TED2018
Essam Daod: How we can bring mental health support to refugees
爾森大衛: 我們如何為難民提供心理健康支援？
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國際難民潮是一場精神健康的災難，數以百萬計的人需要心理輔導來克服流離失所和衝突帶來的創傷。為了減少創傷，兒童心理學家及TED 研究會員爾森大衛在希臘和地中海的營地、拯救船以及海岸線中工作，利用簡短而有效的心理輔導幫助難民（其中四分之一為兒童）重寫他們的經歷。 大衛說：「所有人都可以做一點事情去防止這場精神健康的災難。我們要意識到急救不只是身體上的，還要照顧到人的心靈、靈魂。」
Essam Daod - Mental health specialist
Essam Doad provides first response mental health interventions to refugees and displaced populations. Full bio
Essam Doad provides first response mental health interventions to refugees and displaced populations. Full bio
Double-click the English transcript below to play the video.
00:13
For the last two and a half years,
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過去的兩年半，
00:15
I'm one of the few, if not the only,
child psychiatrist
child psychiatrist
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我是寥寥可數的兒童心理醫生
00:19
operating in refugee camps,
shorelines and rescue boats
shorelines and rescue boats
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仍然在希臘及地中海地區的
00:22
in Greece and the Mediterranean Sea.
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難民營、海岸線和救生艇中工作。
00:25
And I can say, with great confidence,
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我可以很肯定地說，
00:27
that we are witnessing
a mental-health catastrophe
a mental-health catastrophe
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我們正在見證一場精神健康的災難，
00:31
that will affect most of us,
and it will change our world.
and it will change our world.
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它會影響我們，更會改變全世界。
00:35
I live in Haifa, but nowadays,
I spend most of my time abroad.
I spend most of my time abroad.
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我原本住在以色列海法，
但現在很多時間我都在外地。
但現在很多時間我都在外地。
00:40
During my time
on the Greek island of Lesbos
on the Greek island of Lesbos
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當我身處於希臘的列斯伏斯島
00:43
and on the rescue boats
in the Mediterranean,
in the Mediterranean,
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以及地中海的救生艇時，
00:45
thousands of refugee boats
arrived to the shoreline,
arrived to the shoreline,
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數以千計的船隻抵達海岸，
00:48
crowded with more
than 1.5 million refugees.
than 1.5 million refugees.
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船上擠滿超過 150 萬難民。
其中，大約四分之一的難民
00:52
One-fourth of them are children,
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00:54
fleeing war and hardship.
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是正在逃離戰爭和災難的小孩。
00:56
Each boat carries
different sufferings and traumas
different sufferings and traumas
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每一艘船都載著不同的痛苦和創傷，
00:59
from Syria, Iraq, Afganistan
and different countries in Africa.
and different countries in Africa.
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各來自敘利亞、伊拉克、阿富汗
以及非洲不同的國家。
以及非洲不同的國家。
01:04
In the last three years alone,
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單單在過去的三年，
01:05
more than 12,000 refugees
lost their lives.
lost their lives.
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超過一萬二千名難民失去性命。
01:09
And hundreds of thousands
lost their souls and their mental health
lost their souls and their mental health
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此外，數以十萬計的難民
在面對這般殘酷的經歷時
在面對這般殘酷的經歷時
01:13
due to this cruel
and traumatic experience.
and traumatic experience.
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迷失了自己的靈魂並造成心理創傷。
01:17
I want to tell you about Omar,
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我想與大家分享奧馬爾的故事，
01:19
a five-year-old Syrian refugee boy
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他是一位來自敘利亞的五歲小男孩。
01:21
who arrived to the shore on Lesbos
on a crowded rubber boat.
on a crowded rubber boat.
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當時他乘坐橡皮艇
抵達列斯伏斯島的海岸，
抵達列斯伏斯島的海岸，
01:26
Crying, frightened, unable to understand
what's happening to him,
what's happening to him,
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驚恐的他哭著，
不清楚他身邊到底發生什麼事。
不清楚他身邊到底發生什麼事。
01:29
he was right on the verge
of developing a new trauma.
of developing a new trauma.
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他當時正處於造成心理創傷的邊緣。
01:33
I knew right away
that this was a golden hour,
that this was a golden hour,
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我知道當時是救助他的黃金時間，
01:35
a short period of time
in which I could change his story,
in which I could change his story,
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這段短短的時間可以改寫他的故事。
01:39
I could change the story
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我可以改寫他的故事，
01:41
that he would tell himself
for the rest of his life.
for the rest of his life.
