14 May 2014

Africa: Improved Mental Health Care for Refugees in Israel

Tel Aviv — Thousands of African refugees and asylum seekers in Israel suffering from trauma and depression after fleeing abuses in their home country or surviving torture camps in Egypt are now getting improved mental health care, though more needs to be done, say refugee groups.

Until recently the only help available has come from NGOs, notably Physicians for Human Rights (PHR)-Israel, whose volunteer doctors provide basic general care through an open clinic in the city of Jaffa.

But in the last few months, the Israeli Ministry of Health (MoH) has opened a free clinic for trauma and post-traumatic stress disorders [PTSDs] in Jaffa after saying that they had "recognized the need".

The UN Refugee Agency (UNHCR), which is part of the joint-venture, welcomed the move saying "we hope they will be able to include them in more clinics and find more funding for these services."

Activists and volunteers say this is a "much needed and belated step, but a step forwards none the less".

"It's a step forward but it's still not nearly enough; it's only in the Tel Aviv area and the hours are not nearly enough for the number of people we estimate need treatment," said Elisheva Milokovsky, head of the refugees and asylum seekers department at PHR, told IRIN.

The clinic is open for three hours a day, three times a week.

"This is a first step for the GOI [Government of Israel] accepting responsibility: we need to see at least five more clinics opened in the country and a broader support system," she added.

UNHCR representative Valpurgen Englbretht told IRIN it was hard to be precise about the numbers of refugees and asylum seekers suffering mental illness, but, that they "estimate that some 7,000 of the asylum seekers suffer from PTSD due to what they have been exposed to on their way here. The situation now is also a trigger for many of them, as their lives here become more difficult and uncertain."

According to UNHCR, there are 55,000 asylum seekers and refugees residing in Israel.

No health insurance

A report by Human Rights Watch (HRW) in February said security forces in Sudan and Egypt either turned a blind eye to human trafficking, or in some cases colluded with the smugglers.

Reported incidents of kidnapping and torture by Bedouin smugglers in the Sinai region grew markedly from 2009, with the relatives of those held captive told to pay tens of thousands of dollars in ransom money to secure release.

Before last year's completion of a security barrier along the Israel-Egypt border, asylum seekers and migrants regularly arrived in Israel suffering from broken limbs and severe burns.

If detained they are provided with medical care by the IPS (Israeli Prison Service) but the majority of the asylum seekers living in Israel have no health insurance and rely on the few free clinics and projects, and on the goodwill of doctors and volunteers.

Dr Ido Lurie, a psychiatrist and the head of the new government clinic, heads a team of 21 professionals and 4 interpreters.

"The treatment we offer is different from the usual protocol - we need to treat our patients in a holistic view, try and help not only psychologically but also in any other means possible, in general health, shelter and food. We try not only to counsel but also direct them to other NGOs that offer aid."

Among the patients are an Eritrean man suffering from bursts of anger and flashbacks to the brutality he witnessed in the Sinai camps, and also an Eritrean woman in her late twenties who spent seven months in a Sinai camp and now cannot sleep without medication, cries uncontrollably and sees no meaning in her life.

Lurie says it is challenging getting word out about the clinic, and fighting cultural stigmas associated with mental health issues: "It's not an easy task. We conduct group meetings. We hand out fliers and invite those with sleeping disorders, for example, to visit the clinic. We also use translators who many times act as 'cultural mitigators'. It's not easy in a close-knitted community that still stigmatizes psychological treatment."

The government doctors can write reports advising that patients being treated are not sent to the Holot open detention centre, in Israel's southern Negev desert. Holot can house 3,300 migrants and is set to expand, eventually reaching a capacity of 6,000-9,000 people.

"It is our professional view that people suffering from depression and PTSD should not be detained. These reports are taken into consideration."

[This report does not necessarily reflect the views of the United Nations ]


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