The protracted conflict in north-east Nigeria continues to devastate the lives of civilians, resulting in a humanitarian crisis affecting 7.7 million women, men, and children who are all in acute need of help and protection. Since the start of the conflict in 2009, more than 20,000 people have been killed, more than 4,000 people abducted and 1.7 million remain displaced, most of them in Borno State. Those caught up in the conflict have experienced brutal violence, lost family, friends, and homes, lived with acute and sustained levels of stress in poor conditions, seen their communities torn apart, and had little or no access to life-saving services such as health and education. An estimated 2.7 million children and adolescents (1.5 million girls and 1.2 million boys) need cross-sector protection services, including psychosocial support services.
In September 2017, a publicly disseminated mental health and psychosocial support (MHPSS) needs assessment from the region was published. The survey indicated an immense burden of psychological stress: 60 percent of respondents reported at least one mental health difficulty, and 75 percent reported functional impairment associated with unmet psychological needs. Self-reported factors contributing to distress amongst the displaced populations of Maiduguri, the capital of Borno state, included: food shortage; poor physical health; displacement and not having a place to live; separation from or loss of family members; and a lack of survival basics such as clothing. Children and schools are systematically targeted by non-state armed groups fundamentally opposed to Western education. Known threats and risks to the well-being of girls and boys include family separation, explosive remnants of war, gender-based violence including child marriage and conflict-related sexual violence, recruitment and use of children in armed conflict, abduction of children and other grave child rights violations. The posttraumatic stress rate among children is high.
This has led to prevalent psychological distress amongst children and caregivers. To ensure that children are equipped to cope with and manage distress from the conflict, displacement and resulting crisis, attention to age, gender, and culturally appropriate community-based MHPSS is urgently required.
MHPSS IN NORTHEAST NIGERIA
Mental Health and Psychosocial Support (MHPSS) is positioned within the LETSAI Protection Program and focuses on the following; 1. Advocate to mainstream psychosocial support; and 2. strengthen social support. The program is guided by the Inter-Agency Standing Committee Guidelines on Mental Health and Psychosocial Support using a community-based approach. The main channels to provide psychosocial support, adopted by LETSAI Nigeria in Borno state, is through child-friendly spaces (CFS), Safe Spaces (SS) and Sport activities for adolescents. This compliment mobilizing family and community support; a systematic referral process; and integration of MHPSS into other sectors. Activities work to reconnect family members, foster positive social interactions, restore a sense of normalcy in the aftermath of conflict, build resilience and restore a sense of control over their own lives.
- Identify the mental health needs of survivors of child marriage and forced abductions through baseline assessment.
- Access support from other organization who are providing the similar support.
- Conduct community based interviews to understand their perception of the mental and psychosocial support.
- Organize a mental health project for a total of 6 months with possible extensions.
Field assessment: LETSAI conducted a baseline survey to understand the mental health needs of the vulnerable groups in Konduga and Jere local Government area of Borno State. A total of 130 participants were selected which includes, adolescent boys and girls, youths and parents. The interview guide was reviewed weekly over the duration of the assessment through iterative, multidisciplinary team discussions to highlight gaps in information. The tool was flexible to record spontaneously elicited information and tapped upon interviewers’ knowledge of the subject area and contextual gaps in information. All interviews were conducted by the assessment lead in collaboration with the LETSAI’s team for psychosocial support for children. The team also provided translation support from English to Hausa, Kanuri and Shuai, as applicable. It was emphasized that translations be contextually and culturally appropriate, and not literal. To the extent possible, the co-interviewer was the same gender as the participant.
Each consultation was conducted from one to over two hours, and the assessment consisted of 18 focus group discussions and five individual in-depth interviews with a total of 110 participants. A maximum-diversity sample of internally displaced persons and affected host community members in north-east Nigeria, between the ages of seven and 45 years old, was recruited by LETSAI’s team. Participants came from 5 different tribal backgrounds and identified as Muslim or Christian.
- Stigma and isolation:
A common sign of distress was withdrawal from social activities and isolation of those who had previously been associated with armed groups. Parents did not allow their children to play with the girls who had experienced sexual violence. Additionally, there were very few girls at the transit centre and opportunities for positive interactions between girls and boys were nearly absent. Children also highlighted concerns associated with bullying, and parents were reluctant to send their child to the CFS if they had experienced bullying or peer pressure from older children to use drugs. Stigma was associated with children who had been abducted or forcefully conscripted by armed groups. A few girls, when rescued from the barracks where they had been forcefully kept and abused, were pregnant or were nursing babies; reintegration was particularly challenging for these children.
- Prevalence of sexual violence and abuse:
Sexual violence was prevalent at the camps and was reported by every girl interviewed for the assessment. Sexual exploitation by volunteers during food and non-food item distribution was frequently reported during the assessment. Almost every girl shared that she had been followed by a stranger at the camp more than once. When probed for unsafe spaces, the girls shared that toilet and shower areas were unsafe as there was only a thin metal sheet dividing the male and female showers, with the clothes hung at the same place. Girls also complained of holes in the metal sheet through which they had been watched. Places with no light were reportedly unsafe and girls felt unsafe going to fetch water.
- Child marriage due to lack of livelihood support and poverty:
The typical age of marriage in interviews was 14 to 16 years old for girls, and 16 to 17 years for boys. Girls were reportedly at higher risk of child marriage and had little choice-making capacity. Often, adolescent girls were married to middle-aged men as one of multiple wives. Children reported feeling extremely helpless. Most of the children had some knowledge of adverse effects on sexual and reproductive health related to childbearing at an adolescent age. Children also had insight into the adverse effects on the baby. However, it was reported that not being married put one at higher risk of being abducted by armed groups.
- Providing mental health support for adolescent boys and girls between the ages of 12 – and 20 in the Konduga and Jere community which includes camps and host communities.
- Organizing football and volleyball competitions amongst boys and girls to enhance social cohesion and socialization.
- Provision of vocational skills support for 100 beneficiaries between the age of 16-25, startup support, and customer-based support and linkage to source of financial assistance for project sustainability.
- Creating awareness on GBV, sending out emergency hotlines to respond to GBV in the communities.
- Advocacy visit to Government official and social media advocacy and campaigns on child marriage
FDG, KIIs, Feedback mechanism and direct contact with beneficiaries provided a better insight on the project progress.
68% improved community cohesion and socialization especially amongst survivors of GBV and community members.
55% improved awareness on GBV and reporting of cases of sexual violence at the community level.
45% improved livelihood and services to the communities.
There is generally a more acceptance of the survivors and overall 35% reduced stigma for survivors.
LESSONS LEARNT/ COMMENTS:
There is a need for multi-sectoral outreach in the areas of livelihood and empowerment, mental health counseling and other projects that will provide community cohesion and strengthen socialization.
Security is a major challenge in the area of our work.
Lack of funding hindered the continuation of the project.