History » Refugees as Survivors (RASNZ)

The History of RASNZ – Diversity Health

The RASNZ history began way back last century in 1988, when a Mental Health Conference specifically focusing on refugee mental health was held in Auckland. From this conference much debate occurred amongst health professionals, educationalists, social workers and former refugees about the trauma experienced and the impact it has on lives in resettlement. As a result of the discussion remits were drafted - one of which was that there should be a specific torture and trauma service for refugees in Auckland. Similar specialist agencies and services had been established in many countries around the world and particularly across the Tasman in Melbourne and Sydney.

An advisory committee consisting of Dr Max Abbott, Jenni Broom, Dr N. Rasalingham, Sue Elliot, Elizabeth Hoffman and Dr Peter McGeorge was formed to pursue this cause.

For the next five years the advisory committee met frequently to plan the strategy for developing a refugee mental health service. The need for such a centre was well established because:

1995 - 1999 the early days:

The New Zealand Red Cross (Northern Region) generously offered a room at their main office in Wakefield Street. This room became the first office of the Auckland RAS Centre. The Centre so named to emphasise the positive aspect about refugees surviving against all odds - they are not victims but truly survivors. This was the philosophy of the Centre which was officially opened on February 14th 1995 by Governor General Dame Cath Tizard. A host of dignitaries attended the opening, including the advisory committee, staff of the RAS Centre, refugee communities and service providers including other non-governmental agencies who worked in this area of resettlement. The Centre was open Monday to Friday and saw clients by appointment for assessment and counselling.

The RAS Centre logo depicts the mature fern which illustrates that with the right conditions (external) and the right ingredients (internal) the frond will blossom into a fern. This is how the RAS Centre sees its work - a safe and trusting environment for traumatised refugees, which allows each person to develop and grow restoring meaning and purpose to their life.

The motto was "In the Business of Giving Hope."

The first mission statement formulated was "to assist refugee who have experienced torture/ trauma to access mental health services and other facilities, minimising the impact on their lives".

In 1997 the RAS Centre was seen to be developing into its next phase and the decision was made by the Mental Health Foundation Board and the advisory committee for the RAS Centre to become a charitable trust. In October 1997 - interested people were invited to attend a luncheon where the Manager Chris Jane introduced the work of the RAS Centre. From this, people were encouraged to apply for positions as Board members. Interviews were undertaken by members of the Mental Health Foundation and Advisory Committee - 5 people were selected and they were the first Trust Board members of the Auckland RAS Centre. They were: Dr Nick Argyle, Ravi Rudra, Peter Greener, Peter O'Connor and Trish Fordyce.

A formal ceremony on November 18th 1997 marked the official "handing over" of the RAS Centre to the Trust. During this time the MHF also set up a Trust for the Wellington RAS centre in Wellington -this service started in November 1997. In September 1997 a new Manager was appointed to the Auckland RAS Centre to replace Chris Jane (who had moved to a position within MHF) - this was Tina Mullard a nurse/ midwife who had an in-depth knowledge of refugee health, having worked for a number of years in a variety of refugee camps around the world.

Staff at this time included a full-time manager and two part-time psychologists. Counselling took place in one room at Red Cross. It was soon realised that another counselling room was required so the Centre moved downstairs to a larger area that had two counselling rooms, a meeting room and waiting room. This enabled the RAS Centre to increase its service in working directly with clients, as well as teaching interpreters about refugee mental health and holding workshops for service providers.

Marie Sullivan, Manager of the Immigration New Zealand Refugee Quota Branch, was one of the main supporters for the RAS Centre's move to the Mangere Refugee Resettlement Centre. Later that year extra funding became available because of the Kosovo refugee emergency. New staff were employed which increased the range of work the Centre could offer to the newly arrived Kosovo refugees as well as to others from refugee backgrounds. The opportunity to move to the Mangere Refugee Resettlement Centre became a reality in February 1999. The building was redesigned, redecorated and spacious - the centre had 8 counselling rooms, a waiting room, a meeting room and its own facilities including a kitchen. The centre was formally blessed by a Mullah and then opened by the Chairperson of the Board and invited guests.

