Combatting the Stigma of Return

Returning home is often perceived as an easy process, but after months of potentially distressing experiences, going back can be as much of a struggle as the attempt to reach Europe.

“Many returnees come back sad or angry. They leave to support their struggling families, only to come back with more resources spent,” says Muhammed Suso.

“Indeed, many return with feelings of hopelessness and failure. This contributes to psychological distress in various degrees, especially among those with deteriorating social support networks,” echoes Evans Binan, the International Organization for Migration (IOM)’s Mental Health and Psychosocial Support Officer (MHPSS) in The Gambia.

Muhammed was one of the lucky ones to have not felt the often-overwhelming stigma upon return.

When he left The Gambia in late 2015, he had dreams of reaching Italy to pursue further education.

“My father passed away when I was 19. My family depended on me, but I didn’t even go to high school,” explains Muhammed.

“I wanted to study construction or engineering in Italy and learn technical skills.”

Muhammed started a three-year journey that took him as far as Algeria and Mali, where he worked in construction in order to survive and make it one step further. With his prospects of reaching Europe growing slimmer, the young man faced a decision — stay and find his way to Libya or come back home and start anew. In August 2017, with support from his brother, Muhammed decided it was time to return to his homeland.

“My family was so happy to see me home, because I wasn’t able to contact them for months,” he says. Others are not fortunate enough to receive a warm welcome, hence the importance of supporting the psychosocial reintegration of returnees.

Amidst continued endeavours to provide for his family, a friend working at the National Youth Council, one of IOM’s key partners in The Gambia, offered him the opportunity to partake in one such effort through a mobile health caravan that aimed at strengthening the psychosocial reintegration of returnees in their host communities.

Muhammed participated in a capacity building initiative prior to the caravan, in which IOM trains community health volunteers — referred to as “change agents” composed of nurses, midwives, youth counsellors and other community members — on providing psychological first aid (PFA), basic counselling and identifying basic signs of mental illnesses. Volunteers are empowered with the necessary basic counselling skills to participate in the caravan and to provide PFA onward in their communities. Muhammed was one of 30 volunteers trained in his hometown of Soma, Lower River Region, and one of 122 around the country.

This caravan is part of a growing endeavour to incorporate communities in the psychosocial reintegration process.

“IOM recognizes the need for a community-based approach to psychosocial support, to ensure the sustainability of reintegration. Building the counselling capacities of community members creates an enabling environment for returnees to become fully functioning members of society,” explains Dr. Simeonette De Asis, IOM’s Migration Health Officer in The Gambia.

With a health education component on depression, stress, substance abuse and other mental health disorders, the caravan is further aimed at reducing stigma and combatting negative perceptions of returnees.

“We raise awareness that mental health issues can be overcome and explain to communities how they can serve as a support structure to those affected,” explains Dr. De Asis.

IOM has thus far in 2019 toured five communities — Bansang, Basse, Brikama, Farafenni and Soma, all of which are among the communities of highest return migration — reaching over 1,050 community members.

“This initiative is very helpful to communities, as many can’t access medical and psychosocial support,” remarks Muhammed.

“At the training, I learned many things about mental stressors that I can share with other returnees.”

The community-based approach to psychosocial reintegration is designed to complement efforts under the EU-IOM Joint Initiative for Migrant Protection and Reintegration, in which voluntary return assistance have been provided to over 4,500 Gambian returnees since 2017. MHPSS forms a key component of this direct assistance.

Upon arrival, all returned Gambians undergo a medical assessment and benefit from health education sessions, in order to help them understand and recognize symptoms of mental health disorders. Those identified as requiring further psychosocial support are counselled by members of IOM’s MHPSS team, with referrals made to relevant medical authorities when necessary. In subsequent months, IOM conducts monitoring visits to check on the psychosocial wellbeing of assisted returnees.

“Our work in providing both individual and community-based assistance addresses returnees’ immediate psychosocial needs and supports their long-term well-being in their communities,” says Binan.

Over two years after returning home, Muhammed continues to work hard to find opportunities for his family, but he is not ashamed to be branded a returnee. “Why should we be called failures? People migrate all the time for many reasons, but it does not mean we have no use when we come home,” he says.

“Returnees have many skills and expertise to offer. I improved my construction skills while working in Algeria. We should find ways so that returnees and communities can help each other,” Muhammed adds.

And with his newly gained counselling skills, what advice would he give a fellow returnee going through difficult times?

“I would tell them that one failed journey is not the end of your life. You have the chance to work hard, gain skills and help your community develop,” he says with conviction.

“Have some faith,” he quips — a mantra he too repeated to himself when he first arrived back home.

Muhammed’s story is all too familiar in a small country of two million people. In the past five years, over 35,000 Gambians have taken the risky and arduous route through the Sahara and arrived “irregularly” on European shores, according to the European Border and Coast Guard Agency (Frontex). For many others, their journeys ended before ever reaching the continent.

The mobile health caravan initiative forms part of Strengthening the Sustainable and Holistic Reintegration of Returnees, a project funded by the UN Peacebuilding Fund and implemented in collaboration with the International Trade Centre, the UN Population Fund and the World Health Organization.

The direct provision of mental health and psychosocial support to returnees forms part of the EU-IOM Joint Initiative for Migrant Protection and Reintegration, the first comprehensive programme to save lives and protect and assist migrants along key migration routes in Africa. Reintegration support is provided through an integrated approach, which incorporates economic, social, and psychological dimensions.

This story was written by Miko Alazas, IOM’s Communications Officer in The Gambia.