Country: Turkey
Closing date: 30 Jun 2015
1.1. Justification of the position/Background
The Syrian Arab Republic is located at the core of the Middle East, bordering Iraq, Jordan, Turkey, the Mediterranean Sea, Lebanon and Israel. It is inhabited by over 22 million people, mostly living in urban centres in the coastal plains and the Euphrates River. Divided in 14 governorates, Aleppo, Damascus and Homs are the biggest cities. The ethnical, religious, cultural, social composition is complex and similar to the ones of Iraq and Lebanon. A majority of Sunni Arab population lives together with Alawites and mixed with people of Shiite, Kurd, Christian, Ismaili, Druze, Assyrian, Armenian, Turkmen, Palestinian, Circassian, Yazidi and other minority backgrounds. The Syrian state gained independence in 1946 and it has been ruled by the Baath party and the Al-Assad family since 1971. Syria is considered a lower middle income country with an economy based in the oil, state, tourism and the agriculture.
Since March 2011, the protests against President Al-Assad were answered with brutal repression by the paramilitary groups and the army. After 3 years of conflict, the opposition resorted to violence and the situation has evolved towards a full scale war. No region or governorate is currently spared from hostilities and the economy has crumbled.
The international community and regional powers have been also deeply implicated. There are no hopes that diplomatic or political efforts will resolve or moderate the situation in the short term, and minorities that tried to keep themselves out of the conflict are being dragged into the dynamic of war. The implication of radical jihadist groups, the support given to the armed opposition by the West and Arab countries and the back of the regime by Hezbollah, Russia and Iran are leading Syrian war to irreversible deterioration. Currently, the situation resembles the early stages of the conflicts of Lebanon in the 80s or Iraq a decade ago. The path towards sectarian violence and the prolongation of the conflict as the adopted tactic by the regime, gives very little room than the full scale sectarian civil war with no end in sight.
None of the warring parties is respecting the international humanitarian law. Even forbidden chemical weapons have been used against civilians, during 2015 already a couple of attacks on chlorine have being reported on Idlib area. The result of the battle for Aleppo is seen as a potentially game changing and turning point in the war, which could give one of the sides an edge in the conflict. The conflict runs its course with the certainty of deterioration in 2015.
While there were not previously significant indicators for humanitarian crisis or need for medical aid in the country (Drought in the east of the country, vulnerable situation of Iraqi refuge women, endemic communicable diseases,...), the escalation of violence has changed all the paradigm and it has leaded to a full humanitarian crisis were all the key and most important cities and regions have been engulfed, focused mostly in the lack of train and experience human resources (flew to other countries/areas) lack of constant supply, and lack of coordination among themselves. Access to humanitarian aid and medical care has been severely curtailed specially in the areas under dispute. Health centers and hospitals have been damaged or abandoned, and most of the assistance is provided in self-made provisional medical units.
The war has claimed the lives of more than 150.000 people, hundreds of thousands of injured and at least 6.5 million displaced, 2.5 million of them are seeking refuge in Iraq, Lebanon, Turkey, Jordan, Egypt and Europe. Tens of thousands of civilians remain trapped in combat zones. Massive displacements continue as the military situation is stagnated. Civilians are bearing the brunt of the violence. Indiscriminate attacks and deliberate targeting against civilians are happening as witnessed by MSF teams.
The main perceived medical need is the assistance for wounded, but indirect consequences of violence are the bulk of the needs (compromise of live due to maternal conditions, chronic conditions, children’s health, etc.,... ). As the conflict shows no signs of declining, further attacks on civilians, displacement, the likelihood of outbreaks and massive medical and humanitarian needs are expected.
Due to the ongoing situation, MSFOCBA has being one of the few providers of medical supply and care to several health facilities (over 26 in total by 2015) with the area.
The Syria’s mission run by MSFOCBA started its activities since the initiation of the conflict in Syria in 2012, providing PHC, SHC, SRHC, MH, Surgery and others in 3 different locations: Kilis (Turkey), As Salamah/Maskan and Aleppo (inside Syria). The main objective of the intervention is to provide medical relieve to the population in both sides with focus on women and child’s health.
At the beginning of 2015, MSFOCBA counts with the MH component in two of the projects:
- Kilis: psychosocial services are provided to the Syrian population (refuges or not) who are already establish in Turkey or seeking for refugee status. The UN has calculated that a total of approximate 1.6 million people had flew to neighboured countries in seek for security, health, and others. Kilis is the one of the most important points/cities of entry for the population moving away from the northern district of Aleppo which still holds the resistance against the governmental forces and the ISIL. A total of 594 sessions were run during 2014 at this location, including individual, family and psychosocial session. For 2015 it has being foreseen as the stage of consolidation and improvement in the quality of care provided at the “Lemon Tree house” (psychosocial center run by MSF).
