Tag Archives: inclusion

Suicide – devastating, common and preventable

To mark World Suicide Prevention Day 2018 on 10 September, Dr. Julian Eaton (Senior Mental Health Advisor at CBM) shares his views on a topic that is often taboo, despite desperately needing to be talked about to raise discourse, awareness, recognition and policy priority for suicide, in turn reducing a scourge that affects far too many people.

Picture copyright: Pixabay

 

When I was 21, my thoughtful, caring, talented, beautiful friend, killed herself. I think her funeral was the most upsetting thing I have ever attended, with all of us asking how a person with the world at her feet could feel such despair that this seemed the only solution. Her death left a hole in her family, and our circle of friends still feel the painful gap in the space she used to occupy.

September 10th marks World Suicide Prevention Day, a topic that is increasingly in the news, but that people still find difficult to talk about, though many people are affected. Suicide remains a taboo subject in most parts of the world, often frowned upon by cultural and religious traditions. In fact, the term ‘committing suicide’ refers to the fact that suicide was illegal in many countries. We try to avoid using this terminology, and in countries where suicide remains illegal, it is an advocacy priority to change such laws, as part of the process of challenging stigma, making it easier to talk about the issue, being able to accurately record cases of suicide, and reducing unnecessary additional suffering of families and survivors of attempted suicide.

It is a sad and shocking fact that suicide is the second most common cause of death in young people between 15 and 29 worldwide, and is the leading cause of death among young people in many European countries. In total, almost a million people die by suicide globally each year. It is estimated that for every person who dies by suicide, at least 25 attempt suicide. As well as being an awful situation for the person themselves, a suicide has a devastating effect on friends and family, and it is estimated that typically, over 100 people are effected by a single suicide.

Many people who self-harm do not intend to die, and there are many complex reasons why people do self-harm, but it is also the case that people who self-harm are more likely to go on to kill themselves by suicide, so this is an important warning sign, that should be taken seriously, and lead to support being provided.

Why do people seek to harm themselves, and what can we do to reduce suicide?
Of course suicide is strongly associated with mental ill health, and over half of people of people who die by suicide have a diagnosis of depression at the time of death. People with alcohol and drug problems, psychotic illnesses like schizophrenia, and other mental illnesses are also more likely to self-harm and die by suicide. This means that good mental health services, systems to identify people who are distressed or depressed, and easy access to care are important elements for reducing suicide. Similarly, physical ill health (especially long-term, painful and disabling conditions, including non-communicable diseases (NCDs)) increases risk of suicide, so good care of physical health, as well as recognising a psychological component of such conditions is important.

Relationship problems, bereavement, unemployment, work or educational stress, economic hardship, loneliness, isolation and bullying (often online) increase risk of self-harm and suicide, particularly if they come together. Therefore, a comprehensive approach to addressing risk of suicide is important. The easier it is to access means of self-harm (guns, knives, toxic medicines etc.), the more likely people are to successfully kill themselves, so one of the most effective means of reducing suicide rates is to control access to such means of self-harm. Suicide is often carried out in particular moments of despair, which will almost always pass if a person is not able to find a means of harming themselves. One example is where simple measures to reduce easy access to pesticides, a particularly common cause of death among farmers in India, dramatically reduced suicide rates.

It usually helps to be able to talk to someone, and a listening ear, and supportive friendships can really help when people are feeling hopeless. We can all do what we can to support our own friends, or people we work with who are lonely or distressed, but we can also try to raise awareness of the issue, and advocate for more government and social action to implement the measures we know are effective. Suicide is an essential issue for mental health, and as such closely linked to Non-Communicable Diseases. The High Level Meeting on NCDs at the UN General Assembly is an opportunity to make sure that mental health and suicide are recognised, and we work together as a global health community to reduce the scourge of suicide that affects so many people.

Related links

Innovations:

  • RISING SUN (suicide prevention in the Arctic region) – http://bit.ly/2Np9ntY
  • Giving LIFE a chance – http://bit.ly/2NTie3Z
  • Pesticide Regulation for Suicide Prevention – http://bit.ly/2oIEToO

Toolkit:

  • RISING SUN has produced an online Toolkit on how to measure the impact and effectiveness of suicide prevention in Indigenous groups. 5 levels of intervention a) Family b) Individual c) Clinic d) National/Regional e) Community – http://bit.ly/RISINGSUNTOOLKIT

Resources:

  • Suicide Prevention Webinar from Dr Saxena Shekhar, Director of WHO Department of Mental Health and Substance Abuse – http://bit.ly/2eO6ljx
  • WHO Suicide Prevention Factsheet, available in 6 languages including info on key facts, prevention & control & challenges – http://bit.ly/2oIyREG
  • WHO’s Community Engagement Toolkit – http://bit.ly/2oKVLv1

What’s behind CBM’s ‘End the Cycle’?

 

The End the Cycle team and local film crew collecting stories in Bangladesh using a human-rights based approach.

Have you ever wondered what makes End the Cycle so unique?

Or perhaps you watched one of our short videos and felt there was something different about it?

