Second Conference on Psychosocial Rehabilitation for Landmine Survivors and Persons with Disabilities

by Reykhan Muminova, M.D., Ph.D. [ Tajikistan Mine Action Centre ]

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The Ministry of Labour and Social Protection of the Population of the Republic of Tajikistan, the Tajikistan Mine Action Centre and the Afghanistan Disability Support Programme hosted the second Regional Psychosocial Rehabilitation Conference in Dushanbe, Tajikistan, 1920 October 2011. This conference attracted high-level officials from key Afghan, Iranian and Tajik ministries and departments, as well as organizations working with landmine survivors, persons with disabilities and in psychosocial rehabilitation programs.

Sponsored by the Ministry of Public Health and the Mine Action Coordination Center of Afghanistan, the first Regional Psychosocial Rehabilitation Conference was held 14–15 December 2010 in Kabul, Afghanistan. Since Tajikistan and Afghanistan share a common culture, religion and language, and both countries have a growing need to develop psychosocial rehabilitation services, a basis for beneficial regional cooperation exists. The conference, which was designed to serve both Afghanistan and Tajikistan, identified the following necessary tasks:

Conference participants visited different departments of the national rehabilitation center for children and adolescents with disabilities, Chorbogh. 20 October 2011. Conference participants visited different departments of the National Rehabilitation Center for Children and Adolescents with Disabilities, Chorbogh. 20 October 2011.
Photo courtesy of Rasulov Zaniddin, Assistant of VA Programme, TMAC.

Following on the success of the first conference, the Tajikistan Mine Action Centre, in cooperation with the Ministry of Labour and Social Protection of the Population of the Republic of Tajikistan and the United Nations Development Programme, organized the second Regional Psychosocial Rehabilitation Conference, which was held in Dushanbe, Tajikistan, 19–20 October 2011.

Second Regional Conference

More than 60 participants from various Afghan, Iranian and Tajik organizations and other nongovernmental and disability organizations, including TMAC, UNICEF and the International Committee of the Red Cross, as well as landmine survivors and persons with disabilities convened for the second conference. The participants discussed progress made in psychosocial-rehabilitation services in Afghanistan, Iran and Tajikistan, and studied more specific and long-term interventions for helping landmine survivors and persons with disabilities.

Mrs. Latofat Sharipova, Deputy of the Minister of Labour and Social Protection of the Population of the Republic of Tajikistan and Mrs. Suraya Paikan Deputy Minister of Labor, Social Affairs, Martyrs and Disabled of Afghanistan opened the program with overviews of their respective national situations. Sharipova emphasized that improving social services is a priority of the Ministry of Labour and Social Protection of the Population of the Republic of Tajikistan. A law on the social protection of PWDs was adopted in December 2010 that included provisions guaranteeing the rights and privileges of PWDs and addressing the physical accessibility of social infrastructure and public transportation. Unfortunately, lack of funding may prevent the effective realization of these goals. Though existing organizations provide some social services, such as orthopedic workshops, they require capacity-building to use new technologies. The quality of this work needs assessment, because mine survivors have special psychological, social and economic rehabilitation requirements.

Paikan noted that 2.7 percent of Afghanistan’s population is disabled. A new law enables PWDs to take advantage of many services, including primary and higher education, medical care, employment, transportation, shelter and pilgrimage assistance for those who go to the Hajj. Recently, the Ministry of Labor, Social Affairs, Martyrs and Disabled of Afghanistan established the National Institute for the Disabled in Kabul City in order to provide better services.

The total cost of the SACH foot per leg is less than US$100. More than 1,400 people have been fitted with this kind of prosthesis. Group photo of conference participants taken in the National Rehabilitation Center for Children and Adolescents with Disabilities, Chorbogh, after the conference concluded. 20 October 2011.
Photo courtesy of Rasulov Zaniddin, Assistant of VA Programme, TMAC.

Sharipova ended her introduction, stating: “I believe that our regional cooperation in the field of psychosocial support to landmine survivors and PWDs will bring positive results.” Paikan suggested the establishment of an intergovernmental coordination committee so that both neighboring countries—Afghanistan and Tajikistan—could benefit from each others’ experience. As Afghanistan recently joined the Convention on the Rights of Persons with Disabilities and the Convention on Cluster Munitions, it has specific responsibilities to PWDs and could further benefit from regional cooperation.

