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PTSD

Horrors of War: Doctors Without Frontiers

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Doctors Without Frontiers or Médecins sans frontières (MSF) willingly jeopardize their lives and safety to deliver medical care to those in need. Katrin Kuntz summarizes their experiences as “the deadly business of War-zone medical care” here.

Paul Mcmaster who works as a surgeon with the MSF attacks can come from the ground, which is the case in most war zones. Working in Syria, however, has made doctors apprehensive of dangers from the air.

MSF personnel provides care on a needs alone basis.

MSF demonstrates its independence to warring parties by ensuring that all funding comes from private individuals and not governments.

Doctors Without Frontiers experience firsthand the effects of conflicts in war zones. Their work continues to face hurdles that led to the formation of the non-governmental organization in 1971 by a group of French physicians working in Nigeria during the deadly famine and civil war in Biafra.

MSF sought to address frustrations caused by the slow pace of work and restrictions on doctors’ activities.

War and conflicts potentially disrupt the core functions of MSF, which include:

  • Medical,
  • Administrative/finance, and
  • Logistics

The experiences from the disruptions are diverse and affect the doctors and patients in different ways.

Emotional and physical toll

Everyone is different implying hey handle stress in disparate ways. Incidences of doctors completely shutting down and disengaging emotionally to utter hysteria are common occurrences. In most cases, they result from the cross-cultural differences in how to deal with stress.

Doctors who push themselves too much may need artificial relaxers to calm down after long hours of work.

A significant proportion of MSF doctors who work in the emergency pool – an elite team of first-responders who have proven themselves to be able to handle the chaos of emergencies and are on call for 24 hours – often end up with post stress traumatic disorder (PSTD).  Some adopt behaviours such as drinking and smoking that are risky to their health.

Immediate response

War and conflicts, regardless of stature, leads to fear of persecution and violence, uprooting communities and rendering them in need of urgent medical care. Trauma injuries rise during conflicts, and so do problems for people needing routine medical care such as pregnant women and the chronically ill such as diabetics.

Psychological distress and mental illnesses escalate. Sexual violence becomes common.

MSF doctors face the challenge of addressing these medical needs and highly tense environments.

Intense violence

MSF teams demonstrate a great deal of flexibility where violence engulfs their areas of operation. In 2011 when medical facilities in Misrata, Libya were engulfed in violence, MSF doctors had to evacuate the wounded patients safely and quickly out of the city.

Doctors are forced to risk their lives and those of their patients.

The situation worsens with the increase in the portrayal of war zones as death traps. Governments continue to ignore the rights of their enemies in the name of fighting terror – by objecting to their treatment.

The development presents extreme dangers to MSF personnel. Warring parties are likely to see them as sympathizers of the enemy by disregarding neutrality.

Hospital attacks 

“Medical under fire” is a phrase used to refer to an unsettling trend that makes MSF work difficult, denying thousands of victims medical care. Reports of hospital attacks in war zones are common news feature. The horrific attacks involve the destruction of medical infrastructure and attacks on aid workers.

  • The US Air Force attacked an MSF hospital in Kunduz, Afghanistan in October 2015, killing forty-two people including fourteen MSF staff.
  • On January 2015, an MSF hospital with 150 patients and staff in Farandalla was bombed by a jet operated by the Sudanese regime.
  • In May 2018, unknown assailants attacked an MSF vehicle in the Central Republic of Africa, killing its driver.
  • In late July 2016, the Syrian regime attacked four MSF run hospital in Aleppo.

MSF personnel continue to face dangers working in the battlefield. The largest contributor is the growing intolerance of enemies by governments as the war on terror and criminals escalates.

Is PTSD a Death Sentence? (Explanation of a Psychologist)

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Post-traumatic stress disorder (PTSD) is a mental condition that people such as veterans develop after experiencing life-threating events or severe trauma. PTSD in soldiers of Iraq, Vietnam and the World War II, were majorly due to warzone-related stressors like witnessing the death of their colleagues, being ambushed, and severe wounds inflicted by explosives. People with PTSD usually seek help in hospitals and support groups, and these places present some likely scenarios to meet individuals with PTSD. PTSD intervention requires the collective effort of family, friends, and psychologists if notable changes were to be realized.

soldier

Community support groups provide people with PTSD a platform where they can share experiences, learn from others and help them connect with those with similar experiences. In addition to that, community-based clinics provide the needed therapy by telemental health or by referral to various community clinicians. As a psychologist, I should be prepared to provide social support, be a good listener, anticipate and help people with PTSD to manage triggers.

