Care Africa Network
(CAN), is a small UK registered charity which works to improve the lives,
health and education of orphans and vulnerable children and their families in
Africa. In partnership with governments, local organisations and partners CAN
empowers community-supported family care by disseminating effective methods for
this purpose through publications, consultancy and training. It also provided
other needs-led training.
It is primarily a knowledge
transfer agency but has on occasions also funded small income-generating
projects that enable communities to be self-sufficient in the care of children
in need for the future.
CAN offers consultations
to organisation concerning the development of community supported family care
of OVC. CAN now also provides training courses which disseminate effective
ideas and methods collected from 4 sub-Saharan countries, who have made
available to CAN their best projects for developing good community supported
family care.
In response to specific
requests CAN provides in addition a training course in
the treatment of Post-Traumatic Stress Disorder in children using an effective
patented method of Children's Accelerated Trauma Therapy (CATT).
BACKGROUND
The work of Care Africa
Network has developed in partnership with members of governments,
non-government organisations (NGOs), and community-based organisations,
together with the families and children of the countries concerned. Four
countries in sub-Saharan Africa have assisted in making available to CAN their
most effective projects for the development of community-supported family care
of children to promote future health and well-being. Through consultations with
individual organisations, effective methods developed within these projects
have been disseminated elsewhere by CAN to benefit other OVC, and in some cases
CAN has also provided the necessary small initial funding that has enabled
other communities to develop such projects.
For example a method of
drought-resistant permaculture that has proved
successful in Lesotho in enabling families to continue to take into their
household and care for their relative's orphans even in periods of drought, has
been successfully transferred to Swaziland. There is now a plan to train
thousands of community volunteers to teach this method to families in need.
This will enable these families to support the OVC of relatives and thus
prevent traumatised children who have lost their parents through diseases such
as AIDS, growing up alone and being forced to resort to street living by crime
or prostitution.
Methods disseminated
range from those empowering economically to enable families to continue to care
for their children and their relatives OVCs, to
helping to address in other ways all needs of children, - physical ,
psychosocial, educational and ethical including their need for protection from
abuse and empowerment for the future.
CAN also learns from the expertise and experience of local people
through these consultations and in doing so adds to its knowledge of effective
ideas and methods that can benefit children in need elsewhere.
Feedback from those in
the countries concerned about the work of CAN has been very positive.
In addition to
consultations to individual organisations CAN now provide two training courses.
The nature and impact of these in Lesotho and Swaziland in 2015 are described
below.
TRAINING
COURSE 1
Effective methods of
facilitating good community supported care for OVC
Course background
In addition to physical
needs, children have emotional, psycho-social, ethical and educational needs.
These are interdependent. Since research of the |World Health Organisation in
the 1950s, it now accepted that meeting the early attachment needs of children
is critical to their development and mental functioning. A child whose
attachment needs have not been adequately met will not only not develop
healthily mentally but will also be unable to make use of educational
opportunities available to them to learn and may also fail to thrive and grow
normally physically. They are unlikely to be able to develop into healthy
coping adults and mental hospitals and prisons have many inmates whose early
attachment needs were unmet. Continuity of attachments as well as the quality of
the attachments are important.
To meet a child's
psycho-social needs, and particularly the attachment need, it is most important
for the child to grow up in a loving family who can satisfy the need for
attachment.
African culture has
developed naturally and successfully to provide for attachment needs, and also
the support needed to provide resilience to hardships. Traditionally African
children belong to an extended family and are the responsibility of the whole
community overseen by the village chief. A child's attachment needs are
generally well met by child centred care with close quality relationships with
particular family members, and other supportive relationships within the wider
family. Shared care provides continuity when the mother cannot always be
present. Furthermore reciprocity of obligations between a child and members of
a community provide economic incentives for excellence in child rearing.
Considering the
difficulties it faces, this system has been highly successful for centuries in
generally meeting the needs of all children, including OVC, within the family
and community and should be valued and developed to meet new challenges.
However, pressures of increased geographical mobility, poverty, westernization,
and institutionalisation of children have eroded these systems. The
unprecedented pressures of the magnitude of the AIDS orphan crisis with the
loss of so many parents to AIDS, threatens the total destruction of this
system. The consequences would be disastrous both in human and economic terms
with thousands of destitute children and vulnerable adults and progress towards
all development goals reversed.
