Mental health

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Description: "Background: Both Thailand and Burma are currently experiencing severe epidemics of COVID-19, driven especially by new variants including the highly transmissible delta variant. The current wave of the epidemic in Tak Province, bordering Burma, began in late June with large outbreaks detected in factories in the area. With over 4,160 patients currently in treatment for the disease, it continues to severely strain the medical system. On Wednesday, August 12 th , there were 192 new cases diagnosed in Tak, with 140 of those in Mae Sot, home to the clinic, and the nearby districts of Phop Phra, Mae Ramat, and Tha Song Yang. Since April 1st, 2021, a total of 6,748 cases have been reported in the province (Tak Provincial Public Relations Office Page). On June 28th, the Mae Tao Clinic became an official field hospital for the Mae Sot public health system, providing care for between 30-70 infected individuals deemed low risk for developing complications or severe disease. While MTC staff members are responsible for providing daily care, they work in partnership with medical staff of the Mae Sot Hospital and other Thai public health entities, closely monitoring patients for evidence of clinical deterioration and facilitating timely referrals if necessary. To date, the Mae Tao Clinic has served approximately 434 COVID-19 patients who have been referred from the Thai health system, are staff from MTC and partner organizations or are residents of the surrounding communities. On July 9 th, our first staff member was found to be infected with COVID-19. This prompted the clinic, working in conjunction with local health partners, to pursue aggressive contact tracing and screen all members of the staff, along with household contacts, nearby community members, and others with possible exposure. As a precaution, starting on July 15th, most clinical services at the clinic were suspended indefinitely in order to protect the health and safety of our staff members, their families, and all the communities we serve. This pause was also to allow us to efficiently focus our efforts on identifying and taking care of infected members of the extended MTC family and the community..."
Source/publisher: Mae Tao Clinic
2021-08-13
Date of entry/update: 2021-08-13
Grouping: Individual Documents
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Description: "Before the coup, mental health was a neglected issue in Myanmar. Now, the situation is even worse. In this article, I look at the financial, legislative, structural and cultural challenges that have limited the provision of mental health services in Myanmar in the past – and how the coup continues to create shocks within this landscape. Mental health in Myanmar is a critical issue. It is an unstable country, both in terms of political and economic factors. Decades of protracted conflict – the longest-running civil war in the world – combined, more recently with the economic impact of COVID-19, which according to a study in October 2020, saw the proportion of the population living in poverty rising from 16% to 63% over the past 8 months. Moreover, since the February 2021 coup, violent crackdowns have already had, and will continue to have, a significant impact on citizens’ mental wellbeing. Senior UN officials warn of an ‘impending humanitarian crisis’ and have also argued that ‘Myanmar is spiralling into becoming something like a failed state’ with ‘potentially massive humanitarian ramifications’. As Myanmar continues to exhibit more characteristics of a failed state, there will be serious ramifications for its population’s mental wellbeing. These ramifications can be seen in other conflict afflicted countries. According to a global WHO synthesis of 129 studies done in numerous conflict-affected contexts, ‘one in five people in conflict-affected populations have mental health conditions’. Conditions identified among these populations include depression, anxiety, post-traumatic stress disorder, bipolar disorder, and schizophrenia. The report concludes that, ‘given the large numbers of people in need and the humanitarian imperative to reduce suffering, there is an urgent need to implement scalable mental health interventions to address this burden.’ In Myanmar, the mental health burden is being placed on an extremely strained system. A 2019 HelpAge International study further demonstrated the seriousness of mental health issues in Myanmar with the following findings: legally, ‘There is, [effectively], no mental health policy in Myanmar; preventing access to professional support through the primary healthcare system.’ While, as we shall see, some care is given through the private sector, this is limited in scope. Regarding state mental health provision, including funding, staff and infrastructure, the HelpAge study found that ‘staff are not adequately trained and there is little infrastructure to facilitate these services, particularly in rural areas’. As we shall see, much of this stems from a chronic lack of sufficient funding. Finally, the study pointed out that stigma and cultural understanding are also key issues: ‘while there is no data in Myanmar on how stigma impacts mental health, studies from other, similar countries suggest it has serious consequences.’ Going forward, the key challenges facing Myanmar’s mental health landscape are a lack of legislative support, a lack of funding, and misunderstandings about the nature of mental health. I shall explore these issues below..... Legislation and funding: Myanmar’s mental health legislation is outdated, to say the least. The nation’s mental health policy — I’m not making this up — is legislated by The Lunacy Act, dating from 1912. Violate this law at your peril – you’ll face a fine of 50 Indian rupees – a currency that has been obsolete since 1952. That Myanmar’s current mental health law focuses on criminalising ‘lunatics’ who pose a danger to society through incarceration at asylums goes a long way to explain the stigma that mental health currently has in the country, as we shall see later. To give an interesting parallel example, The Lunacy Act was also used in India, yet was replaced in 1987 by the Mental Health Act (where, among other changes, lunatics were referred to as mentally ill persons, and asylums as psychiatric hospitals), and then again in 2017 by the Mental Healthcare Act, which explicitly stated the need to implement ‘programmes to reduce stigma associated with mental illness’, along with more generally empowering those affected by mental health issues – which it was felt that the 1987 act failed to do. In Myanmar, a new bill has ‘been discussed by relevant ministries and agencies [The Ministry of Health and the WHO] since 2013 but has not reached parliament,’ according to the Myanmar Times. Myanmar’s mental health landscape is also shaped by its Mental Health Policy, which is part of its National Health Policy. Last revised in 2006, the National Health Policy sees 0.3%of total health care expenditures spent on mental health, versus a global median of 2% – in other words, mental health in Myanmar is woefully underfunded. Especially once you consider that up until 2012, Myanmar had one of the lowest rates of healthcare spending in the world. While spending since then has risen significantly, Myanmar’s national healthcare expenditure as a percentage of GDP is the lowest in the ASEAN region, and outside of Africa, remains one of the lowest in the world. Furthermore, one has to keep in mind how badly funded and managed healthcare was in Myanmar for so many years. According to DFID: ‘even with the increase, a much larger injection of funds is necessary to reverse decades of neglect and mismanagement.’ How the ongoing Civil Disobedience Movement (CDM) and the junta’s approach to healthcare governance will affect the healthcare system is yet to be seen, though it the impact of these shocks is unlikely to be positive. As we have seen, military rule in the past has coincided with chronic government underspending on healthcare, and their recent behaviour against any health workers who are deemed to be threatening the stability of the government does not bode well. As of early May, at least 97 healthcare workers have been arrested and 10 killed since the coup, while arrest warrants have been issued for 400 health workers participating in CDM. Thousands continue to strike, bringing the country’s public health system – which accounts for 80% of the hospitals and clinics in the country – to its knees. Striking doctors have set up their own clandestine clinics, yet these are overloaded and face the risk of arrest if discovered. ‘The public health system is near collapse,’ Dr Mitchell Sangma, who is on the ground for humanitarian organisation Medicins San Frontiers told the BBC. “It’s a grim situation”. Those who cannot afford private care, simply are going without any healthcare. Though no research is currently available, given how limited the public provision of mental health support is at the best of times, now, when even life-saving care is unavailable, it must be close to non-existent..... (Mis)understandings of mental health: Public understandings of mental health are also an issue of concern. I recently spoke to Nay Chi Soe (pseudonym), a student who graduated with a BA in Psychology from East Yangon University a few years ago, about mental health. Two things stood out. Firstly, how unpopular the course was: of approximately 4,000 students who graduated from the university in her year, she had three other course mates. It was the least popular course in her year. Even Library and Information Studies had around 10 students, while more popular courses such as Engineering and Law had hundreds of graduates. The second thing that stood out from our conversation was the reaction from friends, extended family members and even fellow students when she told them what she studied; ‘Oh do you want to go to a Ywa Thar Gyii?’ (Yangon mental hospital).’ ‘So can you tell me, were the crows black or white originally?’ (a Burmese equivalent of whether the chicken or the egg came first). These comments go some way to show how misunderstood the subject is. Indeed the crow comment is a philosophical question: the chicken/egg or white crow/black crow is a philosophical paradox about the nature of causality that has nothing to do with psychology at all. And even when people don’t confuse psychology with another subject, they tend to associate psychology with extreme mental illness. The subject is deeply misunderstood..... Promising signs: There are, however, more promising signs, most notably in the private sector provision of mental health. One of the most active groups in the mental health field in Myanmar is the Yangon-based, UNFPA-funded Mental Health Psychosocial Support (MHPSS) Working Group, which has half a dozen suppliers in its list of available services. Aung Min Thein, the founder of Counselling Corner, a private mental health CSO based in Yangon, explained how they address the problems facing the provision of mental health services in Myanmar. According to him, ‘we have found that Myanmar people are not very familiar with counselling and generally don’t want to burden the system. This is the result of two main factors, the lack of information and stigma that mental health currently has in the country, and arr nar dal – the feeling of not wanting to impose oneself. It is therefore vital that we take a pro-active approach to mental health provision – while passive techniques have an important role to play, real results require real and meaningful interaction between the target groups and mental healthcare professionals. We have found that interactive workshops offer the best environment for therapy as they encourage people to talk freely in small groups about themselves – often realising that they share the same emotions, feelings and experiences..... Mental health in the wake of the coup: Looking forward, addressing these financial, legislative, structural, and cultural changes will take time, particularly given the current political situation. The junta government has made it clear that it will not accept any criticism of its rule, which causes a problem for any mental health campaign. While mental health was certainly an issue in Myanmar before, it is an issue that has wholly been exacerbated by the military coup and the subsequent, and ongoing, destruction that has followed. Even for those who have not directly experienced extreme traumatic experiences (like being imprisoned, physically attacked etc.), anyone with a Facebook account will have been exposed to content that poses severe mental health risks. Factor in stresses related to the severe economic implications of the coup, such as mass unemployment and financial insecurity, may also act as triggers on top of the previous existing challenges caused by Covid-19, past traumas, or even the normal difficulties in a person’s life. The coup puts mental health at an impasse: many of the mental health issues people will be experiencing will be caused directly by the coup, yet any treatment likely cannot explore these issues or place any blame, lest they run the risk of censorship – or worse. However, as Aung Min Thein tells me, the importance of therapy is not about placing the blame on somebody or something, rather about working on one’s own issues. His approach is to focus on the feelings of the individuals rather than the stimuli that caused them. This strategy does not legitimise the coup, but rather a recognition that the resilience people require to resist the regime depends on their mental wellbeing. While the situation seems bleak, the first step at least is clear: we need to deal with the stigma associated with mental health in Myanmar, and to help people realise that asking for mental health support is both completely normal and healthy. Only then can mental health issues in Myanmar be truly addressed..... Resources: A number of both national and international volunteer-based counselling groups have sprung up since the coup. Readers may also refer to MHPSS’s list of available services. Charlie moved to Yangon in 2014 to work at UNODC. After winning the war on drugs, he worked at BRAC. Then he realised he didn’t like working for INGOs and started running music events. Fast-forward 2 years, he started a record label with local artists. Now, he works with celebrities and influencers in social media campaigns that communicate socially beneficial messages. He speaks pretty good Burmese. He also runs a watch company. Charlie has written on Microfinance and the Ultra-poor, the War on Drugs , Suu Kyi and Islamophobia, and the hip hop scene in Myanmar..."
