The year-long COVID-19 pandemic has reshaped the life of every individual with varying degrees of disruption. Médecins Sans Frontières (MSF) in Hong Kong has been particularly concerned about people’s mental wellbeing after prolonged exposure to uncertainty, especially amongst vulnerable groups who might have difficulty in seeking help. A survey conducted jointly by MSF and the local organisation Uplifters, shows that 72% of the foreign domestic helpers who responded have experienced depression-related symptoms. 47% in the survey sought help from their fellow workers in Hong Kong. To make that help as effective as possible, MSF is providing a 4-week Community Care Training Programme for their community leaders in Hong Kong. By equipping them with the skills of active listening and psychological first aid, MSF aims to empower them to better support their peers and understand their own boundaries when helping others.
 
The online survey was designed based on the Patient Health Questionnaire-9, where the respondents have to self-assess their mental health status in the six months prior to September. A total of 100 valid responses were collected. The results of the survey showed that being separated from their families and working away from their home country is the most common source of anxiety (47%); followed by their worries about their family’s health back home during the COVID-19 pandemic (39%). These stressors have resulted in differing degrees of depression-related symptoms in the past 6 months: feeling down, depressed or hopeless (82%), feeling sad or frustrated (74%) or having trouble in sleeping (70%).
 
“Mental health needs, unlike physical health, can be trickier to detect because of the seemingly invisible presentation of these symptoms. The entrenched stigma of mental illness in Asian societies makes it even more challenging for these needs to be addressed,” said Karen Lau, MSF Mental Health Supervisor. “As COVID-19 has now become a common source of distress globally, many of us are struggling to cope with the uncertainty and restrictions imposed by the pandemic. In particular, we found that many foreign domestic helpers have been suffering from a decrease in social support as they cannot visit their families back home due to travel restrictions. Many are also under increased pressure from working prolonged hours and being confined to their employers’ households. There are limited resources providing care for the mental health of Hong Kong’s foreign domestic helpers. However, MSF has identified how their unique sense of community and extended peer networks can be leveraged to foster social support and improve their understanding of mental health. This can then allow foreign domestic helpers to better safeguard themselves and others amidst challenging times.”
 
Based on the findings of the survey, the MSF team developed a training programme that would boost their mental health related knowledge and skills of the people they turned to for help. The participants of the first batch of the training are representatives from Uplifters and Pathfinders, local NGOs which help foreign domestic helpers. Luisa was one of them who comes from the Philippines and has been working in HK for 17 years. She talked about the added sources of stress during COVID-19. “My previous boss and family decided to move to the United Kingdom and I have moved to a new home. Because of COVID-19, we didn’t have a chance to have the final conversation in person. Also, I have been planning for a long time to spend time with my own family but because of the pandemic, I can’t see and meet them. It was quite a stressful time but I dealt with it with faith and courage and to face all my emotions by connecting with my family and friends.”
 
Dee is an Indonesian domestic helper who has been working in Hong Kong for more than 10 years. “Everybody has got their own stress, especially in these times. Some of my friends lost their jobs which added up to the pre-existed financial problem. With the anti-pandemic restrictions, we have to stay at home, which is also our workplace, 24/7. This has resulted in an even higher level of stress than usual. Sometimes when we are stressed, we just want to be heard but we don’t know where we should go. MSF helps a lot by providing mental health support for us.” Dee can feel the difference it has made to her own help to others. “Before I joined this training, whenever my friend came to me, I would judge her, like saying ‘you should not do this, you should do this’. But after the training, I learn that listening to her is already helping her. You can give advice but not to judge her.”
 
As MSF’s Karen Lau explains, we all need to be kind to ourselves. “Despite being aware that we all experience negative emotions, many of us may still harbor internal judgments about feeling vulnerable or weak, which may then be exacerbated by the fear of external judgments by our community. On the occasion of International Migrants Day (18 December) during COVID-19, it is even more important for us now, during this pandemic, to cultivate compassion towards ourselves and others.”
 
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Since the COVID-19 first broke out in Hong Kong in late January 2020, MSF has been reaching out to vulnerable groups, and has conducted 39 health education sessions and stress and anxiety management workshops, sharing medical information and answering questions that the outbreak has generated. We have also created a website for the general public, offering tips and tools to help cope with the stresses and worries coming from the prolonged exposure to uncertainty: https://howareyou.msf.hk/en/

 

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