We frequently receive feedback that End the Cycle videos are insightful, professional and creative, as well as useful in helping people understand how poverty and disability are linked. Our videos help people understand the importance of including everybody.

But the process along the way to create the great result is also worth exploring – in fact, the way we go about End the Cycle’s work is just as important as the finished product. The foundation of all that we do is our principles, based on Article 3 of the UN Convention on the Rights of Persons with Disabilities. The principles inform our plans and guide our decision-making. In this post, we’ll unpack some of the principles and how they are applied in real situations.

Local Ownership:

When a new set of resources is to be developed, a local partner is identified to work on story collection and development. In many cases, this local partner is a Disabled People’s Organisation, or DPO. In some cases, this has been an existing CBM partner who has people with disabilities in positions of leadership. We want the local ownership to be in the hands of people with disabilities. We draw up a contract with the local partner, clearly setting out roles and responsibilities.

We think it is important that a person with a disability from the local partner is in charge of the process. This means that when the film crew is on the ground, it’s the local person who leads the group and has the final say.

Own story, own words:

In the words of Abena, an End the Cycle self-advocate from Ghana:

“Someone wearing the shoe knows very well how tight it is, how painful it is inside. But because you are not wearing the shoe, you can’t talk for me. So it is better you give us a chance to talk for ourselves.”

This principle relates to the central and consistent role of people with disabilities in defining and directing their own goals. Telling their own story in their own words keeps the person in control of how they are represented. This means ensuring participants understand End the Cycle’s plans for the resources and that consent to be a part of the project is genuinely informed. Later, when videos are being edited and creative elements added, drafts are sent back to participants to check they are still happy with how they are being portrayed. At any stage in the process, or even after the videos are finished, participants can intervene to make changes or even withdraw from the project.

Once everyone is happy, the videos are shared through our global networks, getting the self-advocate’s message out into the world.

Accessibility: increasing all the time

All reasonable measures are taken to ensure End the Cycle resources are accessible to all people. We aim to leave no one behind!

This is an area we always consider and our resources have become more accessible over time, as we learn and grow. At present, key accessibility measures include:

  • All videos are sub-titled
  • Latest videos also have international sign captioning on-screen, as well as audio-description alternative versions
  • Our website can be switched between English, French or Spanish, and many videos are also available in these languages, as well as some in Arabic
  • All documents are available in Word and PDF versions
  • The website has been designed with accessibility in mind and meets AA standard

Accountability

We are committed to being accountable to the people who have shared their story with us. For this reason, we have clear Terms of Use so that anyone who downloads an End the Cycle video is aware that the story must not be edited or changed in any way, without us checking with the person in the story. The Terms of Use state clearly that stories must not be retold or modified, and that photos cannot be used without the story, giving the context that the person provided.

 

What do you think of these principles? Could they be applied to all story collection in the international development sector, or is there more we could do to raise the bar on a rights-based approach? We’d love to hear your thoughts.

 

Send an email to contact@endthecycle.info or check the full set of stories here.

Eye health and the environment – why sustainability and inclusivity go hand in hand

David Lewis, CBM Focal Point for Environmental Sustainability, and Kirsty Smith, Chief Executive of CBM UK  on an important opportunity to  promote environmental sustainability in the eye-health sector amid a month of climate disaster.

The need for global responsibility cannot be plainer. Hurricanes in quick succession battering communities in the Caribbean, leaving many homeless and with little help, including people with disabilities. Hurricane Maria followed Harvey and Irma. Now Nate has struck. Sometimes it’s hard to feel optimistic that our efforts do enough, soon enough, to temper the onslaught of extreme weather following decades of en-vironmental damage.

However there is hope and CBM is determined to do our bit to improve the sustain-ability of all of our work. In September we logged in via Skype to Kathmandu to join the launch of an international working group for environmental sustainability, one of our biggest priorities if we are to see global health of the world’s poorest people improve.

The group has   been set up by the International Agency for the Prevention of Blindness (IAPB) after a proposal  from member organisations including CBM, Vision 2020 UK, Aravind Eye Care System as well as other interested individuals.

Our aim is to bring together well-researched and creative approaches to strengthen environmental sustainability in eye health organisations around the world.

 

Patients after cataract surgery at Caritas Takeo Eye Hospital, Cambodia. Open, airy verandahs allow for air movement, keeping the hospital cooler and creating a pleasant environment for patients to wait.

Central to CBM’s mission
Climate change and environmental degradation have a devastating impact on all parts of the world, but this is particularly true for the world’s poorest communities. What drives our determination is knowing people with disabilities and other vulner-able groups are among those most affected on a daily basis, and in every part of their lives.

Health and well being are at risk in polluted and dangerous environments. These communities often lack access to safe water and sanitation, to sustainable food and energy sources. They face increasing risks due to natural and man-made disasters and more often than not find themselves at the back of the relief aid queue.

In terms of  eye health, we know that the communities most susceptible to envi-ronmental degradation carry some of the highest rates of avoidable and permanent blindness.

CBM is acutely aware that climate change is predicted as one of the largest health threats of the 21st century and that health care itself is a large contributor to carbon emissions.  Working closely with high quality eye health services around the world puts CBM in a strong position to draw attention to the essential need to reduce carbon emissions.