Creator/author:
Source/publisher: Tea Circle (Myanmar)
2021-06-28
Date of entry/update: 2021-06-28
Grouping: Individual Documents
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Sub-title: The Right to Mental Health for Rohingya Survivors of Genocide in Myanmar and Bangladesh
Description: "It has been three years since “Saiful,” 27, escaped genocidal attacks in Myanmar’s Rakhine State. His experience continues to affect him. “I cannot think well,” he said. “I’ve become thin and gangly because of the stress. I feel tired. I cannot eat well. I feel angry when I imagine the persecution.” Born and raised in northern Rakhine State, Saiful survived grinding human rights violations since his childhood, and in 2017, he witnessed mass atrocities perpetrated by Myanmar Army soldiers against Rohingya civilians. In August that year, at the height of Myanmar Army-led attacks on Rohingya, Saiful fled massacres, deadly arson attacks, mass rape, and other crimes, leaving behind murdered family and friends to join Rohingya refugees in Bangladesh, who now number approximately one million. “No one is helping us in proper ways,” he said from a refugee camp in Cox’s Bazar District, Bangladesh. “I cannot sleep when I remember my relatives who were killed. It is very difficult for me to do any work.” Saiful is describing symptoms typically associated with Post-Traumatic Stress Disorder (PTSD), a serious mental health condition. In the case of Rohingya who survived recent attacks, the mental harm of PTSD can be destructive, impairing daily functioning and the ability to live a full and constructive life. Saiful is unfortunately not the only Rohingya refugee suffering from serious mental health conditions due to human rights violations and violence perpetrated against Rohingya in Myanmar. The quantitative research included in this report and conducted by a team of ten Rohingya researchers and Fortify Rights provides new evidence of the pervasive and severe mental health toll that human rights violations and violence has had on the Rohingya community. This report documents and analyzes the findings of this Rohingya-led participatory action research. The World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) estimate that 12 months after an emergency, approximately 15 to 20 percent of adults will experience some type of moderate or mild mental health disorder. The Rohingya are suffering at significantly higher rates. The Rohingya-led participatory action research..."
Creator/author:
Source/publisher: "Fortify Rights" (Myanmar)
2020-12-10
Date of entry/update: 2021-01-07
Grouping: Individual Documents
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Format : pdf
Size: 3.11 MB ( reduce version)
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Description: "When the Myanmar Army attacked and massacred ethnic Rohingya civilians in 2017, more than 700,000 men, women, and children fled to Bangladesh, some riddled with bullets, burns, and gaping wounds. Hundreds of villages were in ashes, razed by soldiers and their civilian proxies. But long after the physical wounds scarred over, Rohingya continue to suffer mental harm on a massive scale. President-elect Biden can and should do something about it. There are upwards of one million Rohingya refugees now languishing in Bangladesh. They are experiencing trauma, depression, and anxiety at staggering rates. The World Health Organization estimates that approximately 15 to 20 percent of adults will experience some type of moderate or mild mental health disorder one year after an emergency, and in theory, those figures should decrease over time. By contrast, a new report published by Fortify Rights finds that 89 percent of Rohingya refugees in sprawling camps in Bangladesh are experiencing serious depression. Eighty-four percent are experiencing severe emotional distress. And a staggering 62 percent are experiencing symptoms equivalent to Post-Traumatic Stress Disorder—a debilitating condition that can prevent its victims from leading normal and constructive lives. What drives these extreme levels of distress? Ongoing genocide in Myanmar is partly to blame, but the new quantitative data reveals that long-term systematic human rights violations in Myanmar and ongoing impunity are also key factors that continue to impact Rohingya mental health..."
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Source/publisher: "Time"
2020-01-06
Date of entry/update: 2021-01-07
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Description: "Globally, a person dies from suicide every 40 seconds, and it is estimated that for every death, 20 others have attempted to take their own lives. The vast majority of suicides take place in low- and middle-income countries, according to the World Health Organization. Young people’s vulnerability to suicide-related mental health problems is particularly concerning in Myanmar, a country that has long grappled with conflict and humanitarian crises. “There is a strong association between conflict, forced migration and higher rates of mental and psychosocial disorders,” said Eri Taniguchi, a UNFPA specialist in issues relating to gender-based violence. “As we all know, the vulnerabilities of women, girls, youth and adolescents increase in humanitarian settings, while mental health and psychosocial needs tend to be overlooked or considered not a priority,” she added. UNFPA, the lead agency for mental health and psychosocial support in Myanmar, is working to change that. With the Johns Hopkins University, UNFPA chairs a working group that has established a referral system for mental health and psychosocial services. “Suicide is a serious public health problem,” Ms. Taniguchi said. “However it is preventable with timely, evidence-based and often low-cost intervention.”..."
