Nepal Project

In 2015 and 2016, TRI conducted two trainings in Nepal since the earthquake of 2015.  The project was funded by the Unitarian Universalist Service Committee and 92 Nepali were trained as CRM Skills Trainers in Nepal.    Newly trained CRM SKILLS TRAINERS were brought to many locations within Nepal to share the skills under the guidance of CRM Master Trainers.  One of the locations was to the temporary housing of Tibetan nuns from the Bigu Nunnery from Bigu, Gorkha. Their monastery was destroyed in the earthquake where the new trainees shared the skills with the nuns.

When we returned in 2016, the returning CRM SKILLS TRAINERS received an enhancement training.  There were many stories shared about the usefulness of the skills.  The following represents a sampling:

One male participant tearfully recounted gratitude for the CRM model in helping him alleviate suffering to many people who suffered great loss as a result of the earthquake. He recounted one particular story of a man who had been celebrating his two-year-old’s birthday party on the day of the earthquake. They were outdoors at the time, but the man asked that his wife and daughter go get items to offer blessings in celebration of his son’s birthday. His wife and daughter went back indoors to get the items when the earthquake hit – both died. This man was so distraught that in the weeks following, he couldn’t stop crying, lacked motivation and was unable to care for the needs of son. The male participant who had taken the original CRM training in August of 2015 was able to teach this man about the CRM skills and helped him practice them consistently over the next few weeks. The man was eventually able to reduce his distress to such a degree that he started completing daily tasks and was eventually able to take care his son once more.

One female participant recounted a story of her use of the skills with a visiting U.N. disaster relief worker from the United Kingdom. She reported that this particular U.N. worker had been so distressed/depressed by the amount of destruction and loss of life that he was assessed by healthcare workers associated with the U.N. and was directed to go home to his country of origin a week early due to increasing depressive symptoms. The Nepali participant who had taken the original CRM training in August of 2015 learned of this and requested that she be permitted to speak with him about the CRM skills before any decision was finalized. She then taught him the CRM skills and helped him practice the skills over the next 24 hours. The U.N. worker reported that the skills were invaluable and he was eventually able to manage his distress and actually stayed on a week longer than originally expected.

 Another female participant who works with sex-trafficked victims recounted her use of the skills with one of her “clients.” She provided a detailed description of the many negative symptoms that this girl was displaying… As one can imagine, this prevented her from achieving academic success despite efforts to attend school in her recovery from the trade. She was eventually prescribed multiple psychotropic medications that also were reported to have interfered with her ability to complete even day-to-day tasks. The Nepali participant who had taken the original CRM training in 2015 began teaching this girl the CRM skills and helped her practice them on a weekly basis. She reported that the girl has improved significantly since learning the skills. She is now off all psychotropic medication and is top of her class academically, reporting a full remission of the psychological symptoms reported previously.

IMPACT
The enhancement trainings’ most significant achievement was the bolstering of CRM skills in those 61 participants that attended. After the training, one of the participants reported having been impacted personally by the bolstering of the skills, which lead to a stronger desire to help others. They wrote, “I like this training very much as this training has helped myself in terms of high and low zone to get back in resilient zone. After taking this training I have [gained] self-confidence that I as a social worker need to help others. The special thing about CRM is that it can be used by anyone.” This pattern of personal impact being transformed into motivation to help others is a pattern often observed after CRM trainings. In fact, the overwhelming response from most participants after the training was a strong desire to bring the CRM skills to more communities throughout Nepal. As one participant wrote, “Let’s spread it out throughout the country, if possible produce trainers to work for different target groups and try to eradicate the root cause of trauma.”

This is especially reflected in the Action Plans that the participants were asked to complete. They were asked to indicate how many people they plan to teach the skills to within the next year. Like the original training in August of 2015, the individuals who attended the training were from  non-governmental organizations serving both adults and children, including orphans, at risk youth, sex-trafficked individuals, survivors of domestic violence as well as all who are earthquake survivors. . Here is a breakdown by NGO of the estimates made by each participant group. Some NGOs had more than one representative at the training so they combined their estimated numbers as follows:

Center for Awareness Promotion (CAP), Nepal (Training 1 and 2): 900
Nirmla Gurung (Shapia Neer): 100
Nepal Children’s Organization (Training 1 and 2): 650
Tewa: 200
Chetana Nepal (Training 1 and 2): 2530
Amare-AP: 140
Nagarik Aawaz (Training 1 and 2): 6,715
Magna Children at Risk: 150
Volunteer Service Overseas: 624
Tuki Association/Plan International: 225
Forum for Community Upliftment System (FOCUS): 95
Foundazione A’Lbero Della Vita (FADV): 400
Gramin Mahila Srijanshil Pariwar (GMSP): 420
Shakti Samuha: 75

Total Estimated: 13,224+

The number estimated has the potential to bring the CRM wellness skills to 13,224 additional people that can further reduce the mental health risks associated with shock trauma like the earthquake and its after shocks and the disruption trauma and stress common to a large-scale disaster. In addition, the participants reported using the CRM Skills for other stresses and traumas experienced in Nepal such as domestic violence and sex trafficking.

