We have been involved in training, researching, and developing services for children in Georgia for 15 years and have established Children of Georgia, a non-governmental organisation (NGO) which advocates on behalf of and for orphaned and disabled children in that country. Georgia became involved in a five-day military conflict with Russia over long-disputed territory in August 2008 and we had just left Georgia before the conflict broke out. Two months after the cessation of hostilities we returned to Georgia to assist in the provision of psychological trauma services for conflict victims. Over 160,000 people were displaced from the two regions of Georgia, Abkhazia and South Ossetia, caught up in the fighting. In addition, many Georgian residents in the adjoining regions came under air or artillery attack and, in some instances, intrusion by Russian troops. The surviving victims of the struggle were in shock. Many had experienced or learned of unexpected and sudden death of family members, injury, rape, beatings, incarceration, loss of home, livelihood, separation from family and friends. Some had the additional strain of two to three days and nights trekking towards Georgian-controlled territory while trying to avoid capture by the South Ossetian militia or their Russian allies.
In the aftermath of the conflict, the dispossessed and displaced persons faced placement from rural communities into tent villages or abandoned Government buildings in cities which frequently were unfit for habitation due to broken windows and lack of adequate cooking, toilet and bathroom facilities. Often, where families were intact, several generations were sharing single rooms. Many of them also faced a number of relocations over the following months, anxiety about the fate of missing family and friends, and a lack of social and mental health support services, minimal financial support, and no opportunities to work. Children who had been uprooted from village life eventually found themselves placed in unwelcoming urban schools, isolated from friends and peer group, and living with distressed and, in increasing numbers, angry and depressed adults, some of whom (mostly males) turned to substance abuse and domestic violence. After 12 years involvement in Georgia, we were aware of the absence of psychologists and psychiatrists with training in cognitive behaviour therapy (CBT) or knowledge of diagnosis and treatment of psychological trauma. We were also aware that the initial international disaster response would most likely last for a maximum of three months, leaving the small and essentially under-qualified and largely unprepared local mental health services to pick up the burdens of post-war trauma that would continue to emerge with the passage of time. Consequently, we returned with the intention of offering an intensive programme of trauma-focussed CBT training that would train mental health professionals as both therapists and competent trainers. This was in keeping with the philosophy of our work in Georgia, which has always been to leave behind locals with knowledge and skills for both independent practice and dissemination to others.
From this Georgian experience we identified some relevant strategies for application to disaster response in New Zealand which, due to its vulnerability to significant seismic, volcanic and climatic events, needs to have available psychological services to meet the human consequences of natural disasters. We foreshadowed some aspects of this in an earlier paper (Parsonson & Rawls, 2010) and expand upon them here.
Establishing a Training Programme
Our first action was to make contact with regional UNICEF and the World Health Organisation (WHO) teams co-ordinating the mental health responses to the conflict's victims by local and international NGOs. It was evident that there was no planning for the longer term trauma that would surely emerge over time. Nor was there any financial provision to support training of personnel for that eventuality. …