Coronavirus: MSF's mobile clinic for vulnerable groups
In France, MSF teams are running medical projects for vulnerable groups, including homeless people and migrants, in Paris and surrounding areas. We are working in emergency shelters set up to accommodate people living on the streets during lockdown, providing medical support, evaluating health status, and identifying potential COVID-19 cases.
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Let's talk COVID-19: Mental health

A live online discussion series hosted by MSF-USA Executive Director Avril Benoît

April 09 2020, 1:00pm - 1:45pm ET

Read transcript here

Avril Benoît:

Hello. Welcome and thanks for joining us today for our weekly series, Let's talk COVID-19. A couple of minutes delay, apologies for that. I'm Avril Benoît. I'm the executive director of Doctors Without Borders in the United States. You might know Doctors Without Borders also by its international name. In French, it's Médecins Sans Frontières and that's why we get the acronym MSF. When you hear us referring to MSF, that's Doctors Without Borders.

Today, we're focusing on mental health. One of the reasons we wanted to really touch on this is we know that healthcare workers who are right there with the patients, treating those with COVID-19 and this includes, of course, MSF staff, they're facing intense pressures. They're facing exhaustion. Social isolation, many of them are separated from their own families. They're also struggling with the same feelings of anxiety as the rest of us. But their issues are acute because there are sometimes questions of ethics, guilt can come into it, fear of contagion, the grief of knowing that their own loved ones might be suffering, might be ill, and of course loss. We've all lost a lot of freedom. We've lost of control over our lives. There are any number of layers for us to dig into today.

We'd like you to have the opportunity to ask a couple of mental health specialists for advice and for insights on how to get through this in a good way, in as positive a way as a possible. So, they're going to share how they're specifically supporting mental health aspects for the healthcare teams through this crisis, and how each one of us can take some of these techniques and look after our own mental health as much as possible. Just a couple of quick points around how you can exchange with us. We're going to go for around 45 minutes. Whenever you can, just go into the Q&A option on Zoom. You'll see that as one of the places where you could just pop in your question and then they will be sent to me. If you're joining us on Facebook or Twitch, send your questions in the comment section.

Our guests today are Kaz de Jong. He's a clinical and health psychologist who heads the staff health department for MSF, long time based in Amsterdam, and he's also the mental health advisor for MSF. He's right now working to support our teams who are on the ground in different parts of the world. We work in more than 70 countries with operations. Those teams are very much bracing themselves for the arrival of coronavirus if it hasn't already come into their country in places where we're working and we have staff. He's also, of course, helping with the mental health needs of our staff who are responding to other kinds of emergencies. We respond in war. We respond in other sorts of outbreaks, in refugee camps, in many different kinds of settings where the stress is real.

So, Kaz, maybe you could just let us know how you're doing, where you are, and just give us a bit of a sense of what your setup is there in Amsterdam. I think you're on mute. You have to unmute yourself.

Athena Viscusi:

Yeah.

Avril Benoît:

Okay. Well, there we go, Kaz. I think you're off mute now.

Athena Viscusi:

No.

Avril Benoît:

Oh no, we can't hear you. Okay. Hold there, Kaz. Let me introduce Athena. In the meantime, we'll try to sort out your sound. Athena Viscusi, we do hear you quite clearly. Athena is a clinical social worker, a psychosocial care specialist at Doctors Without Borders in the United States. She is currently supporting our U.S. based MSF staff with the difficult decisions and challenges faced by humanitarian aid workers in this pandemic. Athena, how are you doing and tell me about your setup there at home?

Athena Viscusi:

Well, fine. You hear me?

Avril Benoît:

Yes.

Athena Viscusi:

Okay. Great. Well, I'm calling from the not so exotic location of Brooklyn, New York. I'm in my house. Yeah, in my apartment.

Avril Benoît:

We're in week four of having scattered in all directions when we closed the office on March 13th, the headquarters in New York. Kaz, we got your sound working out now.

Kaz de Jong:

I'm certain. I think so. Yes.

Avril Benoît:

Yes.

Kaz de Jong:

Yes?

Avril Benoît:

Yes.

