Comments
Displacement and forced migration could build up trauma into young children as they age. In fact, as many as 90% of refugee children suffer from PTSD (PTSD UK).
The accumulation of events and distasteful memories while growing up in a ‘temporary’ place could both directly and indirectly steer the children mental health into a ‘bad place’.
Further readings into this issue can be found at:
1) Mental Health Care Promotion and Mental Health Care in Refugees and Migrants
https://www.euro.who.int/__data/assets/pdf_file/0004/386563/mental-health-eng.pdf
2) Mental Health and Forced Displacement
https://www.who.int/news-room/fact-sheets/detail/mental-health-and-forced-displacement
3) Mental Health and Psychosocial Support
https://www.unhcr.org/uk/mental-health-
Cendep, Oxford Brookes Oxford Brookes University
Today Oxford Brookes University marks with orange lights at our Headington Campus. An initiative of one of our CENDEP post graduates, Victoria Greenwood, who choose orange to stand in solidarity with
https://togetherwithrefugees.org.uk/
Cendep, Oxford Brookes Oxford Brookes University Oxford Mail
قصص من الشباب/ات في أوقات الأزمات: تعاون بين البحث والفن
عروض مصورة تحت إشراف المخرجة المسرحية رويدا الغالي تلاها نقاش مع المخرج هادي زكاك.
العروض هي جزء من دراسة طويلة الأمد لمركز الدراسات اللبنانية وممارسات التنمية والطوارئ (CENDEP) في جامعة أكسفورد بروكس بالشراكة مع مركز الجنى بعنوان "دور وضع الشباب في التعليم والعمل في سياق النزوح المطول في الأردن ولبنان.
Centre for Lebanese Studies
Lebanese American University - LAU Cendep, Oxford Brookes
NHS Pandemic Diaries
Oxford Brookes University Cendep, Oxford Brookes
'My name is Maria Rozalska and I am a 3rd year Film
student at Oxford. Brookes. Over the last year I have
been interested in the portrayal of the NHS in the media
and the government's reaction to the struggles the
medical staff had to face. I took the opportunity over
the last few months to collect stories from front-line
medical workers and give them safe space to share
their thoughts and feelings.'
Stories told anonymously by the NHS staff working on the front line during the pandemic.
INTERVIEWS WITH
• A paramedic working in the pre-hospital setting
• Foundation Year 2 Doctor working in the Intensive Care Unit and Emergency Department
• Deputy Sister in one of the hospitals in Oxford, not only in charge of patient care but also involved in management aspect as well, supervisor of junior nurses and students.
Could you tell me a little about how your work changed during the pandemic?
P: When I first heard the news of COVID19 I was still very much in the thralls of my third and final year as a student paramedic. Fully focused on finishing my dissertation, the idea of qualifying was way off. But very quickly things started to change. The seriousness of the situation very quickly became apparent. And what novelty was initially there swiftly morphed into dread.
I very clearly remember lying in bed one night with my partner, both of us paramedics and both of us overwhelmed by the humid and smothering sense of doom. It all seems melodramatic to look back on, but at the time neither of us knew what we were going to have to face, no one did.
It wasn't long after that we were told we were to be qualified early; months earlier than we were supposed to in order to help with the COVID response. In a strange way, it felt like I'd received my letter for the draft. In fact, the whole situation felt a bit like some neo-war effort. We were young, keen and ready to "do our bit". With the media using language like heroes, deployed and frontline, you'd be forgiven for thinking we'd gone right back to the 1930s.
On the road things were different. I had stacked up many hours working as a student paramedic, but now I was the one in charge, really having to make life and death decisions. I quickly came to ease with being the face associated with the last time a family saw their loved one as I closed them into the back of my van. I often chuckled at the horrid darkness that had overcome my profession. So rarely was I actually there to save a life.
When a patient opened the door to us, we were met with fear. We'd become the grim reaper albeit in a tidy green uniform. All this talk of NHS heroes, when I felt about as heroic as the rag and bone man during the plague, pulling my cart down the streets to collect the dead.
