DECLARATION OF COOPERATION

MENTAL HEALTH OF REFUGEES, DISPLACED AND OTHER POPULATIONS
AFFECTED BY CONFLICT AND POST-CONFLICT SITUATIONS


 BACKGROUND AND METHODOLOGY OF ELABORATION OF THE DECLARATION
 
 

The Declaration is the result of a consensus already reached on the themes contained herein through the international consultations enlisted below. These were either convened by the WHO Advisory Group on Mental Health of Refugees, or resulted from international cooperation between UNHCR, WHO and Collaborating Centres, NGOs, and other operational partners and UN agencies.
The participants came from most of the continents, from both conflict and refugee host countries. They represented UN agencies, NGOs, academic and research institutions, donors, decision-makers of ministries of health or foreign affairs, and other bodies involved in the protection and assistance, including mental health of populations in conflict and post-conflict situations. They belonged to a wide range of disciplines such as psychiatry, psychology, social work, anthropology, sociology, education, public health, nursing, law, management, and human rights. Most of them combined extensive theoretical knowledge and thorough field experience.

The first step of the elaboration process consisted of condensing the seven hundred conclusions and recommendations of these consultations into seventy.
Second step: these were sent worldwide to some fifteen relevant agencies, mental health associations, academic or other institutions, and professionals with a request to review and condense them into twenty principles.
Third step: based on the analysis of the responses the draft Declaration was created.
Fourth step: the first draft was circulated within and outside WHO to a larger group for review.
Fifth step: the feedback served to elaborate the pre-final draft.
Sixth step: the Declaration was technically reviewed and adopted at the “Second Meeting on Community-Based Rehabilitation in Post-Conflict Countries” in Harare, Zimbabwe, 21-23 February 2000.
Seventh step: the Declaration was presented and endorsed at the International Consultation “Mental Health of Refugees and Displaced Populations in Conflict and Post-Conflict Situations”, on 23-25 October 2000, organised by WHO for adoption.
Eighth step: it will be translated into the five WHO official languages and into as many local languages as needed for dissemination and implementation.


List of Consultations:
 

"Health Hazards of Organised Violence", Veldhoven, The Netherlands, 1986;

"Health Situation of Refugees and Survivors of Extreme Violence of Organised Violence", Gothenburg,
 Sweden, 1988;

 “Health Hazards of Organised Violence in Children I”, London, United Kingdom, 1993;

 “Care and Rehabilitation of Survivors of Extreme Violence of Rape, Torture and Other Severe Traumas of War in the Republics of Ex-Yugoslavia”, Utrecht, The Netherlands, 1993;

“Ethical Standards in Mental Health Care for Asylum Seekers, Refugees and Displaced Persons”, Zeist, The Netherlands, 1995;

 “The Psychosocial Aspects of Repatriation of Former – Yugoslavian Refugees and Displaced Persons”, Ribno, Slovenia, 1996;

“Health Hazards of Organised Violence in Children, II – Coping and Protective Factors”, Bergen,
 The Netherlands, 1998.

INTERNATIONAL CONSULTATION
Mental Health of Refugees and Displaced Populations
in Conflict and Post-Conflict Situations
From Crisis Through Reconstruction
Geneva, 23-25 October 2000

 
WHO convened the International Consultation on Mental Health of Refugees and Displaced Populations in Conflict and Post-Conflict Situations in WHO Headquarters in Geneva, 23-25 October 2000.
Thirty five experts in this field were invited from low and high income countries, including several which are currently in conflict or post-conflict situations. United Nations agencies, NGOs, academic and research institutions were represented.
On the first day of the Consultation, the assembled experts were addressed among others by three leaders on the world wide protection and care of refugees.

 
Dr Gro Harlem Brundtland, Director-General of WHO, stated at the International Consultation,

"...We are proposing this document as a contribution towards obtaining international consensus in policy, strategy, and programmes, and as the guiding principle for our efforts in this field…  It is our moral and professional obligation to provide the resources, to preserve mental health, restore dignity, and create hope and self confidence for fellow human beings."
(Full speech)


 
Ms Mary Robinson, United Nations High Commissioner for Human Rights, said in her address,

"...The number of refugees and displaced persons in the world shames us all.  We should be actively seeking ways of alleviating their suffering.  I believe that your deliberations relating to the Declaration of Cooperation… which will be adopted at the end of this Consultation will be significant steps forward."


 
Mr Frederick D. Barton, United Nations Deputy High Commissioner for Refugees, summarized the challenges that lay ahead,

"...Like so much we try to do, the immensity of this challenge can seem daunting. The numbers are huge, the locations are multiple, the resources are scarce, the needs are immediate and varied, and our approaches are often compartmentalised and paternalistic.  Our certainty is that our work will produce as many questions as answers. As we go about this work, it is vital that we remain focused on those we seek to help, renewing our commitment to their futures.  If we do that, we will advance the grand cause of peace - and begin to make progress on these huge mental health problems in conflict-torn places."


 
Ms Erin Mooney, stressed on behalf of Dr Francis Deng, Representative of the United Nations Secretary -General on Internally Displaced Persons that,

"…displacement impacts upon mental health in three major ways. First, there is the trauma associated with the occurrence of displacement, which not only may be induced by but also often involves serious violations of human rights.  Second, once uprooted, the displaced suffer a tremendous sense of loss and dislocation, and an uncertain future for them and their children.  Adding further strain, displaced persons may find themselves in a discriminatory, even insecure environment, such that they continue to be in a very precarious situation even in their places of refuge."


The expert participants in the Consultation reviewed and amended and endorsed the Declaration of Cooperation in Mental Health of Refugees, Displaced and Other Populations Affected by Conflict and Post-Conflict Situations.
They called for:

(i) its adoption and implementation by all governmental, non-governmental, inter-governmental, United Nations agencies, academic and research institutions;
(ii) its inclusion on the agenda of the humanitarian session of the Economic, Social Commission of the United Nations (ECOSOC) in Geneva, July 2001;
(iii), its inclusion in the resolution on mental health at the World Health Assembly, 2002;
(iv) its integration in the United Nations Office for Coordination of Humanitarian Assistance (OCHA) emergency operations.
 

See also: Issue 8 of the WHO Mental Health Bulletin.

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