Back home, exhausted but pleased. The plan ride home was about 22 hours, and I could only sleep intermittently on the place. I slept for about 15 hours when I got home.
Its nice to be home, in fact it is great to be home. But home feels different; from time to time the United States feels like a foreign country, and Rwanda feels like the more natural setting. I expect that this will pass.
This is probably my last blog until the next trip.
Monday, July 26, 2010
Friday, July 23, 2010
Friday, July 23, 2010
This will probably be my last blog post this trip. I'm leaving tomorrow for home; it will be good to be back.
I just finished sending David and Gabo a concept paper based on the interviews. It has to do with the process of dehumanization and rehumanization, which I hope to develop further. I'll send a copy to anyone who is interested. You know where to find me.
I talked to Odette Kayirere today, the director of AVEGA in the Eastern region. We talked about the tradition Rwandan view of the world, including traditional Rwandan psychology although they don't call it that. In many ways it seems to coincide with a lot of family therapy ideas. The ancestors are always present, they want things from the people still here, they affect what we do, they need to be kept satisfied etc. The difference between this and Western views is that they believe it is literally true.
However, Odette is suspicious of some traditional healing methods. She says that people who are schizophrenic are often seen as possessed by the ancestral spirits and treated by traditional healers, who don't help. Only after they have spent all their money do they go to the psychiatric hospital for medication. The relationship between traditional healing and Western psychology/psychiatry seems complex. I've heard other Rwandans who are suspicious of traditional practices. On the other hand, Odette's daughter, who I also met today, is interested in research on traditional Rwandan medicinal plants. She says that they need research to investigate how and when they are effective.
I just finished sending David and Gabo a concept paper based on the interviews. It has to do with the process of dehumanization and rehumanization, which I hope to develop further. I'll send a copy to anyone who is interested. You know where to find me.
I talked to Odette Kayirere today, the director of AVEGA in the Eastern region. We talked about the tradition Rwandan view of the world, including traditional Rwandan psychology although they don't call it that. In many ways it seems to coincide with a lot of family therapy ideas. The ancestors are always present, they want things from the people still here, they affect what we do, they need to be kept satisfied etc. The difference between this and Western views is that they believe it is literally true.
However, Odette is suspicious of some traditional healing methods. She says that people who are schizophrenic are often seen as possessed by the ancestral spirits and treated by traditional healers, who don't help. Only after they have spent all their money do they go to the psychiatric hospital for medication. The relationship between traditional healing and Western psychology/psychiatry seems complex. I've heard other Rwandans who are suspicious of traditional practices. On the other hand, Odette's daughter, who I also met today, is interested in research on traditional Rwandan medicinal plants. She says that they need research to investigate how and when they are effective.
Thursday, July 22, 2010
Thursday, July 22, 2010
Good news. I spoke with Gabo today about my ideas, particularly that the rwandan genocide dehumanized the survivors, and that recovery and healing is a process of rehumanization. He liked the idea, told me that it clarified for him the work that they were doing, and told me that if I needed to collect more data they would raise money for me to return. This is very gratifying, and also makes me nervous. I'm going to write them a brief concept paper which will summarize the ideas and we will take it from there. This is all I could have hoped for; no, it is more than I could have hoped for.
BTW, people here don't call what happened "the Rwandan genocide." They refer to it is "the genocide against the Tutsis." Language makes a difference.
I had lunch with Henny, Sheila's friend Pauline's friend. She is a therapist and a medical anthropologist. She told me about the dark side of traditional Rwandan culture. Traditional Rwanda was a patriarchal culture that subordinated women, and condoned violence against women as a mean's of social control and enforcing gender norms. Now that Kagame's government has greatly improved the status of women (may women in government, in business, etc) traditional men are threatened. They say that the government is taking away their manhood. Pauline is studying gender based violence in Rwanda.
So there is trouble in paradise. Another important corrective to the good things in traditional culture that I talked about in my earlier blogs.
BTW, people here don't call what happened "the Rwandan genocide." They refer to it is "the genocide against the Tutsis." Language makes a difference.
I had lunch with Henny, Sheila's friend Pauline's friend. She is a therapist and a medical anthropologist. She told me about the dark side of traditional Rwandan culture. Traditional Rwanda was a patriarchal culture that subordinated women, and condoned violence against women as a mean's of social control and enforcing gender norms. Now that Kagame's government has greatly improved the status of women (may women in government, in business, etc) traditional men are threatened. They say that the government is taking away their manhood. Pauline is studying gender based violence in Rwanda.
So there is trouble in paradise. Another important corrective to the good things in traditional culture that I talked about in my earlier blogs.
