Stress and Trauma Healing

Karl and Evelyn Bartsch came to Uganda to offer the fourth training module for the training of trainers project. The topic was stress management and trauma healing. I was fortunate to receive the training this time around. Normally, I am responsible for writing the manual, conducting the training, and coordinating logisitics, but to my great relief, I was nurtured by the caring support of Karl and Evelyn.
Karl and Evelyn have successful private practices in America, but they chose to leave their comforts behind to stay in a place without electricity, drinkable water, and thier usual diet, to give us a new and deep perspective on our work as caregivers. Karl and Evelyn have been married for 45 years.
In the picture above Karl and Evelyn are leading us in a song called, "Healing River". The participants loved it, and are translating it into Luo.

Hopeful Skeptic

by Holly

Cautious optimism characterizes the mood around the peace process for Northern Uganda. That is how I feel anyway. In general, I consider myself a naturally hopeful person, but I want it so desperately for this place that it hurts to allow hope too much liberty—the obstacles to any meaningful peace mean a high risk of disappointment.

We all follow carefully the daily developments in newspapers that unreliably print shadows of truth. We listen to Kony and Otti on the radio. They both apologized “for everything” on two different days within the past weeks on an Acholi broadcast. And I dared to be thrilled at such watershed statements. At the same time, their voices sounded hollow and the words echoed off of so many atrocities. If they were sorry for the abductions, truly, than why do they still refuse to release the women and children?

Otti has said his “wife and children” are part of him and they will all go home together. The women and children are a shield, a bargaining chip, they are still useful—and they are evidence that though they might be “sorry” they aren’t willing to make things right, not yet.

The irony of having men who have committed some of the worst crimes against humanity raising issues that are actually of legitimate concern and are real political grievances of people in the North is sometimes overwhelming and borders on the absurd. A cartoon in the paper depicted new seats being added to Parliament and Kony sat in one of them with a bloodied machete. A nameplate on the table in front of him read: “Minister of Child Rights.”

I read an editorial this morning (by Charles Onyango-Obbo in the Daily Monitor) He says, “If you ask those of us, who support dialogue to end suffering, but are opposed to these pacts with the devil, what creative alternative there is to that, we don’t have an intelligent answer. That’s the real tragedy of Uganda.” I join him, and many others in the fear that, “sleeping with the devil” could produce some very ugly children.

When I passed through Gulu on the way home from Kitgum on Friday I had a drink with the Public Relations Officer for the UPDF in Northern Uganda. I got the party line, or the military line, instead of the medias interpretation of it. He told me the meeting went well with Dominic Ongwen, (one of the ICC indicted) he said Kony was lying when he said they’d been shot at after the cease-fire by the UPDF. He told me about the one abduction that has taken place since the cease-fire. I asked him if he was hopeful about peace. “Honestly,” he said, “It’s hard to tell, I say it’s still a fifty/fifty chance.” I’ve talked with him before—it’s his job to put the best foot of the military forward, and he does it well. So, I was disheartened by his prediction, if he says fifty/fifty, I’m guessing the UPDF is thinking and planning for thirty / seventy—or worse.

Still, hope finds ways of asserting itself. While we were in Kitgum there were hundreds of rebels walking, sitting under mango trees, waiting for others to join them and then continuing. Presumably they were going to the assembly points. They weren’t hostile. They weren’t causing trouble. They were “friendly.” I don’t know whether to let myself get excited or not. It is so delicate, fragile, and precarious. There are so many variables and so many unknowns.

Right now, Angelina, the Chairperson for CPA is moving with a team of others on a National Reconciliation team. The team is meeting with leaders all over the country and while they discuss and reconcile with each other they are gathering consensus around the messages they want to send to the government, the UPDF, and the LRA and to ordinary people in Uganda. She consulted me just before she left on the most recent leg of her journey to Bunyoro. We discussed the dangers of “unconditional forgiveness,” that can encourage impunity and conceal the truth. We discussed the need to convince the ICC that the crimes which have been committed against humanity—not only the people of Uganda--could somehow be redressed in a local context, in the interests of peace, through Roco Wot and Mato Oput. Angelina is admirably reckless with her optimism. While it strengthens my heart, my mind finds some safety in skepticism that guards me against the disappointment that may come.

