Hankematkaraportti marraskuu 2015


1) Concerning the project ”Mental health services for refugee children in South Lebanon” (2014-2016) (support for Family Guidance Center, FGC Saida and partial support to FGC El-Buss) Ministry for Foreign Affairs of Finland (MFA) project number 85202501

Activities completed as part of the project monitoring visit:

* Meeting with the coordinators of the mental health program of BAS, Liliane Younes and Dr Madeleine Badaro Taha, and also other partners: Sarah Cheaib, Santé Sud (2 years´ training program of FGC staff) and Deborah Parker, Assoziane Prima Materia (music therapy training of FGC staff).

FGC Beirut staff 20.11.2015 SK

* Visits to FGC Saida and FGC El-Buss 21.11.2015, meeting the staff members of the centers.

FGC El Buss 21.11.2015

In the sunny waiting room of FGC Saida 21.11.2015 SK

* Meetings in financial department of BAS and checking the transactions with accountant, Mr Samer Nasser, and Administrative & Financial Officer, Mr Diab Kassem. 19.11. and 26.11.2015.

Sirkku Kivistö and Diab Kassem, financial department 26.11.2015 FK

* Meeting with Dr Aziza Khalidi 21.11.2015, work schedule of mid-term evaluation (2015) of the program (development of BAS towards the community based mental health model)


Cooperation with beneficiary children & youth and their families in FGCs is seemingly warm, encouraging and professionally managed.

BAS has signed 16.11.2015 with UNRWA the projected partnership on the EU-funded “SPRING –Improving the living conditions of Palestine refugees in Lebanon” (PR#1715000673). FGCs implement awareness raising sessions in the local communities of the Palestinian refugee camps.

In FGCs El Buss, Beddawi and Beirut we learned that FGCs are partners in developing the National Mental Health Program of Lebanon (started May 8th 2014), led by Dr Rabih El Chammay (psychiatrist in FGC El-Buss). Representatives of FGCs participate in the regional meetings about topics related to mental health, e.g. training of mental health service staff, list of accepted psychotropic medicines, mental health work in prisons. The policy program for mental health work was recommended by the WHO (WHO-AIMS Report on Mental Health System in Lebanon, WHO and Ministry of Health, (Beirut, Lebanon, 2010).

The program will offer universal accessibility to patient centered services for all without discrimination” (Newsletter Issue 01, May-July 2014, Lebanese Republic. Ministry of Public Health, p. 3). Because one of the immediate objectives in the cooperation of FiPSR & FAFS and BAS is to advocate mental health services for all, the above mentioned facts (partnership with UNRWA in mental health, participation in the national level mental health program development) actually signify a breakthrough. BAS has since 1996 gained experience in mental health work, has developed multidisciplinary team work practice, a family centered approach in the community-based mental health work, and now BAS is spreading the knowhow to the larger contexts.

2) Concerning the project Services for Palestinian children with multiple special needs (2103-2015)” MSN-project,

Activities completed as part the project monitoring visit:

* Meetings with mental health project coordinators and financial department. There are about 80 children in special schools (2015-16), and 20-30 children who get tailored medical rehabilitation in FGCs, hospitals or service providers (e.g. physiotherapy in Ghassan Kanafani institution). It is problematic to secure the continuation of their schooling if the Foreign Ministry of Finland does not approve a continuation project. However, FiPSR tries to recruit more individual sponsors in order to get funding.
* Visits to FGC Beirut, Saida, El-Buss and Beddawi, and meeting 9 persons either individually or through the project money sponsored MSN-children in FGC Beirut and Saida. Reported to the sponsors.
Preparations during the visit for the review of the annual reports of children to the sponsors (30), which is compiled together with Italian CCF and Swiss PalCH organisations. Decided to add on how the sponsorship money is used to the review a description. For this purpose, interviews in FGC Beirut and Main office, financial department.
* Doctoral candidate Agneta Kallström met Dr Madeleine Badaro Taha and Ms Pauline Bresse, and got the data of the study ”BADARO TAHA Madeleine, BRESSE Pauline, KIVISTÖ Sirkku, YOUNES Liliane (2015):” Children with Multiple Special Needs in the Palestinian Community in Lebanon: Clinical Profile and Need Assessment Study”. She will see, if it is possible to use the data and report the findings in a scientific article.