Source/publisher: United Nations Population Fund (UNFPA) (New York)
2020-03-04
Date of entry/update: 2020-03-05
Grouping: Individual Documents
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Sub-title: This is the last part of a two-part series on them mental health of the Roghingya refugees
Description: "As the world takes stock of the situation two years on from the forced mass expulsion of the Rohingya from Myanmar, the 'leaders' of the refugee community in Cox's Bazar placed a five point charter of demands. Syed Ullah, refugee leader and secretary of the Arakan Rohingya Society for Peace and Human Rights (ARSPHR), placed the demands at a press briefing in Jamtoli camp of Cox's Bazar in August 2019. It has now been two years since a brutal campaign of ethnic cleansing by the Myanmar military forced out of the country, more than two-thirds of the Rohingya population living in Myanmar. Talking to reporters at refugee camps in Ukhiya and Teknaf, youth and elderly alike said they want to return to their homeland but before that they want reassurance from Myanmar authorities about a conducive environment in northern Rakhine state. They said the ultimate solution to the Rohingya crisis will be a safe, voluntary, dignified, and sustainable return of those who fled their homes in Myanmar. Meanwhile, the failure in the reparations and repatriation of Rohingya refugees has been causing mental health problems among the refugee population and people of the host communities as well. A sense of resentment prevails among locals who now fear repatriation of the refugees might take longer than they had anticipated..."
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Source/publisher: "Dhaka Tribune" (Bangladesh)
2019-11-03
Date of entry/update: 2019-11-05
Grouping: Individual Documents
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Description: "Mental disorders (such as depression and psychotic disorders) are common in Myanmar, yet very few people are diagnosed and treated. Beyond the lack of trained healthcare workers, the stigmatization and discrimination of people with mental disorders are also major barriers to access to care. Through a 3-year pilot program in Hlaing Thar Yar Township, Sanofi, the Myanmar Medical Association and their partners have implemented training sessions for healthcare workers, and awareness activities within the community, so that with the use of digital technology, a greater number of people with mental disorders can be identified and treated..."
Creator/author:
Source/publisher: Sanofi
2018-11-05
Date of entry/update: 2019-08-21
Grouping: Individual Documents
Category: Mental health
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Description: "Rupa Patel, MD, and Anne Glowinski, MD, colleagues at Washington University School of Medicine in St. Louis, are working with the Bangladeshi nongovernmental organization Friends in Village Development Bangladesh (FIVDB) to help deliver mental health services to traumatized Rohingya refugees who fled their home country of Myanmar for refugee camps in southeastern Bangladesh. Follow this link for a story on their efforts: https://medicine.wustl.edu/news/docto... Video by E. Holland Durando and Huy Mach, Washington University School of Medicine in St. Louis..."
Creator/author:
Source/publisher: "Washington University School of Medicine"
2019-03-13
Date of entry/update: 2019-08-17
Grouping: Individual Documents
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Description: ABSTRACT: "The Karen, an ethnic minority group in Burma, have experienced a prolonged state of exile in refugee camps in neighboring Thailand due to ethnic conflict in their home country. Nursery schools in the three largest Karen refugee camps aim to promote psychosocial development of young children by providing a child-centered, creative, learning-friendly environment. Psychosocial development and potentially concerning behaviors of two- to five-year old children in nursery schools were examined using a psychosocial checklist. The results showed that psychosocial development of the children increased with age, with a majority of five year olds being proficient in playing cooperatively with other children. A third of the children showed sadness or emotional outbursts. Difficulty separating from parents was also observed. The results also showed that children who attended the nursery schools for more than a year were better at playing cooperatively with other children and were more aware of their own and others? feelings. On the other hand, children who were newer to the nursery schools were more polite and better at following rules and controlling their feelings when frustrated. The results indicate that nursery schools can be a promising practice to promote healthy psychosocial development of children in protracted refugee situations."
