gha.v4i0.7191 

Psychological first aid : guide for field workers

WORLD HEALTH ORGANIZATION (WHO)
WAR TRAUMA FOUNDATION (WTF)
WORLD VISION INTERNATIONAL
2011

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"This guide covers psychological first aid which involves humane, supportive and practical help to fellow human beings suffering serious crisis events. It is written for people in a position to help others who have experienced an extremely distressing event. It gives a framework for supporting people in ways that respect their dignity, culture and abilities. Despite its name, psychological first aid covers both social and psychological support"

Including disabled children in psychosocial programmes in areas affected by armed conflict

VON DER ASSEN, Nina
EUWEMA, Mathijs
CORNIELJE, Huib
2010

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"Children with disabilities are more vulnerable to violence, as well as more likely to experience psychosocial problems in situations of armed conflict than children with no disabilities. All children who live in conflict affected areas have the same rights to psychosocial support, as enshrined in the Convention on the Rights of the Child and in the case of disabled children, additionally the Convention on the Rights of Persons with Disabilities. However, children with disabilities are often overlooked in psychosocial programmes. In this article, the authors examine the reasons behind this observed exclusion and suggest ways to increase the participation of children with disabilities"
Intervention, Vol 8, No 1

Supporting persons living with trauma by rebuilding social and community links : an example of a community-based mental health approach after the Rwandan genocide of the Tutsis

PHAN, Xuan
November 2009

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This report provides an overview of the lessons learned from a Handicap International community-based mental health project for children and adolescents experiencing psychological suffering after the Rwandan genocide of the Tutsis. It highlights successes and limitations of the project, as well as recommendations for the project’s continuation. This report would be of interest to mental health practitioners, mental health service providers and community mental health organisations

Psychosocial counselling and social work with clients and their families in the Somali context : a facilitator’s guide

OFFICE OF THE HIGH COMMISSIONER FOR HUMAN RIGHTS (UNHCR)
November 2009

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This handbook is "designed to be used as training support handbook for helping professionals in the Somali context. The focus is on psychosocial needs for the rehabilitation of persons with trauma, mental health related forms of distress and those who have experienced gender based violence and gender related abuses. The guidelines, developed within a UNHCR funded programme in Somalia, are intended to assist staffs, who are concerned with providing protection and assistance to refugees and IDP"

Introduction to child protection in emergencies : an interagency modular training package|Child protection in emergencies training and resource CD : psychosocial module

CHILD PROTECTION WORKING GROUP (CPWG)
2009

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This document is the psychosocial module of the Introduction to Child Protection in Emergencies and Interagency Modular Training Package. This module is divided into the following sections:
Part 1 presents a background to psychosocial issues including the overall impact of emergencies on psychosocial well-being, psychosocial effects of emergencies on children, and legal framework and advocacy activities.
Part 2 intervention planning presents psychosocial programming principles and priority activities, and co-ordination and sector support.
Part 3 psychosocial programming presents addressing basic services and security developing community and family supports, focused supports, and referrals to specialised services
This comprehensive document will be of particular interest to NGOs, DPOs, international and national bodies and anyone else interested in child protection and psychosocial work with children and their families
Note: The core resources for this module are the Inter-Agency Standing Committee (IASC) Guidance on Mental Health and Psychosocial Support in Emergency Settings and the key interventions of the Sphere Handbook (2004) Standard for Mental and Social Aspects of Health

Disability among clients attending Taif Rehabilitation Centre, Saudi Arabia

AL-SHEHRI, Abdul-Salam A
ABDEL-FATTAH, Moataz M
July 2008

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This is a cross-sectional study examining 850 hospital records of people who were admitted to Rehab Armed Forces Rehabilitation Center, Taif, Saudi Arabia from 1999 to 2005. Data were collected on age, sex, nationality, date of admission and discharge, and type of disability. Recommendations are provided to expand home care programmes, to minimize duration of stay at the rehabilitation centres, and to increase health education of the public to assist in encouraging disabled people to adapt to daily life activities

Tree of life

NCUBE-MLILO, Ncazelo
DENBOROUGH, David
2008

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The Tree of Life is a psychosocial support tool based on Narrative Practices. It is a tool that uses different parts of a tree as metaphors to represent the different aspects of our lives. The use of metaphors and carefully formulated questions invites children and others to tell stories about their lives in ways that make them stronger and more hopeful about the future. While it was not designed as a 'bereavement tool', it opens up space and has been used extensively with children in different contexts to facilitate conversations about loss and bereavement. The tool allows children severely affected by HIV and AIDS, poverty and conflict to tell, hear, and explore stories of loss without remaining trapped in expressions of grief and bereavement. It simultaneously opens up spaces and opportunities to tell, hear and explore stories of hope, shared values, connection to those around them as well as to those who have died. This resource takes facilitators through the different stages of the Tree of Life process

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