Ebook: Activating Psychosocial Local Resources in Territories Affected by War and Terrorism

The book contains the materials from the NATO Science for Peace Security Programme Advanced Research Workshop “Activating Local Resources for the Protection of Psychosocial Development of Individuals and Communities in Territories Affected by War and Terrorism” held in Pristina, Kosovo, April 18-20, 2008.

This workshop was preceded by two Advanced Research Workshops held in the frame of the NATO Science for Peace and Security Programme:

• “Promoting the Psychosocial Well Being of Children Following War and Terrorism” (Ljubljana, Slovenia, June 2003)

See Matthew J. Friedman and Anica Mikuš Kos: “Promoting the Psychosocial Well Being of Children Following War and Terrorism”, NATO 2004.

• “Evaluation of Community Based Psychosocial Programmes in Areas Affected by Armed Conflicts and Terrorism” (Lipica, Slovenia, April 2007).

About the workshop

The 44 participants of the workshop were scholars and researchers, practitioners and field workers from regions affected by armed conflicts, representatives of international NGOs, representatives of social systems and decision makers relevant for the mental health and psychosocial well-being, particularly of the well-being of youths and children (education, health care, youth and child protection etc.), and representatives of donor organisations.

The following 17 countries were represented: Albania, Austria, Bosnia, Croatia, Germany, Hungary, Kosovo, Macedonia, Moldova, Montenegro, the Netherlands, the Russian Federation (North Ossetia – Allania), Serbia, Slovenia, Sweden, Switzerland and the United Kingdom.

The co-directors of the workshop were: Anica Mikuš-Kos, Slovene Philanthropy (Slovenia); Dean Ajdukovic, Society for Psychological Assistance Zagreb (Croatia), Emir Kuljuh, Omega Health Care Center, Graz (Austria).

There were manifold reasons why Kosovo was chosen as the place of the workshop. The region suffered from armed conflicts and is still affected by post-conflict social adversities. A considerable number of psychosocial programmes has been run in Kosovo in which the three co-directors of the present workshop have been involved as mental health experts. The local partner NGO in Kosovo Centre for Promotion of Education – QPEA, who hosted the workshop, is the main organiser of community based and school based psychosocial programmes in Kosovo. The basic philosophy of QPEA is activation of local resources for psychosocial activities and implementing them in existing structures and networks. The work of QPEA which has been financed by numerous foreign and international donors, can serve as an example of building psychosocial recovery on community based processes and on local resources. So the workshop took place in a social context familiar with the practice of mobilisation of local resources.

The objectives of the workshop were:

• To discuss conceptual frames of activation and development of local resources and social capital;

• To demonstrate models of good practice of use of foreign resources for activation of domestic resources;

• To confront the views and strategies used by foreign donors and implementing agencies with views and evaluations by local partner organisations or institutions, and recipients of assistance;

• To analyse the role of local NGOs in the process of recovery, social reconstruction and development of regions affected by armed conflicts;

• To analyse obstacles and most frequently encountered problems in activation of local human resources and capacity building;

• To prepare recommendations and a publication which will contribute to a wide dissemination of practice of activation of local resources and realisation of capacity-building principles.

Some conclusions of the workshop

The participants of the workshop considered that the necessity of activation and building local resources needed for recovery and development should be highlighted at the level of individuals, social systems and structures, social networks, civil society and at the level of the community in general. This combined approach is a solid basis for the efficiency and effectiveness of programmes and assures sustainability of outcomes.

Mental health and psychosocial functioning of the population in post-conflict times are of crucial importance for the individual and community recovery and development of social capital and for the social and political stability. That is an important reason why mental health and psychosocial programmes financed by foreign donors are run in areas affected by war. The bulk of psychosocial activities are aimed to help people to overcome experienced traumas and losses and to cope with post-conflict difficult circumstances. The workshop was paying a special attention to programmes for activation, empowerment and strengthening coping capacities of children and youths. The priority accorded to programmes directed towards children and youths has several justifications. Children and youths are particularly receptive to positive psychosocial influences; all children and be reached by psychosocial interventions in the frame of the school system, etc.

The group of participants and the authors of papers included in the book expect that the workshop will contribute to reducing the gap between declared principles of local capacity building and mobilisation of local resources, and the reality of psychosocial interventions, and consequently to a more efficient use of international funds.

For moving forward in this process, structural changes as changes in requirements and forms for submitted proposals, required outputs and evaluation, are needed. Besides, further efforts are needed to achieve that actors at different levels (policy makers, donors, decision makers, the scientific level, the level of project design, the level of field work, etc.) would recognize the immense advantage of local capacity building for the realisation of this concept of aid. The importance of including the concept and practical realisation of mobilisation of local human resources as a priority topic in training for all players in the field of humanitarian and developmental aid was underlined.

