Since 2013, CVT has provided rehabilitative services in the Tigray region of Ethiopia to Eritrean refugee survivors of conflict. Later, we expanded this work to include internally displaced persons (IDPs) . 

Previously, CT was operating in the Mai Ayni and Adi Harush camps. But when violence broke out in the area in November 2020, Eritrean refugees fled to the Alemwach site in Amhara.

As of last year, the United Nations Higher commissioner for refugees (UNHCR) estimated that 22,000 Eritrean refugees were living in Alemwach. According to our experts, during this transition, former clients reported experiencing re-traumatization. 

This let the CVT Ethiopia team know there was an increased need for both:

• mental health and psychosocial support (MHPSS)
• interdisciplinary care for the refugee community

According to Alemu Lemma, CVT’s Amhara Area manager, MHPSS provided by CVT has a basis of trauma-focused healing. While there are other organizations that may provide basic mental health service, there is a gap when it comes to trauma-focused, specialized MHPSS organizations. Especially those that have capacity to approach that size of a client base and address their needs from a holistic perspective. 

An Unexpected Shift

The need for that sort of care has continued. But, we are saddened to share that CVT Ethiopia will no longer be providing services at the Alemwach site.

“This is not due to an ending of trauma-healing needs in the beneficiary population, but budget cuts our donor has experienced and in-turn CVT has as well,” said Patrick Robbins, CVT Ethiopia program manager. 

“CVT’s departure will leave a significant gap in services and there will be no specialized MHPSS services available any longer to this population.” 

Just this year, the Tigray, Gambella and Amhara regions in Ethiopia saw over 1,100 clients for intakes and intensive counseling. Shifting away from a population that has ongoing needs is proving difficult for everyone involved. The sad reality that there are no other agencies currently engaging in MHPSS in the way CVT has been. 

“It is really painful that we are leaving this community where there is no organization that is going to provide specialized MHPSS care. Even now, there is ongoing conflict between the non-state and state actors in the area and there is a lot of insecurity,” Alemu said. 

“We are leaving them behind and there is no one to support them. Every time I interact with them, it is really a heartache for me, knowing that we have been a solution for them, but we are leaving them just because of funding.”

CVT’s Impact on the Amhara Community

According to Ethiopia-based experts like Alemu, Frezgi Gebrekristos, psychotherapist, and Kiflom Negash, physiotherapist, the community within the Amhara region have become very familiar with CVT. This is particularly true of the Alemwach site.

Tangible Progress After Trauma

According to Frezgi, clients’ first contact with CVT is often through community outreach. This outreach is done in an effort to promote their collective psychosocial well-being.

In situations where someone is looking for support but may not be comfortable coming to CVT as a client, these community outreach sessions providing “sensitization” or psychoeducation. These sessions cover how trauma impacts their body, mind, and heart, and inform them of available services.

Often these activities are conducted by refugee incentive staff who have experienced similar challenges as the (potential) clients. That way, they can share information in the manner that is understandable and resonates with them.

Within the communities where we offer services, CVT is known to put client needs and respect first. Testimony from Alemwach site clients are a great example of this sort of rapport. 

We hear many client testimonies about how the service has benefited them. Our clients see CVT as a safe space and they mentioned the respect they got from the counselors and the clinical team,” said Frezgi. 

“After they started the sessions, some clients mentioned that they were very eager for the next session to come.” 

Kiflom shared that the same has been true of physiotherapy services. Because of CVT’s intentional trauma-focused approach, the staff has seen clients improve dramatically throughout sessions. And, clients have shared their shifts in mindset and ability as well. 

He mentioned varied situations where violence within the community resulted in clients seeking out CVT’s services, hoping to find positive ways to deal with both their physical and emotional distress.

Shifting to Hope

Frezgi also shared two poignant examples of the impact CVT Ethiopia’s counseling and trauma-focused physiotherapy sessions have had on the overall healing journey of clients. 

One woman was subjected to sexual violence during her journey to Ethiopia. As a result, she dealt with suicidal ideation and barriers to daily functioning. She was anxious when beginning, but after attending just ten counseling sessions with CVT clinicians, she reported feeling hope.

“During the follow up session (an individual session we have after completing the 10 counseling sessions) she mentioned that for her, ‘CVT is like heaven.’” Frezgi said. 

The client told the psychotherapist that when she arrives for her sessions the warmth from the clinical team helps her to feel comfortable, dignified. She knew it was important for her to continue her sessions.

“She was telling us it was very impactful in her life. After the services, she was able to interact more positively with her family, the community, her friends and neighbors as well.”

Trusting CVT as an Advocate

With that familiarity has come a trust and an understanding that our organization is committed to the support of our clients. In addition to the direct mental health services, the community has come to lean on CVT for advocacy support and thought partnership.

Community leaders felt very heard by CVT. They trust that CVT will [engage in] appropriate advocacy for them. They understand that we are not there merely for reporting purposes, but really to do a real job with them.”

“They really count on us whenever there is a challenge. They really consider us as a reliable partner or organization that they can go and seek support from,” Alemu said.

What Now?

Services in Amhara will continue, but at a different site, and with a different population. Instead of working with refugees, this new site will focus on supporting the rehabilitation of IDPs in that region. 

An upside to this shift: Our colleagues are well-trained and adaptable. This means that those who currently work at the Alemwach site will be shifted to either this new location or another program in Ethiopia.

Kiflom and Frezgi are two examples of colleagues with experience working with both IDPs and refugees. They both were asked to help wrap up the program details at Alemwach, and are moving back to CVT’s Tigray program. 

Incentive Staff

The process for site closure has also involved training refugee representatives and service providers on mental health integration.

When the refugees arrived in Alemwach in 2021, before CVT was able to establish its operation in this new location, its incentive staff voluntarily provided psychological first aid and psychoeducation for fellow refugees. They sought support from CVT clinical staff by telephone whenever possible. 

Now, over a dozen incentive staff have been trained by CVT for a number of years on trauma-informed services. This includes psychosocial counselors and rehabilitation assistants. These incentive staff are now integrated into other organizations, ensuring continued support for the community. 

And, CVT Ethiopia is doing their best to refer clients to other NGOs engaging in human rights work that may be helpful to clients’ varied needs.

One thing is for certain: a loss will be felt in CVT’s absence. “When we started talking about navigating this issue of closure, I had a chance to talk with stakeholders, including those who are working with the UN. A majority of them said things like, ‘We can’t imagine this refugee community without CVT,’” Alemu shared.

This is because we have a large presence there. We provide very compassionate and quality care, and they were saying that life will not be the same when CVT is not around.”

While CVT may be leaving Alemwach, its legacy will remain as resources for the community.