Sometimes it can be tough for PTSD patients to open up about their traumatic experiences; in such a scenario, we should not pressure our loved ones into talking. In fact, we should let them take the lead instead of always telling them what to do. Anyway, some given ptsd case of medical treatment and therapy is really successful but another demonstrates the sadness of failed mental recovery. Thus, its intervention should be conducted with due diligence.

Often people with severe PTSD tend to be suicidal especially when confronted with situations that they believe to be inescapable, intolerable, and interminable. For instance, the pain of losing a loved one is inevitable and can be so severe and prolonged to the extent of causing a neurobiological and psychological breakdown. More importantly, the pain can be unbearable that the client sees suicide as the only relief.

Further, there are numerous myths about suicide some of which I was not aware until the crisis intervention forum. For example, I did not know that discussing suicide with depressed people might give them the idea of committing suicide. I was not also aware that people who often threaten suicide do not do it and that the tendency to commit suicide can be inherited. These myths can stand in the way of assisting suicidal clients, and it is by disregarding them that the psychologist can identify those at risk and thus providing the necessary assistance. As can be seen, PTSD is a very sensitive issue.

firefighter

Post Traumatic Stress Disorder and firefighters

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Did you know that not only soldiers but firefighters very usually have PTSD?

Mental health illness can only be cured through positive mindset, positive thinking, and one’s inner motivation and courage. In addition, the support from the dear ones, and proper medications from the psychologist will heal the inner traumas of depression.  And it seems that such things do not work out for the firefighters who are constantly facing with the issues of mental illness.

There is a need of proper Health Advocacy Program that will focus upon the needs and requirements of these people; they are constantly exposed to working in stress situations. Hence, they get affected with Post-Traumatic Stress Disorder (PTSD).  Only providing medicines and recommending certain physical exercises will not solve the issue. There is a need to spread awareness through proper marketing campaign, which we shall discuss in this report.

Public Health Issue 

As per one of the latest research reports provided by the UN in 2012, it was found that the global expenditure for resolving fire emergencies has crossed the mark of $17 billion in annual expenditure. This report was presented in the Stockholm International Peace Research Institute (SIPRI) Year Book of 2013.

It seems that these governments are focusing only upon fire-fighting strategies. Despite of this spending, the government is not providing proper support to the firefighters working in different challenging situations.

Also, due to recession firefighters are facing with several financial and healthcare issues. The government did not pay proper attention to their position; instead, it reduced the general spending and continued to spend more and more on other expenses. The US government has even failed to justify the policy objectives when it comes to give aid and assistance to the firefighters.

The firefighters need to be ready to face any situation as per instructions of the government. The firefighters are required to fight any threat of that nation in a given world. The government is not at all serious regarding the spending of huge amounts after these operations. This of course, is not a case of single firefighter belonging to US, is a case of several firefighters, who have been facing with the issues of mental illness.

As per one of the previous research studies, it is found that firefighters just withdraw them from the on-going life situations. The firefighters behave in such a way as if, they are not at all belonging to their respective families, but they are separate entities. They do not enjoy their family lives, and also in some way try to disturb the peace of their respective family. Hence, it becomes important to devise a policy with a complete set of objectives that will help these people to overcome their respective mental health issues.

Description of issue and proposed policy solution

Mental health issues are believed to be a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR) classification system. The key underlying feature of this disorder in any given firefighter seems to be the disturbance in their mood. As per ICD 10, this classification is known as Mood Disorder. It was initially known as affective disorder, but it was then changed to mood disorder, since the condition of an individual refers to the longitudinal emotional state.

The initial term was framed by English psychiatrist Henry Maudsley, where he referred to the state of mind, state of condition, and state of behavior of the given African American individuals to the external expression.

There have been several sub-types of this mood disorder observed amongst the firefighters. The commonly found disorders included unipolar depression, major depression, and several other forms of mood disorder, wherein the given person was experiencing several depressive episodes. The depressive or the mood disorder turns into Major Depression Disorder when, the diagnosis determine successive and recurrent episodes of the depression in the given individual. Some of the firefighters were also found to be suffering from unipolar depression, as their mood was remaining at the bottom pole.

The major symptoms that are leading to such disorders include depression, stress disorder (PTSD), adjustment disorder, and alcohol abuse and dependence. The risk of committing suicide is greatly elevated for these active-duty firefighters since the mental health disorder takes time to get cured.

The firefighters cannot constantly digest the war trauma and the mental stress from the physical and mental health perspective. They will get tired and hence, want to end their lives. One of the recent reports released by the US government in 2013 mentioned that the suicide rates for the firefighters that are deployed is increasing.