Lending a voice to Infants in Crises
WAIMH continues its effort in bringing awareness to the plight of infants and professionals who work with them and their families in states of humanitarian and environmental crises. An infant has no political will, and only through the voice of adults who can move outside of agendas of those who hold power, can the cries of infants be heard who face the darkness of humanity. The WAIMH community chooses to be such a voice for infants around the world.
The Child and Adolescent Mental Health National Health Strategy 2023-2028 document is a collaborative partnership with the UK-charity Medical Aid for Palestinians (MAP) and The Royal College of Psychiatrists, UK, developed for the Palestine Ministry of Health.
“Today’s child in Palestine bears the burden of decades of violence, conflict and hardships that have accumulated during their lives and those of their parents and grandparents. Childhood is not a given for Palestinian children, but instead something that must be determined, retrieved, and understood within a complex web of implications mandated by the dynamics of power that are in play” (Pg. 4).
Palestinian Children at the Cold face of a Humanitarian Crisis
The majority of Palestinians, live in the State of Palestine, West Bank and in the Gaza Strip. A large number of these people are refugees: with an estimated 27 percent in the West Bank and 72 percent in Gaza. In addition, 1.7 million Palestinians live within the State of Israel. Following the Oslo accords, the Palestinian National Authority (PNA) was established in 1994 as the recognized governing authority of Palestine. The ongoing occupation and the stalemate in peace negotiations between the PNA and Israel place a heavy toll on the lives, health and security of Palestinians who face ongoing military attacks, restrictions and forced migration.
According to the State of Palestine National Health Strategy document:
- 2242 Palestinian children have been killed by Israeli military forces between the years 2000 and 2022.
- In Gaza, over 1,000 Palestinian children have died as a result of six major military offensives since 2005.
- In the West Bank, 781 Palestinian children were killed by Israeli military and police forces, settlers, and private security guards between 2011 and 2020.
- In 2021, 76 children were killed by live ammunition with 15 child deaths in the West Bank and 61 child deaths in the Gaza Strip comprising of 26 children aged 0 to 8 years, 17 children aged 9 to 12 years, 20 children aged 13 to 15 years and 15 children aged 16 to 17 years. Seven children were killed by rockets misfired by Palestinian armed groups in the Gaza Strip.
- In September 2022 180 child prisoners, representing 3.9% of the total number of detainees. There is a rising trend of younger children being put under house arrest. These children are prevented from attending school, seeing friends or engaging in activities impacting on the mental health of the family as a whole.
- In 2022, 58 Palestinian schools in the West Bank, including East Jerusalem, are under demolition or ‘stop work’ orders by the Israeli authorities impacting on hundreds of children’s access to education.
The Need for a National Strategy
During periods of humanitarian and environmental crises many local and international efforts are put in place to address the mental health needs of children living in most affected areas. Although these efforts benefit those who most need assistance, they are often in response to imminent mental health risk. The National Health Strategy incorporates a multi-level framework developed by the United Nations Children’s Fund (UNICEF) that sets key priorities for child and adolescent mental health so that funders, institutions, organizations and community members can align their activities in a coordinated and efficient way. This moves mental health from a crisis response to a protective mental health and wellness approach throughout a child’s developmental journey.
The strategy has four pillars and ten initiatives:
- Rights, Regulation and Standards:
-supports advocacy to protect children’s fundamental rights
-the review of regulation and legislation to ensure safe practice by professionals working with children
– institutional accreditation to raise standards of clinical care
- Promotion and Prevention: Promotes positive mental health and well-being through three initiatives from birth to adulthood:
– “Securing the Early Years” initiative for under five-year-olds focuses on giving every child the best start in life through developing secure emotional attachments and preventing or reducing toxic stress.
-“Protecting Childhood” initiative for five- to 12-year-olds creates spaces for children to play, learn and grow with ‘whole school’ approaches to well-being, outdoor play and encouraging families to reduce screen time and increase reading for pleasure.
-“Building for the Future” initiative for 13- to 18-year-olds empowers youth through developing skills for life and citizenship be they socio-emotional, literacy, numeracy and/or technical skills obtained through vocational, apprenticeship and mentorship programmes to prepare them for adulthood.
- Clinical Services and Capacity Building:
– Building services and professionals’ capacity so as to have sufficient capacity to meet demand and provide integrated, effective and efficient child and family-centred clinical services
- Community Integration and Contribution:
-Supports activities that enhance social integration through reducing stigma, and developing a sense of belonging, so children and adolescents engage in and contribute to the community.
Action Plans and Targets
State of Palestine, Ministry of Health Child and Adolescent Mental Health National Health Strategy document also includes a set of specified actions, identifies key stakeholders involved in operationalising targets and timelines for achievement. This makes the document not only an important theoretical framework for achieving mental health and well-being of all Palestinian children but also sets out specific plans to achieve strategic priorities. Incorporated into the document are goals for monitoring, evaluation, sustainability, and research for continuous assessment of the outcomes of the strategy.
