WHO Romania and Creative Communication in MHPSS messaging: participatory approaches
- Helen Patuck
- Dec 16, 2024
- 6 min read
It was a great pleasure to support WHO Romania at their Annual Health Partners Strategic Meeting: Strengthening Collaboration and Enhancing Health Initiatives with a creative workshop. My role was to share story-writing best practices with communities affected by conflict and disaster as part of WHO's introduction to the Inter-Agency Standing Committee's MHPSS Minimum Service Package - available to anyone working to support vulnerable communities with key messaging around mental health and wellbeing.
It was great to work again with İrem Umuroglu again since our collaboration between my organisation, Kitabna - Our Book. and IOM Türkiye in 2021. In Türkiye, our project had involved capacity building psychosocial support mobile teams is six different regions to create a series of children's books addressing challenges faced by the Syrian children in their care. The stories are available to read online, here: Our stories, our Türkiye.
In Bucharest, this November 2024, İrem and Sylvia facilitated a warm and collaborative space in our workshop room, hosting health partners and the working group of organisations assisting refugee communities in Romania. In attendance were representatives from various organisations such as Terres des Hommes, Save the Children, UNICEF, the French Red Cross (Croix Rouge) and the Romanian National Council for Refugees amongst many more. I was glad to meet people from different professional backgrounds - midwives, artists, psychologists, health co-ordinators - all supporting Ukrainian refugees seeking shelter in Romania as the war with Russia continues.
My workshop on "Creative Communication" began with an introduction to Kitabna’s work with communities affected by conflict and disaster since 2014. We started by looking at the role of child, teacher and parent participation in emergency education initiatives, at a national and civil society level, in the work Kitabna has done in the Middle East, Europe and the Caucasus.
We then moved all the way through to MHPSS interventions I have worked on as a creative writer, with the UN, such as Step-by-Step, EASE interventions, My Hero is You, and with affiliated agencies (IOM, UNICEF, WHO) in Europe and North Africa, since the outbreak of the COVID-19 pandemic in 2020.
WHO are we communicating with?
This is one of the biggest questions we ask when working on our MHPSS interventions. Who are we trying to reach with helpful messaging about mental health and wellbeing, and how do we do that?
This has many different names, most commonly recognised is human-centered design, but for me community consultation has always felt best. This is the idea that consulting with the recipient of a helpful resource, perhaps even involving them in the creation of the resource at a foundational level, shares ownership and co-creates a more meaningful outcome.
In the case of our My Hero is You team at WHO Geneva, our projects have started to follow a very clear formula of community consultation, after producing four, almost five, children's books which package mental health and psychosocial support in loving stories.
We set off with a theme - the outbreak of new diseases, natural disaster, conflict, currently the mpox epidemic - and begin with surveying children, caregivers and teachers affected. These surveys aim to uncover what people are afraid of, what gives them hope, and what they would like to know more about.
This data is then analysed and incorporated into a compelling story, written by myself and technical advisors, who establish the WHO/UNICEF technical advice and MHPSS messaging we should be incorporating into our narrative. I then develop child-friendly illustrations, and relevant translations, depending on the context, which are tested for a period with the intended readership of children and their carergivers.
After a testing period, the feedback of children and caregivers is incorporated, alongside feedback from expert reviewers across UN agencies, before we move to finalise the resource. That resource is then made available under Creative Commons non-commercial licence, meaning anyone can adapt our story for their own culturally specific needs. A great example of this is the adaptation phase of My Hero is You: How kids can fight COVID-19! available here.
Participatory approaches
To start the participatory creative element of our workshop, I walked the working group through the Kitabna story-writing toolkit (freely available here at MHPSS Net) which I developed in partnership with Cardiff University and Armenian NGO, Educational and Cultural Bridges, over 2023-34, with support from the UK Arts and Humanities research Council. The toolkit incorporates ten years of best practice in establishing safe spaces, focus-group facilitation, story-writing and book-making with communities affected by conflict. Our toolkit was co-developed with psychologists in Armenia, and piloted in early 2024, resulting in a beautiful book of stories from Armenian women and children affected by the Nagorno-Karabakh conflict. This adds to our series of children's books co-created with children between 2014-2024:
As we had limited time in Bucharest, I highlighted two approaches to creative writing which could be helpful in our health partners' messaging with beneficiaries. Firstly, individual story-writing, which involves bringing two objects into dialogue, to discuss a problem and problem-solve together.
Secondly, I introduced group story-writing, which involves working as a group to use the five stages of a story to think about a problem. In both cases, each table of participants were asked to identify a health message they found particularly hard to implement in their own lives. We used the WHO official guidance for living a healthy lifestyle for this task. The aim of this task was for participants to identify a theme to communicate about in a creative way.
Participants identified the following health challenges: social connection, sleep deprivation and stress reduction. These then became the themes for their story-writing exercises, which resulted in some beautiful and compelling tales.
By bringing objects into dialogue, participants could then create distance between themselves and their problem, and imagine how empathy for their situation, or even resolution, could be found.
A few examples are the following:
A pair of headphones in conflict, which recreated the tensions of sleep deprivation by each ear-piece expressing the contrasting frustrations of needing sleep, and having too many worries and tasks. They had to hear each other in order to find resolution.
A person sits and pulls worries from their chest and the worries turned into wool, slowly forming a ball of wool, which they could then place outside of themselves, as a visualisation of noting and acknowledging difficult feelings and emotions.
A coaster on a table feeling lonely until she realised that if she joined the other coasters on the table, they would form a small flower. In this instance, she recognised that social isolation feels personal until we acknowledge others might be feeling the same, and together we can not only connect: we can potentially make something beautiful.
Although it was only a brief introduction, and time was short, participant feedback was warm and positive. Health partners seemed to enjoy this task, especially when they could work together to address a health issue they struggled with alone. Although it was not easy for some, others expressed that they would immediately incorporate activities into their work with children. Following the workshop, one participant from Save the Children approached to suggest further collaboration with Save the Children’s Romania office on MHPSS initiatives, inviting me to their office in Bucharest. It was a huge pleasure to share our children's book series developed with Save the Children in Poland.
This was a great opportunity to connect with an inspiring working group, and learn more about the WHO’s facilitation of knowledge and skills-sharing in the refugee responses of Eastern Europe. We even had an "artivist" in the group, Codruta Brisan from the Romanian National Council for Refugees, who gifted me some of her beautiful artwork at the end of our workshop...
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