May 14, 2021

A Successful Quarter

Migrant Clinicians Network has spent 35 years facilitating practical solutions at the intersections of vulnerability, migration, and health. In this last year, the challenges of COVID-19 have changed the shape and scope of the work, demanding innovative strategies for delivering health justice to people around the world. Witness to Witness, a project that became part of the greater MCN umbrella shortly before the onset of the pandemic, quickly emerged as one of our most effective programmatic offerings in response to multiple crises. Founded by Kaethe Weingarten, PhD, a Harvard-trained psychologist, Witness to Witness (W2W) focuses on workerswho experience an over exposure to stories of trauma as a result of their jobs, W2W seeks to move people from feeling helpless – often due to inadequate resources – to awareness of the resources they do have and the ones they can leverage for improving situations their clients face. to guide them out of places of helplessness to instead obtain empowerment and awareness.

Central to that focus are the frontline clinicians who are serving the public despite a lack of cohesion across levels of government. Clinicians have shown courage in facing severe emotional and physical hardships in their daily work and W2W has been there to support many of them. One such community is Chico, a rural, heavily agricultural city that straddles the line between central and northern California. With fewer than 100,000 residents according to the most recent Census count, and home to a California State University, Chico is a quintessential college town. It is also a town grappling with tragedy and conflict. On November 8, 2018, the catastrophic Camp Fire that devastated the nearby town of Paradise prompted a mass migration of around 20,000 people to Chico. Chico's two homeless centers, which were already at capacity when the city council declared a housing emergency a month before the fire, had to turn people away by the dozens. The largest number of individuals was forced to crowd together in makeshift shelters. 

And then the pandemic hit. Many of the people who belonged to the group of evacuees unable to find homes remain unhoused. Instead of shelters or hotel rooms, however, these same individuals now sleep in bands across Chico's many parks, frequently the targets of harassment. The city's campaign to forcibly sweep each park of every camp was partly under the guise of reducing COVID-19 infection among the campers, but did not provide an alternative place to sleep. Last week, a federal judge ordered that the sweeps be set aside in favor of creating actual housing solutions. In the meantime, many people remain vulnerable on the streets.

Such solutions should have been implemented at the beginning of the pandemic, rather than towards the end, argue many of the frontline providers who have been engaged in the work. One such worker is Sonya, a licensed marriage and family therapist, who lives and works in Chico. In response to the Camp Fire's lingering impacts, Sonya had immersed herself in community organizing. Her role accelerated during the pandemic, when she participated in mutual aid work to deliver food and medication to those most susceptible to the virus, and she also took it upon herself to become more involved with the city's political process as it pertained to the housing crisis.

While Sonya found meaning in her activism, it also took a considerable toll on her, and exacerbated the stress of her personal life. Sonya felt limited in her options to seek support due to Chico's comparatively small pool of mental health professionals. Her colleagues were either already close friends or personally against the community organizing in which she was involved. Sonya also observed that while many providers increased their caseloads, the emergence of the pandemic required them to be less available in many ways. As a result, Sonya believed that she—and many other providers in similar situations—had fewer choices overall.

Experiences like Sonya’s became more common following the Camp Fire, and amplified in intensity during the pandemic. The need for services in contrast to those available created a vacuum of options for Sonya and others, many of whom felt that Chico had yet to regain its footing before the rise of COVID-19. Since the pandemic began, Dr. Weingarten explains, “The needs of the providers have grown more nuanced over time as their remit has grown in scope and complexity. They are now not just helping people with the loss, grief, destabilization, frustration, anger, and hopelessness related to the aftermath of the fires but also addressing the concerns and distress related to managing a local world transformed by the crises associated with the COVID-19 pandemic.”

Fortunately for Sonya, she learned about Witness to Witness from a trusted friend and reached out to Dr. Weingarten for help. Dr. Weingarten connected Sonya with a trained volunteer. Sonya's volunteer, also a professional therapist, provided her with support and guidance in coping with her work on the frontlines. Describing the impact of the work with her Witness to Witness volunteer as lifesaving, Sonya observed, "In many ways, we're like first responders - the greatest at risk of our falls into deep depression and suicidality, and even then, we have to keep moving to do more and more." Sonya credits her volunteer, and the Witness to Witness program, with getting her through a "very dark patch," and helping her recalibrate her focus to include self-care in addition to her work.

Sonya is just one professional of many to benefit from the services of Witness to Witness within the last quarter. In addition to providing one to one peer support to professionals like Sonya, Witness to Witness also offers learning collaboratives for managers and community health workers across the US and in Puerto Rico. Over 35oo have taken webinars delivered in English and Spanish on 15 different topics. Dr. Weingarten contributes to MCN publications and writes a bi-monthly update about activities related to W2W, as well as articles of interest to health care providers. There is much to do now and there will continue to be in the future. W2W will be there.

Mar 22, 2021

From the Frontline: Working to Honor the Heroes

In the wake of the COVID-19 pandemic, much of the immediate response focused on utilizing the best resources available to mobilize against this public health threat. Across every medical, scientific, and social landscape, humanity maneuvered to confront one of the most significant threats to the public health in recent history Frontline clinicians were crucial to this effort, making up the backbone of the coordinated response intended to beat back the COVID - 19 and save lives. From doctors and nurses to social workers and case managers, essential workers of all stripes answered the call to unite in the face of the pandemic.