Kaz de Jong:

Okay. First of all, sorry for that. Anyway, thanks again for the introduction. I'm in Amsterdam. For here, for us, it's a very sunny evening. As in the U.S., we have to stay home. We can't go out, and it's pretty challenging for us in this beautiful weather. We're working from home.

Avril Benoît:

Fantastic, as we should be. If our work can accomplish anything from home, that's where we should obviously do it. But of course many workers are out there on the frontline, essential workers from various walks of life. We've already got our first question from Deborah who's asking how someone like her can support in their own community with the stress and anxiety. What can we do for one another? Maybe I'll start with you, Kaz. Any ideas for that?

Kaz de Jong:

Well, it depends a little bit about your background. Like I have a psychological background. I'm working in my community, the community hospitals, to give staff support for the people working in the intensive care units, in the internal diseases and emergency departments. That is more professional, but what I try to do for people in my own living neighborhood is first of all to be kind. I think this is a very challenging time for all of us and we very easily slip into bad moods and being unpleasant to each other. So, I force myself to give each of my neighbors, if I see them, a small compliment. Not a big one, but a small one. That gives me fun and it gives them fun. In that way, I try to support them. Of course, if they need groceries and stuff like that, I do also those kind of things, but that's very specific. Be kind to each other.

Avril Benoît:

Athena, what would be your suggestions, in addition to kindness, for how we can help one another through this stressful time in our community?

Athena Viscusi:

Definitely. Well, I think it always starts with ourselves, are we taking good care of ourselves, because like Kaz said, if I'm leaving my house in a bad mood or I'm not sleeping, I'm not eating well, I'm not ever going out for a walk, then I don't have anything to give other people. But I will say there's all kinds of, in the States in different communities, mutual health networks. There's people who are organized to get groceries by bicycle for their neighbors. Then there's the wonderful custom that started in Europe but that has spread to the States of people, here at 7:00 pm in New York, that people go outside and clap and holler for the essential workers who are at their job. I think that's so uplifting for the essential workers obviously who hear that, but just it's a moment to remember that there's all these positive people living around us and to not fall into that despair of isolation. That we have to remember, we talk about social distancing, but really it's physical distancing and we need social closeness at this moment in any way that we can have it.

Avril Benoît:

I actually set my alarm so that I always get a two-minute warning before I go out to my window, open it up and start clapping for the essential workers. I think it's really helped become a highlight of my day, which goes to show what's probably going on in my life trying to run MSF at the time when we're all separated within our apartments in New York City. We're receiving questions for both of you through the Q&A function on Zoom and chat on Facebook. So, let's get right into it again. We have Melissa in the Q&A asking about mental health for children.

Many people are trying to teach their kids or organize their kids through schooling through telecommuting or tele-distance type of schooling setups, and these children have anxieties. They see their parents stressed. They see what's going on around. Maybe they're overhearing what's going on in the news. For parents, what kind of things can they do to reassure their kids while not hiding the reality from the kids? Athena, maybe you first.

Athena Viscusi:

Yeah. First of all, I'd say I'm very fortunate that my kids have grown and that we're not quarantined together, but I think exactly the point of how you tell the truth without alarming children. To remember that what children don't understand, they usually think is worse than what it is. So, sometimes we want to hide things from them. That doesn't work. It's just their little emotions run wild. So, it's important to find a way to bring to children. Then may say, "I'm so happy to be home. There's no school," but "Well do you understand why there's no school? What do you think about that? Do have any questions you want to ask? Are you afraid of anything? Is there anything we can do to make you less afraid?" Don't bombard them with information but ask them first what they're thinking and what their concerns are.

They often have quite charming ideas of what's going on, the little ones. So, it can also be helpful to ask, but to really explain to them. Then maintain, again, as much social connection. A six-year-old friend who was just telling me how she went to visit her grandmother and the grandmother was at the doorstep and she was in the car, but how reassuring it was for her. So just remember to find some way for children to maintain those social connections. I don't know. Kaz maybe you've had working frontline healthcare workers and they probably have concerns about their children.

Kaz de Jong:

Yeah.

Athena Viscusi:

That might be... Yeah. What have you found?

