Setting Up Services in Difficult Circumstances

Abstract

This chapter will give an account of how the child mental health service in Kosovo came to be in the immediate aftermath of NATO air strikes, and detail the practical difficulties encountered in getting the service established. It will describe how the service worked, and the kind of problems that presented. The accounts will provide the perspective of a child psychiatrist working in a humanitarian aid capacity on behalf of a nongovernmental organization and that of a national staff member trained as a psychiatrist and the first member of a new child psychiatry training program in Kosovo. The chapter discusses the issues raised by humanitarian intervention in a complex emergency, the cultural validity of western services, its acceptability with the local population and the methods of intervention adopted. Lastly, the chapter explains what happens when nongovernmental movements and donors withdraw and what are the day-to-day difficulties of sustaining a new service in the long term.