Of special interest in the workshop were the presentations of good practices on territories of the Western Balkans and North Caucasus. Concrete projects were presented in order to show in an operational way how principles can be put into life. These texts cover a comparatively large space in the volume, but the editors consider that a comprehensive display of projects could best serve as concrete models of good practice. Realised activities show that very efficient psychosocial programmes based mainly on local resources can be successfully run.

It was agreed that treating the topic of the workshop is of utmost importance for donors, implementing organisations, NGOs and other parties involved in humanitarian aid and in developmental assistance to countries affected by armed conflicts and terrorist acts and by post-conflict social adversities. Although the idea of developing local human resources and capacity-building on those territories is formally widely accepted, the working reality and the field situation show repeatedly that this principle is not respected sufficiently in the present decision-making processes and implementation processes. The investments of the international community in psychosocial programmes are quite often used for the implementation of “imported” programmes under the leadership of foreign experts without paying sufficient attention to mobilisation of local resources and capacity building. The participants of the workshop and the authors of the book do hope that the workshop and the publication of proceedings will contribute to this process.

The importance of high lightening the perspective of activation of local human resources transgresses the circumstances of various man-made, technical or natural disasters. It is of particular importance in present times when the social economy in general has to be revised in order to overcome the crisis of planetary dimensions and to prevent future crisis.

Workshop Papers

The editors would like to thank all key note speakers who contributed their papers for this volume. The range of topics covers theoretical, methodological and practical issues concerning the activation of local resources for the protection of psychosocial development of individuals and communities in territories affected by war and terrorism.

The opinions expressed by the authors do not necessarily reflect the opinion or position of the editors and the publisher.

Elizabeth Capewell explores action research as a means of mobilising community recovery in traumatised communities. In her analysis of action research in a case study after the Omagh Bomb, Northern Ireland, UK in 1998, Capewell investigates action research strategies and methods used in the immediate aftermath of a traumatic event. Capewell argues that the principles and skills of action research – a method that involves and empowers those it studies – are especially appropriate in dealing with traumatised communities. Action research offers a flexible yet disciplined approach in volatile situations to mobilising traumatised communities towards recovery. Based on her account of action research Capewell elaborates multi-dimensional “disaster management” models of responding to major incidents affecting communities.

Drawing on her work experience with children in different post-war communities Zdenka Pantić illustrates the needs of children in war-affected areas in Croatia and the region, as well as possible ways of recovery and empowerment of children and their immediate surroundings: parents, school and the local community. Pantić argues that to assist children in continuously difficult circumstances in the post-war society in Croatia means to empower their social surroundings. The empowerment of social environment under the complex circumstances of divided post-war communities requires, according to Pantic, to develop a contextual approach to trauma and reconciliation in parallel with other actions in the community.

The paper of Emir Kuljuh tackles the negative impacts of war turbulences on individuals, families and groups. Given the lack of stabilizing factors in families, the author examines positive and protective factors supporting child development in post-war situations. He concludes that after periods of turmoil school as supportive system starts functioning even before family systems do and therefore school can serve as a protective factor for children. The author also discusses the role of school as a resource and protective factor for children's mental health and psychosocial development.

Åke Björn and Ruhije Hodza-Beganovic present in their contribution a medical programme in post-war Kosovo aiming at capacity building parallel to meeting emergency needs. The authors point out that while internationally mental health care for traumatised populations after a disaster or an armed conflict has been increasingly significant during the last decades, Kosovo lost its traditional medical referral systems following the regional conflicts after 1990 and the crisis in 1999, with the effect that families with members suffering from life threatening conditions, where treatment was not available in the country, downplayed mental health aspects. The article discusses the establishment of international networks, ethical dilemmas and aspects of priority-setting within a limited budget.

Jean-Claude Métraux investigates the relationship between collective grief in post-war social environments, the formation of actors' views on change, activity and otherness, and the role of experiences of recognition in processing collective grief. Métraux argues that indicators of recognition are most likely to identify the presence or absence of conditions required for the overcoming of collective grieving and suggests that evaluations employing such indicators be carried out at the levels of the donors, of the local NGOs and of the professionals and volunteers directly involved in the field work in social environments of collective grieving.

The study of Harald C. Traue, Lucia Jerg-Bretzke and Jutta Lindert provides data of post-traumatic stress disorder, depression, anxiety and specific symptoms of mental and somatic disorders and traces relationships between biographical data and experiences of violence to disease symptoms. A key finding of this investigation, which also includes clinical interviews and analysis of data from a cross-sectional survey among Kosovo-Albanians who came to Germany in 1999, is that persons who had spent less time during forced displacement have lower prevalence of main outcome measures. An emphasis is laid upon the correlation between age and anxiety. War and organised violence are disclosed as detrimental to public health.