D: As a Foundation Doctor, we rotate and work in different departments every three months. The start of the pandemic coincided with my changeover between working in General Practice and moving into the Intensive Care Unit.
Naturally, this would be a massive shift in the type of work I would be doing, however, with the pandemic, we were all thrust into completely new ways of working and had to adapt accordingly. The adult intensive care unit (ICU) became the dedicated COVID ICU, whilst the neurological ICU became the non-COVID ICU.
There were expansion plans to extend the number of beds into the paediatric ICU as well as the surgical theatres if required. My work had changed from managing patients in the community, to managing some of the sickest patients in the region.
N: There have been a lot of changes since the start of the pandemic. It has been very challenging and stressful. There are too many protocols and policies to absorb and every day there are new workflows to follow. Infection control policies change every day. There is also a strong emotional aspect that I deal with every day. I had never been so scared to go to work, afraid that I might get the virus anytime.
How was the situation in the hospital you worked in during each of the lockdowns?
P: Luckily most of my work is done in the back of a big yellow van or in my patient's houses. Not much changed except we no longer were offered cups of tea for fear of contamination.
I suppose I should mention how much more rushed off our feet we were, but in all honesty, the ambulance service is perpetually in a state of near collapse. So, these extra jobs made very little difference to my workload. It simply meant the patients suffered from having to wait longer for us to arrive.
There was an odd phenomenon during the first lockdown where people just weren't calling us anymore. Whether this was down to fear of us tracking in the virus on our mucky poorly polished boots, or that we simply weren't needed I don't know. It was the first time in my three years on an ambulance that I would genuinely say it was quiet.
N: Honestly, no one is prepared for this pandemic. Who will think that the virus from the other part of the globe will spread to UK. In our hospital some wards has to close and staff are redeployed to helped care for covid patients. ICU beds are full, our ward capacity have increased 100% due to increasing numbers of covid patients.
D: I only worked in the hospital for the first lockdown.
Things at that stage were very much unknown. There was a definite sense of staff banding together to ensure we did our best.
Fortunately, during my time there, we didn't have to deploy the full surge plans for expanding beds into additional areas of the hospital, but many staff from other departments were re-deployed to help out in places such as ICU and the medical wards.
Conversely, my colleagues in the Emergency Department reported that they were the quietest they had ever been, as people were afraid of leaving their home to come to the hospital.
Is there any specific memory that stayed with you?
P: There is one particular memory that sticks in my head from when I was still a third-year student paramedic, roughly a week or two before I qualified. I was working with two crewmates, one of whom was my clinical mentor. The clinical mentor is the person who ultimately signs me off as being competent to work independently as a paramedic, so as you can imagine it was in my best interest to impress this person at all costs.
We'd been called to a baby having a seizure. We knocked on the door and were quickly met by a father who swiftly ushered us upstairs into their house. Managing seizing babies isn't technically hard but is emotionally hard. I'd managed many similar jobs, but I was aware each one had left me with some degree of emotional baggage, and as I walked up the beige carpeted stairs, I felt myself batting off the claustrophobic sensation of an impending panic attack whilst in my head I ran over the medication dosages I would need to administer over and over and over.
There's a strange phenomenon in ambulance work, I don't know if it has a name, but I can only describe it as the immense anxiety of walking towards a door that you know has a very sick person behind, knowing full well that whatever is behind that door will be relying on you to make whatever nightmare they're experiencing go away.
I open the door, I see the baby screaming on the bed. "Good," I think, "dead babies don't cry". I walk over to the baby and start assessing her. It quickly becomes apparent that she has a very high temperature likely due to a bad upper airway infection.
A slight feeling of calm enveloped me, I know what to do with this. This feeling was quickly swept from beneath my feet. I soon realised that in my stressed state I had not noticed the five other adults in the small bedroom with me and my two other crewmates. All five people coughing, bloodshot eyed and looking feverish. The sudden acceptance that I had now likely been exposed to COVID, that was it. We ended up taking the baby to the hospital.
