Inter Press ServiceSaima Wazed - Author - Inter Press Service

Setting the Record Straight

Saima Wazed — Mon, 09 Oct 2023 07:58:38 +0000

As Key Note Speaker at the Dissemination of the World Mental Health Report, and National Mental Health Strategic Plan 2020-2030, Bangladesh, 2022. Credit: Jishan Sultana

By Saima Wazed
DHAKA, Bangladesh, Oct 9 2023 (IPS)

This year, three of the World Health Organization’s (WHO) six regions elect new Regional Directors (RD). The South-East Asia Region (SEARO) is composed of only 11 Member States, yet is home to over a quarter of the world’s population. Two SEARO Member States, Nepal and Bangladesh, have nominated their candidates to contest for RD.

I have the privilege of being Bangladesh’s nominated candidate.

The SEARO RD election has generated a surprising amount of attention and news coverage, and several prominent regional & international publications have published pieces expressing alarm at my candidacy, and doubts about my suitability for the role.

In building their argument these articles rely on damaging biases, and perpetuate harmful stigmas and stereotypes.

The first contention is that because my mother is the Prime Minister of Bangladesh, my nomination must be fuelled by nepotism.

While I accept it is inevitable that there will be greater scrutiny of me due to my mother’s position, what is unfortunate is the erasure of my years of work, study and accomplishments.

Despite being in the public domain, the articles avoid mentioning my work with Chatham House’s Global Health Program or their Commission for Universal Health.

They ignore that I have been an advisor to WHO’s DG on Mental Health & Autism, or that I have been a member of the WHO’s Expert Advisory Panel on Mental Health for almost a decade.

They do not mention that I am Chief Advisor to Bangladesh’s National Mental Health Strategic Plan, or that I was a Technical Expert for Bangladesh’s National Mental Health Act of 2018.

They ignore any of my teaching engagements, and do not inform their readers that the WHO awarded me in 2014 for Excellence in Public Health.

The articles also neglect to mention that I am currently finishing my Doctorate in Education (EdD) in Organisational Leadership. This is a practitioner-doctorate for complex problem solving to improve the performance of organisations and individuals.

As countless women around the world will attest, we are sadly used to differing standards when being compared professionally to men. The overt and intentional erasure of my experience, and the attendant reduction of me to being simply my mother’s daughter, is sexism and must be called out as such.

The articles proceed to cast doubt as to whether my chosen area of study and work – psychology – is a suitable specialisation for one vying for the role of RD.

When I started my career, I knew that a lot of work needed to be done to mainstream matters of mental health. The persistent stigma which dogged mental health was dangerous and damaging, and I set about to try right this. In the context of South Asian cultures, open and honest discussions about mental health were unfortunately taboo. Over many years of hard work, we have been able to change this somewhat – but I acknowledge that there is still much work to be done.

This stigma is what commentators feed in to when they insinuate that other aspects of medical science are preferable over mental health specialists in this election.

The WHO itself reminds us that it “continues to work with its partners to ensure mental health is valued, promoted, and protected,” and that “one in eight people globally are living with mental health conditions.”

Given this reality, it is highly irresponsible of these articles to continue to minimise the work of psychologists and other related specialists.

On behalf of my broader profession I would like to state loudly and unequivocally – mental health specialists are in no way inferior or unsuited for leadership roles in public health. In fact, I contend that it is desirable for one with such a background to have a seat at the leadership table alongside the existing technocrats and bureaucrats in the WHO.

Finally, some of the reporting on the SEARO RD election makes unfounded claims that Bangladesh is waging a political campaign of arm-twisting and coercion to ensure victory for its candidate.

Quite frankly, the lack of faith that these commentators have in the SEARO Member States is appalling. Each Member State has the agency and independence to assess the candidates and make an informed choice. No amount of scaremongering will change that.

Instead of political pieces focusing on individuals, a responsible writer would correctly frame the choice in this election as that of a policy choice between Bangladesh and Nepal’s candidates.

This would lead to a more reasonable consideration about which of these two countries has better public health outcomes, and therefore more likely to make better choices for the public health of the region. I am proud of the many public health successes of my country, and I am proud to be nominated by Bangladesh for Regional Director of WHO SEARO.

