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Working in Somalia: "I cannot move mountains"

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Thomas Zanghellini is a mental health coordinator currently employed in Somalia. His task is to reactivate and coordinate an MHPSS Technical Working Group. This working group supports all mental health activities in Somalia. Work areas include health, nutrition, education, and protection. Thomas shares his experiences and thoughts with us.

Tell us about Somalia

"Somalia. A place correlated with piracy, terrorism, famine, war and chaos. If you Google or research Somalia, those topics come up straight away. Yet, Somalia has progressed impressively. The Somali population has shown an astonishing degree of resilience. But, decades of conflict have impacted important state institutes and sectors. The health sector is one of them. Mental health, in particular.

Somalia has the highest prevalence of mental health disorders. A variety of factors contribute to this. Poverty, substance abuse, decades of war, droughts, famine, and gender-specific factors, such as female genital mutilation (FGM) and early marriages.

There are few mental health professionals, and health facilities are often not prepared to deal with mental disorders. The complexity increases in humanitarian interventions where the number of people in acute need increases. That is now the case in Somalia due to the drought and the prospect of famine. Mental health response is vital in the humanitarian response."

DSS has sent you to support WHO. What is your mission?

"We often set up a cluster system and sub-clusters during humanitarian emergencies, such as technical working groups (TWG). I am part of one. I am the Mental Health and Psychosocial Support Technical Working Group Coordinator for DSS in Somalia. My task is to support all MHPSS activities here. The TWG has a set of essential core tasks:

  • (Re)activating and maintaining a technical working group;
  • Information management;
  • Establishing links between stakeholders;
  • Building capacity, knowledge exchange and peer support;
  • Monitoring and evaluation;
  • Promoting long-term sustainability; and
  • MHPSS advocacy and awareness raising.

In Somalia, the technical working group has not been active for more than a year. DSS, on request of the World Health Organization (WHO), asked me to reactivate the group. The need arose from the drought emergency response and the general upscaling of the humanitarian response. I have been in Somalia for 2 weeks now. The need for MHPSS coordination is high. Moving fast is extremely important."

What have you accomplished so far?

"In my first 2 weeks, my main focus was establishing the foundation mechanism and modalities for a functional working group. We set up meetings and agreements with the Department of Mental Health to ensure close cooperation. I immediately reached out to all cluster leaders, partners, and actors, building on existing contacts to establish a contact list for MHPSS actors.

I have reached out to 91 partners so far. I conducted an online survey among these partners, with 39 responses, to assess expectations, needs, gaps, and preferences for modalities. The results were interesting, and the need for MHPSS coordination was very high.

Current MHPSS actions and interventions are clearly below what is needed. So, I started attending all relevant clusters and emergency meetings. I aimed to contribute to mainstreaming MHPSS into all relevant service packages, concept notes and response plans. The correlation between drought, climate change and mental health is still an understudied subject. So, I compiled a list of relevant available studies, articles and letters (25 in summary) to support desk reviews, capacity building and training plans related to mental health responses within the drought response.

In these 2 weeks, I also took charge of the humanitarian response site to create an MHPSS TWG information site. This site will be updated regularly. The next step is to plan for the global Mental Health Day and hold our first MHPSS TWG meeting, which hopefully has many attendants."

That is a lot in 2 weeks. Why this job? Why are you a humanitarian?

"So, why am I doing this? Why go to a country where I am under strict security measures, in a hotel or a secured area? I am not so sure I can answer this. I have worked in mental health for 20 years and 11 in the humanitarian sector. Humanitarian work is complex. It is full of experiences that stay with you for the rest of your life. I was in South Sudan during the civil war, Liberia during Ebola, Iraq during the peak of ISIS, North Nigeria during the Boko Haram insurgency, and now I am in Somalia during drought and famine. I grew up in a tiny village, yet I have met ministers and government officials in countries such as Libya, Somalia, South Sudan, Nigeria and Iraq.

I do not want to miss one single day. I have met colleagues from all continents and worked with some of the sharpest minds from different nationalities. I have worked to solve problems in the most challenging settings to improve people's lives. I have worked in cross-cultural teams and built new friendships, and these contacts will remain for years.

It is not always easy. In this work, you see suffering. You have to deal with the inequalities and privileges that some nationalities have compared to others. Sometimes, that is hard to deal with. But sitting home and relaxing is not an option for me.

Thanks to DSS, I am now in Somalia, supporting hundreds of colleagues to help people in need. I am not naïve. I cannot move mountains. But, one small change in a system can change the whole system. I just want to contribute. I salute all people who deal with hardships daily. My goal is to make it easier for them."

In short: It is a privilege to do this work. That is a good point to finish. Thank you very much for the interview.

Would you like to use your knowledge to help out in disaster areas?

Would you like to use your knowledge to help in disaster areas or emergencies? Would you like to contribute to Mental Health and Psychosocial Support (MHPSS)? MHPSS is always looking for experts. Read more on the DSS MHPSS page. Or sign up as an expert.

Sign up as an expert


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