Where we work
We have trained people from 17 countries as well as the UK where we are based. We are committed to expanding our training and support to wherever children are suffering. We work both online and face-to-face, in partnership with local organisations in a variety of community locations and refugee settlements, including some in war zones.
ACT International trains in a number of countries where children’s rights are violated or have laws which compromise our values. We always do our best to uphold and teach internationally accepted standards of human rights, but may in some circumstances be obliged to adapt our programmes so that neither our trainers, trainees nor the children they serve are put at risk.
Africa
ACT International has trained people in Liberia, South Africa, Uganda, Rwanda, Nigeria and Tanzania where civil war and unrest, and use of child soldiers and labour have affected thousands of children.
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Asia
ACT International has trained people working in Armenia, Pakistan and Malaysia with child victims of war, extremist violence and under threat of abduction.
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Latin america
ACT International has trained people working in Colombia, which has the highest percentage of ex-combatant children in the world.
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Middle East
ACT International has trained people in Jordan, Lebanon and Turkey helping children and young people who fled the war in Syria. We also run a child trauma clinic in Gaza with two partner NGOs.
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Our work in Africa
The Gambia
Tanzania
South Africa
Uganda
The Gambia Tanzania South Africa Uganda
The Gambia
In The Gambia mental health services for children are virtually non-existent and there are no referral systems for children experiencing mental health disorders, and only part time specialist paediatric psychiatric services. When mental health conditions deteriorate, children often end up out of school and in prison. Children and young people affected by mental disorders suffer lasting and wide-ranging adverse effects including on their education performance, social interactions, interpersonal skills, self-esteem and coping skills going into adulthood. In addition to poor mental health funding, inadequate facilities and lack of trained personnel, most people in The Gambia believe that mental health disorders are associated with evil spirits and do not seek professional help.
The Gambia was our first post-pandemic overseas CATT training trip in February 2022. This was organised and planned with our in-country partner WAYAS Counselling & Psychotherapy Service, with an experienced training team from Uganda and the UK. The trip resulted in the award of 18 CATT certificates to counsellors from a variety of local NGOs and Government agencies, presented to them by the Minister of Women, Children and Social Welfare. Follow-up supervision is being co-ordinated by WAYAS. There was also a wider purpose to the trip, in terms of promoting WAYAS and mental health service development within The Gambia. Members of the team accompanied Alhagie to a meeting at the National Human Rights Commission, and visited the country’s only psychiatric hospital, Tanka Tanka, plus a Government-run children’s shelter.
The Gambia
Tanzania
South Africa
Uganda
The Gambia Tanzania South Africa Uganda
Tanzania
South Africa
Uganda
Tanzania
The Gambia
South Africa Uganda Tanzania The Gambia
Tanzania is the first country in Africa to undertake a ‘National Study on Violence against Children’- for the first time measuring all forms of violence (sexual, physical and emotional) amongst girls and boys. This study revealed that sexual, physical and emotional violence are common for children growing up in Tanzania, and the perpetrators of this violence are often near and known to the children. It highlights in particular the vulnerability of girls to sexual violence and the negative health consequences of these experiences in their childhoods and beyond (Unicef, 2011). There are various projects set up for children across Tanzania but child-centred mental health services are lacking.
75% of children are victims of physical violence
1/3 of girls aged 13-24 experience at least one incident of sexual violence before the age of 18
According to WHO, acts of violence cause more death and disability than cancer, malaria, traffic accidents and wars combined
72% of girls have experienced some form of physical violence in their childhood
Statistics show that violence prompts an increase in the number of street children
25% of girls are subjected to emotional abuse before the age of 18
In June 2014 we trained children’s workers from across Tanzania at the Arusha Mental Health Trust (AMHT). AMHT was founded in 1996 on the streets of Arusha; it grew out of a great need to offer basic mental health care to this growing population at a time where there were no active mental health services available. Twenty-four children’s workers from across the country attended, these included social workers, counsellors, orphanage workers, teachers, psychologists, those working with street children and nurses. Our CATT training course was incredibly successful with 100% pass rate. The diversity of the group made for an extremely productive week of skills sharing and created an incredibly supportive environment in which to learn and share cases.