In May 2000 the RAS Centre celebrated its fifth birthday and was fortunate to have the Minister of Immigration Hon Lianne Dalziel as guest speaker for the luncheon. She spoke of the work of the Centre and reinforced the continuing need for the specialised services its offered. An olive tree was planted by the Minister at the RAS Centre, with representatives from refugee communities placing soil over the tree roots. The olive tree was chosen for its symbolism of peace and hope.

Establishment:

Funding was finally approved by the Regional Health Authority (Public Health portfolio) in December 1994 with the Mental Health Foundation of New Zealand agreeing to oversee the setting up of a torture/trauma service in Auckland.

Chris Jane was appointed as the first RAS Centre Manager and she organised the design of the service, based on Australian Torture/ Trauma centres and the Medical Foundation in London. A volunteer psychologist initially assisted for one day a week and then became a part-time employee. In 1996 extra funding enabled the Centre to employ a social worker and another counsellor for a period of six months - this increased the availability of the service. Funding was initially by way of six month contracts. This restricted the long term planning of the RAS Centre as only 1.5fte staff could be employed. Contracts for two years did not become available until 1999, although extra funding was made available for the Kosovo refugee emergency. Subsequently, in the year 2001-2003, funding was increased so that the RAS Centre could offer a more culturally appropriate and holistic service. This meant that staffing could be increased to the equivalent of eight full-time staff. Funding for the mental health service came from the mental health portfolio whilst the training and education service funding came from the public health portfolio.

Therapeutic Models 1999-2001:

In March 2001 the Board and manager were instrumental in planning a vision for the future which was towards a holistic model with more cultural input by the Interpreters and Cultural Brokers. In June 2001 the Centre restructured and a multi-disciplinary team was formed. This team comprised a psychiatrist, a child psychologist, a family therapist, a psychotherapist, an occupational therapist, body therapist/physiotherapist, massage therapist and counsellors. Interpreters became an integral part of the Centre and several had intensive training enabling them to organise and run support groups in their own cultures. The centre continues to train interpreters to become Cultural Brokers - empowering them to work with people from their own cultures in a holistic, culturally appropriate way.

1999-2001 - Mental Health Service

Funding since 1995 was for a mental health service which provided purely assessment and counselling for individuals. This continued up to 2001 when the emphasis shifted more towards assessment and short-term therapy (individual counselling, body therapy, group therapy). Initially clients 17 years and over were seen. In 2000 the funding contract was changed so that children and adolescents could be seen. Referrals were by self and/or service providers - health, education, social services, community mental health and legal services.

Referral criteria required only that the person be from a refugee background (quota, convention refugee, asylum seeker or family re-unification) and have suffered torture or trauma. The service developed strong networks with many agencies in Auckland - such as health, resettlement and social services as well as with similar centres in Australia and USA. This aspect of the centre activities became more important as funding became tighter.

Training and Education

The RAS Centre offered training and education for both refugee communities and service providers. It provided many workshops, seminars and lectures to service providers who had worked with refugee clients over the years. As well, the Centre worked with refugee communities on specific projects such as train the trainers programmes, and refugee community profiles (RAS Centre publication). The training/ education aspect increased and the Centre began publishing a newsletter three times a year. The Centre also published a Refugee Service Directory for service providers and a Refugee Community Profile, and launched a website, initiated by a former refugee.

In 1999 the RAS Centre set up an Early Intervention Programme, through which staff and interpreters were able to meet with the newly arrived quota refugees. The meeting was a social one at which staff/ interpreters introduced the role of the Centre and explained how they could help. This gave refugees a chance to work through some of their stresses as well as providing orientation to their new country.

In early 2000 the RAS Centre was fortunate to have its first psychiatrist join the team. An art therapist and play therapist also joined the team, offering another dimension to the service. Both therapists worked with children and adults as well as running groups as part of the early intervention programme. This was the first time that play therapy and art therapy had worked in this environment of traumatised refugees and judging by the art work produced, was a success. Play therapy groups were attended by both children and adolescents.