Kaz de Jong:

Thanks Athena. It's very important what you say especially explaining and be honest to children and explain it in their language. A two year old understands a different language than a 10 year old, but to be honest and fully don't hide. With the frontline workers, they have an extra problem because they take the disease home. At least that's what their environment thinks and they're scared of doing that. So, what I advise them always is to discuss with their family what they need to do, what kind of rituals they need to do before entering the house in order to avoid the transmit. It means for certain households that they have to get the shoes off, use alcohol to wash their hands. In other families, it means that they first have to go and take a shower and leave the clothes in the bathroom and take fresh clothes on.

So, these kinds of rituals that are done every day are extremely important for the healthcare workers themselves to feel reassured, but also for their family because even if you explain how the virus works, then still people will have bouts of fear and anxiety also in your household even if they admire what you're doing. So, be transparent. Try to bring back these kinds of uncertainties into a structure because humans, and MSFers are always everywhere in the world looking for strange environments et cetera, but we're all human beings including MSFers and we all have one characteristic. We love structure.

So, as soon as we are in new situations, we try to bring it back into a structure and that structure for children is extremely important. So, daily a rhythm. A rhythm means it is predictable. A rhythm means that a child can expect in two hours that there's going to happen something fun and that now the class is going on. So, have those rhythms and structure in your day because that gives them the safety, the feelings of safety which is extremely important. Safety and predictability and that's done from structures. For children, this is extremely important.

Avril Benoît:

I imagine for adults as well at a time like this. One of the things that people found difficult, and it's funny what ended up emerging as themes when we all started staying at home, those of us who are not essential workers out having to do something out in the community, is that people weren't changing out of their pajamas during the day. Personal grooming kind of went down the tubes for a while, things like that. Why does that happen? Why was it so difficult for us to get into the routine of things and maintain the kind of habits even in terms of when we work and when we don't work, when we're working from home? Why is that just so difficult to do the transition?

Kaz de Jong:

I think it's difficult because it's new. If it's a new situation, I see the same thing with our international workers abroad, they have to adjust to the situation and they need to read the environment. They need to read what to say and that's exactly the same for us. Yeah. So, that is why it is difficult, but it gives us a lot of peace of mind once we have established that. So, it really works to go back to that structure. You said it also works for adults in the same way and maybe I'm going to insult people, but adults are just big children. They, like the rest, they like tranquility, predictability and hygiene, just like small little kids. So, that's in the essence how we are.

Avril Benoît:

Well, let's get into some of the questions around humanitarian aid workers and also essential workers within health structures. There's so much that they want to do and we have some constraints. Supplies are very difficult to come by. The personal protective equipment, the PPE we hear a lot about. They don't have the masks they need because there hasn't been enough orders. They can't always put people on ventilators. There's too many people arriving and they're concerned about having to make these difficult choices.

Athena, maybe you could answer Christine's question here about how we as MSF, as Doctors Without Borders, are addressing this stress of humanitarian workers who feel unable to do more in this response, who maybe can't travel, who can't go and take that next assignment to go and help or they just can't plug in and be useful. How is MSF helping them?

Athena Viscusi:

Yeah. So, that's one of the losses you mentioned is that loss of identity as a helper, as a useful, engaged person. MSF attracts, of course, an inordinate amount of people who are used to having the solution. It's very difficult for us to sit on our hands and be told, "No, you can't go. You can't do this." I mean, these are the questions that we're always supporting people with, difficult decisions, inadequate supplies, things that they can't control. We work in areas where you can't get supplies if it rains too hard. You can't get through on the phone if it rains too hard. Where there could be, you have the best laid plans and then an armed group comes to a town and there goes your plans for your vaccination campaign or your nutrition program.

Those of us who give psychosocial support to our field staff, these are the issues that we're dealing with all the time. It's just heightened right now. I think what's so strange right now is that when people are far away from home dealing with these issues, now their families back home are also dealing with these things. So, they don't have that kind of rock to support them because they're freaked out too and they're dealing with all kinds of uncertainties. I mean, even taking a plane these days, you don't know if it's going to take off and hope it's going to land. Is this border going to close before I get there? Everything is so complicated. Quarantine rules changing all the time.

So, the way we're supporting is just being more available than we usually are. Providing also some educational materials, not just responding to crisis like when people are not feeling well, but providing, a lot of the offices have generated a bunch of educational materials for our staff to look at what's normal, what's to expect, what are some coping skills. I don't know if that answers the question. I don't know if Kaz wants to add something.

