Nest - Work Of Nest

Occupation and Inclusion are the keys to Therapy in Mental Health

The Skills Development Centre at the Half Way Home in Mulleriyawa, which used to be called Unit 2, have today around 443 women resident in long term Psychiatric care.

Many have lived before this at Angoda Hospital which is now called The National Institute of Mental Health (NIMH), Angoda, for a long time.

Altogether, that is at the Halfway Home and NIMH, as long as 34 years. Many of them are rejected and distanced from their families and friends for ever. But for the work of doctors, nurses, attendants and other Half Way Home staff these residents would have joined the wretched of the earth and shunted from pillar to post, abused and robbed, voiceless, forgotten and devoid of any hope.

Occupation is the therapy for every one of us even when we live ordinary lives, you will agree. If we do not fill our time meaningfully or are prevented for whatever reason to do so, that void and vacuum will remain unfilled and our natural skills become atrophied.

After 34 years of interaction with the residents, Nest continues to work to get rid of apathy, lethargy and indolence. Thanks to wonderful benefactors and funders and friends of Nest.

No longer do the residents do nothing except sleep, take medication, eat and sit aimlessly on corridors and beds.

Movement is a great healer and purposeful movement gives one a sense of self respect and justification for living.

When Nest was given a dilapidated ward (the old admission ward) to turn in to an Activity area in 2005, Nest designed a Skills Development Centre with the help of a British Occupational Therapist. The Scheiblers Legat of oslo, Norway generously funded the renovations; the office and rest room is named after Mrs. Liv Hatland, Board Director of the Scheiblers Legat.

Nest’s trained, motivated and dedicated Community Health Workers are the key to the success of the SDC. Their names are Inoka, Jayenthi and Madushi. Manager of the SDC is Sisira Jayantha who runs the beautiful Trishaw donated by GIP in Holland and the McKays in Scotland. The trishaw takes a few residents at a time out marketing or to a Temple, or just for an outing.

The Nest CHWs have special skills in training such as music, sewing and cultivation. There are 3 part time workers also at the SDC called Swarna and Malini to help run the Shop, the Library and Kitchen.
The Doctors, Matron, Occupational Therapists, Nurses, Attendants, and other Half Way Home staff are doing amazing work. The Halfway Home has its own OT room run by the Halfway Home.

The objective of Nest CHWs is to keep trying to get as many women back to their community, as possible. Caring for friends and relations at home, even when they manifest a deep disturbance, is the best way. Treatment from an Out Patient’s Department in a Government hospital and a Consultant Psychiatrist must continue but the person should return home after the clinic. That is essential and to continue taking medication.
What strikes one when you enter the Nest SDC is the atmosphere of competency, welcoming, happiness and efficiency. Everyone is purposefully occupied and busy. The premises both inside and outside are well maintained.
There are the following options:

• Restaurant
• A sewing machine,
• Area for hand sewing,
• Exercise bikes,
• Pedal bicycles,
• A shop which sells toiletries, clothes and food at subsidised rates. It is open for anyone
• A free telephone service (many of the ladies remember their home telephone number).
• Computer to use
• Painting
• Gardening
• Arts and craft work
• Housekeeping skills
• Make-up and Hairdressing
• Organic cultivation

Each of the residents has a story to tell. Most often it is a sad story but there is a bright light that shines in them, which though clouded has to be discovered. That cannot be done by everyone. Dedication and professional training are two aspects required and Nest community Health Workers have that in abundance and are running the centre in an exemplary manner, and in tandem with all the other of the Halfway Home.