Senseless

I hesitate to write this blog because there are no words. Words are inadequate substitutes for the pain. They can’t describe the depth to which humanity has strayed from our design. I haven’t yet assigned any rational thought to what has deeply stirred me. I don’t know if I will either. It is somewhat freeing not to have to name the emotion. To release the need to make sense of it all. It just doesn’t make any sense.

This past week I went with Tina to Kitgum training a group on conflict transformation. My co-trainer and good friend Anthony was with us. He got a phone call just before breakfast that shattered us. His cousin-brother was driving home to Gulu from Kampala and two kids who were playing ran into the street in front of him. He hit them and they died. Knowing that mob violence is common, it is advisable to go to the police rather than stop if something like that happens. But his cousin decided to go back and apologize toe the family of the children. A mob formed, armed with machetes and hoes. They killed him. Mercilessly and brutally, a death that I don’t even want to describe it was so gruesome and unimaginable. He was 24. The father of the children led the mob. The lack of mercy is confounding. Was it this war that desensitized them to violence that allowed normal human beings to mutilate a young man who’s worst sin might have been speeding? Does it make them feel better? Does the grieved father sleep more soundly knowing that he caused another father and mother to lose their son? That two families are now bereaved instead of one? I just can’t understand and it continues to sicken and disturb my core.

8 years younger on my birthday

Being with Tina makes me feel 8 years younger. It’s fantastic, because I think I’m going through a quarter life crisis, so having her here gives me the freedom to indulge my desire for independence, adventure, and abandon. Since she came I haven’t been taking life or myself so seriously. I’m even behaving less responsibly. I’m sure everyone around me is happy that I have actually matured during the last 8 years, and that this is indeed atypical, but allow me just a few weeks of regression—I’m having fun.

We’ve been sucking the marrow out of life. Last night we went to a friends house for the evening and it started raining on the drive home. As soon as we go to our gate and opened the car door the rain intensified threefold and we were drenched as we dashed to the door and fumbled with the wet keys and lock in the dark. We just giggled, and Tina said, “I think God did it on purpose. He always does that. He thinks it’s funny.” I’d never imagined God in that way, waiting for me to open my car door and then laughing hysterically while He dumped extra water over my head.

Last weekend we took a sister adventure down to Jinja. I can’t write all about it, because there are some things that are just meant to stay between sisters.

Tina jumped 44 meters from a cliff above the Nile, “Nile High Bungee” dipped her to her chest into the water, she jumped with no fear and a scream that sounded more like laughter.


Yesterday we hiked up Ngetta hill. We sat on the massive boulder on the top and talked about life, theology, love and pain and watched clouds pass over the town that is my home. It's remarkable how alike we are. It is a rare blessing to be able to naturally connect to another person with so little effort, with so much understanding and with so much joy.

Betrayal and Reconciliation

Over the past two months, Holly and I have had 5 break-ins. One of which left us feeling very vulnerable with the message of “You Must Die” written on our wall outside. Fortunately, Josh was staying with us and heard the thieves in our attic and was able to scare them away.

The mastermind behind all of these incidences turned out to be our very good friend and person responsible to watching our house when we’re away. For nine months we had developed a close relationship with him and considered him a trusted friend. The most recent break in was on the day that Holly’s sister Tina arrived. We came home to notice that some of the bricks above our window were a slightly different color of blue. I also noticed that some plaster on the wall was broken and dust remained on the chair below. Someone had removed bricks, repainted them, and cemented them back in place. I went to the back of the house where I found freshly washed clothes. However, on one piece of our friend’s clothing I found a spot of blue paint. My stomach dropped, I wanted to cry. How could our friend have done this? Later that night he called us and confessed what he had been doing, and wanted a chance to make things right between us. The Lango words for reconciliation are “Roco Wat” which means being in “right relationship”.

Although angry, hurt, and a bit fearful, we tried our best to put into practice what we teach; reconciliation. We extended grace toward our friend and forgave him. Holly went to the Scriptures and read Matthew chapter five. Toward the end of Jesus’ Sermon on the Mount, he talks about turning your other check, not resisting your enemies; that if you cloak is stolen, also offer your tunic, that if forced to walk a mile, walk two. We wanted to put these words into practice.

