Monsoon in Kathmandu, July 2018

My colleagues, Bharati Devkota and her husband Dr. Hari Devkota visited their families in Nepal last summer and asked me if I would join them to give MOVE FOR CHANGE workshops for five days for NGOs rescuing survivors of human trafficking in Nepal Before I left, I have to admit I was beside myself, worried about monsoon, if I’d find the locations and be on time for the workshops, be too jet lagged, etc. The week went beautifully and in retrospect, I had nothing to worry about. IMG_0523

First a little back ground. According a report titled “Human Trafficking & Modern Day Slavery, in the early years of the 21 st Century” (humantrafficking/Nepal.htm, gvnet.com/), Nepal is a source country for men, women, and children trafficked for the purposes of commercial sexual exploitation and involuntary servitude. Children are trafficked within the country and to India and the Middle East for commercial sexual exploitation of forced marriage, as well as to India and within the country for involuntary servitude as domestic servants, circus entertainers, factory workers, or beggars. NGOs working on trafficking issues report and increase in both transnational and domestic trafficking during the reporting period, although a lack of reliable statistics makes the problem difficult to quantify. NGO’s estimate that 10,000 to 15,000 Nepali women and girls are trafficked to India annually, while 7,500 children are trafficked domestically. In many cases, relatives or acquaintances facilitated the trafficking of women and young girls into sexual exploitation. -U.S. State Dept Trafficking in Persons Report, June, 2009 http://gvnet.com/humantrafficking/Nepal-2.htm

Few of these survivors have access to mental health treatment. In addition, those providing services also face a plethora of challenges regarding proper training and self-care tactics. To ameliorate some of their difficulties, TOYL/Move for Change developed a train the trainer workshop to build the capacity of service providers working with survivors of human trafficking.

Our team, Bharati Devkota LCPC, Priya Dhanani, MA, Lauren Stempler MA, and Dr. Hari Devokta created a program to address the staff needs called MOVE FOR CHANGE. Our goal is to train, educate and provide financial resources to mental health providers and staff, so they can make trauma-informed decisions and take a strength-based approach when working with their clients. Our intention is that this training will produce range of positive outcomes, including promoting mental health services and human trafficking prevention education in Nepal.

Dr. Hari Dekota, Bharati Devkota, Sydney Frymire


Our long term goal is to provide trainings in the United States for mental health clinicians which will include site-visits and field work in Nepal as well as bring Nepalese counselors to the United States for training. Our long term goal is to replicate MOVE FOR CHANGE around the world.

MOVE FOR CHANGE curriculum falls into three components:

Education: Defining human trafficking, understanding the neurobiology of trauma and implications for interviewing victims and how client behavior relates to trauma.

Best Practices: Providing trauma-informed care, including the psychological effects of trauma and how client behavior relates to trauma

Wellness Plans: Developing and implementing a self-care plan for service providers including dance, music and yoga.

In 2015, we began with a pilot workshop for 18 Shakti Samuha Organization staff members. http://shaktisamuha.org.np

Pilote workshop with Shakti Samuha staff 2015

Shakti Samuha is the world’s first organization which has been established and run by the victims of women trafficking. In 1996, the Indian government conducted a raid in the red light area in Mumbai and freed about 500 young girls from Nepal, India, and Bangladesh and kept them in government houses. The co-founders have won many awards including one comparable to the Noble Peace Prize. Charimaya Tamang, co -founder, won the ‘Hero Acting to end Modern Day Slavery’ Award 2011, which was presented by Secretary of State, Hillary Clinton. Kyla Whitemore (Rebecca’s daughter) joined the group and made this video to help with fund raising.

Based on their request, in 2016, Bharati Devkota LCPC and and I conducted a 2- day training for 25 Shakti Samuha Staff members. In 2017, with the assistance of two willing TOYL group members, I gave a 1 day follow-up to further develop the wellness plans.