According to the project plan, the evaluation of the three years project assistance of the FiPSR to the sponsorship program was done in October-November, and the evaluators were parents of 59 MSN-children, facilitated by Liliane Younes and local FGC staff. Lilieane Younes has transalated and compiled the report, which is sent to Finland for comments and questions. Afterwards FGC Beirut will send it to the FGcenters. It is excellent that parents, mostly mothers, but also some fathers, participated in the focus groups. It came up, that the process to seek help for the child with MSN is sometimes very complicated. There can be disgreement between spouses, with siblings and extended family, even with neighbours. Usually the observations how the child´s situation improves during the intervention makes the commitment easier for all family members.

In the project plan there are 3 types of interventions (1. place in a special institution 2. special services tailored according to the individual needs , 3. own pilot service of BAS). These intervention types are ongoing:
1) In 2015-2016 49 children were studying in special schools,
2) about 30 children benefited from a tailored medical test, assessment, medication and rehabiliation plan
3) during project years there have been discussions if BAS could start its own service for children with MSN, because the special institution fees are so high that the share which the families have to pay after receiving project support is too high for poor families. Only wealthier families can afford to pay the gap fee, after the project support limit of 1200 USD. This year BAS got a piece of land in the South from one municipality. There might be a center for children with MSN after some time as Ms Monica Musri, CCF, has submitted a service and staff training proposal in this issue.

In FGCs, there are several kinds of patient/family groups, which need different approach especially in client guidance and psychoeducation. There are well-educated parents. With them, the cooperation is usually excellent. But especially families from remote areas in Syria have difficulties to settle in, seek help and cooperate with the FGC staff.

All the contacts to children with MSN and their parents are positive. The parents do their best to help their children, together with FGC staff. There are also some very difficult family cases, which would need profound support from several actors. But also those families are in contact with FGCs, which means that they can trust, at least to some agree, on the good will of the staff. One case in FGC Saida is so severely unprotected in her family that Director Kassem Aina promised to follow the case.

We decided to plan a continuation project plan

To cope with the negative decision of Foreign Ministry of Finland to the continuation project application /2016-2018) FiPSR continues to recruite more individual sponsors, prepares a project plan and aid application to the Ministry for the years 2017-2018. A share of the project money is transferred from the year 2015 to 2016. Through information work we try to get also other donors for this work. The previous years mean a breakthrough in the service development for children with MSN. With country coordinator of NORWAC, Ms Kristil Haraldstad, we propose to BAS to organise a meeting in February 2016 for joint planning of the continuation of the work.

3) Concering the project ”Mental health services for children in Northern refugee camps of Lebanon” by Finnish Arab Friendship Society (FAFS) 2014-2016

Activities completed as part the project monitoring visit:

Negotiations about the Northern FGCs –project in FGC Beirut with the coordinators, with social worker Hanan Dabdoub (contact person for Storycrafting project), with Sarah Cheyab and Dr Rana Darwish (training of social workers), in the main office with Director Kassem Aina, sponsorship program coordinator Fatima Khaizaran and with Rania Khartabil (KG-sponsorships).
* Visit to FGC Beddawi, Tripoli, meeting the team members, and having an evaluation discussion with them. We saw the construction site of additional space for FGC. We were also taken on a walking tour in the Beddawi camps by Yehia Zweidan.
* Met sponsored children in Shatila center and organized one home visit, delivered the letters and gifts sent by the Finnish sponsors.


It is a pity that FGC Nahr el-Bared lack team leader –psychiatrist. Still, it is nice that Dr Rita Hosri has offered some time for patients from Nahr el-Bared. Psychologist Arda Kashkasian works successfully as ”managing team leader”. It is excellent that BAS wants to run mental health services in the Northern camp despite the difficulties to get the complete team recruited.