The Conference

On the first day, participants exchanged experiences about the realities of mental health in their countries and reviewed new developments, including psychosocial problems, rehabilitation services and opportunities available for PWDs and landmine and explosive remnants of war survivors in Afghanistan, Iran and Tajikistan.

Presentations devoted to mental health in Tajikistan and Afghanistan revealed the reasons and causes of mental illnesses. Dr. Nematullah Ahmaddulah, a trainer from the International Psychosocial Organization, presented on the organization’s rehabilitation activities in Afghanistan, including the development of a psychosocial training program and the establishment of 15 clinics in Kabul. With funding from the German Government, the International Psychosocial Organization works closely with the Ministry of Public Health and the respective provincial health directorates on current rehabilitation programs in hospitals in Northern Afghanistan.

Davron Valiev, head of the Social Protection Department of the Ministry of Labour and Social Protection of the Population of the Republic of Tajikistan, presented on social protection in Tajikistan. Various organizations provide a variety of social services to the Tajik population including housing, social-rehabilitation centers, part-time and full-time centers for the elderly and social-assistance departments. At present, more than 15 organizations provide social services run by the Ministry of Labour and Social Protection of the Population. In 2011, the first international rehabilitation center with the capacity to serve 150 people opened in the Baljuvan district.

The total cost of the SACH foot per leg is less than US$100. More than 1,400 people have been fitted with this kind of prosthesis. Discussion between Director of Chorbogh Mavluda Shamsullayeva and Afghan participants Sulaiman Safdar, Mohammad Ali Mohabati and others, 20 October 2011.
Photo courtesy of Reykhan Muminova.

In his presentation, Mohammad Ali Mohabati of the Afghanistan Independent Human Rights Commission explained that “issues of PWDs are not only social issues, but also human rights issues.” The Afghanistan Independent Human Rights Commission has a department for the social inclusion and improvement of living conditions for PWDs. Mohabati emphasized the importance of making all facilities accessible for PWDs, including health, education, social and economic services. He stressed the need to raise awareness and overcome the prevalent negative attitude toward PWDs. The empowerment and social inclusion of PWDs is essential in helping them become contributing members of society.

Asadi Mohammadreza, a community-based rehabilitation expert in the State Welfare Organization in Iran, presented a project to prevent injuries caused by landmines and to provide rehabilitation to survivors. Another presenter, Davlatov Mahmadullo, a psychologist from the Tajik National University who has authored more than 70 articles for Tajik journals, has worked with the Tajikistan Mine Action Centre on summer rehabilitation camps since 2006. He shared his work providing psychological support and consultation to mine survivors during the camps.

Ms. Nafisa Murodovna Yunusova, the head of the department of psychology at Tajik National University, presented on psychological assistance in emergency situations, using her work with residents after an earthquake in the Vanj district and after floods in Kulyab as examples. She shared role-play, drawing and art-therapy techniques used for psychosocial rehabilitation of traumatized children.

Dr. Fareshta Quedees from the International Psychosocial Organization and Dr. M. Ihsan Gulban, general manager of Disability Research and Capacity Development of the Ministry of Public Health of Afghanistan, also gave presentations.

The second day was organized at the National Rehabilitation Center for Children with Physical Disabilities in Chorbogh, Varzob district. A national rehabilitation center for children and adolescents with disabilities, the Center can house up to 240 patients. Since 2009, it has also provided rehabilitation and daycare for 40–60 children and training for their parents to care for them at home. With support from the European Commission, which has already started developing curriculum and trainings, a training center for social workers and mental health care professionals will soon also be established at the National Rehabilitation Center. The director of the center, Mavluda Shamsullayeva, led participants on a tour and explained the center’s contemporary rehabilitation methods.

After this trip, landmine survivor Shukhrat Kholmadov, a conference participant, shared his personal experiences, discussing his life before and after his accident.

Sulaiman Safdar, the executive director of Afghanistan Landmine Survivors’ Organization, was among the Afghan participants in the conference. In late 2007, Safdar and others established the Afghanistan Landmine Survivors’ Organization to provide psychosocial support to PWDs. In between the two conferences, in the framework of regional cooperation, six Tajik participants attended an Afghanistan Landmine Survivors’ Organization training on peer-to-peer support in Kabul, Afghanistan in September 2011. As a result, a peer-to-peer support program is included in the 2012 TMAC Annual Work Plan. TMAC also plans to organize a joint summer rehabilitation camp for Tajik and Afghan landmine survivors in 2012.