“I think the child-centered approach to CATT is great! It provides an opportunity for the child to express how they feel and gives them a rare opportunity that they don’t get usually. I think it’s really great. It just really gives an opportunity for a child that wasn’t an option before. ”
South Africa
Luna’s Training Partner in South Africa is Lefika La Phodiso, which is Africa’s first Art Therapy Centre, established in 1993 in response to the effects of trauma from political violence in the final years of apartheid in South Africa. Today Lefika works to better the lives of those individuals, families and communities affected by abuse, crime, poverty, xenophobia and HIV AIDS. This work predominantly takes place within Johannesburg’s townships and inner city where the levels of these problems are amongst the very highest in the world. It is the only organization in South Africa which trains local people in Community Art Counselling skills. In February/March 2012 Luna ran a very successful training week there which resulted in 27 people receiving Level 2 certificates. Lefika’s Director Hayley Berman then attended CATT level 3 training at Pennthorpe School in July 2012 and her colleague Luke Lamprecht was sponsored by Luna to attend the Level 3 course in July 2013. Together they ran their own CATT Level 2 course in 2014.
Uganda
Uganda has experienced almost continuous conflict since independence, through the regime of Idi Amin until the mid 1980s, when President Museveni came to power
People in the north especially are still living with the consequences of frequent attacks by the Lord’s Resistance Army which only ceased in 2006
Uganda is now the centre of the world’s fastest growing refugee crisis. In the past 12 months the central African nation has taken in around 1.5 million people — more than Greece, Turkey or any other country in the world at the height of last year’s crisis in Europe.
Every day around 2,000 people stream across Uganda’s borders fleeing famine, drought and violence in neighbouring countries, including nearly a million from South Sudan.
Refugee and returnee children
UNHCR data tells us that Uganda now has over 1.5 million refugees, of which a very large number are children. The three main population groups are from South Sudan, the DRC and Somalia. Nearly two-thirds have arrived within the past five years in successive waves of refugee influxes that have followed periods of conflict and insecurity in neighbouring countries. In addition, rebel activity by the Lord’s Resistance Army killed and displaced many thousands of people in northern Uganda. Since the LRA’s departure in 2006, many former abducted child soldiers have returned to their home communities. Some of them are girls held as ‘wives’ of rebel soldiers, and who now have children of their own. There are very high levels of complex trauma among both refugee and returnee groups of children and young people across Uganda.
Our work
CATT TRAINING
Over the past ten years we have run 11 full CATT courses in Uganda and have over 150 counsellors across the entire country, and 12 Ugandan trainers. They work for local mental health teams, in refugees camps and for NGOs both large and small, including the International Rescue Committee. We are especially proud of our ongoing work with UK charity Christian Relief and Education for South Sudan (CRESS) which has set up a specialist child trauma team and treated over 600 children living in refugee settlements in the West Nile region using CATT.
MENTAL HEALTH LINK WITH BUTABIKA HOSPITAL, KAMPALA
Since 2012 we have worked in worked in partnership with East London NHS Foundation Trust on its mental health Link with Butabika National referral Hospital, Kampala and mental health services across Uganda. CATT is now an established part of the trauma module for the CAMHS Diploma accredited by the Mbarara University of Science and Technology.
FRIENDS OF BUTABIKA CHILDREN’S WARD
In June 2013 the ‘Friends of Butabika Children’s Ward’ project was set up in response to concerns raised about the care and treatment of child patients at Butabika Hospital. This became our first children’s rights project, aiming to support the ongoing efforts of Ugandan professionals to promote changes in cultural attitudes and provide high quality care and treatment in the context of severe material limitations and very low staffing levels. The project promotes good safeguarding practice and funds a trained volunteer to work on the ward for four days per week, providing the children with recreational, educational and therapeutic activities.
The objectives of the Friends are:
To finds ways to improve, promote and monitor observance of the rights of children who are patients on the children’s ward of Butabika Hospital
To improve the relationships and living conditions of children who are patients on the children’s ward of Butabika Hospital
To raise and provide funds which will further the achievement of objectives 1 and 2
BISHOP ASILI COMMUNITY DEVELOPMENT FOUNDATION, LIRA
Bishop Asili Community Development Foundation in Lira, northern Uganda, supports several hundred women and children who have been affected by the Lord’s Resistance Army. In 2006 UNICEF estimated that it had abducted at least 25,000 children since the conflict began in the early 1990s. Many local people lost family members in attacks, are themselves the victims of rape and violence, or are returned captives. Most recently, the Foundation has been helping more than 50 trafficked children to resettle into local communities. The Foundation provides vocational training as well as psychological counselling and mental health education. Sister Florence Achulo is the Director, and she is a qualified psychologist who has treated many children using CATT since her training at Butabika Hospital in September 2013. However, Lira is largely by-passed by aid agencies and Sister Florence struggles to attract funding for the Foundation, so supporting it is one of our special projects. In recent years we have begun using the Foundation’s hall (pictured) as a community training centre for PTSD awareness, which brings it some additional income.
