Crisis psychologists on call

The war in Sudan has forced millions to flee. Many have suffered abuse and violence, and others have witnessed loved ones lose their lives. The extent of the trauma is hard to grasp. Sudanese psychologists and mental health workers are doing what they can, on the phone.

Psychosocial and mental health support is desperately needed by a population traumatized by war and violence, but in some parts of the country the clinics that offer help have been completely destroyed. At her old university, Ahfad University for Women, where she was one of the pioneers in establishing community centres for mental health support, the Trauma is alternately occupied by the warring parties RSF and SAF.

With extremely limited means and for many of the volunteers, without an actual clinic to work from, the team of mental health workers do what they can – on the phone.  Shahla Eltayeb is grateful for one thing about the covid pandemic. Not being able to meet people face to face gave her and the team of psychologists from Ahfad University experience in offering psychosocial and mental health support one the phone. This experience is invaluable now.

Rolling out a system for psychosocial and mental health support
When a small team of psychologists at the Ahfad Trauma Centre started doing counselling work in the local community in 2012, they focused on student counselling. But being located on the border of Omdurman, where a large community of refugees from South Sudan had taken refuge, the psychologists saw a big need for extending their services also to the refugees.

Professor Shahla Eltayeb was one of the early pioneers in bringing psychology out of the lecture halls and into the communities. The small team at Ahfad, and with it the capacity to provide mental health support in the local community, grew when Ahfad University reached out to the Dutch Embassy and secured funding. With this financial support, the psychologists based at Ahfad could establish a cohort group (that is still functioning today) and start a programme in which they trained psychology students to offer psychosocial and mental health support in their local communities.

Professor Shahla Eltayeb was one of the early pioneers in bringing psychology out of the lecture halls and into the communities.

-When we train 20 students, that means we have 20 people who will then eventually go out and use their skills in different parts of the country, she says.

After this training, Ahfad Trauma Center received funds from USAID and were able to rehabilitate the Ahfad Trauma Center and to extend their services to Kordofan, White Nile and Gadarif establishing centers and building teams of mental health service providers there.

They have also trained lay counsellors in psychological first aid in Narrative Theater; a community healing program. These volunteers work in the communities and raise awareness around mental health issues.

Actively making the different practical trainings part of their academic programme at Ahfad, the original team was able to build a continuously larger presence of mental health support clinics. Their goal was all along to create and build a sustainable way of offering mental health support to people in the local communities, and they succeeded. Clinics have been established all over the country, offering support in states all over the country. Establishing clinics in the local communities where people had easy access contributed to remove the stigma connected to mental health issues and also circumvented one of the barriers of getting help.

Their goal was all along to create and build a sustainable way of offering mental health support to people in the local communities, and they succeeded.

-Psychiatric wards at hospitals were not able to help anyone who were not sick enough to require prescriptions or being admitted. The trauma centers we have established provide a lower threshold to getting help. Through our networks we have ensured that there is also a pathway to psychiatric hospitals for those in need, says Eltayeb.

War intensifies the need for support
Sudan has been a hub for refugees from neighbouring countries for decades. The country also has a large number of internally displaced persons, dramatically exacerbated by the ongoing war. According to estimates from the International organization for Migration (IOM) 7.1 million Sudanese have been internally displaced since the outbreak of the April 2023 war, adding to the 2.8 million that were already displaced, making Sudan the worst internal displacement crisis in the world. In addition, over 2 million Sudanese have sought refuge in neighboring countries.

But the ongoing war makes it impossible to keep up the services. Several of the clinics cannot operate because of the risks, some have been obliterated. For others, they simply do not know. The Ahfad team has lost touch with their colleagues in El Fasher and Ad Damazin.

 Several of the clinics cannot operate because of the risks, some have been obliterated.

-The need for psychosocial and mental health support is bigger than ever. Such support is not only important from a short-term perspective considering the well-being of the people who have been traumatized, but also crucial on the macro level and in a long-term perspective. Education seems to be the number 1 buffer to mental health issues. Many children and youth are denied access to schooling because of the war. This could possibly lead to a very fragile situation that will exceed the duration of the war itself. We need mental health support programmes and services as a buffer to extremism, says Eltayeb.

Precisely because these psychologists and their team of volunteers recognize the importance of mental health, they also recognize that their work simply has to continue, amidst a raging war that has destroyed much of their infrastructure. The solution is to offer crisis psychology on the phone.

Working hard to raise funds
The trained team who are now offering counselling over the phone are doing it in their spare time, and without any pay. Anyone who needs to talk to someone can call their team to get counselling and support. To hinder that the volunteers are forced to pay out of their own pocket, Eltayeb and others are raising money to fund their expenses for phones and phone credits. Rasing money from the diaspora have been an important source of financial means. But money in itself is not the only problem. How to get access to the funds and hand the money over to the volunteers is an equally big challenge in a country where the bank system and money transfers have come to a complete halt because of the war.

An insider’s perspective
Another crucial challenge is to prevent that the volunteers burn out.

-The traumas that they hear about, all the stories and anguish, are not something you are able to disconnect from when the day’s work is over. There is also a certain element of survivor’s guilt that can be hard to deal with on your own, says Eltayeb.

That is why an important part of the job is also to provide peer support to the volunteers who talk to survivors and refugees in the local communities on a daily basis. How they react to being exposed to dealing with people who have suffered immense and often violent trauma is something we know very little about. There has been very little research on burn out among people who provide support in local communities in African countries.

How they react to being exposed to dealing with people who have suffered immense and often violent trauma is something we know very little about. 

-Research has been skewed also on this topic. What we know is based on the experiences of those who provide support in Western countries, she says.

This question is close to her heart. So much of the research on experiences of war and trauma is done with a Western perspective in mind. Being a psychologist with academic as well as practical experience, she stresses the importance of also being able to focus on the larger picture and the role of research in the midst of war.

- There are very few articles that focus on African refugees in African countries. It seems like there is simply an assumption that being an African in Africa, it is easier for you to adapt. The vast majority of research is done on how refugees cope after they arrive in Western countries.

She is currently working on a book about community initiatives as a response to the war in Sudan.

-The Sudanese people are by default communal. They have a long tradition of supporting each other through difficult times. We have a word that describes the action of individuals coming together, nafir, to help and support each other, she says.

As Eltayeb underscores, addressing the mental health crisis in Sudan requires more than just local efforts; it demands a global response. The challenges of burnout among volunteers and the lack of research on trauma support in African contexts highlight the urgent need for broader involvement.

-The Sudanese people are by default communal. They have a long tradition of supporting each other through difficult times.

-For those of us in the diaspora, this is a call to action. Our distance from Sudan does not diminish our responsibility to contribute. Whether through financial support, advocacy, or leveraging our expertise, we can make a meaningful impact. The tradition of nafir—coming together to support each other—should extend beyond borders. By rallying together, we can provide vital support to mental health initiatives, ensure that local volunteers receive the assistance they need, and help drive research that reflects the realities faced by Sudanese refugees and survivors of trauma.

-The future of Sudan hinges on collective effort. Let us unite, harness our resources, and contribute to these crucial mental health initiatives. It matters, and our involvement can make a significant difference.