Interview of Gay Doh Htoo, VCT counselor in charge in Maela camp

What is your position in AMI ?
I’m the VCT counselor in charge of Maela camp. I’m working with AMI since June 2007.

Can you explain the meaning of VCT?
VCT stands for voluntary Counseling and Testing. When someone has questions related to HIV or worries, he comes to a VCT center and receives information regarding transmission and prevention. All this is done in strict confidentiality and based on voluntary action: we can only suggest, we never force the person to do the testing. We inform the people about what are advantages of testing and why one should do it and we give information about HIV and prevention.
This part is the pre-counseling. After that, if the person is agree, we collect his blood and do the testing to check his HIV status. When we give him the result, we also give him information, what is the post counseling: if he or she is negative, we give information about prevention to avoid contamination, and if he or she is positive, we explain how to avoid transmission to others and how to live with HIV.
One part of our activity concerns support of people having HIV. We try to reduce discrimination and stigmatization among the community against PHA (people having AIDS). We organize social gathering and individual support to increase positive leaving.

Did you notice any changes in the situation in Maela camp since you started working with AMI?
Yes I observed some changes among the community, mainly regarding the understanding of HIV. They have more knowledge about the disease and the way of transmission and there is less discrimination against PHA. PHA are more and more involve and active in the activities. There is in general a positive change. Awareness has increased.

Today was World Aids Day. this was the second year it was organized in the camps. How did you organize it?
Yes this was the second year. We invited people from many other organizations to have a meeting including other AMI staff. We discussed together the activities that could be organized during 2 meetings.
Then VCT team managed all the preparation, decoration, we created the décor of the stage, draw all the paintings for the exhibition and arranged the place for the different activities. Camp health committee organized flowers and different things to ameliorate the décor on the stage.
We worked hard to make it nice and attractive! Then we meet among VCT team to finalize activities that should be organized.

What kind of activities did you organize?
There was first a play competition. 4 teams created a play with songs related to HIV. Solidarité, Bibleway School, Nb1 high school and Nb2 middle school prepared a show and presented their creation at the opening of world aids day. They have been judged and won prices accordingly.
We also had various activities to attract people, raise their interest and increase their knowledge regarding HIV, such as games (puzzle, ability, word games…), exhibitions (drawings and paintings related to respect, reducing discrimination, prevention…), testimony (people having AIDS talking about their story and life), quiz with questions related to HIV/AIDS.
There was also a stand to inform and recruit blood donors. People were informed about importance of giving blood and the one willing to go further were giving their name and address in order to be contacted when needed.

Who are the people attended these activities?
Regarding the number of persons who attended this day, I know that we distributed all 1500 ribbons, and many people didn’t get. We also had at least 150 persons who gave their name to be a potential blood donor, so we can say it was successful. Mostly children attended this day, but there were quite a lot of adults as well. We had few PHA who came to talk about HIV which was very interesting as well.

What is the feedback that you get from the people who attended this day?
Feed back was really good. Above the fact that people enjoyed and had a good time, they were listening; they were catching the information that was displayed through the plays, through the games and through the songs. I’m really happy with this day and with the interest and the involvement shown by the people.

What are the results that you expect from this day?
I think this kind of event can really increase awareness, improve knowledge related to HIV and decrease stigmatization and discrimination.
I also think that more people might come to visit VCT centers to get more information, and hopefully to accept testing.

What are the plans for the future regarding VCT activities?
Last year we focused a lot on youths, teenagers. Next year we’ll keep having peer to peer activities in order to maintain youth’s awareness and knowledge, but we’ll focus on male too. We plan to inform them about safe attitude that they should have. We also plan to organize another world aids day in 2009! consult this article only
Staff member interview

Goi Kornkawan, Counseling psychologist supervisor in Thaïland

Can you tell us about you, your background and your position in AMI?
I am a 34 years old Thai psychologist. I’m working since 1 year and a half with AMI as a psychologist supervisor.
I am mainly responsible of psycho care givers trainings, in order to improve their abilities and skills regarding psychosocial activities. I’m also managing some patients, mostly the ones having severe symptoms.

Can you explain who the psycho care givers are? The PCG are living in the refugee camp. There are from the same community than the people they work with. They escaped from Myanmar but are from different ethnic group (Karen, Kachin, Chan, Burmese…)

What kind of training do you offer them?
I have a background of philosophy, humanitarian and counseling psychology. This background is helping me to provide complete training to the psycho care givers. They are trained to improve their positive psychological attitude and their aptitude in counseling so they can help efficiency the people who need psychosocial support.