Uganda
The Gambia
Tanzania
South Africa
Uganda The Gambia Tanzania South Africa
Our work in Asia
Armenia
Pakistan
Armenia Pakistan
Armenia
Armenia is a Christian nation, and former Soviet republic, in the mountainous Caucasus region between Asia and Europe.
There are many troubled children in Armenia who have fled the war in Syria, whilst others have suffered recent loss and trauma in the tragic conflict with Azerbaijan in the disputed territory of Ngorno Karabach. This small country has become a safe haven for Christian refugees, many of Armenian descent - a big burden for a people with limited resources.
Our work
We formed a partnership with Children’s Center Foundation in Yerevan, the capital city of Armenia. Here we trained 26 psychologists and social workers to be CATT practitioners in November 2019. We planned to return in 2020 to run a second course plus a training of trainers (ToT) course, but Covid and the conflict with Azerbaijan intervened. However, we conducted a research project in 2020 with those who received the 2019 training, and they are keen for us to run the training again in 2021 for people working with children across the country.
Armenia
Pakistan
Armenia Pakistan
Pakistan
Everyone has heard of Malala Yousafzai and the challenges faced by girls in obtaining education in the Swat Valley in northwest Pakistan
The attack on the school in Peshawar in December 2014 killed 132 schoolchildren aged 8 to 18
As a result of the Peshawar attack it has been estimated that two-thirds of the population of this city are now suffering from trauma
Terrorism and radicalisation
Many children and young people in northwestern Pakistan are affected by the Taliban’s fundamentalist ideology and campaign against the education of women and girls. The radicalization of Pakistani youth and the threat of terrorism are having a big impact on the mental health of people living in the region, as well as challenging the ability of the authorities to provide safe, universal education.
Our work
We have trained four therapists from the Sabaoon School in the Swat Valley, which rehabilitates boys recruited by the Taliban. They travelled to the UK for training in 2012. Two have become CATT trainers.
Since the Peshawar massacre we have trained a UK-based psychiatrist who went to Pakistan to treat survivors and others affected by the terrible events of December 2014. CATT-trained staff of Sabaoon are also working in Peshawar.
Our work in Latin America
Colombia
Colombia
Colombia
in partnership with Children Change Colombia
Colombia has an estimated population of 50 million which makes it is the third biggest country in Latin America, after Brazil and Mexico. About nearly 27% of the population is 15 years old or younger.
Between 1964 and 2016 civil war between the government and a number of guerilla groups, including the Revolutionary Armed Forces of Colombia (FARC), created extreme violence, abuse and massive displacement of the civilian population. An unstable peace has been sustained since 2017 which is allowing the country to rebuild and restore rights and property. As a consequence of 52 years of armed conflict, Colombia has the highest percentage of ex- combatant children in the world, who have missed out on education and normal family lives. Poverty and inequality are extreme and evident on the streets of every city. Furthermore, the country’s challenges have also increased as it has received a large number of refugees fleeing the human rights and humanitarian crisis in Venezuela. More than 1.4 million people moved from Venezuela to Colombia between March 2017 and August 2019.
Children Change Colombia is an international NGO that works with children and their families in Colombia to challenge poverty, inequality and violence and create a better everyday life for the children and young people who are survivors or at risk from Colombia’s most neglected issues. It has a strong focus on mental health and in 2019 asked ACT International to provide mental health and PTSD training to the staff of its in-country projects. At the height of the pandemic in early 2020 we began with online training in Children & War’s teaching for recovery technique. This was followed by in-person CATT training for 20 people in 2022, and which we will follow up with a further course and training of trainers in 2023.
Our work in the Middle East
The Yemen
Palestine
Turkey
Lebanon
Jordan
Syria
The Yemen Palestine Turkey Lebanon Jordan Syria
The Yemen
In the Yemen, a civil war that began seven years ago between the Yemeni government and the Houthi armed movement, has led to an ongoing humanitarian crisis. According to UNICEF, 80% of Yemen’s population are in need of aid and protection, with over 11 million children affected and nearly 2 million internally displaced and malnourished. A large proportion of the population is living in constant fear of attack and September has seen renewed fighting for control of the oil-rich province of Marib. Now, coronavirus threatens their lives too.
