Please find a response from an IOM representative below this piece.
The levels of profound despair that can lead anyone to take their own life can rarely be attributed to a single cause.
For Yazidis in Iraq, the latest in so many genocides against them has been ongoing since August 2014. Thousands of Yazidis are still missing, mass graves of genocide victims are still being discovered, and their bodies exhumed and buried almost seven years since they were brutally murdered. Forced displacement, migration, limited access to healthcare, economic crises, unemployment, as well as intra-community conflicts, have placed an unbearably heavy burden on the Yazidis since – whether they be in their heartland in Shingal (Sinjar), in camps for the internally displaced in Iraq and the Kurdistan Region, or resettled abroad.
Virtually none of the Yazidis who have died by suicide from September 2020 to January 2021, in camps in the Kurdistan Region or in Shingal, were survivors of the Islamic State (ISIS). With rare exceptions, all of the Yazidis who have recently died by suicide were under the age of 30; the youngest was only 15 years old.
In the face of this crisis, mental health and psychosocial support interventions are a crucial part of the humanitarian response. But one of the major, long-term challenges to mental healthcare for Yazidis is the limited number of adequately trained psychologists available to provide the support that they need. Although there has been training of non-professionals to provide basic psychosocial support and counseling at community levels, we are still miles away from tackling the problem of mental ill health, particularly suicide.
Related: ‘We need help’: suicides spike at Duhok’s camps for Yazidis
Small, non-governmental organisations like Joint Help for Kurdistan (JHK) stretch to fill a part of that gap. Run by volunteers from the camp and their supporters from 22 different countries around the world, the JHK team at the Bajed Kandala camp in Duhok has done a tremendous job for their community. Genocide is a communal trauma, and our members have always worked with a community- based rehabilitation program. As members of the camp’s community themselves, the volunteers are able to build trust with other camp residents. They are able to integrate mental health activities and services into the community support mechanisms that already exist; this way, they’re able to reach more people, challenge stigma, and make sure the mental health support lasts. Each team member tries to become a trusted mentor for a group of youths, letting them know that they have someone they can confide in.
In an effort to coordinate mental health efforts in Iraq, the World Health Organisation (WHO) created a platform for both national and international aid agencies in the sector. MHPSS (mental health and psychosocial support) working groups meet once a month to talk about how to fill in the gaps in Iraq’s approach to, and treatment of, mental health; talks on the lack of capacity development for health providers, gatekeeper trainings, and awareness-raising among communities have been a point on the agenda since more than two years.
Since fall 2020, IOM and WHO have had several conferences and workshops about mental health in Baghdad, and though Iraq has two official languages – Arabic and Kurdish – it has chosen to hold the workshops only in Arabic, excluding those of us who operate in any other language. WHO also failed to invite representatives of health directorates in the Kurdistan Region, despite the fact that the majority of IDPs and refugees, Yazidi or otherwise, live in Duhok province. Building better healthcare takes time, investment, and efforts not just from Baghdad, but the Kurdistan Region too. How can we build a better healthcare system when some of the most important parties are being excluded?
In a MHPSS meeting we had in December 2020, I tried hard to highlight the situation many female survivors are struggling with, and how so many adolescents who came to the camp as children now face psychological stress and very fragile mental wellbeing. Our concerns as a small NGO were dismissed with a reply of “thank you for raising concern”.
To my knowledge, there is no UN migration agency (IOM) or WHO database shared with NGOs working on mental health in Iraq and the Kurdistan Region – something that we have been asking for several years. In our last meeting, on January 28, I directly asked the working group meeting’s co-chair why he couldn’t share this information with us, but our requests for coordination and knowledge fell on deaf ears. I asked him to share the statistics that he was showing in the chart with us too, to tell us from where and how they have obtained the information; once again, I was thanked for my “thoughts and concerns”.
It is understood that there has to be confidentiality and limited access to sensitive data, but organizations need to know what the findings are in order to plan their way forward. The information we aren’t given could help us plan for evidence-based interventions, instead of it being used a tool for getting more donor attention. WHO and other UN agencies should aim to share relevant good practices and lessons learned with actors on the ground – not just to policymakers and donors – in order to be able to identify emerging perspectives regarding suicide prevention and response. This way, we’d be able to enhance and promote mental health care services together. Without transparent cooperation, how can we be successful in promoting community participation and support for mental healthcare?
It is the information UN agencies take from small organisations working on the ground in IDP camps and in Shingal that make it possible for them to have something to say to donors, and those results should make their way back to the field. We need WHO to work side-by-side with us – not above and beyond us. Share your data and analyses with us NGOs on the ground, and make it possible for us to save the lives that could be saved.
Dr. Nemam Ghafouri is the chairwoman and founder of Joint Help for Kurdistan (JHK), a not-for-profit organisation founded in 2014 by Kurdish-Swedish doctors and humanitarians.
The views expressed in this article are those of the author and do not necessarily reflect the position of Rudaw.
Editor’s note: In response to Dr. Ghafouri’s article, Vanessa Okoth-Obbo, Media and Communications Officer for IOM Iraq told Rudaw English that “neither IOM or WHO has a database of suicide statistics… it is incorrect to claim that these agencies are hoarding data that would help all of us with better and more efficient programming.”
On the IOM-led conference that took place in Baghdad at the end of 2020, the health officials Dr Ghafouri said had not been invited “declined the invitation, with apologies, due to a scheduling conflict,” Okoth-Obbo said – though Dr. Ghafouri was able to provide screenshots of a conversation with a senior health official who said they had no knowledge of the conference.
Updated on February 21, 2021