Last week was the mental health week that you organized in the 3 camps in which AMI is working. It was the first time such an event was organized. Can you tell us how the idea of organizing the mental health week came?
The idea of the mental health week came through discussions between AMI staff (Coralie, the previous psychologist officer, psycho care givers and me). We wanted to present mental health activities to the community and to increase awareness about mental health issues. We also wanted to improve positive life skills to the community through sharing and communicating with them.

How did you manage to organize this special week?
We decided half a year ago to organize this week. All mental health staff was involved to make it as effective and attractive as possible. We first had group discussions with the PCG to decide what we should expect and how to make it. We designed bags, t-shirts, badges, pens and stickers with our logo.
We then managed all the logistic issues, like location of the event in the camps, creation and purchase of material, making of big banners, presentation boards and information leaflets… the logistic aspect was quite important due to the fact that this event was happening in 3 different camps at the same time, which are located 1, 2 and 4 hours from Maesot (base).
The concrete preparation started one month before the mental health week, involving all mental health staff as well as logistic and administrative teams.

Can you describe some of the activities that happened during that week?
We had different activities to respond the different expectations from the participants: yoga sessions every day, listening and drawing group, children time, chatting rooms (individual counseling). We used psychological questionnaire to evaluate participant’s well-being (happiness scale which shows the ability to understand the positive and negative aspects of life and to handle them peacefully, gratitude scale which evaluates the ability to love and respect one-self and others, satisfaction scale, which shows the ability to enjoy present moment in their life).

Who were the participants who attended these activities? Most of people who came to attend the activities are the refugees living in these 3 camps. Many of AMI staff attended some of the activities (medics, nurses, VCT counselors, home visitors…). Other organizations involve in the camps were also invited and many of them came. Some members of local organizations also participated, .as well as camp authorities (camp committee, camp leader…) and some representatives of the Thai authorities (camp officer).

What were participants’ feedbacks?
They were attracted by our activities, mainly the questionnaire and yoga. Children were very receptive and enjoyed drawing and yoga activities.
We also had good participation for all listening group sessions. In general, we had very good feedbacks from the participant and information related to our activities was spread by attendants. One other positive point is that we reinforced the understanding of our activities, the trustfulness in our program and the links with other organizations working in the camps.

Would you like to organize again such an event in the future?
Yes of course! The responses from attendants and participants were very positive, and it has a great impact on our activities. We also realized that most of people would like to get more support to handle some of the difficulties they face in their daily life. I would also like to add that suffering is not only belonging to the patients coming to our hospital: everybody body can face difficulties in their life.
And everybody can improve his awareness and his psychological aptitude to enhance his personal, familial and social life. Psycho care givers can support and provide care to any body that requires, not only hospital patients.

By Cecilie Alessandri, Health Project Officer

More information about AMI Mental health activities consult this article only

AMI Mental Health Activities in Thaïland

AMI started in 2004 to implement psychosocial activities for refugees in Thailand on the Thai/Myanmar border. After an evaluation done to assess the mental health of the population in the different camps in which AMI was involved, it came out that more than 40% of this population was suffering from psychosocial disorders as anxiety or depression.

There are many reasons that can explain this suffer: the situation in their home country that forced them to leave can be source of traumatism; the isolation and impossibility to move out of the camp, sometime since many years, can increase depression; the resettlement process (going to a third country) can also be very difficult to handle, for the ones who applied, for who it might raise stress, grief to quit loved ones, family separation problems, as for the ones who stay in the camp and get separated from relatives or friends.

Step by step the mental health program was set up in order to offer a psychosocial support to these persons.

Teams of psycho care givers have been recruited in the 3 camps and trained to handle psychosocial activities and to support the medical team to manage the patients suffering with mental disorders.

Listening and drawing group with children

The program that has been implemented aims at responding the needs with the most appropriate activities. It is based on an Eastern approach, aiming to reduce the suffering of the patient in a whole instead of treating specific mental diseases. The treatment includes group discussion and experience sharing, relaxation, yoga and seems to be more efficient. The major targeted people are those suffering from moderate disorders, resulting from adjustment difficulties (anxiety, stress, depression, insomnia…).

A total of 1259 consultations were delivered and 27 group sessions were performed during the last 5 months period.

The program is well settled and acknowledged now in the camps. It is still improving, and psycho care givers keep increasing their skills and knowledge in order to always better adjust the care provided to the person, whether it is a mental health patient or a staff member who needs support to avoid burn out.

Cécilie Alessandri,
Health Project Officer

More information about the World mental health week consult this article only