25.11. SK

25.11.2015 With Dr Rita Hosri we checked the list of children with MSN (10) who are referred to special schools for the school year 2015-16 and followed up by FGC. Unfortunately, we heard that for child Amer Hindawi things are not going well after the return to UNRWA school. He had to leave the special school because of the increase of the tuition fee (3000 USD).

Dr Rita told us that there are different patient groups, which FGC Beddawi serves. PRS parents are usually well educated and easy to work with. Many PRS children are born in Lebanon. However, some Syrian families, who came from remote areas in Syria are not educated, and their children have a lot of difficulties in speech development and health problems, and some aggressiveness is common. Parents do not have work, and families get more children every year. Palestinian community in Lebanon (PRL) is changing according to Dr Rita Hosri. PRLs are trying their best, and while comparing with the situation of the newcomers, they feel that they have achieved a lot.

In a joint session with team members, we spoke about the training for the FGC staff. FGC Beddawi works in the community, and for them some lectures have been a bit far from reality. If both social workers are in training in Beirut, the daily work place lacks resources.

FGC Beddawi, staff meeting 25.11.2015 SK

Cooperation with parents has still improved. FGC staff supports the group of mothers, who work by sharing the information with other mothers. A community based model has developed in FGC Beddawi.

Also every staff member told about the improved work model and increase of personal satisfaction at work. Edit, speech therapist: in on-going year the work has been more efficient. The length of the appointment was lengthened to 45 minutes, and some time was used to work with parents. She has more time, and managing the reports is more systematic. The team uses more time to discuss about the cases. Also, the existence of 2 social workers is benefitting more. Layal, the psychologist especially mentioned that having two social workers in the team is a valuable benefit for the positive changes in children. They are better off.

Dalal and Sonja, social workers, evaluated the year 2015 as a year of improvement, Dalal got a work mate, Sonja, and their work division is formed successfully. The team held case discussion meetings every week (before this was done only once a month), social workers report having meaningful work and through group discussions they form the objectives to the home visits. SWs would like to work more with fathers and couples, and actually, men are coming when invited.

FGC Beddawi will continue and increase the group support activities, especially with the Syrian refugees. Some of their complaints are common, and peer support is relieving.

4) Other activites during the project visit

We introduced visits from Finland and Estonia, and BAS welcomes journalist Maria Santto, psychology students Iman-Maria Itani and Saara Haapanen, and psychologist Riikka Toivanen for a visit.

Dr Monika Riihelä sent hard copy books of the e-book ”Utters of Shutters – Personal stories told by Palestinian children and adults from 2006-2010” to BAS. Storytellers and Storycrafters got own letters. She would be happy if she knew how the things are going for them now. The book can be downloaded for free: http://www.into-ebooks.com/book/utters _of_shutters/

Also we put BAS in contact with Ms Anastasia Pertsjonok from of Anna Lindh Foundation, Estonia. Ethical Links and the Estonian Refugee Council are interested to learn if there are possbilities to start a project for PRS in Lebanon.

With Ms Hanan Masri we discussed the draft project plan ”Jobs for young people including PRS and PRL”. The application will be addressed as a EU Trust Fund. It is desperately necessary that young people get work.

To study the water problem (water tower and water pipes already several years without any water) in Shatila we interviewed Dir. Kassem Aina, director of the Shatila center Jamile Shehadeh, had meetings with UNRWA region director and Shatila popular committee. Unfortunately, we did not get access to the EU delegation in Beirut, and have got no answer to inquiries about this failed project, which the locals tell being EU-funded.