Group Analysis

In four groups, participants discussed the practical objectives of regional cooperation. The outcomes of these groups laid the foundation for the conference’s concluding recommendations. As a result of one of these discussions, available resources (human, technical and information) in Afghanistan, Tajikistan and Iran were identified, and mechanisms of support and sharing were agreed upon. Another discussion group created the following list of important activities to help PWDs:

  1. Conduct joint technical research on psychosocial rehabilitation, as existing research is very limited.
  2. Establish standards of psychosocial rehabilitation services.
  3. Increase attention to psychosocial rehabilitation from governmental organizations, and ensure the proper implementation of government policy and strategy.
  4. Increase state and donor monetary support for psychosocial rehabilitation.
  5. Establish a system to coordinate organizations working in the mental-health field.
  6. Increase primary healthcare workers’ knowledge of mental health and disabilities at the early stages of psychological rehabilitation.
  7. Increase the number of technical staff trained in psychosocial rehabilitation, especially hospital-based medical psychologists.
  8. Organize psychological consultation centers in rural districts.
  9. Organize vocational rehabilitation centers to educate PWDs.
  10. Organize recreation, sport, leisure and cultural activities, which contribute to psychosocial rehabilitation.
  11. Establish monitoring and evaluation of past trainings.
  12. Increase society’s awareness of psychosocial rehabilitation through mass-media and community mobilization.
  13. Include psychosocial rehabilitation in the university curriculum and prepare educational materials (packages).
  14. Organize advocacy for national and international laws and policies (U.N. Convention of Rights for PWDs, national disability laws, laws on social protection).
  15. Increase the role of civil-society organizations in developing policies and plans of action.

Conclusion

The total cost of the SACH foot per leg is less than US$100. More than 1,400 people have been fitted with this kind of prosthesis. Deputy Minister Latofat Sharipova summarizes the conference results on the second day.
Photo courtesy of Reykhan Muminova.

The conference activities led to the identification of joint resolutions for further action. Recognizing the great need for services in Afghanistan, Iran and Tajikistan, participants accepted the following recommendations aimed at the development of regional cooperation in the field of psychosocial rehabilitation:

A regional working committee of seven experts from each of the three countries’ line ministries and organizations was formed to work on the implementation of the conference recommendations and to report to the next conference (date to be determined). The committee will be responsible for developing a joint action plan in the field of psychosocial rehabilitation of landmine survivors/PWDs and for further implementation.

This conference facilitated the closer coordination between the line ministries of disability and mental health in Afghanistan, Iran and Tajikistan, and the improvement of psychosocial rehabilitation services for PWDs and landmine survivors. Deputy Minister Latofat Sharipova from Tajikistan and Mohammedreza Asadi from Iran closed the conference. The Ministry of Labour and Social Protection of the Population of Tajikistan agreed to write an official letter to the Government of Iran with a proposal to fully join in regional initiatives (only one representative from Iran attended the conference) and to examine the possibility of organizing the next regional conference on psychosocial rehabilitation in Iran. J

Biography

Reykhan MuminovaReykhan Muminova, M.D., Ph.D., joined the Tajikistan Mine Action Centre in 2006 as the Victim Assistance Officer to coordinate the VA Program and ensure that VA initiatives were well integrated into national disability planning and frameworks. She has worked on projects related to victim and survivor assistance and has significantly contributed to TMAC’s surveys and VA activities. Muminova graduated from Tajik State Medical University and holds a doctorate in psychiatry and has expertise with the medical-social rehabilitation of persons with disabilities. She served at Tajikistan’s National Research Institute for Rehabilitation of Persons with Disabilities, where she started her research devoted to landmine survivors and their quality of life. Muminova has authored more than 30 scientific articles in different medical journals and research papers published in Tajikistan and abroad. She is a 2010 graduate of the Senior Managers’ Course in ERW and Mine Action organized by James Madison University’s Center for International Stabilization and Recovery.

Contact Information
Dr. Reykhan Muminova
Victim Assistance Officer
Tajikistan Mine Action Centre
15 M. Kurbonov Street
Dushanbe 734025 / Tajikistan
Tel: +992 37 227 09 47
Fax: +992 37 221 66 87
Email: reykhan.muminova@undp.org
SKYPE: reykhan_ti
Website: http://mineaction.tj

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