Dancing to relieve stress during the workshop


Bharati and her husband, Dr. Hari Devkota visited their families in Nepal during July 2018. They asked me to join them for a week to give workshops to NGOs rescuing survivors. We started our week together and giving a two-day workshop on Trauma and Treatment strategies, facilitated by Sanam Poudet, founder of CAP https://capnepal.org , to a group of 35 students, clinicians, program directors and field workers from a collaboration between the Counseling, Psychology and Social Studies College, the Mental Health Participatory Research Center, Move for Change and the Association of Psychologist in Nepal.

lunch break during workshop


Dr. Hari Devkota and Bharati Dekota teaching


Role playing the resistant client


Sydney teaching mental health aspects of childhood trauma


workshop group learning about trafficking and suicide prevention


The next day, we gave a one-day workshop on the ethics of self care, burn-out, compassion fatigue for Shakti Samuha staff, which was a continuation of the previous workshops for them. Each year, we had another module to our training program.

Yoga with Shakti Samuha Staff


Dr. Hari Devkota explaining mirror neurons, 3 parts of the brain and the Vegas nerve


Bharati and Sydney


On Thursday, we had a meeting with Anupama Shreshta (President ) and five staff members of the Himalayan Social Welfare Organization (HSWO) to learn about their programs including opening training/information centers for migrant workers, income generation for single women, and education programs for HIV/AIDS affected children and disaster management.

In the afternoon, we visited Sanam Poudel founder of CAP https://capnepal.org for lunch, to learn about their programs rescuing girls and boys trafficked in the entertainment industry, raising awareness training programs, emergency shelters, education program, counseling/health treatment, and reintegration into society. They closely collaborate with trade unions and police.

CAP staff


CAP programs


CAP gift shop


Meeting with CAP staff


On Friday, we gave a three-hour workshop on trafficking and effective parenting programs for CMC,http://www.cmcnepal.org.np, the community mental health center where Bharati worked before moving to Baltimore, Maryland. This was our second workshop for them. In 2016, Bharati and I reviewed basic concepts of intake, keeping records, and confidentiality.

lost children in Nepal


chart illustration programs


Bharati and Hari Devkota at CMC


PRE/POST TEST RESULTS

In order to better understand and assess knowledge-gaps regarding stress management and the needs of the staff members, Ms. Devkota, Priya Dehani, Lauren Stempler and I designed a curriculum, conducted a pre and post questionnaires and evaluations for each workshop. The curriculum covers definitions on topics like compassion fatigue, stress, burnout, and short-term and long-term stress reduction plans. There were a total of 44 participants, who worked with survivors of trafficking at Shakti Samuha who attended the two day workshop in 2016.

Based on the data collection, participants was a 90% knowledge-gap on awareness of general concepts of trauma and its symptoms among the staff, who were predominantly working with traumatized survivors. Many of them are survivors also and were often re-traumatized by trying to help others. Additionally, 60% of participants acknowledged burnout, fatigue and personal trauma, and admitted that it impacted their abilities to be effective service providers. More than 85% of the pre-test showed that service providers did not have a stress-reduction plan and found their work caused more stress and exacerbated their trauma. There was also a consistent lack of awareness of self-care planning, However post survey results indicated a significant improvement regarding their understanding of these concepts, including trauma. Participants used the test results to develop individual as well as group and organizational self-care plans. This was the first step in creating a holistic plan to improve the services provided to survivors and to the lives of services providers. Pre and post tests to assess progress and what is needed in the future have been conducted after each workshop. This data has not been analyzed yet.

The study was focused the area of raising awareness about mental health in Nepal among the active staff working in the field of trafficking victims. Mental health professionals trained in the US and Nepal conducted this training. This study helped trainers identify critical knowledge and awareness gaps in regard to mental health as well as the impact of human trafficking and trauma among the participants and the staff and with the survivors of trafficking they are assisting.

Our study concluded that trauma-informed training, basic concepts of trauma, its symptoms and self care, are core topics that staff need to learn and understand in order to be better equipped to properly serve their clients and identify vicarious trauma in themselves as well as help them to make better referrals and treatment plans. This ongoing project has as its main goal to prevent and promote mental health in Nepal among various organizations working with survivors of human trafficking. Trained mental health professionals in the United States will be actively involved in the teaching and learning process throughout the continuation of this project.

#traumainformed

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