Avril Benoît:

Yeah. So, what is the setup then, just to elaborate, Kaz? How does MSF as a humanitarian organization respond to, address these mental health needs of its own staff to keep them as healthy as possible and able to get through the difficult times? What is the approach?

Kaz de Jong:

Well, we have people like Athena and we have many of them in our organization. We have availability 24/7 for people in distress. What Athena was saying about people that are workers who cannot do what they actually want to do or what they used to do at home and they cannot do in those countries. That is a matter of frustration and we're confronted with that now also here. So, that's a similarity and it's good to look at it. What we do with those kind of workers who are frustrated about this, I think it's good to be realistic and say, in this situation, it is not there and you better accept it. You're your own worst enemy if you continue to battle things you cannot change. That is a huge source of frustration that I think is nowadays not only part of our international staff, but of all of the people in this world dealing with this COVID. So, accept the situation in which you are.

I think a very, very important other issue is tell yourself the whole story because people tend to focus on what they cannot do. I cannot do this. I cannot go outside. I cannot whatever. Now, again you're your own worst enemy if you only tell that story to yourself and to others. The story is more. Currently, we have healthcare workers in the hospital who are, because of their mask, unable to give proper care, human care, human touch. Even when people die, they cannot be close to them. That's horrible for them. One of the questions we ask them is, "And what did you do," because people usually don't tell that part of the story. It is not what it used to be. You cannot be close as a nurse to somebody who is dying in the way you were before this, but you're still able to do something. It can be a look in the eyes. It's very small things. It can be nice. It can trying to give a good message to the family.

So, this is very important that we tell ourselves the full story, which we cannot do. That's there. Accept it. Acknowledge it, but also give yourself a compliment for what you're doing. That is extremely important to keep the balance of things.

Athena Viscusi:

What you just said about the nurses-

Avril Benoît:

We have a question here from Wilber. Oh, sorry. I'll just keep going through the questions and then you can come back with the nurses. Well actually, let's go into the nurses. We have Carla who is asking about how this compares to our experience as MSF, Médecins Sans Frontières/Doctors Without Borders when we responded to Ebola. What is different because what I see is similar is that people are, when they go into that intensive care unit, they're struggling. Their family is not around. They're not with them. There's no presence of the reassuring loving presence of a family member who will be their advocate right there in the hospital room and things like that. Then if they die, they died alone not surrounded by loved ones. These are some of the things that I've seen as parallels with those who are dying of COVID-19.

Athena, what would you say is a way to sort of process that distance when people go into a hospital, when you're caring for somebody knowing their family is not around, all these kinds of scenarios? It's so sad.

Athena Viscusi:

Well, when Kaz was talking about giving care with the mask and feeling like it's a misery, remembering in Ebola, we were wearing these astronaut suits. We had goggles and masks and yet I was amazed that the patients would recognize as individuals with this costume on. They would recognize. Just at times we would write our name in the forehead so they could, but they would learn to recognize us just by our eyes. Don't underestimate the power of human connection. The people are so hungry for connection, but they will recognize the care from the goggles and saying, "How are you today?" That is always there. But yes, I mean it was devastating in Ebola, I've been thinking about that a lot, that the patient would go into the hospital and was just sort of a black hole.

Us, MSF, psychosocial intervention during Ebola. We had staff whose whole job was to stay in touch with the families and to give them information and to keep them updated. They had a hotline for them and that's what made our hospital so different from the other hospitals. That we had this, families anytime, they could not go see, but they could drop off some stuff, their loved ones knew. Then later as it progressed, we developed a system, with that we could have the family talking remotely to the patients inside the treatment center.

And then did that during quarantines when people were quarantined in their village. They could not leave their village. We would record them and bring it to relatives in the village next door. Even there, we were using technology in very creative and… But the support, the psychological support to the families was very important. Also, very important also in maintaining trust in the healthcare facilities because if they just saw them as a place where people, a relative goes and disappears and dies, then if they got sick, would they go to that place or would they try to hide their symptoms and stay home and infect more people? So, building that relationship was important for that particular family member, for the patient but also for the entire community. I hope that in the hospitals here we can build similar things.