It is important to
prevent this destruction by the dissemination of innovations and methods which
have been used successfully to resurrect and empower good community supported
family care in some areas, so these ideas and methods become available to
benefit OVC elsewhere. This would enable the excellent cost effective and
culturally appropriate African community care systems to develop to meet new
challenges and be available for the benefit of future generations. The aim of
Care Africa Network is to help to achieve this goal
Course Content
This course seeks to
disseminate a range of effective ideas and methods that have been collected from
four countries for the purpose of promoting good community supported family
care of OVC. This includes methods of economic empowerment to enable extended
families to continue to care for OVC as well as methods which help communities
and families to meet the whole range of children's needs, - physical,
emotional, psychosocial, educational and ethical including their needs for
protection from abuse and empowerment for the future. The course encourages
participants to consider which of these methods might be most appropriate to
the particular situations and problems they encounter in meeting needs of OVC
and to make plans how they could develop and implement appropriate solutions to
these challenges so that the needs of OVC are met.
The specific aims of the
CAN methods course are to enable participants to:
1. Identify the particular
needs of the OVC concerned and assess the difficulties in meeting these needs,
2. Consider the range of
methods which have been successfully used elsewhere in similar challenging
circumstances,
3. Select from these
methods those that would be most relevant to their particular circumstances,
and hence most helpful in enabling good community supported family care of the
particular children in need,
4. Make plans for the
tailoring of these ideas for the benefit of the children concerned and for
their subsequent implementation.
The evaluation of the
CAN methods training course constitutes an integral part of the evolution of
the course to ensure it remains fit for purpose. The delivery of this training
in Lesotho and Swaziland in 2015 was accompanied by the provision of evaluation
forms and the feedback forms collected from the organisations and individuals
participating. This will be subsequently joined with any information received
concerning the success, or otherwise, in implementing the plans made.
Evaluation results of
the CAN methods course held in Lesotho in 2015.
All course participants reported
that the course had been helpful in enabling them to support the needs of
orphans and vulnerable children with whom they came in contact. They indicated
that the course was pitched at an appropriate level.
The average overall
rating the participants gave the course as a whole was 86.7%, which is between
good and excellent. A score of 100 equates to excellent, 80 to good, 60 to all
right, 40 to not good, and 20 to bad.
The following bar charts
indicate how each participant scored the parameters of: course content, course
presentation, exercises, and handouts.
Participants, who were
drawn from all districts of Lesotho, made some very constructive proposals and
proposed plans for how they could employ the ideas and methods from the course
to improve the community- supported family care of OVC in the areas in which
they worked.
Qualitative feedback
forms concerning the work of Care Africa Network in Lesotho was also very
positive. (See report on training).
Evaluation results of
the CAN methods course held in Swaziland in 2015
All participants
reported that the course had been helpful in providing them with ideas that
would enable them to meet the needs of OVC better. They also suggested that the
course was pitched at the right level.
The average overall
rating the participants voted for the course as a whole was 86.8% , which is between good and excellent. A score of 100
equates to excellent, 80 to good, 60 to all right, 40 to not good and 20 to
bad.
The following bar charts
indicate how each participant scored their perceptions of the various features
of the course in terms of: course content, course presentation, exercises, and
hand-outs. All aspects were evaluated as being between good and excellent.
Participants, who were
drawn from across Swaziland, proposed a number of excellent ideas as to how
they would wish to improve the lives of OVC by developing community supported
family care. These built on the ideas and methods presented in the course.
Qualitative feedback
forms concerning the work of CAN in Swaziland were also extremely positive.
CAN Extension Workers
Everyone working for CAN
donates their time free of charge. The overall aim of
CAN is to improve the lives of OVC and their families by disseminating ideas
and methods which effectively enable good community supported family care of
OVC, ensuring that all their needs, physical, psychosocial, emotional, ethical
and educational including their need for protection are provided for. Course
participants are invited to become CAN Extension Workers disseminating further
any beneficial ideas and methods learnt from the course to benefit more OVC.
TRAINING COURSE 2
The treatment of
Post-Traumatic Stress Disorder (PTSD) in children using Children's Accelerated
Trauma Therapy (CATT)
One of the CAN aims is
to provide, if possible, specific needs-led training when requested. Because of
the numbers of children traumatised by conflict or the death of their parents,
often due to AIDS, and subsequently experiencing severe mental health
difficulties, partner organisations and others have specifically requested that
CAN provide training in the treatment of Post- Traumatic Stress Disorder (PTSD)
in children.
In order to do this
well, the founder of CAN, Francesca Simms, who was already employed as a therapist
in the NHS Child and Adolescent Mental Health Service (CAMHS) in UK, offered to
undertake additional training in the treatment of PTSD using Children's
Accelerated Trauma Therapy (CATT). She also underwent training to teach this
method, and in return for helping to teach it in South Africa for the charity
concerned, now has a licence to teach this very effective, patented method.