In the early years approximately 100-150 new clients were seen for assessment with up to 400 clients attending follow-up appointments. In the latter years the Centre has seen up to 200 new clients for assessment and up to 500 clients for follow-up therapy per year.

Early in 2003 RAS developed a Community Development section to provide continuous health promotion, prevention and social information in the community through language specific groups. Ten key refugee members from different refugee communities joined the RAS Community Facilitator programme. They became the refugee group facilitators who developed support groups in a range of different refugee communities.

Period of Crisis

During 2005, the Auckland RAS Centre underwent a period of crisis after the discovery that a staff member, over a period of time, had fraudulently taken a large sum of money and spent it gambling at an Auckland casino. Following conviction of the offender, stringent financial management safeguards were put into place to prevent any possible future problems of that nature. The depletion of nearly all funds, debt and damage to trust and morale was a major setback. Nonetheless, quality services continued to be provided by the dedicated staff and volunteers who were committed to the RAS way of working with refugees.

Dr Nyunt Naing stepped in as General Manager over this period until March, 2006. His leadership was vital in stabalising the organisation and supporting the staff and services. Clinical Manager Victoria Camplin-Welch led the clinical services and was instrumental in quality improvement. Even through this difficult period, there was a new service established by Dr Naing and Community Services Coordinator Dr Arif Saeid. The Refugee Road Safety Action programme was developed to meet the urgent need for helping arriving refugees become road safe and obtain their driver licences. This new initiative, started by two former refugees (Dr Naing and Dr Saeid), was requested by the former refugee communities as a top priority. Getting drivers licenses increased independence and mobility, reduced isolation and greatly enhanced newly resettled refugees' prospects of getting a job. This, in turn, improved their mental and physical health.

A New Era and Directions: Extensive Service Developments – 2006 to 2012 R A S N Z

A new Board, revised Constitution and major changes in organisational direction and growth came about from March 2006.

The first Chief Executive, Gary E. Poole was appointed as a new Board took over Governance. The new Board included a former senior Cabinet Minister, Hon A.G. Malcolm, Dr N. Rasalingham, a medical practitioner and pioneering refugee advocate who founded the Refugee Council of New Zealand, Barrister Trish Fordyce, Revd Jim Milne, Meng Ly, Fariba Motlagh, and subsequently former Auckland Mayor Dick Hubbard and Pharmacist Ahmad Zary.

In April 2006 a Clinical and Operations Manager, Tony Cooper, was appointed to develop quality improvement and to advance clinical services. In 2007 RASNZ attained a major milestone of TELARC accreditation as a result of its drive for continuous quality improvement. RASNZ remains the only refugee-related service in New Zealand to have achieved this standard of service. Body therapy, clinical assessment, treatment and rehabilitation services developed and evolved at the site of the National Refugee Resettlement Centre at Mangere.

The revised Constitution expanded the organisation's scope to a national focus of activities and operations and increased the range of work to encompass general health and well being in addition to mental health. It also brought about a change of name to Refugees as Survivors New Zealand. RASNZ became the generic name of the evolving organisation.

At the MRRC, the Community Services Team led by Dr Arif Saeid developed refugee orientation services in health promotion in smoking cessation, injury prevention, nutrition, child and maternal health and in how to understand and utilise the health system. The highly successful Refuge Road Safety Action Programme continues to achieve a pass rate of over 90% for learners licences.

Five Year Strategic Plan

The Board and CEO developed the first comprehensive Strategic Plan over a 5 year period from 2007 through the input of grass roots former refugee community representatives.

The Mission Statement resulting:

Refugees will have access to quality, culturally responsive health services to assist positive resettlement in New Zealand

The Strategic Plan established some ambitious goals for responding to the needs indicated from the detailed input of former refugees who had experienced the entire resettlement system. The plan called for a much broader focus on primary health, community services, and greater responsiveness to input and leadership from former refugees. The new motto was "Making a World of Difference."