We also had a counseling staff who was dedicated uniquely to the families of our workers because a lot of the families were afraid. They were even throwing workers out of the home saying, "Don't come back." Now the infection process for Ebola and for coronavirus are completely different. I mean, it's totally different. If something is contagious but it's only by symptomatic people and this disease we're still not 100% sure how long it stays in the air, how long it stays on clothes, all this stuff. Respiratory, it's very different but still the psychological component is the same. So, we also found we needed to support the families of the workers because again they need that love of their own family being a secure place for them.

Avril Benoît:

There's a lot of camaraderie often within a healthcare team and these moments of really finding meaning in the work. One almost gets the impression that clinical people, doctors, nurses who are seeing lots of people suffer and die every day that's their job as medical people. That they somehow have a kind of a distance or a training in how to keep themselves separate, how to protect themselves emotionally from this kind of circumstance where you just have so many sick people coming in. Kaz, what are you finding of the impact though of this pandemic on healthcare workers? Are they able to keep that sort of professional distance or are you starting to see signs that they're suffering from some of the mental health effects of this?

Kaz de Jong:

Yeah. I think a good healthcare worker, a doctor, nurse, a psychologist is also a human being. Despite your training, there is always a case that affects you. So, that is part of our job. I think it's very important to acknowledge that. It's a big risk if you are impacted by your work and you just deny it. That is probably one of the worst risks for getting burnout or for accumulation of misery in there that causes all kinds of stress and whatever, unnecessary. So, I think we need to acknowledge as healthcare workers that we're also human beings and that's what we tell them. This hurts. The example of myself but also what Athena explains, our own examples of the fear, of the moments of panic, of a rush in your body that you feel, "Did I touch myself or did I not touch myself?" It's part of the human experience that also healthcare workers are experiencing. So, acknowledgement is very important.

It is also important that you are able to also overcome it. So, the distance, of course, is important and you need to function. So, sharing this, acknowledging it for yourself and if you want and this what we're doing all the time here in the hospitals, we debrief people at the end. Now, this is not a structure to debriefing. It's just how was your day, what worked, what can be done better? What was the best experience in this shift? So, in that way to keep the balance. But we're all humans and we should not become robots.

For healthcare workers, it's also important that they understand that their technical actions are also supporting people. So, very often, they are not fully acknowledging what added value they have except for the technicals, but also what they're doing. So again telling the whole story to themselves. Healthcare workers have a risk factor because they're used to care for others, to give to others, and they are always neglecting themselves a little bit more than they should. I'm a healthcare workers so I'm allowed to say this. It's my own experience also. This is something that you should not do because you won't run these kinds of marathons if you don't take care of yourself.

Avril Benoît:

What kind of psychological distress or effects are you seeing now among the health workers that you're helping, Kaz?

Kaz de Jong:

Well, at least we hope, we think we are over the peak. So, what we see is basically the adrenaline rush, the anxiety, the extreme fear is sort of going down. People have gotten used to in between big practice, but developed a certain routine and a certain whatever you call structure. So, now we are bracing ourselves for people thinking that they know it now. They can blow the margins. They can wash their hands one time less. That's one thing and that is dangerous. The other thing is that in high peaks, you don't feel you're fatigued, but if it's going down, you certainly start to feel your body also. The adrenaline has a price and you pay back and that's what they feel now. So, they're experiencing that when they're at home, they think, "Oh, I'm at home. I'm going to do this, this, this." That's their heart thinking, but their body says, "No, I don't want it. I can't do it anymore."

Those kind of experiences they have and it makes them also doubt about, "Am I sick? Should I see a psychologist?" We normalize this. It's a normal thing. You need to pay attention to it but it is still a normal experience. Again, you have to acknowledge and take care of yourself. You get over this for sure.

Avril Benoît:

Athena, I'd be interested to hear you talk about stress because it's related to this. If we're at a heightened level of stress all the time working every day, essential worker, the adrenaline rush is constantly at the peak level, what is the way that we can somehow break the stress in a healthy way without completely just denying the reality that in fact part of that stress is going to protect us because we'll take the precautions necessary. What is a way to modulate the stress if your work is essential and every day you're supposed to give 100% and be completely on because you're an essential worker?