When one considers the tremendous injustices that our friend faces, being born into an incredibly poor family, having been abducted and forced to kill, Holly and I wanted to be a part of giving him “a way out”, and we decided to pay for one year of his education at an agricultural school. We have come to love our friend, and see a wonderful heart in him. It seems as if this is a critical time in his life where he could continue to make bad decisions, or turn his life around and live out of his talents and loveliness.

I know that forgiving him and even seemingly rewarding him may sound strange. But our faith doesn’t ask us to judge our enemies, it asks us to love and forgive them, over and over.

Visit from Josh and Erin

Josh and Erin were with us for about 5 weeks. There was never a dull moment. If we weren't building something, then we were in a remote village dancing and recieving new names! The first thing Josh did when he arrived was install a hot water tank. I think about him every day as I appreciate the warm water. Erin was constantly busy in the kitchen teaching Sandra how to prepare something besides cabbage and beans. (I like cabbage and beans, but every day...) To this day we're eating foods that I thought I would never eat again, and I'm lovein it!
This is a picture of Josh and I at the source of the Nile at Lake Victoria. Having just been to the Nile's outlet in Egypt, Josh and Erin were particularly excited about seeing the other end.
Holly and I really wished that we could've spent more time with them, but work usually kept us late. However, our evenings were blessed.
I all, we had a great time with them and felt rejuveniated by having them with us.

This picture is of Erin and Holly, shortly after the vehicle we rented broke down, in the middle of absolutely nowhere. Fortunately for Holly and Erin someone we knew was a short ways behind us. This is a picture of them leaving us. Unfortunately for Josh and I, we were stuck with figuring out what to do with the car. After hours of dealing with the car situation, Josh and I ended up on the last minibus going North. Because it was the last one, we got to ride with 28 others, 2 goats, some chickens, and I don't know what else. All of this in a vehicle licensed to carry 14 passengers!

The State fof Mental Health Services in Lira, By Ben

In the community, you will frequently here of the “community volunteer counselor” and of their efforts to provide “psychosocial support”. What isn’t clear is how they go about counseling those in need. These individuals are deemed counselors after a one or two day workshop (a week if they’re lucky). Crisis and trauma counselors in rehabilitation centers for formerly abducted children become qualified to do the work with a bachelor’s in social studies (or less) and no clinical experience. While the international community has recognized the great need for psychological recovery in conflict and post-conflict settings, actors seems satisfied with slapping a superficial, insufficient and unprofessional “band-aid” on the ubiquitous and complex psychological issues. This may be a result of the general absence of mental health practitioners in decision-making positions for programming strategies of INGOs.
I’ve been doing a bit of research on the state of mental health care in Lira and have come up with disheartening results. Here is an example of a short interview I had at the main hospital a week ago. The “mental health clinic” was three weeks old. It was staffed by one Psychiatric Clinical Officer (education equivalent: 2 years after high school) and two psychiatric nurses (one was still enrolled). For an office, they were given the tiny room that hosted the electrical breaker for the entire hospital; the room wasn’t painted and the ceiling was leaky.
Me: What do you use as a screening tool for diagnosis and treatment?
PCO: The ICD-10
Me: Okay, do you have a copy of the ICD-10?
PCO: No
Me: Any photocopies?
PCO: No
Me: So, how do you know if you’re asking the right questions?
PCO: I learned all the diagnosis in school.
Me: Do you make referrals for counseling services?
PCO: No, I learned how to do that in school too.
Me: How many clients do you see in one week?
PCO: Around 200.
This man was doing the best that he could, but it was obvious that he needed some help.
I will be going to Italy in Nov. to attend a “Masters Certificate Course” in Global Mental Health: Trauma and Recovery. It is a program run by Harvard University’s program for refugee trauma (since I am unpaid at the moment, they have graciously granted me a full-tuition scholarship!). It consists of two weeks of on-site training in Orvieto and 5 subsequent months of web-based learning. As a component of the program, we will be analyzing trauma clinics in a variety of international/conflict settings. The Concerned Parents Association and I are looking forward to new prospects in bringing a heightened level of mental health expertise into Lira and other Northern districts. Any volunteers? More later…