Sphere Based Assessment of Psychosocial Support Services at Internally Displaced Persons Camps in Maiduguri, Borno State, Nigeria

Introduction

North-eastern part of Nigeria has witnessed one of the worst armed conflicts in recent times. According to International Federation of Red Cross and Red Crescent societies (2000) [1], a crisis disastrous when ten or more people are reported killed, hundred or more people are reported affected, an appeal for international assistance is issue and state of emergency is declared. Out of the 40.8 million displaced from arms conflict and violence worldwide about 2,152,000 was displaced in Nigeria according to Internally Displaced Management Centre [2], over 1.5 million displaced persons are housed in overcrowded camps across the disturbed northern region [3]. Also, the ongoing crisis has generated an estimated 13,000 – 17, 500 deaths, and resulted in massive population displacement due to the fear of insurgents, assaults, destruction of property, and loss of livelihood [4, 5, 6].

In a humanitarian disaster, about 30-50% affected people develop signs of psychological distress in varying degrees manifesting as non-specific distress and psychosomatic symptoms rather than a particular syndrome. Rates of mental disorders, especially mild to moderate, are expected to rise [7]. In the months that follow a disaster victims are more likely than non-victims to experience interpersonal, financial, ecological changes and stress. In a study conducted by Onyencho VC, et al. [8] in which the psychosocial needs and services available at the IDP where assessed using HESPER revealed that basic needs such as food, clothing and shelter were grossly inadequate as reported by majority of displaced persons.

Similarly, Irfan M, et al. [9] assessed psychosocial support services for displaced persons in Pakistan based on sphere standards and indicators. The study revealed that funeral services, space for community celebrations, tracing services, psychiatric care and information need significant improvement. There has always been a need for the development of a humanitarian charter to cater for this need, spare project launched in 1997, produced a “Humanitarian Charter” and identified “Minimum Standard” for relief operations in disasters, in the area of water supply and sanitation, nutrition, food aid, shelter and health services. Mental Health and Psychosocial Support (MHPSS) have already been discussed as a standard in the 2004 Sphere Handbook on Mental and Social aspects of Health, covering standards and indicators for the acute emergency phase of a humanitarian [10, 11].

Previous studies failed to assess the level of psychosocial support services among IDP in Maiduguri based on sphere standards and indicator, the only accessible study was on the humanitarian emergency settings perceived needs scale [8]. The parameter used by sphere standards and indicators is quite different from the humanitarian emergency settings perceived needs scale in psychosocial support services available among the IDPs. Considering the ongoing humanitarian disaster in the North Eastern Nigeria, this study was conducted to assess the psychosocial needs and services available at the Internal Displaced person’s Camp in Maiduguri based on sphere standards and indicators.

Results

An average household size of 6.9 persons per family, the average household had 4.5 children. Among the families we surveyed 119 (26.4%) families did not relocate with them to the IDPs camps. Of these, members of 100 (22.2%) families are still missing out of which 90 (20%) believes they might still be recue. However only 4 families without missing members were unaware of tracing services; difference in awareness between families with missing members and no missing members was not statically significant (x2 = 0.4371; p > 0.005).

Our study revealed that 293 (65.1%) families had school going children before they left their villages, 444 (98.6%) families were aware of school facilities in the camp, 349 families reported that their children are using these facilities. There was statistical significant difference between the families with school going children and the families of non-school going children (x2 = 0.002; p < 0.005). According to the camps administration there were 15 schools present at the selected camps as at the time of this survey established by government, and other non- governmental organizations. Families were asked about social services; their awareness varied widely for various social services

• Place of worship 436 (96.6%);
• Community celebration 435 (96.6%);
• Funeral services 428 (96.2%);
• Recreational facilities for children 198 (44%);
• 20(4.4%) were opportune to participate in relief effort and construction of mosques, schools, water pumps, sanitation facilities.

Of 450 Families 197 (43.7%) reported that they have been informed about situation in their hometown after arrival through camp administration which comprises of military, national emergency management agency (NEMA), state emergency management agency (SEMA) and non-governmental organizations. Other mode of information dissemination were through place of worship 171 (38%), through mobile team 40 (8.8%), none got information through pamphlet. One hundred and twenty families representing twenty eight percent had orphaned persons or members with disabilities. Social involvement activities are available for 29 (6.4%) of the disabled within the camps. The camp administration also reported the absence of any rehabilitation and recreational facility for the disabled and the absence of database of disabled and orphaned individuals. On post-traumatic stress disorder, 65 (14.4%) reported a family member experiencing vivid imagery related to a violent memory, 45 (10%) families reported a family member with a previous diagnosed mental disorder, of which 25 (55.5%) are still receiving regular medication from psychiatric hospital, 20 (45.5%) had abruptly stopped medication due to the displacement. No respondent reported the presence of mental health services in the camps. Averages of 3-4 patients were referred to psychiatric hospital daily from primary health care clinic in the camp.