Finding the method
exceptionally successful in treating her own patients, both in curing PTSD and
in resolving secondary severe mental health difficulties (see table of
treatment results), she offered to train other CAMHS clinicians in the UK in
the method. For a year she was employed to train a selected number of
clinicians from all the CAMHS teams in Hampshire, UK in the treatment of PTSD
using CATT, and then provided ongoing supervision to those trained across
Hampshire.
All of the evaluation
reports from participants on these courses voted that the courses provided were
good or excellent.
The CATT method
CATT is a child friendly
adaption of the Cognitive Behavioural Therapy (CBT) protocol utilising a
play/art method, and is based on scientific evidence on the effects of trauma
in the brain. It works by transferring the memory of the traumatic event from
the amygdule to the hippocampus so that it can be subjected to logical thought.
Francesca has found it has been successful in 100% of the cases where she has
employed it (see table of treatment results). Children report that their PTSD
symptoms disappear immediately after the core treatment session and once the
symptoms have gone, secondary severe mental health difficulties are usually
quickly resolved.
CATT has been highly
successful when used in Rwanda for treating PTSD following the genocide there,
and has been adopted as the official method of treatment in that country. It
has been used successfully in the UK, and random control trials are now
underway in Uganda. (See the evidence basis for CATT).
This dramatically
effective method needs to be made available for the benefit of traumatised OVC
elsewhere in Africa.
Aims and objective of
CAN training course in treatment of PTSD in children using CATT
The aim of the course is
to train members of partner organisations and others working with traumatised
OVC in the diagnosis and effective treatment of PTSD using CATT. The course is
designed for participants to become practitioners since the restrictions of the
patent prevent them being able to be train others in the procedure.
The specific objectives
of the CATT course are to enable participants competently to:
1.
Diagnose
whether a child has PTSD
2.
Select a
suitable treatment method
3.
Display
competence in how to adapt the method to suit a particular child, for example through
the reasoning for why a particular stage may be omitted for that child.
4.
Demonstrate
the successful implementation of all the stages of the CATT method by:
i.
Creating a
comfortable setting for the child
ii.
Ensuring a
sense of safety
iii.
Systemic
working with those in sustainable relationships with the child
iv.
Psycho
education
v.
Identifying
the difficulty in a child-centred way and upholding children's rights
vi.
Conducting
a needs assessment
vii.
Setting and
agreeing goals
viii.
Applying
phase 1 of the trauma treatment
ix.
Applying
phase 2 of the trauma treatment
x.
Rehearsal
(guided imagery) and progressive desensitisation
xi.
Trial and
evidence
xii.
Returning
to the needs assessment, reviewing the needs of the child, and reassessing what
is still required.
5.
Treating
multiple traumas
6.
Considering
when it is appropriate to use CATT
7.
Prevention
of compassion fatigue and secondary trauma (care of oneself as the therapist).
Post event evaluation of
the CAN training course in the treatment of PTSD using CATT constitutes an
important feature to ensure an appropriate evolution of the course.. Accordingly, course evaluation forms are provided to
participants as well as feedback forms concerning the work of CAN. Participants
are also requested to send follow up information concerning success of
treatment as measured by CRIES 8, (an effective measure of PTSD developed by
The Children in War Foundation) and PTSD checklists before and after treatment
of each child.
Evaluation of CAN
training course in CATT for treatment of PTSD in Lesotho in 2015
All of the participants
reported that the course had been helpful in enabling them to treat children
suffering from PTSD, and that the course was pitched at the right level.
The average overall
rating the participants gave the course was 82.8% , which
was between good and excellent. A score of 100 equates to excellent, 80 to
good, 60 to all right, 40 to not good, and 20 to bad.
The following bar charts
indicate how each participant scored the parameters of course content, course
presentation, exercises, and handouts.
Feedback forms were very
positive, and a follow up course was requested.
Evaluation of CAN
training course in CATT for the treatment of PTSD in Swaziland 2015
All of participants
reported that the course had been helpful in enabling them to treat children
suffering from PTSD, and that the course was pitched at the right level.
The average overall
rating the participants gave the course was 86.7% ,
which was between good and excellent. A score of 100 equates to excellent, 80
to good, 60 to all right, 40 to not good and 20 to bad.
The following bar charts
indicate how each participant scored the course in terms of the parameters of:
course content, course presentation, exercises, and handouts. All parameters
were assessed as being between good and excellent.
Feedback forms were also
very positive, and a follow up course was requested.