No major interventions had to be performed in the ambulance, no dying children, no having to tell a parent their child had died. I'd simply turned up, assessed, given the baby some oxygen and taken them to hospital. But somewhere along the way, I'd left something behind. A part of me had succumbed to the moment and been lost to the helplessness I'd felt in that small COVID infested room. I soon developed feelings of anger and resentment. Why did I not notice? why didn't we have masks? why am I being put at risk?
Four days later, the cough started.
D: When I first donned the PPE required for the COVID ICU, I knew things were serious. From a full sealed 'astronaut like' face visor to hat, aprons, gloves, boots, it was actually very uncomfortable. We were designated to spend 2 hours in the unit at a time to maximise the usage of the available PPE.
However, even after 20 minutes of donning, it felt extremely hot and unpleasant. The straps would pull at your hair, the seal would give you headache and even the smallest tasks were hugely amplified in that environment.
N: There are quite a lot of memories. Our first covid patient in the ward, I remembered, we didn't have proper PPE, and we had to use orange bin bags to wrap our feet and neck to make sure we are fully covered. Our patients are very sick; caring for them is quite a challenge. Every shift we transfer patients to ICU and the number of deaths are climbing every day. The sad part of it, they are unable to be with their loved ones. They cannot talk to their families because they are either ventilated or too breathless to talk.
What do you think of the government's attitude towards the NHS? Opinion on “Clapping for carers” Do you think the government has done enough?
N: I have been with NHS for almost 2 decades now. I feel the NHS workforce has been neglected for many years. Clapping for carers has become politicised, they think it’s enough to show appreciation for being in the frontline of the pandemic. We are not heroes not martyrs. They think we are strong and when we say we are struggling, people don’t believe us, our voices are not being heard.
P: In all honesty, I have conflicting feelings. I love the NHS with great pride, almost patriotic to the institution. But the NHS has all too often been weaponised for party politics. We have been privy to newspeak and doublethink that would even have made Orwell gasp. And due to this, I have absolutely no idea what our government's actual motivations for the NHS are.
The first time I heard the clap I nearly shed a tear. The first time since my grandmother had died. The last time I heard the clap I felt the same resent I'd felt as a teenager at my mum telling me to tidy my room. The clap changed from a beautiful example of British spirit to a sound I lamented as I tried to sleep after a twelve-hour shift. As I write this my partner, of a much kinder inclination, is telling me that what I am writing will suggest that it was all a waste of time. I don't doubt for one second that the clap likely fuelled on many people as they came back dreary eyed from another long day on the ward. But I cannot pretend that I felt no great feeling of resentment. To whom exactly? I don't know.
Is enough a plan that results in no COVID deaths? Or one that results in a tolerable amount of COVID deaths? Is there such a thing as a tolerable number of deaths? I am a strong proponent of "tend to the garden you can touch".
The government response is out of my power therefore should I allow myself an opinion? I should probably answer yes, but I feel so completely impotent to enacting any actual change in the political world that I believe the most I can offer is another spoiled ballot.
How the pandemic disrupted your normal life? Did any of your plans have to be changed?
P: In a rather bizarre way, I have been blessed to have been in the profession of paramedicine. Whilst yes, I have had to deal with things I wish I hadn't. Far too many final goodbyes to loving mothers, fathers and grandparents. What it did offer me was financial stability and the privilege to regularly, and legally might I add, leave my house and meet new people. So, in that manner, I have managed to come off relatively unscathed from the erratic change 2020 enacted upon so many people's lives.
D: The pandemic has definitely disrupted my normal life. However, in a sense, to less of an extent than others. When the lockdown first started back in March 2020, people were at home and experiencing something we had never been through as a generation. Whereas myself and my colleagues were still going to work as usual. Although the work itself changed, we were fortunate to still have employment and a routine for each day.
N: Yes, definitely it has changed a lot. I normally go out on my days off, it’s my way to relax my mind but now my routine is just work and home. Plans to visit my family back home are hanging in the air as we don’t know if it’s safe to travel. My mother and mother-in-law are both elderly and they are not in good health either. My husband and I plan to visit them every year, enjoy our time with them but I’m afraid it might not happen.
Do you think the lockdown had a big influence on mental health? What are your ways to cope with the lockdown?
