Lisa Ouss, Karine Leroch, Thierry Baubet, Marie-Rose Moro
Medecins Sans Frontieres
France

A five-year mental health intervention in Gorazde

Cinco años de intervención en salud mental en Gorazde

The town of Gorazde in Bosnia & Herzegovina was besieged for three and a half years. Declared a "safe haven" by the UN, the population of the enclave knew what their fate would be if they failed to defend themselves. Medecins Sans Frontieres (MSF) was one of the few NGOs present during the siege, supporting the work of the local hospital in particular with regard to the surgical unit. After the Dayton agreement, the mental health needs of the population were assessed. The population of Gorazde had been exposed to war, in a very vulnerable environment, with little hope of escape and a clear knowledge of what was happening in "ethnically cleansed" parts of Bosnia. The fate of Zepa and Srebrnica in particular was highly disturbing.

At the end of the war, the population was still partly "trapped" in the enclave and the town was hosting a large refugee population. No mental health services were available. MSF decided to start a mental health program in which the treatment of individuals in need was the initial priority. The establishment of a small care centre was then planned to be the base for the recruitment of local mental health professionals or their training if there were none.

In September 2000, a three-day conference marked the end of the direct involvement of MSF in Gorazde. The MSF care centre had merged with the CBR (Community Based Rehabilitation centre) financed by the World Bank and a local psychologist trained with the support of MSF was in charge of the psychotherapeutic interventions.