State of Palestine Ministry of Health Child and Adolescent Mental Health, National Health Strategy 2023-2028
- A summary of the strategy development process can be found here: Developing a National Strategy for Child and Adolescent Mental Health in Palestine | BJPsych Open | Cambridge Core
Full reference: Dabbagh, N., Jaber, S., Raboczki, A., Tina, E., & Al-Uzri, M. (2023). Developing a National Strategy for Child and Adolescent Mental Health in Palestine. BJPsych Open, 9(S1), S84-S85. doi:10.1192/bjo.2023.264
- The complete document can be accessed here.
Acknowledgment and correspondence
WAIMH would like to thank Dr Nadia Dabbagh (Royal College of Psychiatrists, UK) who so generously shared the complete document with Perspectives in Infant Mental Health and has been instrumental in supporting infants in crises.
Correspondence can be sent to: Dr Nadia Dabbagh. Email: email@example.com
Perspectives IMH Assistant Editor,
Kwa mujibu wa taarifa ya shirika la WHO, WAIMH inaendelea na juhudi zake za kuangazia hali ya watoto wachanga na wataalamu wanaofanya kazi pamoja nao na familia zao katika hali za mgogoro wa kibinadamu na mazingira. Mtoto mdogo hana mapenzi ya kisiasa, na ni kupitia sauti ya watu wazima ambao wanaweza kusonga nje ya ajenda za wale walio na nguvu, kilio cha watoto wachanga kinaweza kusikika ambao wanakabiliwa na giza la ubinadamu. WAIMH ni chombo cha kimataifa cha kutoa sauti kwa ajili ya watoto wachanga duniani kote. "Hatua ya ""Usalama wa Kitaifa wa Watoto na Vijana wa Afya ya Akili 2023-2028"" ni ushirikiano wa ushirikiano na Msaada wa Matibabu wa Palestina (MAP) na Chuo cha Royal cha Psychiatrists, Uingereza, iliyoundwa kwa Wizara ya Afya ya Palestina." "Mtoto wa leo nchini Palestina anashikilia mzigo wa miongo kadhaa ya vurugu, migogoro na magumu ambayo yamejilimbikizia wakati wa maisha yao na yale ya wazazi wao na babu na nyanya zao. """ Utoto si kitu kilichopewa kwa watoto wa Palestina, lakini badala yake kitu ambacho lazima kiwe na uhakika, kufunuliwa, na kueleweka ndani ya mtandao tata wa athari zilizoamriwa na mienendo ya nguvu ambayo iko kwenye mchezo. 4) Watoto wa Palestina katika hali ya dharura ya kibinadamu: Idadi kubwa ya Wapalestina wanaishi katika Jimbo la Palestina, Ukingo wa Magharibi na ukanda wa Gaza Idadi kubwa ya wakimbizi ni wakimbizi, asilimia 27 katika ukingo wa magharibi na asilimia 72 katika Gaza. Zaidi ya hayo, Wapalestina milioni 1.7 wanaishi ndani ya Jimbo la Israeli. Baada ya makubaliano ya Oslo, Mamlaka ya Kitaifa ya Palestina ilianzishwa mnamo 1994 kama mamlaka inayotambuliwa ya utawala wa Palestina. "Ushindi unaoendelea na mgogoro katika mazungumzo ya amani kati ya PNA na Israeli unaathiri sana maisha, afya na usalama wa Wapalestina ambao wanakabiliwa na mashambulizi ya kijeshi, vizuizi na uhamiaji wa kulazimishwa. """ Kulingana na taarifa ya serikali ya Palestina, watoto 2,242 wa Palestina wameuawa na jeshi la Israel kati ya mwaka wa 2000 na 2022. Katika eneo la Gaza, zaidi ya watoto 1,000 wa Palestina wamefariki kutokana na mashambulizi sita makubwa ya kijeshi tangu mwaka 2005. Katika eneo la Ukingo wa Magharibi, watoto 781 wa Palestina waliuawa na jeshi la Israeli, polisi, wahamiaji na walinzi wa kibinafsi kati ya mwaka 2011 na 2020. Mwaka huu, watoto 76 wameuawa kwa risasi za kweli, 15 katika Ukingo wa Magharibi na 61 katika ukanda wa Gaza, ikiwa ni pamoja na watoto 26 wenye umri wa miaka 0-8, watoto 17 wenye umri wa miaka 9-12, watoto 20 wenye umri wa miaka 13-15 na watoto 15 wenye umri wa miaka 16-17. Watoto saba waliuawa na makombora yaliyopigwa na vikundi vya Wapalestina vya silaha katika eneo la Gaza. Mnamo Septemba 2021, watoto 180 walifungwa, wakifanyiza 3.9% ya idadi ya wafungwa. Kuna mwelekeo unaoongezeka wa watoto wadogo kuwekwa chini ya kifungo cha nyumbani. Watoto hawa wanazuiliwa kuhudhuria shule, kuona marafiki au kushiriki katika shughuli zinazoathiri afya ya akili ya familia nzima. Shule 58 za Palestina katika Ukingo wa Magharibi, ikiwa ni pamoja na