The reaction we are seeing in this campaign reaffirms two unfortunate truths. The first is that challenging the status quo in large established global networks and organisations always generates a partisan pushback. The second is that women competing for positions of power in major institutions face opposition laced with a vicious strain of sexism. In this campaign we have a toxic cocktail of both.

But I will not back down. I will continue advocating for the most vulnerable amongst us, I will continue telling my regional neighbours my vision for our shared future, and I will continue fighting for what I think is right.

My message to fear-mongering commentators is simple: do not be afraid of a woman or her experience, do not be afraid of mental health specialists, and trust the Member States to make the best decision for themselves.

Saima Wazed wears multiple hats including being the Chairperson of the National Advisory Committee for Autism and NDDs, Bangladesh, Chairperson of Shuchona Foundation, and Thematic Ambassador for Vulnerability for the Climate Vulnerable Forum. For more information, please visit www.saimawazed.info and www.shuchona.org.

IPS UN Bureau

Follow @IPSNewsUNBureau

Our Wonderful Differences Enriches Societies

Saima Wazed and Zain Bari Rizvi — Fri, 31 Mar 2023 11:36:55 +0000

On the occasion of World Autism Awareness Day on 2 April 2023, IPS is republishing ‘When Is Too Much Autism Awareness Still Not Enough?'

By Saima Wazed and Zain Bari Rizvi
DHAKA, Bangladesh, Mar 31 2023 (IPS)

When is too much Autism awareness still not enough? This thought recurs every April as we near World Autism Day on April 2, and parents reach out to me after reading enthusiastic and well-meaning news and journal articles – which are actually harmful and hurtful.

Saima W. Hossain

In 2008, along with a few dedicated parents and professionals, we began our effort to raise awareness around Autism Spectrum Disorder (ASD). We eventually came together to form an advocacy, capacity-building, and research-based not-for-profit organization (Shuchona Foundation) established in 2014.

Today, we feel our work in Bangladesh, through effective national and international partnerships with equally dedicated parents and professionals, has impacted the country. Professional training, extensive awareness activities, and inclusion in social situations are demonstrable. The best part is that parents no longer view themselves as victims punished by fate for having a child with a disability.

Despite all the efforts in educating people in the many sectors of our country, including the formulation of a detailed National Strategic Plan, it is shocking to still find blatant disregard for the truth. I have, therefore, requested a parent, a former Shuchona Foundation head of operations and now a member of our executive board, to share her thoughts. Nothing speaks the truth louder and stronger than the person who has been on the receiving end of the discriminatory, hurtful, and unethical behaviour than the parent who hears it over and over again.

Here below excerpts of what I learned from Zain Bari Rizvi

If I had a Taka (Bangladesh currency) for each time someone said: ‘But he looks so normal,’ when I share that my son is on the Autism Spectrum, I would have been able to take early retirement at a villa in the Maldives!

Zain Bari Rizvi

I do not blame these mostly well-meaning people and their lack of awareness when widely read, and circulated dailies choose to use photos of children with Downs Syndrome to illustrate what children with Autism look like. Autistic traits cannot be captured with a still photograph, and most individuals with ASD look just like any other typical peer.

This sort of misrepresentation is not innocent and borders on dangerously harmful.

Deliberately associating a congenital genetic condition with a neurodevelopmental one will confuse the readers into thinking they are the same. This may also prevent parents and caregivers of children with Autism from seeking early intervention services that could potentially improve outcomes because they will have the false sense of comfort that their child ‘looks normal’, aka neurotypical.

There is no one true face of Autism because it is a not-one-size-fits-all spectrum disorder. It stays true to this famous quote by an Autism Advocate and Autistic person, Dr Stephen Shore: “If you’ve met one individual with autism, you’ve met one individual with autism.”

I am not a psychologist nor an expert, but as a parent who had the privilege to be educated and used my spare time and resources to do research, this incorrect and harmful visual misrepresentation enrages and upsets me.

Bangladesh has made considerable strides in Autism advocacy and policy changes due to extraordinary efforts by the leadership team at Shuchona Foundation. The Foundation has selflessly spearheaded the job of educating and opening the minds and hearts of people about what it entails to be on the Autism Spectrum. Because of their single minded dedication to this cause, we, in Bangladesh, are finally having a discourse on what Autism is and acknowledge and accept the differences in our children with Autism. We also have access to world-class services like early interventions such as ABA therapy and parent/caregiver engagement without shame or guilt.

