A simple, effective humanitarian act

I was 17 when I sat in Psych 101 and studied the infamous 1971 Stanford prison experiment, in which a mere toss of a coin designated the student volunteers to the role of ‘prisoner’ or ‘guard’. Intended to last two weeks, the experiment was shut down after less than a week because of what unfolded. Within a few days, the ‘guards’ became consumed by their roles of power and turned abusive, and the ‘prisoners’ became psychologically distressed and traumatised, despite having the choice to withdraw from the experiment at any time.

I didn’t anticipate that 20 years later I would be working as a psychologist in a real-life Stanford prison experiment, but without the option to withdraw – Palestine. 

My first assignment with MSF was in the West Bank. I left 10 months later with everything I knew about mental health in doubt.

In my time in the West Bank, we saw patients diagnosed as chronically ‘depressed’, ‘anxious’ and with ‘panic disorder’. But the typical treatments that worked for my patients in Sydney, such as cognitive behavioural therapy, did not work. In Sydney, to disengage from unrealistic catastrophising, I would gently ask my patients, “What is the worst thing that can happen?”

In the West Bank, I made the mistake of asking that same question. “My other son could be killed by the soldiers… like my first one,” answered a grief-stricken mother. I never made that mistake again. 

My time in the West Bank has haunted me in my dreams ever since: a child shepherd cowering behind rocks as Israeli settlers slaughter their flock; the blank look of dissociation on children’s faces in our clinic, after witnessing their family members suffer unspeakable violence by settlers.

And from my recent time in Gaza, my dreams have new images. Everyone is in extreme distress and terrorised all night and day by drones, quadcopters and bombings. In my dreams I am torn with guilt as I leave the confines of Gaza for safety, leaving behind my colleagues, the doctors, nurses and counsellors, who show up to work without fail every day, despite immense grief, fear and pain. These words from former MSF president James Orbinski’s Nobel Peace Prize speech ground me:

“Humanitarian action is more than simple generosity, simple charity. It aims to build spaces of normalcy in the midst of what is profoundly abnormal… The act of humanitarianism comes down to one thing: individual human beings reaching out to those others who find themselves in the most difficult circumstances.” 

Back home, people often ask me, “What can a psychologist possibly do in the midst of crisis? Aren’t you best there after the conflict? It’s not the time for mental health.”

Mental health in conflict is not complex therapy like it is in high-income contexts like Australia or New Zealand. Delivering mental health activities is one of the simplest, low-cost, yet most effective humanitarian acts: we are creating spaces of normalcy in very abnormal situations. Enabling people who have been dehumanised to regain dignity, simply by hearing their stories. Showing compassion and care by validating their distress.

We are human beings reaching out to our fellow human beings who find themselves in the most difficult circumstances. That is what caring for mental health is at its core, and that’s what my team did in Gaza.

We created breastfeeding spaces for women who hadn’t had privacy in eight months and were unable to lactate due to the incredible stress and pressure of having a newborn in these circumstances.

We helped new mums cope with their starving babies and supported the mother–child bond necessary for the baby’s survival.

We created a day school program for kids who hadn’t been to school in months, in a population with a 97 per cent literacy rate.

We conducted play therapy with traumatised children who had no words to describe the horrors around them.

We trained counsellors to calm distressed and desperate crowds of people, parents carrying their sick, injured children in their arms, waiting in the sun without food or water, who needed urgent medical assistance.

We taught children, using a few pencils and paper, what unexploded ordnance looks like and what to do if they saw something dangerous.

At MSF our mental health projects adapt to the needs of that community, guided by what they tell us mental health looks like. Sometimes yes, that means treating acute psychosis and severe depression, which we do in several projects elsewhere in the world. Other times, it means showing solidarity and care for another human being, who by a mere flip of a coin found themselves on the ‘wrong’ side of the fence.

Scarlett Wong
MSF international mobile staff member 
MSF Australia Board member