In this situation anyone who works with children is dealing with high levels of emotional distress and anxiety. We have developed an effective online training programme which equips child care workers and teachers to use well-established tools and techniques to help children who are frightened and anxious, and who live in unsafe places. ACT International is working closely with Dr Kawkab Alwadeai, a Yemeni mental health activist, counsellor and researcher now living in Canada. There she has set up ‘Bridges to Peace and Solidarity’ which works hard with local partners on the ground to support teachers, psychologists in different schools, centers based in all provinces of the Yemen. Together we were able to offer a pilot training course in March 2021 in the province of Taiez. It was delivered entirely online in Arabic, by trainers based in Jordan and Gaza. With some practical help and funding from the British Yemeni Society and IMET2000, we are now using Kawkab’s network to roll out this successful model of training to people working with children across the whole of this war-torn country.
Palestine
After training two practitioners from Gaza, we set up a child trauma clinic there with our partners, IMET 2000 and Firefly International in July 2019. Watch this short film to learn more about the challenges facing children who live in the Gaza Strip, and why we need to keep this clinic running.
New practitioners receiving their certificates in Gaziantep, Turkey. The majority are themselves Syrian refugees working with refugee children either there, or in the camps along the border.
The Syrian Conflict
Since the beginning of the national uprising in 2011, conflict in Syria has escalated and nearly half a million people have lost their lives, including over 50,000 children.
More than half of Syria’s population have fled their homes. About 5.1 million Syrians are refugees who’ve left the country across borders to Egypt, Turkey, Lebanon, Jordan and Iraq, and 6.3 million are internally displaced within Syria
Of those displaced, half are children. These children are at risk of becoming malnourished, physically sick, abused, or exploited, and are extremely likely to have experienced trauma. Many have been out of education for many years, and are being called a ‘lost generation’.
The number of refugees created by the Syrian conflict shows no sign of slowing down.
TURKEY, in partnership with the SYRIAN ASSOCIATION FOR MENTAL HEALTH
In April 2014, we travelled to Turkey, home to more than 1 million Syrian refugees, to run a level 2 CATT training course in the city of Gaziantep. Participants from all over the Middle East were selected in conjunction with the Syrian Association for Mental Health, and comprised a group of 11 psychiatrists, psychologists, and trainee psychologists/child support workers. The course was extremely well received, qualifying 11 mental health professionals, 10 of whom were Syrian, to deliver CATT to traumatised children. At the request of Syria Relief, one of the agencies which sent its staff for training, Luna subsequently supported an experienced UK-based CATT practitioner to travel to Reyhanli to assist with follow-up work, as so many cases had been identified requiring treatment.
LEBANON, THE INTERNATIONAL INSTITUTE FOR PSYCHOSOCIAL DEVELOPMENT
In May 2015, we delivered another successful level 2 course in Lebanon, home to 1.1 million Syrian refugees. This training was made possible with the help of a second Middle-Eastern training partner, the International Institute for Psychosocial Development (IIPD). The course proved exceptionally popular, with twenty-nine mental health professionals and front-line workers in attendance. 24 trainees obtained level 2 CATT certificates and 5 gained level 1. Afterwards, Luna received the following feedback from the psychiatrist who had organised the training on behalf of IIPD, and acted as our Arabic interpreter: ‘Well, the training was really great and everybody around feels energised and motivated to help children with PTSD.’
JORDAN, in partnership with the SYRIAN AMERICAN MEDICAL SOCIETY
In February 2016, we delivered a level 2 course in Jordan, home to over half a million Syrian refugees. Here we worked with the Syrian American Medical Society at its mental health centre in Irbid. We successfully trained 16 people from a variety of organisations, many working in the refugee camps located in the north of Jordan. We were delighted that one of the psychologists trained in Turkey in 2014 was able to join the training to tell everyone about his experience of using CATT successfully with children in Amman.
Our work in the UK
ACT International runs an annual CATT course in the UK for individual mental health professionals, and those who work for small NGOs supporting vulnerable children and youth at high risk of PTSD. Details of up-coming courses will be published on our social media.
TraumaPsychology runs regular CATT courses for registered mental health professionals working in the NHS, Social Services and larger charities. Please see the website for details.