Athena Viscusi:

Like Kaz said, it has a physical component that's mobilizing in the short-term and extremely destructive in the long-term, not healthy. Even it probably lowers immune response to this virus, and then there's the thinking component and then there's the emotional component. What is the stress doing? If my heart is beating all the time, then I need to do some kind of relaxation exercise or take a walk. I need to bring that heart rate down. I have to find a way to do that. If it's tension to the point of having aches, some pains, I need to do something to address that. But if it's emotional, I think we way underestimate, for example, the sadness I mean from the accumulated losses. You need to have a good cry. We have to undo the reaction or it's storing itself.

So, we have charges in some way, a healthy way because there's also that it accumulates and it's unbearable so we don't want to feel it anymore. That's where the risk for substance abuse, where the risk for family violence and for carelessness like Kaz is saying too in our work with that, I'm not going to be able to protect myself 100%. So, we really need to look out for each other on a team. I think one great thinking about our jobs is by saying to people, "You really should have a schedule. You really should eat regular hours." I have to do that now. I find yoga in my calendar now so that you can always go back to it if you want, but from 6:00 to 7:00 you're going to do that because it will accumulate in my body and I need to do something to undo it. So, we just need to schedule, just as we schedule work, we need to schedule, I want to call it, the calendar work. The opposite action.

Avril Benoît:

Yeah. We have a couple of questions about information overload. So, Wilber and others are asking about the anxiety that comes from just paying attention to what's going on in the news and Wendy has the extra layer of the fake news. We watch these daily briefings, the live briefings from politicians and sometimes you know what's coming out of their mouth is political. It's not science and there's a lot of conspiracy theories roaming around and floating into our inbox from relatives and so forth. What can people do about the anxiety that all this news and fake news, and fake news being the expression for misinformation, what it's doing to us in terms of increasing our stress and anxiety? Athena, you want to take it first and then Kaz?

Athena Viscusi:

Well, I mean there are things that we control and there's things that we don't control. You turning on your television is something that you control. So, really thinking again scheduling. How much of your day do you need news? How much has the virus mutated between 9:00 AM and 9:00 PM? Probably not. Do you really need to be minute by minute or do you need to be scheduling sometime to take care of yourself and your loved ones? Like you were saying, putting in your schedule to go outside and clap, people who are going to save us from this.

So, really being mindful, again, of how we're spending our time. We still control our time. We don't control it in the sense if I want to go to a movie, I can't do that anymore. If I want to go to the theater, I can't do that right now. But what I put in its place, I as a fully functioning adult, I control. So, we really need to take the power that we have. We have so little power right now. We need to really enjoy the power that we have and we can filter what we're exposing ourselves to. They are not coming to our house to have the press briefings. We are turning on the televisions.

So, really looking at in 24 hours, how much do I want to expose to this? Essential workers can't control that. They have to be in the hospital 10 hours. So, those of us who can't control, there's these pictures that are going around of healthcare workers with a sign saying, "I have to go to work, so could you please stay home?" I'm going to work, so could you please take care of yourself and your emotional wellbeing? I don't know if Kaz you want to add something?

Avril Benoît:

Well, on Wendy's point about the news cannot be trusted. Here is the miracle portion that cures everything. False hope, that you can order online. Or here's the conspiracy theory where we can blame somebody and other somebody. Kaz, what about this prevalence now of false information that's either making us fear even more or giving us false hope?

Kaz de Jong:

Yeah. First of all, you can also switch that off. If I have one line, that would be my advice. Maybe I can explain a bit more because your brain does not make a distinction between real news and fake news. Your brain sees it as potentially frightening and it arouses the whole system that you very often are not totally aware of. So, the more you watch television, and this kind of news, the more you arouse your system. Now, and in that way, you are continuously stressing your body.

Now, there's a very interesting scientific publication on this after the experience you had on 9/11, the tragedy. They looked at how many people developed PTSD, those who were actually witnessing this and those who were watching television continuously or almost continuously, seven, eight hours a day. Now, the ones who watch television, the amount of PTSD among those people were much higher. Now that illustrates that watching television is arousing your system and potentially traumatizing your system in such a way that you really have to switch that off. That's what we tell healthcare workers, switch it off when you come home. You had already nine hours of Corona and it's enough. It's very strong advice. Really switch it off.