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一個他將來可以告訴自己的故事。
01:43
I could reframe his memories.
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我可以重新塑造他的記憶。
01:47
I quickly held out my hands
and said to his shaking mother in Arabic,
and said to his shaking mother in Arabic,
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我很快地握住他母親顫抖的雙手，
01:52
(Arabic) "Ateeni elwalad o khudi nafas."
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以阿拉伯語對她說：
01:54
"Give me the boy,
and take a breath."
and take a breath."
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「將你的小男孩交給我，深呼吸。 」
01:56
His mother gave him to me.
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他的母親把他交給我。
01:59
Omar looked at me with scared,
tearful eyes and said,
tearful eyes and said,
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奧馬爾眼眶佈滿淚水，害怕地看著我，
02:03
(Arabic) "Ammo (uncle in Arabic),
shu hada?"
shu hada?"
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用阿拉伯語問我：
02:06
"What is this?"
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「叔叔，這是什麼？」
02:07
as he pointed out to the police
helicopter hovering above us.
helicopter hovering above us.
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他指向頭上的警用直升機。
02:12
"It's a helicopter!
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我回答說：「這是直升機！
02:13
It's here to photograph you
with big cameras,
with big cameras,
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他正在使用巨型照相機來拍攝你，
02:15
because only the great
and the powerful heroes,
and the powerful heroes,
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因為只有像奧馬爾你這樣強大的英雄
02:18
like you, Omar, can cross the sea."
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才可以越過海洋。」
02:22
Omar looked at me,
stopped crying and asked me,
stopped crying and asked me,
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然後，奧馬爾停止哭泣，看著我問：
02:27
(Arabic) "Ana batal?"
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「我是個英雄？」
02:28
"I'm a hero?"
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02:32
I talked to Omar for 15 minutes.
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隨後我跟他談了十五分鐘，
02:34
And I gave his parents
some guidance to follow.
some guidance to follow.
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也給了他的父母一些指示。
02:37
This short psychological intervention
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這段簡短的心理介入會減低
02:39
decreases the prevalence
of post-traumatic stress disorder
of post-traumatic stress disorder
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他將來患上創傷後壓力症
以及其他心理問題的可能性。
02:42
and other mental health
issues in the future,
issues in the future,
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這令奧馬爾可以好好準備上學、
02:45
preparing Omar to get an education,
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投入工作、建立家庭
以及完成更多事情。
以及完成更多事情。
02:47
join the workforce,
raise a family and beyond.
raise a family and beyond.
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如何做到？
02:50
How?
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杏仁核是人腦的情感的保管箱，
02:51
By stimulating the good memories
that will be stored in the amygdala,
that will be stored in the amygdala,
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透過刺激儲存在杏仁核的美好回憶，
02:55
the emotional storage of the human brain.
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02:57
These memories
will fight the traumatic ones,
will fight the traumatic ones,
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未來再激發出這些記憶時，
就可以對抗當中的痛苦回憶。
就可以對抗當中的痛苦回憶。
02:59
if they are reactivated in the future.
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03:02
To Omar, the smell of the sea
will not just remind him
will not just remind him
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對奧馬爾來說，海洋的味道不單能令他
03:05
of his traumatic journey from Syria.
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回憶起從敘利亞逃難的艱苦旅程。
03:07
Because to Omar, this story
is now a story of bravery.
is now a story of bravery.
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因為對奧馬爾來說，
他的故事是一個勇敢的故事。
他的故事是一個勇敢的故事。
03:12
This is the power of the golden hour,
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這就是黃金時間的威力，
它可以用新的敘述來改寫創傷的經歷。
03:14
which can reframe the trauma
and establish a new narrative.
and establish a new narrative.
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03:19
But Omar is only one
out of more than 350,000 children
out of more than 350,000 children
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可是奧馬爾只是這場災難中
三十五多萬名小孩之一，
三十五多萬名小孩之一，
03:25
without the proper mental health support
in this crisis alone.
in this crisis alone.
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其他的小孩都沒有
接受到適切的心理輔導。
接受到適切的心理輔導。
03:30
Three hundred and fifty
thousand children and me.
thousand children and me.
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三十五萬名小孩，醫生卻寥寥可數。
03:36
We need mental health professionals
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在現時危亂的情況下，
03:38
to join rescue teams
during times of active crisis.
during times of active crisis.
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我們非常需要心理健康的專家
加入拯救團隊。
加入拯救團隊。
03:42
This is why my wife and I and friends
co-founded "Humanity Crew."
co-founded "Humanity Crew."