D: Looking back now, it is evident that the pandemic itself, the lockdowns, restrictions and the change to normal life has had a significant effect on the mental health of the population.
I believe that a healthy daily routine is crucial for providing structure to often very unstructured days and supporting mental health. For me, this is waking up at the same time every day, having a good breakfast, trying to accomplish 1-3 things on my to-do list, catching up with friends and family and most importantly, scheduling time for myself at the end of the day. This could be watching a movie, reading, going for a run or doing exercise at home. As I said before, I think I was able to maintain some level of normality due to the fact I was still going to work as normal.
I also personally enjoy taking on a task in lockdown, whether that be a fitness goal, learning a language, learning an instrument or anything similar. I think it keeps your mind focused on something and provides a great sense of achievement as you make progress. On the other hand, people should not feel obliged to be 'productive'. This is an unprecedented time, and simply taking time to do nothing is also okay.
P: I have seen first-hand the devastation lockdown has caused on mental health. Going as far as to note the diagnosis as "lockdown related mental health exacerbation". Humans simply were not built to endure solitude for such time. All through human history, we have fought for the freedom of our common man. And lockdown presented a rather odd predicament. We knew our duty was to stay indoors and behave. But it was fundamentally against our nature as humans. There was an old mafia technique of interrogation I saw in a movie once. The victim would have their hands and legs tied back on a bed with their belly exposed. The interrogator then placed a rat with a bucket upon it against the victim's soft warm belly. The idea was that the interrogator would hold a blow torch to the bucket, making the rat increasingly frantic and desperate to find any method to escape as the surrounding bucket increased in temperature. This ultimately led to the rat eating its way through the doughy flesh of the victim. I believe we are currently at the stage of the rat frantically running around the bucket, stressors from every direction and no way out. We haven't started to chew at the entrails just yet, but any more heat and it will all be over. So many people are at their breaking point that I think it will require relatively little toil on top of the already accumulating mountain of stress to turn people to find any manner of a way to escape from this mess.
N: Definitely, it has a big impact on everyone.
Talk to someone, communication is one way of coping with stress, educate yourself on how to better deal with the ongoing pandemic.
How will the world be affected by coronavirus? Will the world change for the better? Is there anything we can learn?
D: There is no doubt that the world will change following COVID, and it already has in many significant ways. However, what remains a mystery, is to what extent COVID will impact our future and for how long. I think more budget and resources will be allocated to pandemic and epidemic response systems, including managing pressure surges associated with outbreaks and increased demand. However, I don't think the fundamental way health systems are run will change drastically.
The main lessons I have taken away are those of gratitude and appreciation. This pandemic has shown how easily these things can change or be taken away from us. Therefore. I think we should reflect on what we are lucky to have and be grateful for our health, circumstances and loved ones, where possible.
P: We are at the beginning of a new era in modern human history. I believe we are going to see a fundamental shift in almost every way we experience life. Never again can we allow this to happen. But in order to grantee such a demand we will have to pay.
Whether this is taxes or liberty I do not know.
COVID has given us a chance to study society's best and worst habits. We've seen remarkable examples of kindness all too often intermixed with incredulous performances of self-serving greed. All I can hope is we as a society take time to reflect upon the last year or so devoid of the framing of party politics. An honest look into our societal and individual behaviour. For without it we will not heal.
What can we learn? If anything, could people stop coughing on me when I walk into their house?
N: The virus I’m afraid is staying but with the help of the vaccine it can weaken how the virus attacks our body. And with the advancement of science now, I believe the treatment will improve in the future. And as long as everyone is committed to following the guidelines in not spreading the virus,
I think we’ll be all right.
13/12/2022
30/11/2022
30/11/2022
09/11/2022
09/11/2022
15/09/2022
14/09/2022
17/08/2022
16/08/2022
15/08/2022
27/07/2022
25/07/2022
24/06/2022
28/04/2022
04/04/2022
18/03/2022
14/03/2022
11/03/2022
09/03/2022
28/02/2022
25/11/2021
12/11/2021
02/11/2021
08/10/2021
21/09/2021
02/09/2021
05/05/2021