Oxana Alistratova delivers a tangible example of social work aimed at the reintegration of victims of human trafficking in the Transnistria region in the Republic of Moldova. The author depicts experiences of grass-roots work of the NGO “Interaction” in activating local resources promoting the psychosocial development of affected individuals and in supporting policies at community level. A typology of target-persons' profiles is presented, designed to tailor services and enable a solution oriented assistance to victims of human trafficking.

The activation of local human resources in the psychosocial field is tackled also in the article of Ramush Lekaj, Muharem Asllani and associates presenting the activities of the Centre for Promotion of Education (QPEA) in Ferizaj, Kosovo. Objectives such as protecting the psychosocial well-being of children, promoting their education or hedging the psychosocial and psycho-pedagogic quality of the educational system of Kosovo are outlined alongside operative tasks such as the coverage of rural and less developed areas with programmes, the coordination of activities of involved actors as well as the conjunction between individual recovery and the community development.

A further contribution of Lekaj, Asllani and associates makes a deeper cut in provisions to mobilise institutional and human resources in the school system. The study of psychosocial programs in Kosovar primary school system envisages a variety of outreach, training and counselling activities to conclude that such provisions can activate substantial human energies and in targeting school children aged 6–15 lay a cornerstone for the future of the community.

The future is also a core theme in the third contribution of Lekaj, Asllani and associates in this volume. The authors comment the Kosovar situation and especially work experiences of the Centre for Promotion of Education (QPEA) with programmes of mobilising local professional and institutional resources and resources of civil society (volunteers). Voluntary work for covering psychosocial needs of children and youths is regarded as an important investment in community's future as it not only supports recovery processes of adolescent generations but also fosters participative behaviour of citizens and civil engagement in post-conflict societies.

Anica Mikuš Kos' analysis discusses the relations between human resources, social capital, capacity building, sustainability, mental health and psychosocial well-being. Drawing on rich experience of field work in areas affected by armed conflicts and terrorist acts Mikuš Kos highlights some negative effects of the impact of psychosocial training and programmes on local human resources. The author points out the gap between the political rhetoric and the actual practice of mobilisation of local human resources in the frame of psychosocial assistance and brings this problematic to the attention of donors, programme designers, field workers and local agents by way of examples from the practice.

Special thanks

The editors would like to express their special thanks to Elizabeth Capewell (Centre for Crisis Management & Education, Newbury, England), who summed up the workshop results, Petra Založnik (Slovene Philanthropy, Slovenia) for her work in editing texts of this volume and Nicola Baloch (Omega Health Care Center, Graz, Austria) for proof-reading the papers of this volume.

Eva Baloch-Kaloianov and Anica Mikuš Kos

This paper outlines the key principles of authentic action research showing how its fundamental philosophy and purpose make it a distinct activity from traditional scientific research. It is particularly suited to inquiry into social situations with self-determining people who can be engaged as co-researchers to produce useful answers to issues relevant to themselves. Action research offers a flexible yet disciplined approach in volatile situations to mobilising traumatised communities towards recovery. It can begin with low-cost self-research to transform reactivity into useful action thereafter engaging others, and ultimately large systems, as co-enquirers.

The article provides an overview of certain aspects of mental health in the war-affected population in Croatia and the region. The altered society, destroyed communities, overwhelmed and traumatized parents cannot provide an adequate protective shield for the normal development of children. The article illustrates the needs of children in war-affected areas, as well as possible ways of empowerment of children and their immediate surroundings: parents, school and the local community. Emphasis is put on close collaboration between the civil scene and mobilization of local resources. Establishment of mutual trust and connection, between the civil scene and governmental institutions is of crucial importance, both on a local and national level. In order to assure normal development and respect for children's human rights, it is necessary to combine top-down and bottom-up approaches in the areas of special state concern in Croatia. The discrepancy between proclaimed values of the society and the neglect of children is also emphasized. Conclusion: On those with the greatest power, both socially and politically, lies the greatest responsibility after an armed conflict, both on a national and international level. An honest attempt to rebuild life is called for. This takes fare more than merely rebuilding infrastructure.

This paper tackles the negative impacts of war turbulences on individuals, families and groups. Given the lack of stabilizing factors in families, the author examines positive and protective factors supporting child development in post-war situations. He concludes that after periods of turmoil school as supportive system starts functioning even before family systems and therefore school can serve as a protective factor for children. The author also discusses the role of school as a resource and protective factor for children's mental health and psychosocial development.