Creator/author: Akiko Tanaka
2011-11-00
Date of entry/update: 2011-11-13
Grouping: Individual Documents
Language: English
Format : pdf
Size: 357.44 KB
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Description: Acknowledgement The World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was used to collect information on the mental health system of Myanmar. This study was carried out by Professor Hla Htay of the Department of Mental Health, University of Medicine (1), Yangon and Mental Health Hospital Yangon, Myanmar. The preparation of this study would not have been possible without the collaboration of the Ministry of Health, Department of Health, Department of Health Planning, Department of Medical Sciences, University of Nursing, Budget and Finance Unit, Department of Health, Mandalay Mental Health Hospital, Mental Health Units in States and Divisions and Department of Social Welfare. We are grateful for the support of the Medical Superintendent, Yangon Mental Health Hospital, Consultant/Lecturer, Forensic Psychiatric Unit, Yangon Mental Health Hospital, Rector University of Medicine (1), Rector University of Nursing.
Source/publisher: WHO Regional Office for South-East Asia
2006-00-00
Date of entry/update: 2010-11-02
Grouping: Individual Documents
Category: Mental health
Language: English
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Description: Abstract In June 2001, we assessed mental health problems among Karenni refugees residing in camps in Mae Hong Son, Thailand, to determine the prevalence of mental illness, identify risk factors, and develop a culturally appropriate intervention program. A systematic random sample was used with stratification for the three camps; 495 people aged 15 years or older from 317 households participated. We constructed a questionnaire that included demographic characteristics, culture-specific symptoms of mental illness, the Hopkins Symptoms Checklist-25, the Harvard Trauma Questionnaire, and selected questions from the SF-36 Health Survey. Mental health outcome scores indicated elevated levels of depression and anxiety symptoms; post-traumatic stress disorder (PTSD) scores were comparable to scores in other communities affected by war and persecution. Psychosocial risk factors for poorer mental health and social functioning outcomes were insufficient food, higher number of trauma events, previous mental illness, and landmine injuries. Modifications in refugee policy may improve social functioning, and innovative mental health and psychosocial programs need to be implemented, monitored, and evaluated for efficacy. Published by Elsevier Ltd.
Creator/author: Barbara Lopes Cardozoa, Leisel Talleya, Ann Burtonb, Carol Crawford
Source/publisher: Social Science & Medicine _58 (2004) 2637?2644
2004-00-00
Date of entry/update: 2010-10-28
Grouping: Individual Documents
Language: English
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Description: Historical perspective The care of the ?insane? The earliest history of services for the mentally ill in Myanmar goes back to 1886. The British authorities felt that a national facility was required; however, its function was to be merely containment. Sadly, the prime motivation for this wnuaissantchea.t Itthweas mcaelnletadllythe i?pllriscoanusefodr thae inpsuabnleic? and was built close to the City Prison in Rangoon ?(innomwateksn?,ownby as19Y1a4ngtohne). nIunmitbiaelrlsy whiathd sroismeen 5t0o around 750 and yet more space was needed to accommodate the unfortunates.
Creator/author: Khin Maung Zaw
Source/publisher: Psychiatric Bulletin 1997 v. 21, p. 506-509
1997-00-00
Date of entry/update: 2010-10-27
Grouping: Individual Documents
Category: Mental health
Language: English
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Description: GENERAL HEALTH: Living as a refugee. By Charles Kemp; What is Mental Health? Mental Health and Addictions. By Pam Rogers... MOTHER AND CHILD HEALTH: Mental Health of Refugee Children;. Causes and Consequences of violence. By Karine Le Roch, Clara; Barilani A protective Network for Victims of Violence... MANAGEMENT: What Health Workers can do? Coping with Stress; Management of Mental Health at Community Level; Happy Saturday Group. By Karine Le Roch.; Counseling for Mental health. By Claudia Pedraglio Martinez... SOCIAL: The Psycho-Social Approach. By Elsa Laurin... INTERVIEW: Interviews with Mental Health Helpers... TEST ;Test your Psycho Potential; How Vulnerable are you to Stress? LACKS COVER PAGES
Source/publisher: Aide Medicale Internationale (AMI)
2005-06-00
Date of entry/update: 2007-07-17
Grouping: Individual Documents
Language: Burmese, English
Format : pdf
Size: 1.81 MB
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