From the Executive Director - Caring for Invisible Wounds, Speaking Out for Unheard Voices

From the Executive Director 
Before going to medical school, I did a bachelor’s degree in psychology. This instilled in me the principle that people do not only need doctors and nurses to treat their physical ailments, but they also need support to recover from psychological trauma. MSF’s mental health support and its paramount importance during humanitarian crisis is the overarching theme of this edition of Borderline.
Through working with MSF, very often in emergency situations, I have seen people who have lived through the horrors of armed conflict, natural disasters and epidemics suffer from severe psychological consequences. It is in this light that MSF’s medical humanitarian action goes beyond ensuring people’s physical wellbeing. Mental health professionals are there to listen, support, and provide care, so that traumatic experiences do not come to define their lives. 
Sadly, there are times when MSF is not allowed to offer such critically-needed assistance. Having provided psychological and psychiatric services to asylum seekers, refugees, and the local community in Nauru for nearly one year, MSF was forced to leave the country with just 24-hour notice. Our team who worked on this remote Pacific island witnessed an alarming number of suicide attempts and incidents of self-harm, indicating that the mental health situation of those being held indefinitely is ‘beyond desperate’. MSF calls for the immediate evacuation of those asylum seekers and refugees who have no voice, hope or protection, and for the end of the cruel, inhumane and degrading offshore detention policy of the Australian government. 
We also want to give voice to people whose suffering is rarely covered by the mainstream media. This issue’s Cover Story features the elderly trapped in conflict in Ukraine, the children and adolescents attempting repeatedly to leave Eritrea for a better future, and the victims of sexual violence in Central African Republic. Providing mental healthcare in many of these places is not straightforward, particularly when violence and trauma maybe ongoing, or language and cultural barriers may prevent people from seeking support. My colleague Guleed, MSF – Hong Kong Psychosocial Focal Point speaks about our challenges and solutions; together with Rangi, our Indonesian medical doctor recently returned from mission, they highlight the importance of the mental health of our staff. 
Since March this year, weekly demonstrations in Gaza in the Occupied Palestinian Territory have been met with lethal force by the Israeli army. At a time of escalating violence, the Photo Story exposes a collective and transgenerational mental health crisis faced by the Palestinians in the West Bank, and their diminishing ability to cope with this. 
It is encouraging to see that in our home societies, the general public has recognised the need of caring for the invisible wounds. MSF will continue to bring to your attention those voices from afar: please, hear their pleas. 
Dr. Natasha Reyes 
Interim Executive Director, MSF – Hong Kong