Establishment and Launch of the Auckland Regional Refugee Mobile Team RMT- November 2007

The urgent need for an outpatient, community follow-up service beyond the initial assessment and treatment at the Mangere Refugee Resettlement Centre was established in response to the strong demand from multiple former refugee communities and from feedback from mainstream service providers.

Responding to the feedback and considering the international literature and best practice from overseas providers, the CEO designed a proposal which was accepted by the NDSA (Northern District Services Agency) and the District Health Boards. The program design also included substantial partnership funding from the philanthropic sector as well as Government support.

The Prime Minister, Rt Hon Helen Clark officially opened the RMT in November 2007 with over 150 people present from multiple communities and agencies.

The RMT: Refugee Community Link Workers and Clinicians Working Together

The ASB Community Trust provided vital matching funding for the team of Refugee Community Link Workers. The CLW's are all from refugee backgrounds and represented the Afghan, Burmese, Ethiopian, Iraqi, Sudanese, Somali and other communities. The CLW's are specially trained and multi-lingual and provide the essential cultural knowledge, as a vital bridge between the refugee community and the clinical team professionals.

Some unique features of the RMT design:

Evaluation of the Refugee Mobile Team and the TheMHS Supreme Gold Award in Sydney 2010

Funding from the ASB Community Trust allowed the most extensive outcomes evaluation of any refugee-related service in New Zealand to be carried out. The evaluation was conducted externally and included direct feedback from clients, from client family members, from referring agencies and key informants in the community. The effectiveness of the RMT was evaluated on the basis of clinical outcomes follow-up data.

The results were very positive. The findings of the external evaluation were that the services were highly regarded by clients, by family members, by community agencies and key informants, and by refugee groups. Most importantly, clinical outcomes measures showed that the combined treatment services resulted in improvements leading to recovery from torture and trauma and to better settlement outcomes.

In September 2010 the RASNZ Refugee Mobile Team received the Gold Supreme Award for quality and innovation among health services in Australia and New Zealand presented at the international TheMHS Conference in Sydney, Australia.

Building National Workforce Capacity – The CALD (Cultural and Linguistic Diversity) Training

From 2007 the RASNZ CEO worked with Sue Lim, Manager of the Asian Services for the Waitemata District Health Board (WDHB) in collaborating on the development of a training package, curriculum and materials for training health professionals to develop cultural competency. The materials were written principally by former RASNZ Clinical Manager Victoria Camplin-Welch and Dr Kathy Jackson. Te Pou, the National Health Workforce agency, provided $100,000 in funding to pilot and evaluate the programme across the country in Christchurch, Wellington, Hamilton and Auckland. The success of the training models and curricula led to the CALD training being established permanently.

RASNZ, Christchurch Resettlement Services and the Wellington Refugees As Survivors Trust (now Refugee Trauma Recovery) signed an MOU to form the Coalition of Refugee Services and collaborated on delivering the CALD capacity-building. In 2007 and 2008 the three organisations convened conferences at Tauhara Centre at Taupo for mutual training, support and collaboration. At the first of these Taupo conferences Paris Aristotle, Director of the Victorian Foundation for Torture and Trauma in Melbourne came over to share his expertise and experience. Subsequently RASNZ became a member of the International Rehabilitation Council for Torture in Geneva IRCT, and connected with visits to the Victorian Foundation in Melbourne and the STARTTS Centre in Sydney.

Trauma Team Response to Christchurch Earthquake Survivors and Families

Immediately following the devastating February 2011 Christchurch earthquake, a RASNZ Trauma Team was on the ground in Canterbury to work with the Canterbury Primary Health Organisation and Christchurch Resettlement Services. Working from a Maui campervan out of Burnside Emergency Centre and other locations as well as through the PHO facilities in Shirley, RASNZ clinical staff provided trauma response and evacuation for former refugees but also assistance to bereaved families of international students killed or injured, as well as triage work for all affected people from the mainstream Canterbury community. The RASNZ trauma team had a presence in Christchurch for the first 12 weeks following the February earthquake.