Avril Benoît:

All right. We're going to wrap it up with this last question which is coming in different ways from a variety of people, including Nick, asking about survivor guilt. Survivor guilt is when maybe you got a light version of COVID-19 with hardly any symptoms. You didn't have to go to the hospital. You never even went for testing because you were just managing your symptoms at home, or maybe you were aware you were in a similar situation with somebody. They got it. You didn't. Describe then some ways that we can frame for ourselves survivor guilt if we're feeling that right now. Athena.

Athena Viscusi:

No, I would say one thing that always works is the practice of gratitude rather than guilt. I mean, how wonderful that some of us haven't gotten sick. We don't control who gets sicker and who gets less sick. We don't control that. So, let's celebrate. In Ebola, as tragic as it was, I mean there was one wonderful thing that we did. We had a celebration every time a patient was cured and left the hospital. We had a wall where they would leave hand prints so that we documented it. Yes, we lost so many patients. It's horrible, but to have the gratitude, the celebration for the ones that are here. I didn't do anything wrong that I'm healthy. It's just a beautiful thing and that's what makes that I can go get groceries for my neighbor who's you know.

So, really the practice of gratitude I think it's just so important in this. Like Kaz was saying, also for workers, to celebrate all the good that we're doing than all the things that we cannot do. But our brain is wired for the ‘not’ and we have to rewire it for the ‘yes’ and celebrate all that we do still have. Our health is a wonderful thing. Nobody should feel guilty for being healthy.

Avril Benoît:

Today and through the weekend, those of the Judeo-Christian traditions are trying to find ways to have Seder for Passover, Easter egg hunt for Easter, practice their religion. They're missing their congregations and their groups of people that they normally would get a lot of strength from and that sense of community. Kaz, do you have any words of wisdom for people who are feeling the loss of that connection, those rituals that help to ground them?

Kaz de Jong:

Well first of all, I think it's very good to pay extra attention to those who are still ill, families who are having people in the hospital and people who have lost. I think that this tradition is about mutual solidarity also. So, what I would do is we cannot be together in the way we were and you should not try to do it like that. But you can do something special for those families, something small maybe. Maybe just put something on the doorstep. Maybe just send a message and just check in because I think that is the core of the Christian tradition, and of many other traditions by the way, to be there for the one who's next to you. I think that would be a very meaningful way of celebrating this festivity, this Easter festivity. So, rather than looking how we did it and we cannot do it, try to find a very meaningful way, up keeping this tradition and be creative in it.

Athena Viscusi:

I had to explain to my seven-year-old friend that the Easter Bunny was afraid that he had been contaminated. So, he's in quarantine and really, really wants to bring her eggs but he's just trying to keep her safe. So, he's in quarantine and there will be Easter later.

Avril Benoît:

All right. Well look, I thank you both for sharing your expertise with us. Athena Viscusi and Kaz de Jong, both of you have been wonderful to check in with and thanks for being available for all these questions. That's all the time we have for today for this Let's Talk COVID-19. Apologies if we didn't get to your question, but we're trying to respond to those in writing. So, you should be able to hear from us. We hope you'll tune in every week at the same time when we come to you with different perspectives on the medical humanitarian work of Médecins Sans Frontières/Doctors Without Borders at a time of pandemic.

So, next week we are confirmed to have Dr. Javid Abdelmoneim from the UK, an emergency medicine physician with the NHS in London also working with MSF, and Dr. Craig Spencer. He is hopefully going to be joining us. He's an emergency care physician in New York City and like Javid, a member of the board of directors of Doctors Without Borders. Experienced MSF aid workers who also worked in the Ebola outbreak in West Africa a few years ago.

So, please stay informed about this work that we're doing at MSF and our response to COVID-19, our perspective on many of the issues that are arriving. Our website is doctorswithoutborders.org. You can sign up for email updates. You can support our work financially, including by becoming a monthly supporter. You can follow us on Facebook. That's the MSF English page. Twitter, it's @MSF_USA. Instagram, we're @doctorswithoutborders. We have a YouTube channel, you'll find us. For more specific information, you can always contact us and our events team will try to respond to you with event.rsvp@newyork.msf.org.