 
Why sustainability and inclusivity go hand in hand
Environmental sustainability and inclusion have been at the heart of CBM’s work for many years. We want to improve the environment and at the same time make  sure people with disabilities and those from other marginalised groups participate in environmental programmes as their human right. Thanks to advocacy by CBM and others, the Agenda 2030 for Sustainable Development Goals agreed by world leaders in September 2015, became much more inclusive.
CBM has in recent years created a resource booklet to help and inspire those seeking to make eye health services, and health and development programmes generally, more environmentally sustainable. It includes case studies, checklists and ideas with input from our  global advisors and partners in the field.  We want to demonstrate the wide ranging actions possible to strengthen environmental sustainability, particularly in the poorest countries, and gather evidence of the effectiveness of CBM’s actions so that we can replicate our most effective interventions elsewhere.  As well as environmental sustainability and inclusion, – this booklet highlights the need for accessibility, gender equality , safe-guarding those at risk, and disaster risk reduction as keys to sound development practice.

 
Case Study, Cambodia
We were delighted to have one of our studies highlighted at the IAPB Council meetings in  Kathmandu, as an effective model  of environmental sustainability which others in the field can learn from, as well as contributing their own ideas.
We are particularly proud of what has been achieved during our partnership with the Caritas Takeo Eye Hospital from 1996 – 2013.
Cambodia is one of the poorest countries in  Asia, with the majority  of the population living in poor  rural areas, with low access to services. Blindness is a key factor  contributing to this poverty.
It was in 2006 when  the chance came  to innovate in all areas of hospital life. The old hospital had to be demolished and all the stake-holders  wanted the new one, from its construction, energy and water supplies, to its cooking equipment and even surgery techniques to be of the lowest impact on the environment possible.  The hospital is proving to be a great model, with ongoing assessment of things which could be improved.
The hospital offers excellent eye care in accessible buildings which like many of the other facilities are above ground to reduce the threat from flooding. The “3 R’s” are used everyday -reduce recycle re-use .

 
Environment Sustainability Work Group – sharing expertise
CBM hopes the Cambodia study will help other IAPB members strengthen  high quality environmental practices and widen inclusivity in their own eye hospitals.

As a result of this and other expertise recognised within CBM, we had the opportunity to be one of the leads in  setting up the Environmental Sustainability Work Group for the IAPB.
Its launch in Kathmandu was a great success with CBM and other IAPB members setting out ambitious plans for innovation and learning, so that the best community eye services can be available while minimising their economic and environmental impact.
We are making progress.  Our determination to put the environment and inclusion at the epi-centre of the fight against poverty and inequality is moving forward.

 

Tomorrow we celebrate World Sight Day – make sure to read about it on our website! Also have a look at our newly released Neglected Tropical Diseases Report 2017.

Opening doors for positive change that will end discrimination and ensure our freedom and rights

crpd-10yr-logo-small

The Convention on the Rights of Persons with Disabilities, together with its Optional Protocol (which provides for the right of individual petition to the Committee), was adopted on 13th December 2006. The Convention rapidly came into force in May 2008, and has retained its momentum in rate of ratifications – to date 170 countries have ratified the Convention.  See a map of country ratifications here.
To celebrate the 10th anniversary of the Convention on the Rights of Persons with Disabilities, you can read about many global activities, along with highlights over the last 10 years here.  The United Nation’s annual photograph and film festival on 3rd December showcases the best global contributions, and includes a short film by CBM Australia linking the Sustainable Development Goals and disability rights.
CBM International supported the design of the official Office of the High Commission for Human Rights logo and animated icons for the 10th anniversary, as well captioning and sign language for a film by members of the Expert Committee on the Convention, and a beautiful musical recital by Dame Evelyn Glennie in Geneva.

Musical recital by Dame Evelyn Glennie in Geneva

Musical recital by Dame Evelyn Glennie in Geneva

Today is a time to reflect on the participation of persons with disabilities, and their representative organisations who inspired the drafting process of the Convention. The United Nations General Assembly in New York constantly supported the active involvement of disability organizations in the drafting of the Convention. A broad coalition of organisations of persons with disabilities and allied NGOs formed the International Disability Caucus, the unified voice of organizations of people with disabilities from all regions of the world. One of its members stated that its goal was “to open doors for positive change that will end discrimination and ensure our freedom and rights”. The level of participation of organisations of persons with disabilities and NGOs in the drafting process was probably unprecedented in United Nations human rights treaty negotiations. By the Ad Hoc Committee’s final session, some 800 organisations of persons with disabilities were registered.
Beyond the negotiations, organisations of persons with disabilities have been actively involved in the lifecycle of the Convention. They were closely involved in the signing ceremony on 30 March 2007 and have been involved in the work of the Committee on the Rights of Persons with Disabilities, the Conference of States Parties and the Human Rights Council’s annual debates on the Convention. I have been a member of the Committee on the Rights of Persons with Disabilities since 2013.

 

Please join in the celebration the promotion and protection of human rights and fundamental freedoms for all persons with disabilities.