And if there is one thing I learnt working closely with Shuchona Foundation, the key to making a difference is “to acknowledge that people will not always get it right but to look out for whether they want to learn to make it right”.

As World Autism Day on April 2 nears, my humble request to journalists and mainstream media is to do your duty of imparting factual and medically sound knowledge and information. Learn from your mistakes and ensure your stories and visual representations are accurate because media has the power to help or harm.

As I watch my feisty, opinionated and uber affectionate ASD child thrive in a typical school and social setting thanks to early childhood interventions and therapy, I shudder at the thought of what could have been our reality if I had paid heed to the photos of what Autism looks like in Bangladesh media.

I hope those reading this will take heed. Autism is a complex state of being, and no two autistics are alike. Every time I meet and spend time with someone with Autism, I am amazed at how unique, creative, and what a gift they are to the world. I want to change how we treat those we deem to be different, not change who they are.

For centuries all we have done is find creative ways to separate the majority from the minority. I hope the two years of the global pandemic will finally make us realize that when one group of people mistreat another, be it through military, financial or social power, we all suffer, not just the ones we discriminate against.

Saima Wazed Hossain is Advisor to the Director-General, World Health Organization (WHO), on Mental Health and Autism. She is Chairperson, National Advisory Committee for Autism and NDDs, Bangladesh and Chairperson, Shuchona Foundation. She is a specialist in Clinical Psychology and an expert on Neurodevelopment disorders and mental health. Her efforts have led to international awareness, policy and program changes, and the adoption of three international resolutions at the United Nations and WHO.

Zain Bari Rizvi is a Board Member of Shuchona Foundation, an Operations and Finance professional who is a passionate advocate for people with Autism and a mother of two children.

IPS UN Bureau

Follow @IPSNewsUNBureau

Excerpt:

On the occasion of World Autism Awareness Day on 2 April 2023, IPS is republishing ‘When Is Too Much Autism Awareness Still Not Enough?'

When Is Too Much Autism Awareness Still Not Enough?

Saima Wazed and Zain Bari Rizvi — Fri, 01 Apr 2022 08:40:56 +0000

By Saima Wazed and Zain Bari Rizvi
DHAKA, Bangladesh, Apr 1 2022 (IPS)

Saima W. Hossain

Here below excerpts of what I learned from Zain Bari Rizvi

Zain Bari Rizvi

Zain Bari Rizvi is a Board Member of Shuchona Foundation, an Operations and Finance professional who is a passionate advocate for people with Autism and a mother of two children.

IPS UN Bureau

Follow @IPSNewsUNBureau

Mental Health Strategic Plan for Bangladesh: An Overview

Saima Wazed and Nazish Arman — Thu, 28 Oct 2021 18:11:00 +0000

Meeting of the Working Group on the National Mental Health Strategic Plan, January 2020

By Saima Wazed and Nazish Arman
DHAKA, Bangladesh, Oct 28 2021 (IPS)

Mental health and treating mental health conditions involves not only treating an individual’s ability to manage their thoughts, emotions, behaviors, and interactions with others, but also ensuring that the social, cultural, economic, political, and environmental conditions are in place through effective national policies, social protections, adequate living standards, working conditions, community social support, and a tiered system of care through a robust network of health services. In Bangladesh, the Mental Health Act 2018 and the National Mental Health Policy 2021 were developed with the above in mind.

The Act and the Policy have also directed the development of the National Mental Health Strategic Plan for the country. The Strategic Plan document has been developed at the request of the Ministry of Health and Family Welfare’s Department of Non-Communicable Diseases. This document has been prepared with funding from the Department for International Development, and technical support from the World Health Organization’s Regional Office for South-East Asia and the Shuchona Foundation. It is envisaged that the strategic plan will allow the incorporation of required priorities of the Government within the broader framework of the policy including appropriate resource allocation with an effective monitoring and evaluation mechanism.

