Psychiatry is a field of medicine that is not for the faint-hearted. Tackling mental health is a extremely difficult and emotionally-draining challenge, period. Doing so for those suffering from the indelible trauma of war and conflict is an even more Herculean task. Refugees fleeing war-torn regions, often witnessing the deaths of their loved ones, and subjecting themselves to treacherous journeys in the hope of a better life, carry scars of trauma that may never heal. Addressing the mental health issues of refugees has not received the sufficient attention it merits, and while efforts are being made, more needs to be done.
However, there is one particular psychiatrist who has dedicated himself to addressing the mental health needs of migrants crossing the Mediterranean Sea: Dr. Essam Daod, through his health humanitarian organization, Humanity Crew.
Daod, a Palestinian psychiatrist based in Haifa, Israel, first offered his services in 2015 as a physician providing medical assistance in Lesbos, Greece, when the refugee crisis was rapidly worsening. His decision to provide medical aid stemmed from a sense of Arab solidarity, as he himself hailed from a village of Palestinian refugees in the Israeli region of Galilee.
While his role largely involved providing CPR, as he returned to his home in Israel, both he and his wife, Maria Jammal, realized just how marked the mental health issue actually was, and how the response and attention to this issue has been lacking. It was the sight of a picture in a newspaper, of a child they remembered in Lesbos, that truly brought about this dawn of realization.
Jammal, a lawyer providing counsel to the refugees, clearly remembered working with this particular child, and Daod retrospectively recalled how this child exhibited catatonia when he saw him. While the emergency medical resources were very much on hand, there was a severe lack of mental health resources for these refugees.
This situation inspired Daod, his wife, and colleagues to establish the Humanity Crew organization that same year in 2015, which emphasized, as he said on a TED Talk, the fact that first aid is not just needed for the body, but for the mind and soul as well.
During this TED Talk, Daod was the embodiment of the humanitarian nature of psychiatry. He distinguishes humans from machines by the “beautiful soul that lies within us.”
The Humanity Crew provides mental health intervention right at the boat, even before getting refugees on land, with mental health lifeguards on hand to evaluate these refugees. This has been made possible through Humanity Crew’s collaboration with the Spanish lifeguard organization, Proactiva Open Arms. The next step is getting these refugees to hospitals and clinics at which even more mental health professionals are on hand. The goal, following this crucial intervention, is to eventually help these refugees to integrate into the societies of the countries in which they will seek asylum.
Addressing Trauma is Multi-Stage Process
Daod believes that there is a multi-stage process for these refugees in addressing trauma. The first stage is the trauma associated with fleeing their country and taking the life-threatening journey across the Mediterranean.
The next stage is the adjustment to being in the refugee camps. This is followed by having to adjust to leaving these camps and moving to the unfamiliar territory of living in a new society.
The final step is the process of acclimatizing and assimilating into their new country. Daod seeks to provide intervention at each of these stages.
However, the most crucial intervention at is stage one, which requires a response within a narrow time frame, and knowing how to appropriately shape the memories of these individuals. This intervention is particularly vital with children, who make up a significant proportion of the refugee population. Where this is particularly pertinent is with respect to post-traumatic stress disorder (PTSD). Young children are at a very critical stage in their development, at which they are highly susceptible to carrying the burdens of trauma for the rest of their lives.
As it turns out, PTSD among Syrian refugee children has been so severe, and so unprecedented in magnitude, that it has escalated to the point where some mental health professionals have coined a new term for these particular cases of trauma: “human devastation syndrome” (Ahmed, Mahood, & Waheed, 2018).
Members of the Syrian-American Medical Society (SAMS) indicate that Syrian children, dating back to the war they witnessed at home, experience trauma significantly worse that what soldiers have seen in times of war. Given that we have seen how many veterans have suffered from PTSD, one can imagine how much worse this must be for such young children.
One memorable case of how Daod has been successful with the Humanity Crew was with a five-year-old Syrian refugee boy named Omar. Dr. Daod met Omar in Lesbos, crying and frightened, and on the cusp of suffering from the indelible ramifications of trauma. However, in his words, Daod saw a “golden hour” in which he could change Omar’s story for the rest of his life.
The first thing he did was to tell Omar that “he was a hero”. With just those few words, Omar stopped crying, become more relaxed, and even before physical medical treatment, probably received the most crucial intervention of his young life.
Establishing a New Narrative is Key Intervention
Daod worked to ensure that Omar’s memory of his time at sea was not processed and stored in Omar’s limbic system as a traumatic experience, but as one reflective of Omar’s success and bravery in making it to the other side. What Daod did was to use this critical window to frame this event into something positive, to establish a new narrative.
This not only prevents the otherwise probable risk of PTSD, but establishes a character building experience that would shape Omar’s character as being one of bravery and resilience. This (approach) can and will go on to instill, in Omar, the belief that he can overcome any obstacle in his way, something that will hold him in great stead for the rest of his life.
It is this sort of intervention that has been greatly successful in providing essential mental health intervention for thousands of refugees ever since Humanity Crew’s formation. With hundreds of mental health professionals and a growing number of volunteers, this organization continues to grow and blossom. However, there is still a very long way to go yet, as, even with Humanity Crew, there are still far from enough few mental health professionals on hand to help an ever-growing refugee population.
There are still more than 350,000 refugee children in dire need of mental health assistance. However, Daod’s efforts have gone a long way, and will continue to do so, particularly as he now aspires to expand Humanity Crew’s efforts into Asia, to assist, among others, the Rohingya people suffering from one of the worst genocides in recent history.
Geopolitics, conflict, and the growing stigma and hostile sentiments towards refugees continue to mar the world in which we live. However, Dr. Daod is an emblematic figure of just how much impact psychiatry can have on overcoming these issues on a global level. He is a champion of the field, and his efforts just go to show that, if the desire to really make a beneficial difference is strong enough, there is no limit to how far that those in the mental health community can go in improving the lives of people the world over.
For this, Dr. Essam Daod is, without doubt, a hero of psychiatry.
For more information, the Humanity Crew website is in the link below:
Dr. Daod’s TED Talk can be accessed below:
After Fleeing War, Refugee Children Face Lasting Psychological Trauma. (2018, June 28). Retrieved from https://news.nationalgeographic.com/2018/06/refugee-mental-health-trauma-children-lesbos-greece-crisis-world-refugee-day-culture/
Ahmed, S. R., Mahmood, S. U., & Waheed, H. (2018). Rise of human devastation syndrome in Syria. International Journal Of Community Medicine And Public Health, 5(4), 1227. doi:10.18203/2394-6040.ijcmph20181194
Shani, A. (2018, April 10). Reconnecting refugees’ bodies and souls: A Haifa resident’s humanitarian mission. Retrieved from https://www.haaretz.com/israel-news/.premium-a-haifa-resident-s-humanitarian-mission-on-the-shores-of-greece-1.5414964
Translating and healing the trauma of refugees with Dr. Essam Daod. (2018, September 05). Retrieved from https://tedtranslators.com/2018/08/31/translating-and-healing-the-trauma-of-refugees-with-dr-essam-daod/