Upon closer inspection of some of the proposed action plans, this number might be a relatively conservative estimate. For example, one of the major goals of Chetena Nepal is to train at least one person from each Resource Centre in each district throughout the nation of Nepal. There are 1,050 RC’s in Nepal and each are under the direction of the District Education Office (DEO). They explained that their goal in doing so would ultimately be to get basic CRM skills training included into the national curriculum for schools. If that were the case, then CRM skills could potentially impact an entire generation of children and teens throughout the entire nation of Nepal. They recognized the need to build up a strong foundation of capable CRM skills trainers before an expansion on that scale could be implemented effectively. Accordingly, part of their action plan is to find sources of funding from different organizations to make sure the trainers are properly trained.

On a slightly smaller scale, participants from NCO proposed training children whose parents are in jail. While this may only target a handful of children whom they have access to, it has been our experience that children who learn CRM skills not only exhibit improved behavioral and emotional management, but they also teach the skills to the adults that they come in contact with. Thus the impact of these skills will likely reach more people than reported in the participants’ action plan. Even more importantly, the impact may go beyond just the number of people that might learn the skills. Having a parent in jail is considered one of ten specific adverse childhood events that, when coupled with other specific adverse childhood events, has been proven to increase the risk of children developing both physical and mental health problems when they’re adults. By teaching CRM skills to children and adolescents, there is the potential for the longitudinal impact on reducing the risk of those children developing debilitating mental or physical health problems. This would also apply to the many other organizations (e.g., Tuki Association, Shakti Samuha, Nagarik Aawaz, etc.) that are planning to teach these skills to children and adolescents.

In regards to our goal of increasing the capacity of CRM trainers from the Philippines, another significant impact of this project was the increased confidence of the two CRM trainers from the Philippines, Irish Grace Ramirez and Maria Patricia Vito Cruz de Vera, and the expanding capacity of PhilActs to provide services internationally. Ultimately, having master CRM trainers from the Philippines doesn’t just increase the capacity of PhilActs, but also expands the capacity of TRI  in ameliorating the effects of human made and natural disasters. It allows us to provide an international team that models the underlying goals of TRI  to create resilient communities throughout the world. People in the areas where such teams go will see the hope of recovery and resilience by learning from actual survivors who had received CRM training and are now able to help others in other countries as well as their own. It also allows us to partner with other trainers in various parts of the world that might be closer to the areas affected, thus potentially lowering costs to allow more participants to take part.

If communities and/or individuals were directly impacted, what were the numbers?
A total of 61 individuals attended the two enhancement trainings. Based on the Participant Information Form, the participants estimated that they had already trained over 3,650 people throughout Nepal since their original training in August 2015.

Center for Awareness Promotion (CAP), Nepal (Training 1 and 2): 320
Nirmla Gurung (Shapia Neer): (Broadcasted orientation on community radio heard in five districts)
Nepal Children’s Organization (Training 1 and 2): 380
Tewa: 32
Chetana Nepal (Training 1 and 2): 755
Amare-AP: (Did not provide actual numbers)
Nagarik Aawaz (Training 1 and 2): 1,225
Magna Children at Risk: 100+
Volunteer Service Overseas: 30
Tuki Association/Plan International: 130
Forum for Community Upliftment System (FOCUS): 100
Foundazione A’Lbero Della Vita (FADV): 350+
Gramin Mahila Srijanshil Pariwar (GMSP): 80
Shakti Samuha: 149

Again, of note were the participants from Chetana Nepal. As already noted, they had representatives from their organization in both trainings. The participants from Group 1 were eager to share their experiences in providing CRM orientations and trainings to a large number of people throughout Nepal. Their exuberance in describing the work that they had completed over the past year was infectious and their desire to display some of the posters that they had made could hardly be contained! They eventually hung these posters on the wall in the training room and provided a pretty detailed report of the many trainings at higher secondary schools throughout Nepal.

One of the more unique reports was from Nirmala Gurung, who reported having provided an orientation to the CRM skills through “Community Center”, a community radio show broadcasted in five districts. While we can’t measure the exact impact of such a broadcast, we recognize that dissemination of the CRM skills over the radio can help create an environment where increasing one’s ability to be more resilient is a possibility. As one participant pointed out the “Nepalese context is highly needy for CRM skills due to vulnerability of various kinds of disasters and social, domestic and political violence that can traumatize people. As useful skill, we should expand this knowledge and skills in all over the country…As the representatives of local organization, we are crazy to expand and support TRI as well.” A radio broadcast regarding CRM skills provides a clear impact that “expands this knowledge” and can help provide guidance for a wide network of people in how and where to seek such help.

Ms. Grace and Ms. Cruz  from the Philippines were able to outline their own journeys after being introduced to the CRM skills in the aftermath of Typhoon Yolanda (Haiyan) in the Philippines. As a result, many of the participants were eager to learn the practical steps that they took to progress from having been trained by TRI to forming their own NGO focused on providing CRM trainings for those throughout their own country to ultimately becoming a part of a training team in Nepal. In fact, one participant suggested that it “would have been great if more time was spent (with seriousness) about creating a dedicated Nepal based CRM group.” Another participant said that they would like to “get the opportunity to volunteer as CRM trainers in other countries.” These participants spent time after the training collecting contact information of all of the participants in the Group 2 interested in keeping in contact and working toward this goal.

As a result, another goal is to help encourage and support ongoing communication between these participants and members of PhilActs in order to help the Nepali participants develop a sustainable organization similar to PhilActs, focused on providing CRM skills throughout Nepal.

LOMA LINDA UNIVERSITY’S RESEARCH ABOUT THIS PROJECT IS IN THE PROCESS OF BEING READIED FOR PUBLICATION.

Copyright © 2017 Trauma Resource Institute · Web services by DRH Designs * (209)728-8855