With over 100 million people now displaced globally as a result of conflict and climate, there has never been a more important time in our history to consider our role as rehabilitation professionals in supporting displaced persons in accessing quality healthcare.
The last 8 weeks of the ReLAB-HS massive open online course (MOOC) on Understanding the Rehabilitation Needs of Displaced Persons has provided a fantastic opportunity to learn more about the impact of displacement on health and wellbeing.
Hundreds of global learners from over 86 countries have completed thousands of learning activities and interacted in the online discussion forums. A wide range of rehabilitation professionals participated – including physiotherapists, occupational therapists, psychologists, speech and language therapists, doctors, nurses, prosthetists and orthotists, to name just a few.
In Course 1 on the global context for displaced persons we explored the terminology and data surrounding displacement. It was eye opening to learn about the numbers of people currently facing displacement globally. The reality of displacement was really brought to the fore within the discussion forum, with participants sharing their own experiences of displacement.
The learning so far is providing me with a better understanding of the diverse population clusters among immigrants. In my own writing and research on the cultural consequence of immigration, I divided immigrants into two main groups: willing to and forced. The course so far has given me a much wider view and important resources.
Course 2 considers the many complex health challenges that can accompany displacement. A key highlight for me during this course was on self-care, and the importance of developing support structures within your work environment. I think how the course instructor Wala’a Awwad describes self-care as being “something that refuels us rather than takes from us”, was very thought provoking, and has certainly made me consider what I do within my work environment to become more resilient so that I can then better meet the needs of those that I work with.
As someone who I feel is getting close to burn out at the moment, the self care section helped me to recognise my signs and remind me what I can do to prevent a full episode. I have spoken to work colleagues and made changes that will help support me. I have taken on a new project – instead of something else I am working on rather than in addition to – and this has boosted my enthusiasm. I feel this will have a positive impact on my patients now that I am feeling calmer.
Trauma informed care was a fundamental element of Course 3 for me, and something I now recognise as being essential in working with any patient population. Understanding trauma and the impact of trauma on individuals is vital when working with any population, but is key when working with individuals who have been displaced.
What caught my attention most is trauma-informed care. It is essential for us as rehabilitation professionals to seek to understand their experiences. We must respond to them appropriately while being sensitive and respectful to the client without dismissing their experiences or coping strategies.
Course 4 provided a great opportunity to consider the diversity seen within displacement, and considering the implications that this may have on access to health and rehabilitation services. In particular it was interesting to learn more about some of the specific challenges that are faced by many LGBTQIA+ individuals both pre, during and post displacement.
Communicating with them and asking about their preferences will also help .
I had not fully considered the implications of marginalisation and the impact of this on resettlement, and recognising individual preferences and acknowledging these.
I would offer a section on the intake form for them to identify with the gender identity that they are, as well as their sexual orientation. I would also offer them a space to decline answering those questions, as I believe they should reveal what they want to in the time that they want to. Should they choose to offer that information, I would let them know that we could be in a private treatment room, or accomodation of their choosing in order to bring about a good therapeutic relationship and a cycle of trust again within healthcare.
Coures 5 and 6 provided some amazing insight into working with individuals who have experienced sexual violence, sexual trafficking and torture and approached these very sensitive topics with great compassion, providing excellent strategies and practical ideas to support individuals with these experiences.
The best element I have noticed in this course was that it covers all the gender based research covering both male and female violence in the household and armed conflict scenarios.
In particular, I found the mindful movement, body awareness and graded exposure really useful strategies to incorporate into my work, and will utilise these more in my practice.
The different treatments provided for both women and men’s health and in how to cater to survivors of sexual violence was a very good learning experience. Knowing about sexual violence during armed conflicts and the psychological bases of committing such acts was surprising for me. Hearing the experiences that these people have experienced has left me sobered up on the harsh realities and injustice placed upon them.
The final Course 7 of assessment and management of displaced persons with pain really highlighted to me the high prevalence of persistent pain in torture survivors and in individuals who have experienced conflict. The presented Pain and Disability Driver Model provides a great tool for exploring pain, and understanding the impact of different domains. Having the opportunity to also hear more from the course instructor Zafaer Altunbezel and ask specific questions during the live webinar was a real bonus of the MOOC, and something that will hopefully be brought forward in to future MOOCs.
Overall the highlight of the MOOC for me this year has been the amazing participation in the discussion forums. The diversity of professionals from a broad range of settings and contexts worldwide encouraged rich conversations. The opportunity to discuss the barriers and challenges that rehabilitation professionals face when providing rehabilitation services for displaced persons resulted in constructive dialogue around creative solutions to increase access to quality services – a very encouraging outcome.
Don’t miss out on these fantastic resources
Free access to the understanding the rehabilitation needs of displaced persons programme has now finished. However, Physiopedia Plus members can continue to access the programme resources (including recordings of the two live webinars) and submit an assignment. Plus members can choose to take the whole programme of courses on, or dip in to the individual courses for specific knowledge, with both monthly and annual options to join.
People in low and low-middle income countries get free Plus membership, and there are several discounts available based on where you live and for students. Don’t miss out on these fantastic resources!
This work is supported by the USAID funded Learning Acting Building for Rehabilitation in Health Systems (ReLAB-HS) project and is not possible without the generous and committed contribution of the Leahy War Victims fund.
ReLAB-HS is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and is implemented under cooperative agreement number 7200AA20CA00033. The consortium is managed by prime recipient, Johns Hopkins Bloomberg School of Public Health.