Tuesday, July 20, 2010
Tuesday, July 20, 2010
I did a small focus group with counselors from AVEGA and solace ministries yesterday. I've formulated a very tentative narrative about the process by which they work with people. I'll paste it below right after I comment/complain about what seems to be a typical hassle: people promise things, don't or can't deliver, and then avoid me rather than explain. In this particular case I was told I would get a CD of the recorded interview right away. I only found out from a chance encounter that they needed permission from someone else to bill SURF, the survivors fund. Of course, there are the same hassles at Yeshiva, but they feel more difficult here, probably because I don't know who is who or whom to ask. I also need to figure out a way to turn this into an open ended survey. suggestions welcome.
1.Dehumanization leading to isolation and marginalization - Z is a young man whose arm was hacked off during the genocide. When he came for treatment he was not working felt worthless, not a man, not part of the community of his village. In fact, he couldn’t do farm work and had no training for any other occupation. He felt ashamed of his state, although the shame was not something he could give voice too, speaking about feelings isn’t part of Rwandan culture.
2.The marginalization and isolation create problems which bring person to the attention of or into contact with the CTP system – the people in his village brought him to the attention of solace ministries because he was given to angry outbursts directed at people in his village. They were both frightened of his and concerned for him, and didn’t know what to do.
3.Outreach and establishment of trusting relationship – he wouldn’t travel to the facilities that solace ministries had, which were too far away, and also he didn’t know anybody there. The ministry established a facility closer to him, which he was willing to attend. However, when he met the worker he wouldn’t say anything to her. At some point when she persisted he began hitting her with the stump of his missing arm, uttering the words “human, human, human” which she took to mean that he was a human being, despite what was done to him. As she persisted he began talk about what happened to him. After many sessions of telling his story he broke down into tears and cried for 20 minutes. When he stopped crying he asked the worker what she had done, and said he had tried to be strong and having cried he was weak. (Showing emotions is a taken for weakness in Rwandan village culture.)
4.Stabilization, stopping of decline – he began to be less angry and disruptive of village life, more connected to the village and more social.
5.Rebuilding life, family connection, identity ¬– after much talk and encouragement he began to feel less hopeless about his life, and to see other possibilities. He asked to be sent to a local training facility, where he learned to write with his left hand, and got other training as well. He graduated and went to university (I’m not sure of all the details here, but he did find employment). He also began to talk to other survivors, encouraging them to not despair and find a way to live. (If I had more time in the interview, I would have asked for more details. It was a focus group interview with five counselors talking about their clients.) He was worried that he had somehow contracted HIV/AIDS from what had happened to him. He was able to be tested and found that he didn’t have AIDS.
6.Connecting with community, spirituality, the transcendent ¬– this work was done as part of solace ministries who encouraged him to find hope from faith in Jesus, and from the support and fellowship of the community. Again, with more time and more knowledge I would fill in the details.
This is a very sketchy account of narratives I hope to develop. The message is that treating survivors involves going beyond medication and their physical health to the psychological and spiritual issues as well. This particular man didn’t have HIV/AIDS but many of the clients do. I would call this a biopsychosocial approach. One of the pastors I spoke to calls it a holistic approach of body, mind, and spirit.
1.Dehumanization leading to isolation and marginalization - Z is a young man whose arm was hacked off during the genocide. When he came for treatment he was not working felt worthless, not a man, not part of the community of his village. In fact, he couldn’t do farm work and had no training for any other occupation. He felt ashamed of his state, although the shame was not something he could give voice too, speaking about feelings isn’t part of Rwandan culture.
2.The marginalization and isolation create problems which bring person to the attention of or into contact with the CTP system – the people in his village brought him to the attention of solace ministries because he was given to angry outbursts directed at people in his village. They were both frightened of his and concerned for him, and didn’t know what to do.
3.Outreach and establishment of trusting relationship – he wouldn’t travel to the facilities that solace ministries had, which were too far away, and also he didn’t know anybody there. The ministry established a facility closer to him, which he was willing to attend. However, when he met the worker he wouldn’t say anything to her. At some point when she persisted he began hitting her with the stump of his missing arm, uttering the words “human, human, human” which she took to mean that he was a human being, despite what was done to him. As she persisted he began talk about what happened to him. After many sessions of telling his story he broke down into tears and cried for 20 minutes. When he stopped crying he asked the worker what she had done, and said he had tried to be strong and having cried he was weak. (Showing emotions is a taken for weakness in Rwandan village culture.)
4.Stabilization, stopping of decline – he began to be less angry and disruptive of village life, more connected to the village and more social.
5.Rebuilding life, family connection, identity ¬– after much talk and encouragement he began to feel less hopeless about his life, and to see other possibilities. He asked to be sent to a local training facility, where he learned to write with his left hand, and got other training as well. He graduated and went to university (I’m not sure of all the details here, but he did find employment). He also began to talk to other survivors, encouraging them to not despair and find a way to live. (If I had more time in the interview, I would have asked for more details. It was a focus group interview with five counselors talking about their clients.) He was worried that he had somehow contracted HIV/AIDS from what had happened to him. He was able to be tested and found that he didn’t have AIDS.
