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Working in a field hospital after manmade or nature disasters is a demanding mission, known to cause various physical and mental bad outcomes, from depression to post-traumatic stress disorder. The mental health professional (MHP) is critical for every field hospital and humanitarian missions. At the immediate aftermath of the trauma, his or her main mission is to help the other teams to cope with the sights and difficult decision making and, in later stages, the role is enlarged to helping the coping of disaster casualties as well as community leaders. The MHP’s part starts prior to leaving for the mission, with building the team’s resiliency, and ends weeks after coming back from the mission making sure no personnel suffers from secondary traumatization. The demands from the MHP varies when the mission is in high resources country versus low ones, with its differences on the hospital teams condition, urgency, and mental and physical load. Yet, he or she would always have a place in working with the teams during working hours and in a daily closure (through a modified debriefing), liaisons, and actual patient’s treatment, and that should be his or her main mission in field hospital activity.
The phenomena of child soldiers can be found manifesting in situations of horizontal inequalities between groups with clearly defined cultural or ethnic identities. In war and violent conflict, children are traumatized by such common experiences as frequent shelling, bombing, helicopter strafing, round-ups, cordon-off and search operations, deaths, injury, destruction, mass arrests, detention, shootings, grenade explosions, and landmines. The impact of war on their growing minds, and the resulting traumatization and brutalization, is decisive in making them more likely to become child soldiers. Apart from death and injury, the recruitment of children becomes even more abhorrent when one sees the psychological consequences. Reintegration of the former child soldiers can be challenging. Some children have no families; either they have fled the country or they have been killed in the war. Child soldiers often face psychological and social problems.
This chapter explains that debriefing should sit in the spectrum of response to those who have suffered severe psychologically traumatic experiences. The practice of debriefing has received substantial attention during the last two decades. The chapter attempts to contribute to the survival of debriefing by arguing that the interventions should not be viewed as treatment for trauma but rather as stress management techniques. Debriefing would often occur during a period of ongoing traumatization. Therapeutic flexibility has been wisely recommended for interventions conducted at the early stages of the response to trauma. Historical group debriefing (HGD) would combine aspects of institutional fact-finding debriefing with psychological understanding of human performance under stress. Finally, the chapter presents a study of debriefing in military units in support of the argument that simple reconstruction of a group narrative is sufficient to effectively reduce anxiety in recently exposed combat soldiers.
This chapter presents a description of chronic traumatization and its effects, over many generations, and in many different forms, for Australian Aboriginal peoples. It highlights an issue critical for the whole field of debriefing, that of prolonged traumatization and the impacts of disadvantage and other socially determined pervasive trauma and loss. Repeated traumatization and enduring traumatic stress responses are thought to potentiate the impact of subsequent traumatic events and also prolong recovery from the initial trauma. The quality of care offered by state mental health services has been crucial for Aboriginal Australians, since accessibility to other services has been restrained by financial and, for rural and remote dwellers, geographical considerations. Australian Aboriginal people are well aware that recovery from acute, chronic and collective traumatization defies a wholesale remedy and cannot be adequately addressed by any short-term methods.
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