- The MH team is composed of 3 Syrian psychologists; 10 Syrian CMHW; 1 head of CMHW; 1 Translator/Data entry officer (de facto, performs as a MHAM assistant); 1 Syrian referral translator.
Since Oct 2014, MH project is under the coordination and management of a national (Turkish) Mental Health Activity Manager (MHAM). She has been in the MH team as a clinical psychologist, almost from the beginning of the project.
Added to this component, MSF also provides counseling services in the district of Bab Al Salamah (in the north part of Aleppo) through its project in Al Salamah Hospital. The project is run by satellite approach due to the difficulties in accessing the area by international staff since March 2014. An approximate total number of 175 MH consultations were run during 2014 at the Hospital. The team there is composed by 2 Syrian counselors that are being provided support through “Skype” by the MHAM located in Turkey.
Apart from MSF, there are several other NGOs/organizations in in the mission, which run MHPS activities at some level. However most are at the level of recreational activities, or ‘case management’ by ‘social workers’ (CMHW) or psychiatric treatment. However, as a system of MHPS Services; MSF is the only project providing an encompassing intervention at all levels:
Few of the challenges faced at every level by MSF and the team working in both projects are:Lack of “clinical approach/background in the national staff” Difficulties in understanding the need of follow up and management of the cases. Difficulties in providing support through the satellite approach to the NS in the field - Lack of information/training/capacities in approaching children and other vulnerable populations (survivors of SGBV, women, family issues)
After the annual revision done in 2014, and the visit of the MH Referent in 2015 (first trimester) it was evident that support was needed for the NS MHAM as the overall workload remains high and the number of activities keep on growing. Adding to this, there has being some incidents regarding managerial issues and support given to the MHAM in her position as manager by her colleagues. For the reasons explained above it was decided to provide an “On-site technical support to provide the counsellors and psychologist in both teams with the basic clinical skills to increase the quality of care, without undermining the overall structure of the team (managerial and organizational aspects will remain with the MHAM while the technical training will be provided by the Expat Psychologist for only a determine period of time).
1.2. Main objectives/responsibilities of position
Main objective: Provide technical support and on the job, daily training to the MH team (psychologist and counsellors) in order to improve the quality of care provided at both projects ASH and Kilis.
1.3. Timeframe - The overall duration of the intervention has being estimated in 3 months, place mostly in Kilis project (LTH: Lemon Tree House) but allocated as well in the provision by “remote control” to the ASH team.1.4. Expected outcomes Development of a training curriculum and implementation of the training strategy together with the MHAM. Individualized training plans and follow - up for the staff in both projects. Monthly reports evaluating the outcomes and evolution of the intervention. Overall evaluation of the experience by the end of his/her mission.
- RESPONSIBILITIES AND TASKS
Works in close collaboration with the Mental Health Manager in the design and implementation of the training curriculum (in both Al Salama and Kilis project) regarding clinical care and counselling with the support of the MH Referent HQ - Provide to the counsellors and psychologist with the training and tools to carry out evaluation of psychological and mental health needs of patients, elaborate a diagnosis and establish a plan of treatment.
- Supports in the training for diagnosis of psychological and/or psychiatric disorders.
- Supports the team in the establishment of a clear referral system between LTH and the OPD in Kilis project and between the services (in ASH project).
- Follow up and support the implementation of the Sexual Gender Based Violence (SGBV)’s protocol, and reinforces the flow of the patients together with the MH team in Kilis Project.
- Provide psychological support and psychotherapy sessions training to the MH team (in both types of intervention: individual, family/ group) to patients according to MSF protocols.
- Provides “on the job and daily” training regarding data collection, analysis, and monitoring about mental health activities
- Provides feedback to the MH manager regarding the status of the training and final recommendations after the intervention for follow up.
- Ensure that all patient information is kept confidential
- REQUIREMENTS
Education - Essential degree or diploma in Psychology
- Desirable degree in clinical psychology
Experience - 2 years’ experience minimum as a Psychologist
- Previous experience as clinical psychologist is a must.
- Desirable previous experience with MSF or other NGO’s in developing countries.
- Desirable experience in training and coaching.
- Desirable experience in counseling.
Languages - Mission Language (English) essential
Knowledge - Desirable computer literacy (word, excel and internet)
Competences - Result, teamwork, flexibility, commitment, stress management
How to apply:
Applicants should send their CV and motivation letter under the reference "Clinical Psychologist" to:
Médicos Sin Fronteras - Dpto. RR.HH.
recruitment-bcn@barcelona.msf.org
Closing date: 30th June 2015.
Replies will only be sent to short-listed candidates