Research Unit and International Publications

In 2006 RASNZ Research Associate and leading Cross-Cultural Psychologist Dr Kathy Jackson, through RASNZ, published the book Fate, Spirits and Curses, a groundbreaking study of concepts of mental health from many different cultural understandings of those from refugee backgrounds. The book was launched at the Hyatt Hotel in Auckland by Hon Peter Dunne, Associate Minister of Health with over 150 people in attendance. The book has been recognised as an important resource in the field and is frequently cited with sales to at least 15 different countries.

Chaykham Choummanivong subsequently became director of the RASNZ Research Unit. Ongoing publications in domestic and international professional journals have come out in recent times. Of particular importance was the publication of original research into Refugee Family Reunification, Mental Health and Settlement Outcomes published in 2012.

In 2012 RASNZ signed with AUT University's Refugee and Migrant Centre a collaborative MOU for research initiatives along a similar model established between the Victorian Foundation in Melbourne and the La Trobe University. This MOU established a collaborative relationship for future research initiatives which will be based on a clear criteria for potential for practical benefit to settlement, health and wellbeing which is refugee-community driven.

Recycling Bicycles for Refugees, Gardening for Health, Smoking Cessation, the RAS Angels

A new initiative was started by RASNZ in 2010 organised by Diana Swarbrick, Administration Manager and involved receiving old bicycles from donors and recruiting volunteers to fix them up. The 'recycled cycles' are given to arriving refugee families at the National Centre at Mangere who use them for transportation as they move into community settlement. This innovative initiative has gone from strength to strength and hundreds of bicycles have been recycled for newly arriving refugees. The Recycling Bicycles for Refugees project has also been the highlighted in newspapers, radio programmes and television as a very positive development. Diana has also been a key driver of the essential "RAS Angels" who are the volunteers supporting refugees who making the biggest difference in successful settlement outcomes.

Together with Counties Manukau DHB, RASNZ started a community garden in 2009 at the National Refugee Centre at Mangere. This project subsequently expanded to include providing tools and seeds to former refugees settling into the community. Community Services Manager Dr Arif Saeid and his Team of Community Facilitators have developed, expanded and evaluated this very positive initiative which allows refugees to engage in healthy activity and increase self-sufficiency.

The Community Facilitators have very successfully delivered the Refugee Road Safety Action Programme for new drivers with an 80%+ licensing success rate, and in the Smoking Cessation Programme which has been collaboratively run with the MRRC Medical Services (Auckland Public Health) has been very successful. Community Facilitators Priscilla Dawson and Patrick Au have been integral in developing a comprehensive programme to both identify arriving smokers and help them successfully become smoke-free early on into resettlement.

RYAN – Refugee Youth Action Network – 2011

At the November, 2010 RASNZ AGM a delegation of leaders from some of the former refugee communities asked the Board to do something to address the issues facing their young people. A proportion of young people from refugee backgrounds were struggling at school, having difficulties getting into careers and employment, and were at risk of social problems affecting other minorities including involvement in gangs, drugs, alcohol and crime.

As a result of this delegation and submission by grassroots community leaders, the RASNZ Board set, from 2011, initiatives to address the needs of children and young people from refugee backgrounds as a top priority for the organisation.

As a direct result, the Refugee Youth Action Network (RYAN) was established together with two refugee-led organisations: the Umma Trust and the Ethnic Youth Employment and Education Trust. This partnership set up the basis for the establishment of a unique and innovative initiative for young people from refugee backgrounds. RYAN was established through the generous funding partnership with the ASB Community Trust and the Ministry of Social Development in Auckland and in Hamilton.

RYAN opened officially with keynote speaker and famous New Zealand adventurer, author and youth advocate Graeme Dingle at the Mt Roskill Centre. RYAN prioritises involvement in sports, job and employment initiatives and even a Radio Programme: Radio RYAN. The RYAN Project is going from strength to strength and sets a clear example for the new and needed priority of youth and employment.

RASNZ has developed as a highly professional NGO which remains integrally well-connected to the grassroots former refugee communities. The organisation has developed as a key leader in the sector and is recognised both nationally and internationally as a responsive and quality provider in the field of refugee health and wellbeing.