At the end of the semester, many of the MIDP seminars require fellows to face new international development problems and resolve them through teams of 4-6, often from as many countries around the world.
In the case of Rosemary Fernholz’s core Policy Analysis seminar, fellows who had joined the MIDP program this fall were required to deal with an issue most had never encountered: mental health in post-conflict countries.
In Rwanda, for example, 25 percent of survivors still suffered from post-traumatic stress disorder (PTSD) 16 years after the genocide, and many more had anxiety disorders or even suicidal tendencies. And in Cambodia, more than 30 years after the genocide, a similar proportion of the population was still affected. Meanwhile, existing public health systems had been able to devote only limited resources to mental health.
Fellows were challenged with preparing a strategy to deal with mental health, with two teams focusing on Cambodia and two on Rwanda. The whole exercise was evaluated by three judges who were asked to decide which team would be funded to carry out its project proposal. Each of the proposals was to be based on the policy analysis logic, starting from the policy context and relevant stakeholders, and moving to the definition of the policy problem and its significance, the diagnostic of its causes, proposals to overcome these, their costing, and an implementation strategy to ensure sustainability of the recommendations.
All four teams focused on the development of community-based services, examined the extent to which they should be provided by the public, private, or NGO sectors or through partnerships, and whether the issue should be dealt with essentially as a health issue, or as one requiring an integrated approach. In addition, all looked at human resources development needs at all levels of the system, as well as the necessary back-up infrastructure.
Some were concerned with overcoming likely reluctance to ask for mental health assistance. Others thought of rebuilding the social capital of communities, encouraging job opportunities for the victims and their families, and including traditional healers in their strategy. Still others proposed to use mobile clinics to reach larger numbers of dispersed population centers.
One team also thought of proposing a central unit to monitor the situation, identify patterns, and provide a round-the-clock help-line. Another thought of using community traditions of mutual help and group work complemented by poetry, music and drawings to help individuals and groups share their feelings and rebuild their trust in each other and the future.
Finally, all were concerned with minimizing the risks of younger generations being affected by the trauma and proposed special training of teachers and development of educational materials.
Altogether, this was an outstanding demonstration of how much participants had gained in their very first semester in terms of capacity to diagnose and solve problems new to them and constructive use of all team members’ knowledge and experience.