Mental health care has increased its importance internationally as a priority sector in traumatised populations after a disaster or an armed conflict during the last decades. Kosovo lost its traditional medical referral systems following the regional conflicts after 1990 and the crisis in 1999, leaving the population with a lack of basic health care services. This led to putting mental health aspects in a lower priority for families with members suffering from life threatening conditions where treatment was not available in the country. This paper describes an eight years long medical programme with the aim of supporting capacity building parallel to meeting emergency needs. One important and hopefully sustainable result of the project was the establishment of professional friendships and professional international networks leading to possibilities for continuous contacts. Ethical dilemmas and priority aspects within a limited budget are discussed in the article.

It can be assumed that armed conflicts within communities cause many and various forms of collective grief. The quality of collective grief processes defines the actors' view on change, activity and otherness. Their theory helps to precise the conditions for a growing conscience of being author and actor, both individual and collective, of one's own becoming; the conditions, too, for a full respect of otherness. As recognition plays a crucial role in the elaboration of collective grief, its indicators are the most likely to identify the presence or absence of the conditions required for the process of collective grieves. Such indicators will be defined. This kind of evaluation should be led simultaneously at the level of the donors, of the local NGOs and of the professionals and volunteers directly involved in the field work.

The study provides data of post-traumatic stress disorder, depression, anxiety and specific symptoms of mental and somatic disorders and determines the relationships between biographical data and experiences of violence to disease symptoms. The analysis of clinical interviews is presented, including a report on escape conditions, quantitative biographical data, and mental health data from a sample of 99 Kosovo-Albanians living in refugee camps in Germany which were documented and statistically analyzed. Serious forms of violence were reported. Independent of gender 40.2 per cent of the refugees suffered from symptoms of post-traumatic stress disorder, 80.3 per cent from symptoms of depression and of anxiety. Persons who had spent less time during forced displacement have lower prevalence of main outcome measures. Anxiety correlates with age, with a peak at the age group of 30-50 year old. War and organised violence are revealed as a serious threat to and a challenge for public health.

The social reintegration services for victims of trafficking in human beings of the NGO “Interaction” is an example of activating local resources for the protection of psychosocial development of individuals and communities in the Transnistria region of the Republic of Moldova. The presented work experience serves as a best practice model in organizing rehabilitation/reintegration support for victims of trafficking in human beings. Taking into account their different types of personalities, “Interaction” has developed different kind of approaches and interventions to best support and empower the beneficiaries of their services. In view of the large number of affected victims the organization saw the need and reacted in developing a complex system of approach to empower the beneficiaries to be able to reintegrate and cope with their everyday problems in a solution oriented way.

The paper presents the situation in Kosovo and the philosophy and activities of the Centre for Promotion of Education (QPEA) in Ferizaj, Kosovo, as an example of good practice for the activation of local human resources in the psychosocial field. The main objectives of QPEA are: The protection of psychosocial well-being and the promotion of education of children; the contribution to the psychosocial and psycho-pedagogic quality of the educational system of Kosovo; the mobilization of human resources for the psychosocial protection and well-being of children. The coverage of rural and less developed areas with programmes, the comprehensive and developed synergies between involved actors and agencies, the linkage between the individual and the community recovery and development are the main characteristics of the activities of QPEA.

This chapter contains presentations of concrete psychosocial programmes which are school based or tightly connected with the school system: psychosocial seminars for teachers; outreach activities of professionals in schools; counselling centres for children, parents and teachers; and training of schools psychologists. The leading idea of those programmes is that substantial human energies can be activated in the frame of the most universal social system – primary schools including all children aged 6-15. The Kosovo experience shows that investments in the school system are productive and economic.

The authors, all members of the professional staff of the Centre for Promotion of Education (QPEA), describe programmes as examples of good practise of mobilising local professional and institutional resources and resources of civil society (volunteers). Developing voluntary work in children and youths is an important investment in a future participative behaviour of citizens. The programme on mine-risk education is an interesting experience in which psychosocial know-how is linked in synergy with methods for mine-risk education. Activating resources of the health care system for psychosocial activities has a sustainable impact on involved professionals broadening their experience and enriching their medical views with the mental health perspective.

The author analyses the impact of psychosocial training and programmes on local human resources focusing on some negative effects. Statements are illustrated with examples from the author's experience of long lasting practice of field work in areas affected by armed conflicts and terrorist acts. The relations between human resources, social capital, capacity building, sustainability, and mental health and psychosocial well-being are discussed. The gap between the declarative need for the mobilisation of local human resources in the frame of psychosocial assistance and the actual practice should be a matter of concern of donors, programme designers, field workers and local agents.