New Ways of Working: Delivering Health Services to Forcibly Displaced People in Africa
September 16, 2019 | Dwight Hall, Yale Campus
The New England chapter of the Yale Alumni Nonprofit Alliance put a spotlight on global health and the issues faced among forcibly displaced people in Africa by hosting a collaborative discussion on new ways to address the health needs of refugees and internally displaced people in Sub-Saharan Africa.
LaRon Nelson, Associate Dean for Global Health and Equity at the Yale School of Nursing, moderated the panel, which included:
- Meghan Gallagher – Save the Children Monitoring and Evaluation Advisor for Maternal, Newborn and Reproductive Health in Emergencies. Save the Children has worked in Africa for more than 30 years, responding to emergencies and providing lifesaving health care and nutrition to children in the poorest and most vulnerable communities throughout the continent.
- Myriam Ghorbel – International Affairs and Public Health leader and Advisor to INGOs, governments, community-based organizations, and global agencies, Myriam has 15 years’ success directing and advising public health program development and management, and extensive field-based experience in MENA and Sub-Saharan Africa.
- Mick Hirsch, M.Div. ’03 – Executive Director of THRIVEGulu. THRIVE is a trauma recovery organization that provides mental health counseling and economic empowerment programs to Ugandans who survived the Lord’s Resistance Army’s 20+ year insurgency and to South Sudanese refugees forcibly displaced into Northern Uganda.
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The presentations and discussion were content-rich; a full video recording and access to the presentations can be found below.
The following briefly summarizes some of the key messages:
Dr. Nelson set the global context, noting that the world is in constant flux and movement is a core characteristic of our modern world, including mass migration and forced displacement. New humanitarian aid solutions need to be developed to address the challenges that arise along the way as people move, so that critical support services are not delivered only at the beginning and end of the journey.
Myriam Ghorbel noted that 20 of the most violent crises in the world are at the origin of more than 80% of displacement and humanitarian needs. The Red Cross has predicted that Syria, Iraq, Yemen, the Horn of Africa, the Lake Chad Basin and the Sahel, will continue to be hotspots in 2019. In countries gripped by protracted conflict, and with healthcare systems further weakened by armed conflict, resources are often unavailable to deal with treatable diseases. Some locations have decimated health facilities. In others, armed groups block attempts to reach patients, e.g. Ebola case. While outbreaks of disease are a medical concern, it is the larger structural and political issues that allow diseases to thrive and recur. The combination of weak systems, flaws in prevention efforts, ineffective response capabilities, and ongoing conflict is making healthcare a great source of concern for humanitarian workers.
The United Nation’s 2030 Agenda and its 17 Sustainable Development Goals (SDGs) sets a framework for global sustainable development and public policy. For fragile and conflict-affected states, this agenda is particularly relevant.
Save the Children works all over the world with the mission to protect children from harm and provide children and families with better opportunities. Meghan Gallagher described how Save continues to experiment and adjust its best practices based on critical learning in the field. For example, in Syria, women were uncomfortable receiving Save’s services because men were not included. Save re-targeted its programs and saw that by including men, Save helped refugees creates a stronger, more equitable society in their new location. Other new approaches are being tried, including cash vouchers to provide individuals with immediate support to address their most pressing needs. The use and importance of cash vouchers is being evaluated.
Mick Hirsch discussed the long term impact of forced displacement on those who survive. Mental health trauma lingers, taking the form of depression, anxiety, suicidal thoughts, and loneliness. It interferes with one’s ability to get an education or hold a job. It disrupts relationships and tears apart families. It leads to alcoholism and gender-based violence. And it gives birth to 2nd- and 3rd-generation trauma. THRIVEGulu addresses the complexity of trauma through a holistic approach they call the “5 to THRIVE” model, which includes five different aspects of “health” necessary to move from being a survivor to a thriver: mental, financial, social, spiritual and family.
- THRIVEGulu Opening Video, “After the War — Life is Not Easy”
- Save the Children video, “Stop the War on Children”
- Meghan Gallagher’s Slide Deck (Save the Children)
- Myriam Ghorbel’s Slide Deck
- Mick Hirsch’s Prezi Presentation (Thrive Gulu)
YANA New England wishes to thank Dr. LaRon Nelson, Meghan Gallagher and Save the Children, Myriam Ghorbel, Mick Hirsch and THRIVEGulu – and the Dwight Hall Center for Public Service and Social Justice for their contributions to this important conversation. In addition, we wish to acknowledge the many students who attended from several different departments at Yale, including Yale College and the graduate schools of Public Health, Medicine, Nursing, Management, and International Development and Economics who attended the event. It was truly awe-inspiring to see their collective talent, commitment to humanitarian aid, and interest in forging new directions for improved health service delivery to some of the most traumatized areas of the world.