Prestigious water tower for many years, unfortunately no water. Shatila, 22.9.2015 SK

Visit with Jamiel Shehadeh to Shatila Popular Committe about the water construction issues in Shatila. 24.11.2015 AK

Next year BAS has 40 years anniversary, and collects old photos for exhibition. Sirkku Kivistö and Dir. Kassem Aina. 26.11.2015 SK

Day by day program

Beirut 14:20 arrival in Beirut
Met researcher Tiina Järvi (blog about her experience in South Lebanon and thoughts about the research topic hope of Palestinians, ”Ma fii mustaqbal hoon – täällä ei ole tulevaisuutta”,
https://turvaaetsimassa.wordpress.com) and Elina Sandelin.
8.30 meeting with Kassem Aina in the main center. News, visit plan schedule, agreed transportations.
Delivery of the Utters of Shutters books and letters sent by Dr. Monika Riihelä. Information about possibe visitors to Lebanon: journalist Maria Santto, psychology students Iman-Maria Itani, Saara Haapanen and psychologist Riikka Toivanen. Information about Leena Sarastes photos about BAS activities, which are valuable history documents for BAS:
Shatila center, discussed with director Jamile Shehahed about sponsorship of Abdel Hadi family, met Ziad.
Delivered newspaper Kotkan Sanomat, article by Jaakko Raittila. Discussion about Shatila water problem.
Delivery of Utters of Shutters –book to Shatila center, sent by Dr Monika Riihelä.
14:00 FGC Beirut, Hanan Dabdoub, Pauline Bresse, Deborah Parker Liliane Younes, Sirkku Kivisto, Agneta Kallstrom, Hannu Juusola. Discussion about the projects.
In the morning running issues in the main office. At 10.30 meeting with Liliane Younes and Dr. Madeleine Badaro Taha about the project news, and budgets.
Pauline Bresse delivered the data of study concerning the progress of children with multiple special needs to Agneta Kallström, 2013-2014 for planning an article about the study report.
8:00 departure from the hotel. FGC Saida; met 8 MSN-sponsored children, 3 social workers. We met also Bahaa Tayyar, director of the Ein el-Helweh center.
Afternoon in FGC El-Buss: director Khawla Khalas presented the center and the ongoing development projects (awareness raising brochures, plans how to use piece of land, donated by the municipality, collaboration in the mental health program development for Lebanon, led by Dr Rabih El Chammay). We made a walking tour in El-Buss with social worker Siham.
In Beirut we met Dr Aziza Khalidi, and discussed the mid-term evaluation and Shatila water & health problem.
In the morning meeting with Marinella Corongiu & team who has a photo-story project in Bourj el-Shemali ”An usual day in the Palestinian family”. 10.30 Shatila, followed activities, visited Abdel Hadi family, met Jerbi family, meeting 2 Family happiness –sponsored children, Hanin and Nadin.Concert in Music center for Health Society.
Written and sent reports to the sponsors.
12 taxi to Mrs Birgit Ghossoub
Jobs for young people including PRL & PRS, working on the project plan for Ms Hanan Masri.
8.30 main center Kassem Aina and Hanan Masri, the application ”Jobs for young people”, agreed about some additional points.
9:00 with Hanan Dabdoub to visit Maria Ayoub in Ne’ emeh, reported to the sponsors.
11.30 UNRWA Shatila office, meeting Mr Mohamed Khaled Khaled, chief area coordinator, Central Lebanon. Discussion about the infrastructure constructions, water constructions and water station construction in Shatila. Further information must be asked from Ms Katie Travers, k.travers@unrwa.org
12.30 meeting with Liliane in FGC Beirut, project issues checked.
14:00 with Jamile Shehadeh meeting the PLO Popular committee in Shatila camp
18.15 Agneta Kallström invited meeting with Prof. Hannu Juusola, journalists Marika Kataja-Lian and Jad Lian in the hotel.
Visit to Beddawi Family Guidance Center, met the project team, and took a walking tour in the camp with Yehia Sweidan.
Back to Beirut, and trial to visit EU-delegation to learn about the EU_funded water construction project in Shatila and other camps.
20:00 meeting with Ms Kristil Haraldstad. Planning of joint work for fund seeking for mental health program of BAS.
8:30 Main office, meetings with Kassem Aina, Dr Rania Mansour, sponsorship program coordinator Fatima Khaizaran. Meeting in financial department with accountant Samer Nasser and Ms Diab Kassem. We checked the project budgets and planned the time schedule of financial reports. Departure to the airport 13.00

English language consultation: thanks to Dr Jessica de Bloom