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這促使我和我的妻子、朋友
創立了「人道拯救隊」。
創立了「人道拯救隊」。
03:48
One of the few aid
organizations in the world
organizations in the world
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我們的機構是世界少數
03:50
that specializes in providing
psychosocial aid
psychosocial aid
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專門提供心理方面的
緊急介入和治療
緊急介入和治療
03:52
and first-response
mental health interventions
mental health interventions
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給難民及流離失所的人士。
03:55
to refugees and displaced populations.
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03:58
To provide them
with a suitable intervention,
with a suitable intervention,
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為了提供適當的心理輔導給他們，
04:01
we create the four-step approach,
a psychosocial work plan
a psychosocial work plan
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我們創立了一個社會心理工作四部曲，
04:04
that follows the refugees
on each step of their journey.
on each step of their journey.
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這個輔導計劃能照顧到
難民經歷的每一個階段。
難民經歷的每一個階段。
04:08
Starting inside the sea,
on the rescue boats,
on the rescue boats,
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從他們在海上搭救生船那一刻起，
04:12
as mental health lifeguards.
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這個四部曲會保障他們的精神健康，
04:14
Later in the camps, hospitals
and through our online clinic
and through our online clinic
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直到他們抵達營地、醫院
以及透過我們的網上診所，
以及透過我們的網上診所，
04:19
that breaks down borders
and overcomes languages.
and overcomes languages.
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可以跨越國界並克服語言障礙。
04:22
And ending in the asylum countries,
helping them integrate.
helping them integrate.
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最後在庇護國家紮根時，
也會幫助他們融入當地。
也會幫助他們融入當地。
04:26
Since our first mission in 2015,
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自我們 2015 年的首次任務，
04:29
"Humanity Crew" had 194 delegations
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人道拯救隊已經有 194 位
04:32
of qualified, trained
volunteers and therapists.
volunteers and therapists.
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符合資格、經過培訓的
志工和治療師幫助。
志工和治療師幫助。
04:35
We have provided 26,000 hours
of mental health support
of mental health support
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我們提供了二萬六千個小時的
精神健康服務
精神健康服務
04:39
to over 10,000 refugees.
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予一萬多名難民。
04:42
We can all do something
to prevent this mental health catastrophe.
to prevent this mental health catastrophe.
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所有人都可以做一點事情
去防止這場精神健康的災難。
去防止這場精神健康的災難。
04:47
We need to acknowledge that first aid
is not just needed for the body,
is not just needed for the body,
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我們要意識到，急救不只是身體上的，
04:52
but it has also to include
the mind, the soul.
the mind, the soul.
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還要照顧到人的心靈、靈魂。
04:55
The impact on the soul is hardly visible,
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我們難以察覺心靈上的影響，
04:57
but the damage can be there for life.
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但是它的創傷可以持續一輩子。
05:00
Let's not forget that what
distinguishes us humans from machines
distinguishes us humans from machines
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別忘了，我們人類與機械的一大分別
05:05
is the beautiful
and the delicate soul within us.
and the delicate soul within us.
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就是我們美麗又細膩的靈魂。
05:10
Let's try harder to save more Omars.
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來吧，我們更加努力
嘗試拯救更多的奧馬爾吧。
嘗試拯救更多的奧馬爾吧。
05:13
Thank you.
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謝謝
05:14
(Applause)
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（掌聲）
05:18
(Cheers)
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（歡呼）
（掌聲）
05:20
(Applause)
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ABOUT THE SPEAKER
Essam Daod - Mental health specialistEssam Doad provides first response mental health interventions to refugees and displaced populations.
Why you should listen
In 2015, child psychiatrist Essam Daod was a volunteer doctor on the Greek island of Lesbos, where he witnessed the unspeakable suffering and trauma of thousands of refugees arriving from the Middle East, Asia and Africa. “I left the island wondering how these people can handle all this loss and trauma without any kind of psychosocial support,” he remembers. So, Daod founded the humanitarian aid agency Humanity Crew in 2015 with his wife Maria Jammal to provide such support. With an operating base in Greece, Humanity Crew recruits, trains and deploys mental health professionals and qualified volunteers to deliver psychosocial services to refugees and displaced populations in an effort to improve refugee well-being and prevent further psychological trauma. Leading research in the field of refugee mental health, Humanity Crew ultimately hopes to raise the profile of mental health care as a fundamental aspect of emergency humanitarian crisis response.
Essam Daod | Speaker | TED.com