Yet these efforts were not without penalties to this overworked population. Just weeks after the United States entered the fray, policy experts and health advocates alike issued a warning about the increasing cost being paid by professionals at the frontline. Faced with escalating moral injury, burnout began to take on the shape of its own crisis across mental health lines. Confronted with this inescapable reality, Migrant Clinicians Network turned to Witness to Witness, asking, “What is the best way for us to help the helpers?”

Thus, our campaign, #HelpTheHelpers was born, and the need immediately became clear: frontline clinicians were experiencing unprecedented moral injury as a result of fighting the pandemic. One such helper in need is Sonia, a licensed family and marriage therapist in California. Just a few months into the pandemic, she observed the emergence of symptoms consistent with burnout, a common experience among individuals whose professional works begins to overload their personal lives. Sonia chose to respond by getting more involved in outreach efforts designed to assist individuals being hardest hit by the virus. While she found meaning in her work, she also encountered increasing levels of tension as a growing number of neighbors resisted mask mandates, defied business closure ordinances, and refused to socially distance.

Frustrated by the city’s inability to respond to such measures, Sonia’s stress load amplified, leaving her feeling completely helpless in the face of the systemic issues impacting her work. At the suggestion of a friend, she contacted the Witness to Witness program, finding relief in connecting with a peer who validated her experience. Sonia received four peer sessions with a trained volunteer therapist, whose focus on Sonia’s natural resilience to coach her out of the sense of helplessness and guide her to a place of resilience. For Sonia, the work has created a considerable shift in her perspective, one that she believes will be permanent. The credit for that, she feels, is attributable to the participants of Witness to Witness, reflecting, “I think I got lucky, because she’s so sharp. I can tell she’s a great therapist. I’m not back in therapy, because folks like her are so hard to find. She just helped me through a very dark patch.”

Sonia’s experience with Witness to Witness, under the umbrella of the Migrant Clinicians Network, demonstrates the wide reach of what has been offered to numerous frontline clinicians during the COVID-19 pandemic. For the last calendar year, Witness to Witness volunteers have cast a wide net, generating a considerable impact across the globe designed to promote empowerment among the individuals working to deliver the world from the worst of the pandemic’s impacts. In the last three months, much of this work has been domestic; Witness to Witness has promoted significant education around the importance of resiliency in the face of moral injury through social media posts, email blasts, and newsletters. This education has also generated more direct contact with constituents, evident in the more than a dozen online seminars designed to help facilitate increased awareness of moral injury, and education about how best to support workers in need of witnessing. Much like the peer sessions Sonia benefitted from, Witness to Witness has offered a number of small groups and individual connection work to dozens of people, creating a shift in the status quo for providers engaged directly at the frontline.

The knowledge that there will always be a need for efforts to Help the Helpers, a rallying cry that Witness to Witness and the Migrant Clinicians Network will be all too ready to answer.

Jan 13, 2021

Little By Little: Witness to Witness Outcomes

In 2020, the world grappled with unprecedented challenges. Across the globe, the Coronavirus pandemic, worldwide economic losses, and political unrest all contributed to mounting alarm about the long-term consequences to public health. Professionals warned of a developing mental health epidemic for frontline clinicians who faced an increasingly stressful state of conflict across numerous intersections of the personal, professional, and economic, including cultural, emotional, physical, political, and social health echelons.

One such clinician is Willow, a registered nurse who has worked with burn victims in a public hospital for five years. As COVID-19 cases began to spike in her hospital, Willow found herself experiencing heightened anxiety about her job, particularly after she learned administrators were considering moving COVID-19 patients to her floor. Despite the presence of a sterile environment, necessary to protect burn victims who are susceptible to infection, the virulence and ease of COVID-19's contagion scared her, especially as she realized that the burn unit staff would have to absorb the care of the COVID-19 patients. "For the first time ever," she confided, "I was truly worried that just by showing up to my job, I could kill someone.”

At the same time, Willow, whose spouse is an essential worker, felt overwhelmed when people close to her expressed doubt about the seriousness of the pandemic. “Our daily lives changed very little, but all of a sudden, the stress jumped for both of us, and we didn’t have many other outlets to vent and work things out, besides with each other,” she explained. Her frustration reached a fever pitch when challenged to use her professional credentials to prove the seriousness of the virus working its way through her community. "I had to tell people that being a nurse didn't mean I had some insider access to information that someone else couldn't review for themselves." She reached out to Witness to Witness a short time later, seeking validation "from someone outside my circle, an impartial third-party." It was a move that helped her understand the stress facing her, and work through it.

Willow is just one of hundreds of clients who have benefitted from Witness to Witness since the onset of COVID-19. During this most recent quarter, Witness to Witness volunteers have remained responsive to the development of subsequent events that have promoted stress within vulnerable communities. Six webinars have been produced and hosted for audiences up to several hundred participants at a time in the last 90 days. In addition to their peer-to-peer services, Witness to Witness clients have benefitted from a multitude of services, including topical social media posts, newsletters, and event-specific email blasts promoting resilience, understanding, and emotional growth, values that will continue to shape future work.

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