Author and former BBC journalist Rebecca Tinsley’s organization brings psychotherapy to children devastated by a brutal African war
Imagine how you would feel if the nine-year-old neighbor who killed your husband moved back in next door. Now imagine that dozens of other mentally-disturbed young murderers have arrived in your town.
That is the unthinkable daily reality I found on my first visit to Northern Uganda in 2008. The UN estimates that more than 30,000 children have been abducted and forced to become soldiers during two decades of a devastating war. They were kidnapped and brutalized by the vicious Lord’s Resistance Army, forced to kill or be killed, often murdering their own families. Girls were gang raped and became sex slaves, bearing the children of the officers who abused them – infants who are now stigmatized because of their paternity. More than 80% of citizens were seized at some point during the war, often for years at a time. Every single person I met had a scar from a bullet or knife wound.
The war has now moved elsewhere, and the child soldiers are returning to their villages. My charity, Network for Africa, is there, in this forgotten corner of the country, passing on skills enabling local people to rebuild their devastated communities. We set up farming co-operatives and train people in health, nutrition, women’s empowerment, family planning and improving agricultural techniques.
But how can people concentrate on learning a skill when their surroundings provide triggers that daily plunge them into post-traumatic stress and depression? Forty percent of the people we interviewed admitted feeling suicidal, constantly reliving the atrocities they endured or witnessed. How can a child soldier come to terms with killing his sister to save himself? How can a mother start each day when the child soldier who massacred her baby has returned and is living in the hut next door? And how can we expect villagers to welcome such damaged young people back into their midst?
Northern Uganda is extremely poor, without enough basic medicine like aspirin to go around, let alone electricity or running water. Lack of medical facilities and qualified staff means people still have bullets in them, so it is unrealistic to expect adequate psycho-social care for traumatized people.
Our charity knows that shipping in outside experts to give one-on-one treatment does not work. Westerners will never understand what it is like to live in constant fear of attack by a rebel group that are still at liberty in the bush. Nor can we grasp being haunted by recent memories of enslavement and rape. One of the cornerstones of our psychiatric tradition is assuring the patient they are no longer at risk, and that their continuing fear is irrational. But in Northern Uganda there has been no justice and the perpetrators may return at any time. It’s entirely rational to live in fear, expecting to have to suddenly hide for your life – because that’s how it’s been for twenty two years.
However, two psychotherapists from Missouri have thrown themselves into a pioneering project that tackles these problems head on. Dr. Barbara Bauer and Shelly Evans are volunteers with Network for Africa, using their expertise to train well-respected local leaders and village ‘wise aunties’ in the basics of psychotherapy. Their lay counselors then help and support local people in the most culturally sensitive manner.
Barbara and Shelly’s understanding of local needs is based on interviews, ongoing conversations and village meetings with hundreds of people about their experiences during the war. The results show post-traumatic stress is affecting the very foundations of society, with high levels of suicide, rape, alcoholism, domestic violence, HIV-AIDS, early pregnancy and severe depression. Women and girls very often bear the brunt of these problems, struggling to hold together their fractured families. Yet, say the Americans, the women’s incredible courage, enthusiasm and resilience makes the project work.
Twice a year, Barbara and Shelly go to Northern Uganda to run a series of ten-day-long workshops on how to recognize and manage post-traumatic stress. People in Uganda are not accustomed to expressing or analyzing their feelings. Nor do they grasp that emotional distress can manifest itself as physical pain, insomnia or paralysing sadness. Hence, the Americans must start by explaining the meaning of post-traumatic stress, and how to diagnose it. With the assistance of translators, Barbara and Shelly use games and drama to demonstrate standard psychotherapy techniques. Simple exercises like relaxation and imagining a safe place can help calm ever-present anxiety.
After their intensive course, Barbara and Shelly’s ‘graduates’ are given bikes to reach distant villages. Already the lay counselors are having a positive effect, with villagers reporting they are better able to work, study and sleep. However, Barbara and Shelly will continue running their workshops and refresher courses for the foreseeable future, aware they have only just scraped the surface of local needs. They devote hours of each trip to processing the feedback and conversations with their team.
Network for Africa plans to broaden the lay counselors’ role: they have become trusted messengers who can pass on essential information about health, nutrition, family planning, and women’s rights. Civil society was destroyed during the decades of war, so our lay counselors are well placed to help rebuild social networks and coping mechanisms.
The project needs financial support from outsiders to pay for the training, equipment and resources necessary to roll out the pilot project, reaching thousands more people. In the words of Dr. Barbara Bauer, “Speaking as someone who has spent my whole professional life treating trauma, the challenge has never been greater. But the rewards are enormous. It’s life-enhancing to watch a community healing itself and rebuilding.”
Shelly Evans adds, “Africans are often portrayed as helpless victims of poverty and war. Yet we’ve found the majority are resourceful and determined, coping in the face of circumstances that would overwhelm most of us in the ‘developed’ world,” she says. “They deserve a helping hand.”
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Editor’s Note: Rebecca Tinsley, a former BBC reporter, is a journalist and human rights activist who has worked in nine African countries. She founded Waging Peace, a London-based group campaigning on Darfur, and Network for Africa, a charity working with survivors of genocide after the big aid agencies move elsewhere. Her new novel, When The Stars Fall To Earth, is based on actual events of the genocide in Sudan.