BANGLADESH: PROJECT 1

Cox’s Bazar is the world’s largest refugee camp and home to 1.1 million Rohingya refugees. The Rohingyas were driven out of Myanmar in 2017 by a military offensive that triggered the greatest exodus in Asia since the Vietnam War. The UN calls it a textbook genocide.

More than 50% of the refugees are children. Four years on, there’s still no way back. This tragic history, together with crowded camp conditions and the pandemic, have placed refugees and the frontline workers that serve them at grave risk from mental health crises. Fear, depression and suicide are destroying the lives of the some of the world’s most vulnerable people and those who serve them.

‘Mrs P’, aged 24, is a NGO caseworker in Cox’s Bazar, offering mental health and psychosocial support to refugees.

Mrs P’s story
Mrs P was born and raised in the local community and now works in the Rohingya refugee camp, a job she loves. But the stress of work and the pressures of the pandemic have led to a struggle to cope at work and her suffering domestic abuse at home. This has taken a grave toll on her mental health. Soon after she began our training on Zoom, Mrs P self-referred to Dr Saleh via the telephone hotline. She was diagnosed with depression and post traumatic stress disorder (PTSD).

“I’m married with two children aged seven and two. My husband is 30 and he’s been unemployed since the Covid crisis began. My father suffers long-term mental health problems and I care for him after dealing with the stress of my full time job helping the refugees.

“In my job, I’ve been working with highly charged, emotionally vulnerable families & children with very little help. My employer has high expectations.

This increases pressure on me.

“At home, I’ve been suffering from domestic violence due to financial worries, my husband’s unemployment and little or no support from my husband or his extended family.”

Dr Saleh describes how the Beyond Conflict/GDC project helped our trainee Mrs P
“After our initial assessment, it became clear that she’s been suffering from periodic depressive episodes and Post Traumatic Stress Disorder. Subsequently one-to-one Intensive Therapeutic Communication ( ITC) was undertaken with her to manage the risk and Religio-Cultural Therapy (RCT) was provided to prevent family breakdown.These interventions took place on more than one occasion. Also, she was signposted for emergency support, should it become necessary at any stage. Up to now she has had access to our telephone hotline counselling support.”

Mrs P’s feedback
“I’m proud to be helping Rohingya refugees and this training helped me. I wish for more emotional, psychological and social support personally. I would like more training on psychosocial interventions for my own professional development. I believe better financial incentives would encourage fieldworkers like me to continue our challenging and low paid work.”

‘Mr M’ works in Cox’s Bazar refugee camp as a frontline worker

Mr M’s story
In recent months he became overwhelmed by suicidal thoughts brought on by the pressures of his work but primarily by issues relating to his sexuality. After one of our training sessions, he used the hotline to call Dr Saleh privately. He explained he was being forced into a marriage by his family, but unknown to them he is gay. He feared his future so much he did not see the point of living anymore and told Dr Saleh he had attempted to take his life. These thoughts continued to affect him.

After speaking to Dr Saleh, Mr P was referred to a psychiatrist but also continued to talk to Dr Saleh, with his psychiatrist’s knowledge. Under professional guidance, Mr M explained to his family he cannot marry and that he was in counselling. His parents accepted this and the wedding was cancelled. He no longer fears that his sexuality will cause him to become an outcast and lose his job in a conservative community, where homosexuality is taboo. He no longer wants to take his own life.

Mr M’s feedback
“My work, the pressure from my sexuality was so great. I thought what is the point of living in this world? I’ve been living with this for two years. I tried to kill myself twice. I took tablets. I wanted to die. On the training course I decided to speak to Dr Saleh. He told me to call him privately on the hotline. I told Dr Saleh, ‘This is not a hotline. It’s a lifeline. It saves lives. It saved my life. Now I will encourage others to use it.’”

Dr Saleh describes how he helped Mr M:
“Whenever a patient’s suicidal thoughts are pre-meditated, their situation is urgent. He was suffering from a combination of severe workday stress helping refugees, but at home he faced a crisis because of he was being forced into a marriage but he knew he was gay. He could not explain the truth to his family because he feared the religious taboo of the Rohingya community, he feared losing his family and his job if people found out. Today, thanks to the professional help he received through the pilot, Mr P is still working, he has explained to his family he is in counselling and the wedding is cancelled. His mental health is stable.

“I’m not approaching these cases from a religious perspective in this community, but from a humanitarian perspective. People should not kill themselves for what they feel, who they love. You have to show them a way out. I’ve seen many cases like his, some as young as 15. The poorest and most desperate need the help most as they have nowhere to turn. This kind of work can save lives.”