The National Mental Health Strategy 2020-2030 embarks to establish a comprehensive, inter-sectorial, integrated, and responsive system to ensure access to and utilization of quality mental health and psychosocial wellbeing services and information. The mission of the strategic plan is to establish a sustainable, rights based, holistic, inclusive, multi-sectoral framework. This will ensure provision of information and quality services for promoting mental health and psychosocial wellbeing, prevention, treatment, as well as rehabilitation of mental health conditions throughout the life course of the people of Bangladesh.

The strategy development process included a series of reviews of program evaluation reports, literature search, evidence, strategy, and policy documents by consultants, focus group discussions with relevant professional societies, ministries and division, semi-structured interviews with experts, technical group meetings, field visits and stakeholder consultative workshops for consensus building on critical issues and finalization. The core values and principles in the strategic plan are guided by the National Mental Health Policy 2021 (currently pending final approval), the Mental Health Act 2018 and several global plans and charters including the WHO Comprehensive Mental Health Action Plan 2013-2020, UN Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, the Rights of Persons with Disabilities which have been ratified by the Government of Bangladesh.

Snapshot of Stakeholder consultation with members of the Bangladesh Association of Psychiatrists, October 2020. Some stakeholder consultations were held virtually due to the pandemic.

Four general objectives have been envisioned in this strategic plan which are derived from the ‘WHO Comprehensive Mental Health Action Plan 2013 – 2020’:

The Strategic Plan has been organized in a manner such that, there is a breakdown of specific objectives indicated against each of the General Objectives of WHO’s Mental Health Action Plan 2013-2020, along with global and Bangladesh’s country specific indicators and targets. The mental health strategic plan also outlines Core Responsibility, Collaborative Partners, Advised Activities, Resources, Output Indicators and Funding Allocation for each of the specific objectives.

The Strategic Plan also highlights the different factors across the lifespan that are associated with mental health and provides an overview on how they are linked. There is consistent evidence worldwide that there is a link between mental health and physical health and in fact, one can easily say that they coexist since many of the risk factors of poor physical health are also risk factors for poor mental health. The key factors highlighted in the Strategic Plan include noncommunicable diseases, poverty, nutrition, violence, childhood and adolescence, humanitarian crisis, substance abuse and suicide, amongst others.

In conclusion, it is clear that an effective strategy for mental health, requires a multi-sectoral approach with specific considerations for the needs of vulnerable groups of the population. In order for such a plan to be implementable, sustainable and relevant, it is imperative that stakeholders, especially those with lived experience, provide important insight from their point of view. The goal of the current plan, once approved, is to ensure that not only those living with mental health conditions receive timely and effective treatment, but that the treatment approaches are not further stigmatizing, harmful and threaten their basic human needs and rights. It is hoped that the strategy which has been developed can be easily implemented and will result in a plan of action that will enable greater understanding of mental health in the community and enable greater psychosocial well-being for the people of Bangladesh.

Saima Wazed, a licensed School Psychologist, is currently Clinical Instructor for the Department of School Psychology at Barry University. Additionally, she is Advisor to the Director General of WHO on Autism and Mental Health, Member of WHO’s Expert Advisory Panel on Mental Health, Chairperson of the National Advisory Committee on Autism and NDDs in Bangladesh, Thematic Ambassador for “Vulnerability” of the Climate Vulnerable Forum, and Chairperson of Shuchona Foundation.
Nazish Arman is Lead Content Developer of Shuchona Foundation.

Shuchona Foundation is a non-profit organization focusing on advocacy, research, and capacity-building, specialising in neurodevelopmental disabilities, and mental health. It aims to construct an effective bridge between national and international researchers, policy makers, service providers, persons with NDDs and their families, to promote inclusion nationally, regionally, and globally. The Foundation is a member of the UN ESCAP Working Group on disability as of May 2018, and holds special consultative status with UN ECOSOC since 2019.

Shuchona Foundation was the member of the Working Group on the National Mental Health Strategic Plan; and Saima Wazed was its Chief Advisor.

