Ileana Hatton is a mental health specialist and has worked in Ethiopia
Why did you decide to work with Médecins Sans Frontières?
Before I started this work, I was completing my PhD and working part-time in private practice and in the public sector in youth mental health and sexual assault. The idea of being involved in humanitarian work was always in the back of my mind. I wanted to contribute to creating equal access to quality health services for people who might not otherwise have that right. I chose Médecins Sans Frontières because I admired the integrity of the organisation, particularly its efforts to remain true to its charter and principles regardless of the struggle that often entails.
You are currently working in Degehabur, Ethiopia. Could you describe the project?
Degehabur is a small town in Somali region, Ethiopia. The Médecins Sans Frontières project opened in 2007 in response to a nutritional crisis and the ongoing Ogaden conflict. Médecins Sans Frontières supports the local hospital’s inpatient department for children under five, ambulatory nutrition program and emergency department. The mental health program opened in 2009. We provide trauma counselling for victims of the conflict, including response for sexual and gender-based violence, plus a psychostimulation program for children under five, which encourages caregiver bonding and play.
"These days, with all the expectations and distractions thrust at us, working in the field is a daily reminder to me to maintain perspective and try to cultivate compassion, love and respect for others"
Have there been any particularly rewarding cases?
A young woman recently came through who was pregnant as the result of rape by one of the local militias. She presented to us due to complications with the pregnancy, which we assisted with. We also tried to provide psychological support, however she remained silent. When I visited her for counselling she lay facing the wall and looked to her mother to talk on her behalf. However, after delivering her baby (by Caesarean section, at a larger hospital nearby) I couldn’t believe her transformation. She was talking, smiling and holding her baby girl like a priceless possession. The midwives did not want her to go, she brought such joy. She told me with a big smile that she had given the baby the second name ‘NGO’ because without Médecins Sans Frontières she would never have been born. It was so rewarding to see the stigma surrounding her situation eclipsed by the love of the staff, and her joy with her baby.
What are the main challenges of working in Degehabur?
There are vast cultural differences, ongoing violence and restrictions on our ability to access patients in need. But one of the hardest things is witnessing the mental health services. When I viewed the only psychiatric ward in the main hospital in the state I almost cried with shock at the inhumane conditions in which vulnerable patients are expected to stay. Many people do not receive treatment and instead turn to the local drug khat to cope.
What is your favourite part of work with Médecins Sans Frontières?
Meeting the patients. Working with them reminds me of two things. First, that everyone experiences suffering in some way, and second, that the human spirit can constantly amaze you. These days, with all the expectations and distractions thrust at us, working in the field is a daily reminder to me to maintain perspective and try to cultivate compassion, love and respect for others.
Could you tell me about a patient who has challenged you professionally?
There was one young man in Hebron, Occupied Palestinian Territories, who always returns to my mind. When he first came he was experiencing severe symptoms of post-traumatic stress disorder and depression following his release from several years in jail. He described terrifying nightmares which woke him up with heart palpitations, dizziness and unexplained visual problems. He was avoiding going to sleep, had isolated himself from friends and family and lost motivation for his studies. He was having medical problems but didn’t trust any doctor to examine him. He sometimes reported that he would rather go back to jail than live his life as it was. As well as providing practical strategies for reducing and managing these symptoms, many of our sessions focused on the concept of trust.
Two things stay with me when I think of him. First, the helplessness I felt, to see someone I could relate to, so close to me in age and aspirations yet without any hope of being able to live out his dreams. Knowing there was nothing I could do to change his situation was very confronting. Second, I felt pure admiration for this young man who despite the darkness he was navigating, kept finding the courage each week to sit and talk about what had happened and trust someone again. To me he will always be an illustration of the resilience of the human spirit.