So, my well wishes to you. I hope you are healthy and managing to find your little moments of release from all the stresses that we're under. I'm Avril Benoît. Thanks for watching. We'll see you next week. Bye for now.

Athena Viscusi:

Bye.

 

Join us for this live online discussion series to find out how Doctors Without Borders/Médecins Sans Frontières (MSF) is responding to the evolving COVID-19 emergency.

During the event, MSF aid workers and medical experts will answer your questions about the humanitarian impacts of COVID-19.

On Thursday, April 9, our focus will be on mental health as MSF-USA Executive Director Avril Benoît welcomes Dr. Kaz de Jong, clinical and health psychologist and head of the staff health department for MSF based in Amsterdam, and Athena Viscusi, clinical social worker and psychosocial care specialist for MSF-USA.

Dr. de Jong provides psychosocial support to MSF staff responding to the coronavirus pandemic and other emergencies. He is also working independently in his home country of the Netherlands to support health care workers on the frontlines of the COVID-19 response there. Ms. Viscusi is supporting US based MSF staff with the difficult decisions and challenges faced by humanitarian aid workers during this pandemic.

They will talk about how aid workers and health workers around the world can cope with intense pressures, exhaustion, and social isolation, as well as manage feelings of guilt, fear, grief, and loss. They will also discuss some of the anxieties we all share in these uncertain times, and how we can take care of our own mental health.

Your registration allows you to attend all events in this series.

After you register, you'll receive an email confirmation with the Zoom link to attend online. You'll also receive email reminders before each event.
 

Featuring:

Avril Benoît, MSF-USA Executive Director, has worked with the international medical humanitarian organization since 2006 in various operational management and executive leadership roles, most recently as the director of communications and development at MSF’s operational center in Geneva from November 2015 until June 2019. Throughout her career with MSF, Avril has contributed to major movement-wide initiatives, including the global mobilization to end attacks on hospitals and health workers. She has worked as a country director and project coordinator for MSF, leading operations to provide aid to refugees, asylum seekers, and migrants in Mauritania, South Sudan, and South Africa. Avril’s strategic analysis and communications assignments have taken her to countries including Democratic Republic of Congo, Eswatini, Haiti, Iraq, Lebanon, Mexico, Mozambique, Nigeria, Sudan, and Syria. From 2006 to 2012, Avril served as director of communications with MSF Canada.

Kaz de Jong, PhD, clinical and health psychologist, is head of the staff health department and mental health advisor for Doctors Without Borders/Médecins Sans Frontières (MSF)’s based in Amsterdam. This unit addresses prevention and treatment of both physical and mental health concerns of national and international field staff; administers management trainings; and provides on-site trainings and psychosocial support to field teams. Dr. de Jong joined MSF in 1994 and gained extensive field experience both as a mental health aid worker and in the capacity of mental health advisor in the public health department of MSF in Amsterdam. As member of the MSF crisis team he has been involved in the management of serious critical incidents. Dr. de Jong earned his PhD in clinical psychology at Utrecht University and an MA in organizational psychology at Vrije Universiteit Amsterdam. He has contributed to numerous scientific publications on the development of mental health programs to address the psychosocial consequences of man-made and natural disasters. He created MSF’s own mental health guidelines and participated in writing the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings (IASC/WHO, 2007).

Athena Viscusi, clinical social worker, is the Psychosocial Care Specialist for the US office of Doctors Without Borders/Médecins Sans Frontières (MSF). In this role she provides psychosocial support to humanitarian workers before, during, and after their MSF assignments. Previously, she directed mental health and psychosocial programs for MSF in several different countries, including work during the epidemic interventions for cholera in Haiti and Ebola in West Africa. Prior to MSF, Athena worked as a clinical social worker in Washington DC, mostly in the Latino community. Currently she provides pro bono psychological assessments for asylum applicants. Athena is a proud graduate of the Howard University School of Social Work and of Barnard College, with advanced training in Sensorimotor Psychotherapy, Solution Focused Brief Therapy, Play Therapy, and Family Systems Theory.

 

Future events in this discussion series:

Thursday, April 16, 2020 - 1:00 PM EDT (10:00 AM PDT)

*Each event will run approximately 45 minutes.

 

Past Events in this series:

Thursday, April 02, 2020

Thursday, March 26, 2020