Excerpt:

[Second of a two-part article]

Mental Health Achievements in Bangladesh

Saima Wazed and Nazish Arman — Wed, 27 Oct 2021 18:29:01 +0000

Meeting of the Working Group on the National Mental Health Strategic Plan, April 2019

By Saima Wazed and Nazish Arman
DHAKA, Oct 27 2021 (IPS)

Mental health is a state of well-being when both your body and your mind are in balance, and you are able to deal with the difficulties and challenges that come your way and easily find joy, peace, and happiness once the challenge is overcome. For many people though, the challenges often remain for too long – the pain of losing someone you dearly loved, being diagnosed with a chronic disease like cancer or a heart condition, losing your family/home/job or feeling like you failed to meet expectations. All those things and more can trigger so much intense stress and maladjustment, that if it goes unchecked and untreated, it may lead to a chronic disease, a mental health disorder. WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. The majority of people are able to cope and get back to life as normal, but for the many who cannot, they begin to experience intense detachment from reality (experiencing delusions, pervasive sadness, uncontrollable fears, intense anger and/or fantasies and hallucinations). For those individuals, there is limited help and treatment in every country in the world. Those who suffer from mental health disorders and the brave professionals who learn to treat them are chronically stigmatized, under-appreciated and under-paid.

Mental health conditions, substance use disorders, suicide, and neurological disorders like dementia affect more than a billion people annually, account for an estimated third of the global burden of disability and result in 14% of global deaths. (Vigo et al., 2016). There has been increasing global recognition of the importance of mental health and the significant global burden of mental health conditions in both developing and developed countries. More than 80% of people experiencing them are living without any form of quality, affordable health care. Due to negligence and ignorance, we have high levels of mortality through suicide and increased comorbid medical conditions. According to a study published in 2016, it is estimated that 14.3% of deaths worldwide, or approximately 8 million deaths per year are attributable to mental health disorders.

The 7th Five Year Plan (FYP) and Vision 2021 of the Government of Bangladesh recognized the urgency of addressing mental health and developed a comprehensive system of care that can be implemented within our well tiered health infrastructure. This plan emphasized that proper health is essential not only for physical well-being but also for economic livelihood. To realize the vision of the 7th FYP, the Ministry of Health and Family Welfare is implementing its 4th Health, Population and Nutrition Sector Programme (4th HPNSP) from January 2017 to June 2022. The 4th HPNSP’s objectives include strengthening governance, institutional efficiency, expanding access and improving quality within the universal health care system. To achieve the SDGs target, the Ministry of Health and Family Welfare has committed to ensuring that mental health is a priority in the 4th HPNSP.

Saima Wazed, Chief Advisor to the Working Group on the National Mental Health Strategic Plan, at its meeting in April 2019

It is important to note that Bangladesh is among the first few countries in the WHO South-East Asia Region to place mental health as one of its top 10 priority health conditions. Mental health programming in Bangladesh has undergone several phases of evolution. Bangladesh passed a new Mental Health Act in 2018; is working on finalizing a Mental Health Policy; and has developed a National Strategic Plan after conducting a thorough situation analysis involving both professionals and those with lived experiences. The focus of the Mental Health Act is to protect the dignity of citizens with mental health conditions, provide them with healthcare, ensure their right to property and rehabilitate them. The law has 31 sections and will oversee the direction, development, expansion, regulation, and coordination of mental health related issues and duties entrusted to the Government. The National Mental Health Policy 2021 which is currently under final approval, provides an overarching direction by establishing a broad framework for action and coordination, through common vision and values for programing and mental health service delivery. Although still under review, this policy document acknowledges the significance and importance of relevant and useful local knowledge and practices, and adheres to global and regional thinking, taking into perspective the Bangladesh context.

Across the globe in most nations, mental health treatment is underfunded and lack a well-designed system of care within the health system primarily due to a limited understanding of how to treat adequately, severe social stigma, and complication of the conditions. The situation is similar in Bangladesh, where mental health has been a low priority in both health services delivery and planning for many years now. To address these issues, developing a comprehensive and multi-sectoral National Mental Health Strategic Plan was the only way forward to ensure access to quality mental health care services across the nation.

Nazish Arman is Lead Content Developer of Shuchona Foundation.

Shuchona Foundation was the member of the Working Group on the National Mental Health Strategic Plan; and Saima Wazed was its Chief Advisor.

Follow @IPSNewsUNBureau

Excerpt:

[First of a two-part article]