What happens at a Nest residential, Community Health centre

  • At Ududumbara (Kandy district) and Kåre House (Gampaha District) Centres families and individuals can stay overnight for specialist clinics and appointments.
  • The community can drop in at any time.
  • Education for Health is through information and discussions such as workshops on Mental Health and HIV and AIDS issues.
  • The Library is open all the time and books can be borrowed or read in the premises.
  • First aid services are available 24hrs of the day; one just rings the gate bell and a CHW will attend to the caller
  • Community Health Workers ( CHWS) live and work from a centre
  • CHWs travel by foot, motor cycle, trishaw and public bus to visit the commnuity in their homes
  • A playgroup for children under 5 years of age, in the community, is conducted daily except during school holidays and weekends
    A person can visit Nest from a government hospital for 3 months re-integration into the family/ community programme

Promotion of Well Being

Nest gives priority to the promotion of mental wellbeing and one of the principal means of achieving it is by its facilitation of the return of those institutionalised to their homes and communities and by minimizing the stigma attached to such illnesses.
Brochure-anyakande-woodworkAnother feature special to Nest as stated earlier is that it does not go to a community with a plan already drawn up. Nest approaches the community with an open mind and has a framework inspired by its mission statement within which it will operate:
a. To enable individuals to establish necessary community links in order to access services and support.
b. To strengthen local services in order to strengthen communities’ coping systems
c. To influence National and local policy in order to ensure that Communities are provided with effective and respectful services

Nest works with Government institutions

As stated in its Memorandum and Articles of 1987, at the district level Nest Community Health Workers are closely associated with staff of Government Health Departments and Social Services. Nest supports their services improving capacity; policy influence; and, conducting awareness programmes and workshops. Right now Nest CHWs are involved with training women and youth who have no jobs in organic cultivation and Home Gardening.

Let’s include and not exclude women and children from our midst

Many of us find ourselves excluded from the Community we live in because there is an aspect in our being which labels us as “different”.
Often this exclusion is based on:
• poverty,
• economy,
• geographic location,
• perceived sexual habits,
• class structure and circles (such as not speaking English fluently),
• mental difficulties,
• social issues,
• appearance,
• education,
• religion,
• economics (such as demeaning jobs) and
• Politics.What is left? Surely you will agree, not much! We care about others and we accept each other. We are glad to be together. One steering change we can be part of, however, is bad behavior. Bad behaviour inadvertently destroys ourselves and those around us.
lunch
Finally, Nest is thankful that we never excluded anyone with say HIV and AIDS, Huntington’s disease, Leprosy. All persons whom Nest CHWs meet are included in the family and community and encouraged with support, love, care, and equal rights.
Same with a mental illness and mental disturbance.

The Lady Ridgeway Hospital for Children, Borella (Colombo District)

When Nest found that Children under 13 years of age were being referred to the Psychiatric clinic at the Lady Ridgeway Hospital for Children from many hundreds of miles away, Nest began working every week on a Wednesday morning with the children while they are waiting for their number to come up to consult the Psychiatrist.
Dr. Swarna Wijetunge, Consultant Psychiatrist, gave Nest a small room to keep activity equipment outside the clinic room No 22.  Nest CHWs give joy to the children from 8.30 a.m. until the clinic finishes every Wednesday. They engage the children in games, drawing, painting and refreshments. The refreshments are kindly donated by Jameeleh Pilapitiya, Karin and Nelson de Silva, Srima Senevirathne, Paan Paan and others.
As many as 71 children are referred to this clinic per day, and caregivers and relations often have to bring not only the child but often siblings as they cannot be left at home. This can amount to a large number of people.   Sometimes they have no money for bus fare both ways; they have no cash for food in Colombo and no money for an overnight stay.
Nest provides sometimes free overnight stay at Kåre House when necessary. But we could do with funds to continue this work.

Sustainability

child Nest promotes low cost interventions suitable to local conditions, which do not rely on the mobilization of huge amounts of resources that communities cannot afford long term. Nest’s investment is in the skills and capacity of people which cost little but have great impact. This is what has enabled Nest to survive long term. The Patron, and Board of Directors, take an active role in day to day work of the organization and carry many responsibilities in an honorary capacity. Nest works with the State, and encourages the State, to see the benefits of Nest’s goals and objectives.

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