By Teresa Welsh // 06 July 2020
WASHINGTON — Kathleen Rutledge spent her first day following the 2004 Indian Ocean tsunami in Sri Lanka delivering cook sets to people who had lost everything. She recalls meeting with a Buddhist family sitting in their tent, about a month after the disaster.
“They held a picture of their daughter who had been killed and said, ‘Where’s God?’” Rutledge said, recalling how ill-equipped she felt to provide appropriate faith-sensitive comfort to a family that was obviously religious, and suffering. She said her training as a humanitarian worker discouraged talking about controversial topics such as religion.
“The fact that their questioning was at that deep fundamental level and that those were the types of things causing them distress, in addition to physical needs, stayed with me. And it also challenged me to consider how can we appropriately respond if it doesn’t follow Maslow’s hierarchy that physical needs are first,” Rutledge said, who after 10 years in the field is now pursuing her Ph.D. studying the role faith plays in coping and recovery in humanitarian settings at the Institute for Global Health and Development at Queen Margaret University.
“Secularism is not neutral or impartial. And that’s causing harm.” — Kathleen Rutledge, researcher
Although 84% of the world’s population self-identifies with a religion or faith tradition, many humanitarian and development organizations steer clear from putting spiritual matters at the core of their work. Organizations can be wary that they don’t possess the knowledge base or expertise to provide faith-sensitive counseling, and bringing religion into organizational activities could be perceived as proselytizing, violating the humanitarian principle of impartiality and “do no harm.”
But completely disregarding something that is so central to the identity of so many people is a mistake, Rutledge said, arguing that faith is a key aspect of proper mental health and psychosocial support when dealing with any religiously affiliated population that has undergone trauma. Humanitarian organizations traditionally tend to separate people’s physical needs, like food, water, and shelter, from their spiritual needs.
“For a lot of world views, that’s not even an option. They’re just integrated. And so, if people are coming and saying, ‘This is my faith, I’m asking for help for my faith and my issues,’ to then stonewall that and to exclude it rather starkly is a different kind of coercion and it actually violates humanitarian law,” Rutledge said. “Secularism is not neutral or impartial. And that’s causing harm.”
Prioritizing religious needs after trauma
In 2007, the Inter-Agency Standing Committee issued guidelines for humanitarian organizations providing mental health and psychosocial support in crisis settings.
The body, the highest-level humanitarian coordination forum in the United Nations, noted a “significant gap” in available guidance on how to identify useful practices in mental health and psychosocial support, and how those practices may complement one another in an effective multisectoral, interagency framework. The document includes a section on facilitating conditions for appropriate communal cultural, spiritual, and religious healing practices.
The guidelines note that survivors of trauma in non-Western societies often experience suffering in spiritual, religious, family, or community terms, rather than exhibiting individual symptoms, such as depression, that are more common in the West. The document suggests aid workers approach local religious and spiritual leaders to learn how a population can be best supported; ask critical questions about how people have been spiritually impacted by an event and how rituals like burials are to be conducted in accordance with religious practices; and facilitate conditions for appropriate healing practices.
But the guidelines also caution that “because some local practices cause harm (for example, in contexts where spirituality and religion are politicized), humanitarian workers should think critically and support local practices and resources only if they fit with international standards of human rights.”
Appropriately meeting religious needs in emergency settings like refugee camps or disaster response can be a key piece of mental health care, said University of Birmingham researcher Sandra Pertek. This includes things such as providing a space to pray or worship, and making sure that both men and women have access to the space in accordance with local tradition. It can also include providing religious objects, like a hijab to women whose custom requires them to wear a head covering to access public spaces, or a bible to a migrant who finds solace in religious text.
“To support any survivor with psychosocial intervention, you need to be able to understand the root causes of people’s experiences, the reasons why they went through it.”Sandra Pertek, researcher, University of Birmingham
Being faith sensitive to a population that has experienced trauma can also include things like ensuring that people have access to appropriate foods for religious celebrations, such as Eid or Easter. This can help provide the comfort of tradition and religious practice even when people’s lives are otherwise disrupted.
Ensuring access to religious objects and facilities can be more difficult depending on the context, Pertek said, who formerly worked at Islamic Relief. Her research found that Christian women migrating from sub-Saharan Africa had difficulty attending church services in Muslim-majority Tunisia, while Syrian refugees in Turkey faced fewer barriers to practicing their Islamic faith because both countries are majority Muslim.
“The only thing keeping them going was their belief and their connection with God. There is nothing else in terms of psychosocial activities and mental health that was provided to them,” Pertek said of the refugees she spoke with. “The only lifeline that they have is their relationship with the divine.”
Typical psychosocial support interventions, like mindfulness activities or art therapy, are not always faith sensitive, Pertek said. The need for such mental health services is even greater when people find themselves in a humanitarian emergency because of their religion.
“To support any survivor with psychosocial intervention, you need to be able to understand the root causes of people’s experiences, the reasons why they went through it,” Pertek said. “Religious inequalities and religious persecution is often a cause of flight for many.”
‘Take the blinders off’
Faith must be taken into consideration from the beginning when programs are being designed, Rutledge said, to ensure they accurately reflect the needs of the population. Too often, an NGO constructs a humanitarian response or development intervention based upon their own belief system. Because so many aid organizations are based in the West, they tend to operate with secular Western values that do not put religion at the center of someone’s identity.
“We have such blinders because we can’t see the world through the population’s eyes,” Rutledge said. “We should try to take the blinders off and ask the questions just to understand: What do people think the causes of problems are? What should solutions be? And who should be involved?”
Staff must be appropriately trained for the context in which they are working, and must be sensitized to local culture and belief systems if they are to have the right tools to provide mental health and psychosocial support to populations. This includes understanding things like how people grieve and process loss in their faith tradition.
One way of ensuring a humanitarian response will be appropriately faith-sensitive is to encourage localization, said Esther Lehmann-Sow, partnership leader for faith and development at World Vision International. The organization employs mostly local aid workers in its humanitarian response activities, which helps guard against program implementation being Western-centric.
Donors “have a mindset that if you’re educated enough you don’t need religion anymore,” Lehmann-Sow said — a mindset the Christian organization tries to avoid as it operates in mostly Muslim contexts.
Increasingly, the importance of incorporating religion and faith into humanitarian response activities is being recognized. In 2018, a consortium of faith-based NGOs produced specific faith-sensitive guidance for mental health and psychosocial support in humanitarian response that aligns with and expands upon the 2007 U.N. document. It presents more detailed guidelines outlining how organizations can strengthen psychosocial support by achieving more effective engagement with faith-oriented individuals and communities.
“We all want the best for the population — I genuinely believe this. We want good recovery outcomes, and good aid is responsive aid that’s appropriate to the population and is shaped by the population,” Rutledge said. “So how can we possibly be working in contexts where 85% of the world is religious and not be listening and adapting, without harm? And the answer is you can’t. We’re creating harm and it’s just unfortunate and sad for those who are experiencing the adverse impact of that.”