Yerusalemu Mashariki, ziko chini ya amri ya uharibifu au "kusimamisha kazi" na mamlaka ya Israeli, ikisababisha mamia ya watoto kupata elimu. Katika kipindi cha mgogoro wa kibinadamu na mazingira, juhudi nyingi za ndani na za kimataifa zinafanywa ili kukabiliana na mahitaji ya afya ya akili ya watoto wanaoishi katika maeneo yaliyoathiriwa zaidi. Ingawa jitihada hizi zinawanufaisha wale wanaohitaji msaada zaidi, mara nyingi zinategemea hatari ya afya ya akili inayokaribia. Mkakati wa Kitaifa wa Afya unajumuisha mfumo wa ngazi nyingi uliotengenezwa na Shirika la Watoto la Umoja wa Mataifa (UNICEF) ambao huweka vipaumbele muhimu kwa afya ya akili ya watoto na vijana ili wafadhili, taasisi, mashirika na wanachama wa jamii waweze kusawazisha shughuli zao kwa njia iliyopangwa na ufanisi. Hii inahamisha afya ya akili kutoka kwa majibu ya mgogoro hadi mbinu ya kinga ya afya ya akili na ustawi katika safari ya maendeleo ya mtoto. Mkakati huo una nguzo nne na mipango kumi: Haki, Udhibiti na Viwango: Inasaidia utetezi wa kulinda haki za msingi za watoto; ukaguzi wa kanuni na sheria ili kuhakikisha mazoezi salama na wataalamu wanaofanya kazi na watoto; Uhakikisho wa taasisi ili kuongeza viwango vya huduma ya kliniki; Kukuza na Kuzuia: Inakuza afya nzuri ya akili na ustawi kupitia mipango mitatu kutoka kuzaliwa hadi utu uzima; -Mkakati wa "Kulinda Utoto" kwa watoto wa miaka mitano hadi kumi na mbili huunda nafasi kwa watoto kucheza, kujifunza na kukua na mbinu za "shule nzima" kwa ustawi, kucheza nje na kuhamasisha familia kupunguza wakati wa skrini na kuongeza kusoma kwa raha. """Kujenga kwa ajili ya siku zijazo"" mpango kwa ajili ya vijana wa miaka 13-18 nguvu vijana kwa njia ya kuendeleza ujuzi kwa ajili ya maisha na uraia kuwa ni kijamii-hisia, kusoma na kuandika, hesabu na ujuzi wa kiufundi na au ujuzi wa kiufundi kupatikana kupitia programu za ufundi, mafunzo na ushauri ili kuwaandaa kwa ajili ya watu wazima." - Huduma za Kliniki na Ujenzi wa Uwezo: <unk> Kujenga huduma na wataalamu <unk> uwezo ili kuwa na uwezo wa kutosha kukidhi mahitaji na kutoa huduma za kliniki zilizounganishwa, zenye ufanisi na ufanisi za watoto na familia - Ushirikiano na Mchango wa Jumuiya: <unk> Inasaidia shughuli ambazo zinaongeza ushiriki wa kijamii kwa kupunguza utambuzi, na kuendeleza hisia ya kuwa na jamii, hivyo watoto na vijana kushiriki na kuchangia. Mipango ya vitendo na malengo: Serikali ya Palestina, Wizara ya Afya, Afya ya akili ya watoto na vijana, na Mkakati wa Kitaifa wa Afya pia ni pamoja na seti ya vitendo maalum, hufafanua wadau muhimu wanaohusika katika kutekeleza malengo na ratiba za mafanikio. Hii inafanya hati hiyo sio tu mfumo muhimu wa nadharia ya kufikia afya ya akili na ustawi wa watoto wote wa Palestina, lakini pia inatoa mipango maalum ya kufikia vipaumbele vya kimkakati. Kuingizwa katika hati ni malengo kwa ajili ya ufuatiliaji, tathmini, uendelevu, na utafiti kwa ajili ya tathmini ya kuendelea ya matokeo ya mkakati. "Utafiti wa Utafiti wa Afya ya Watoto na Vijana wa Palestina (BPSH) unaonyesha kuwa ""Utafiti wa Afya ya Watoto na Vijana wa Palestina"" unaendelea katika ""Utafiti wa Afya ya Watoto na Vijana wa Palestina"" na ""Utafiti wa Afya ya Watoto na Vijana wa Palestina"" na ""Utafiti wa Afya ya Watoto na Vijana wa Palestina"" na ""Utafiti wa Afya ya Vijana wa Palestina"" na ""Utafiti wa Afya ya Vijana.""" Kuendeleza Mkakati wa Kitaifa wa Afya ya Akili ya Watoto na Vijana nchini Palestina. BJJ Open, 9 S1, S84-S85 (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (BJR) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) (R) "Wakili wa WAIMH, Nadia Dabbagh, alisema: ""Tunashukuru kwa msaada wa Royal College of Psychiatrists, Uingereza, ambao kwa ukarimu walishiriki hati kamili na Perspectives in Infant Mental Health na wamekuwa muhimu katika kusaidia watoto wachanga katika mgogoro." Mawasiliano yanaweza kutumwa kwa: Daktari Nadia Dabbagh. Email: @mwenyeji.com, Mkurugenzi Msaidizi wa Mkurugenzi wa Mkurugenzi Msaidizi