A focus on young minds amidst disaster

In central Nepal, children affected by recent floods and landslides receive mental health support from clinical psychologists mobilized as part of a UNICEF-led initiative

UNICEF Nepal
This image shows a group of children undergoing a mental health session in an open field in Melamchi in Sindhupalchowk District
UNICEF Nepal/2021/AShakya
19 July 2021

Sindhupalchowk, Nepal: The arrival of the monsoon in mid-June this year was marked by days of heavy, incessant rainfall in many parts of the country. Among these was Sindhupalchowk District in central Nepal, which experienced flash floods and landslides that led to devastating losses of life and property.

This image shows a flooded riverside in Melamchi Municipality in Sindhupalchowk District
UNICEF Nepal/2021/AShakya

Responding to a request from the Melamchi Municipality authorities to help address psychological issues among children and young due to this traumatic event, a mental health session was recently conducted in the village of Danwar, one of the areas hit hardest by the disaster. Part of the UNICEF-initiated child and adolescent mental health (CAMH) programme that was started in 2020 in collaboration with the Kanti Children’s Hospital/CWIN Nepal, the session connected over 40 local children with experts in the field of child psychiatry and psychology.

“Children don’t have a very advanced capacity to process trauma,” says Ram Pukar Sah, one of the clinical psychologists who facilitated the session. “That’s why disasters can have such a huge impact on their mental health, because it makes them feel like nothing is in their control.”

This image shows the mental health session for children in progress at a school in Melamchi Municipality in Sindhupalchowk District
UNICEF Nepal/2021/AShakya

That combination of “helplessness and hopelessness”, already set in motion to an extent by the COVID-19 pandemic in recent times, means that children could easily be suffering a great deal of stress and anxiety without us realizing it, according to Ram Pukar.

“Because they are young, we tend to assume children don’t understand or feel too much,” Ram Pukar says. “But they are constantly internalizing things they see and hear, and deeply affected by what is happening around them.”

Held on the premises of a local school in Danwar, the session started with getting the children and young people to be comfortable with the facilitators, so that the latter could take better stock of their states of mind. Many seemed initially scared and closed off, but as time went on and following their participating in different relaxation exercises designed to calm them, they seemed more willing to open up.

This image shows a mental health session for children in progress in an open space in Melamchi Municipality in Sindhupalchowk District
UNICEF Nepal/2021/AShakya

Through the discussions, facilitators discovered that many of the children were having trouble sleeping, suffering nightmares and sleep paralysis, as well as anxiety-related symptoms such as sweating, restlessness, loss of appetite, among others. “Several of the children talked about how it felt to learn that their school had collapsed in a landslide,” Ram Pukar says. “And there were some who had directly witnessed their homes being swept away, which is terrifying in so many ways for a child.”

Aside from helping the children vent their emotions related to recent events, the session also included activities designed to teach them the differences between a “good touch” and a “bad touch”, in an effort to help them better identify instances of abuse.

This image shows a mental health session for children in progress in an open space in Melamchi Municipality in Sindhupalchowk District
UNICEF Nepal/2021/AShakya

Ram Pukar says there was a clear change in the participants’ moods and bearings by the end of the day. “While they had seemed awkward and shy at first, they were actively taking part later on,” he says.

“It really moved us to see smiles on faces where they hadn’t been before.”

This image shows project members handing out hygiene kits to children who are lined up in Melamchi Municipality in Sindhupalchowk District
UNICEF Nepal/2021/AShakya

The participants were also among 120 other disaster-affected children from the village who were provided hygiene kits by the team with UNICEF support – containing basic sanitation and cleanliness supplies, as well as some recreational materials like drawing books, color pencils and a toy.

This image shows a young girl in Melamchi Municipality in Sindhupalchowk District walking away with a UNICEF-supported hygiene kit
UNICEF Nepal/2021/AShakya

Following the session, the CAMH team met with local psychosocial counsellors in the area – associated with TPO Nepal and Tarangini. Following the meeting, the counsellors were assigned to follow up with the children who had attended the session and linked to the Kanti Children’s Hospital for referral, tele-counselling and other support services in case any psychological or mental health issues are identified. Plans were also made to conduct similar sessions in other villages in the municipality.

“People here have already lost so much during the pandemic, and natural disasters have only worsened things – they are going through a lot of pain and stress,” says Bhagwati Nepal, Deputy Chief of the Melamchi Municipality. “It would be great to conduct such mental health sessions regularly for different groups – children as well as parents.”

A variety of interventions have been taken forward through the CAMH programme – including training for psychosocial counsellors around the country, mental health sessions for teachers, nurses/frontline health workers and caregivers of children, as well as sessions designed for children themselves. In the span of just nine  months, the programme has reached  more than 24,000 parents, teachers and caregivers; more than 2200 nurses and frontline health workers and more than 26,000 children and adolescents.

This image shows three children in Melamchi Municipality holding toys provided by UNICEF together with hygiene kits
UNICEF Nepal/2021/AShakya