Egypt: Supporting survivors of trauma

24 May 2019

Alie Rodwell, a psychologist from Melbourne, spent six months in Cairo on her first field assignment with Médecins Sans Frontières (MSF). She reflects on providing mental health care for refugees and asylum seekers in the Maadi clinic.

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Since 2012, the MSF project in Cairo has been developing individual rehabilitative treatment plans for asylum seekers and refugees, consisting of medical and mental health assistance, physiotherapy and social support.  © Sima Diab / MSF

What did you do before joining MSF?

I have been working as a psychologist since 2013.  Prior to MSF, I spent much of my career working in psychological trauma – with people affected by violence.  I have worked for the Queensland government with survivors of violence; the Victorian government with adults convicted of violent crimes; and more recently, in a youth justice facility.  This work brought me into contact with vulnerable and marginalised young people and families, including refugees.

 

What does MSF’s work in Cairo involve?

MSF primarily supports refugees and asylum seekers in Cairo, many of whom need access to healthcare after experiencing immense difficulties in their home countries or on their journey to Egypt, including violence and exploitation. The clinic has a multi-disciplinary team of health professionals: medical doctors (including obstetricians and gynaecologists), nurses, psychologists, psychiatrists, physiotherapists and social workers. The mental health team is the largest, with 13 psychologists and three psychiatrists. Much of the work in the clinic is related to sexual and reproductive health, and includes providing care for patients who have experienced sexual violence. 

“On my last day, I learned that a vulnerable patient I had been working with had been granted resettlement. She was a 16-year-old unaccompanied minor, with her own infant child who had been born following an incident of rape.”

What were your main responsibilities as mental health supervisor?

I was responsible for case allocation and rostering, line management, overseeing the intake of new patients to the service, liaising with external organisations (for example, organisations working with family violence, hospitals or legal aid professionals), overseeing collaboration between different departments, data collection and analysis and, most importantly, clinical supervision. The patients had varied and complex mental health needs, and for this reason, meeting staff for regular clinical supervision was extremely important to ensure high-quality care for our patients, and for the wellbeing of our Egyptian psychologists, who carry the program long-term.

 

Could you share a story of a patient or staff member that stands out for you?

I was fortunate to meet many dedicated, passionate and empathetic people during my time in Cairo.  On my last day, I learned that a vulnerable patient I had been working with had been granted resettlement. She was a 16-year-old unaccompanied minor, with her own infant child who had been born following an incident of rape. I feel proud of the efforts of the MSF team to take care of this patient while she waited for the decision on her refugee status and resettlement. This is a long and sometimes agonising process for refugees.

The patient worked with one of our cultural mediators, who was from her home country. Our cultural mediators provided insights to help with my understanding of the patients, their culture, and the trans-generational impact of the multiple and repeated traumas they experienced, and this colleague stands out in my memories of Cairo as kind and thoughtful. For my farewell session with this patient, she cooked a meal from her home country for us to share with the patient and her infant son. Being able to engage with my patient in this special way is a memory I will hold close. 

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Many of the patients at the Maadi clinic are living in limbo, having been forced to flee their home countries and now facing lengthy resettlement processes. © Sima Diab / MSF

What did you take away from this assignment?

I feel proud to work for MSF, knowing that we are impartial and not subject to influence from governments or political agendas. At times it was challenging to be unable to offer patients access to durable solutions like resettlement. We would like to see more legal pathways for migrants and refugees made available, including increased resettlement slots. As a psychologist, it is hard to know that so many patients are living with the psychic wounds of trauma, and yet they have such limited access to services. The work being done in the Cairo clinic is needed and meaningful – it was a huge challenge to say goodbye at the end of my assignment.