6.Connecting with community, spirituality, the transcendent ¬– this work was done as part of solace ministries who encouraged him to find hope from faith in Jesus, and from the support and fellowship of the community. Again, with more time and more knowledge I would fill in the details.
This is a very sketchy account of narratives I hope to develop. The message is that treating survivors involves going beyond medication and their physical health to the psychological and spiritual issues as well. This particular man didn’t have HIV/AIDS but many of the clients do. I would call this a biopsychosocial approach. One of the pastors I spoke to calls it a holistic approach of body, mind, and spirit.
Sunday, July 18, 2010
Sunday, July 18, 2010
I'm not settled in the guest house of solace ministries, somewhat on the outside of the center of kigali. Its a very different place with a very different atmosphere. Its located on one side of a rough dirt road with only a few houses and faciltiies next to it. As I walk outside of the guest house - it has a gate which opens to the road - I see people who seem much more rural, or at least much less urban. Many women walking side by side in traditional dress, little children who run after me and say hello, just being friendly and curious, young men strolling along. It feels a bit like rural vermont, except for the foliage and the color of the soil, and of course the road isn't paved.
I had a very interesting conversation with an evangelical group who come here every year to work with and pray with surviving widows and orphans. I will skip the evangelical part of the conversation except to note the the group is called wholeness through christ (they are based in canada and have a website which strikes me as somewhat ironic). They said that the people they have talked to and worked with have lost any sense of what i would call social trust or deep meaning, and hence any sense of connected humanity, any source of positive emotion. (I'm translating loosely from their spiritual language to a more humanistic psychological one.) They feel that through their work in community this sense of a meaningful benevolent world can be restored, and that this is necessary for the more psychological kind of work that individual trauma therapists do to be effective.
I find them convincing, although I would quibble about the details of accepting jesus christ as my personal savior. What do find convincing is a need for spirituality and community as part of the healing process, and in Rwanda the spirituality is probably going to be Christian of some sort. I've also found the need for economic development that reaches them and gives them the resources to rebuild their lives. This includes all the microfinances that people talk about.
So I locate psychological work midway between microfinance and spirituality.
I had a very interesting conversation with an evangelical group who come here every year to work with and pray with surviving widows and orphans. I will skip the evangelical part of the conversation except to note the the group is called wholeness through christ (they are based in canada and have a website which strikes me as somewhat ironic). They said that the people they have talked to and worked with have lost any sense of what i would call social trust or deep meaning, and hence any sense of connected humanity, any source of positive emotion. (I'm translating loosely from their spiritual language to a more humanistic psychological one.) They feel that through their work in community this sense of a meaningful benevolent world can be restored, and that this is necessary for the more psychological kind of work that individual trauma therapists do to be effective.
I find them convincing, although I would quibble about the details of accepting jesus christ as my personal savior. What do find convincing is a need for spirituality and community as part of the healing process, and in Rwanda the spirituality is probably going to be Christian of some sort. I've also found the need for economic development that reaches them and gives them the resources to rebuild their lives. This includes all the microfinances that people talk about.
So I locate psychological work midway between microfinance and spirituality.
Friday, July 16, 2010
Friday, July 16, 2010
I'm back in kigali, staying at the okapi, although I'm about to move to the solace ministries guest house, which is more convenient for the interviewing.
I continue to be fascinated by all the little details of Rwandan life, particularly the collective culture and its pluses and minuses. The minus is public opinion, what people say and think and how much rwandans act to avoid censure. Sylvia told me that Rwandan couples often will not divorce, because it is too shameful. Instead they put on the appearance of happiness in public, and in private lead separate lives.
She and Eric both say that the force of public opinion is diminishing in the city, which is good sociology.
I asked about the street children. Apparently their parents send them out to beg, to make a little money for the household. I say parents but it is often only one parent, maybe disabled by the genocide or for some other reason. The effect is that they don't go to school, which perpetuates the poverty. Apparently it is illegal to give them money in some places, and people who do so are fined.
Also, there is no social security in Rwanda, except for people who work for the government, so people work till they die.
I continue to be fascinated by all the little details of Rwandan life, particularly the collective culture and its pluses and minuses. The minus is public opinion, what people say and think and how much rwandans act to avoid censure. Sylvia told me that Rwandan couples often will not divorce, because it is too shameful. Instead they put on the appearance of happiness in public, and in private lead separate lives.
She and Eric both say that the force of public opinion is diminishing in the city, which is good sociology.
I asked about the street children. Apparently their parents send them out to beg, to make a little money for the household. I say parents but it is often only one parent, maybe disabled by the genocide or for some other reason. The effect is that they don't go to school, which perpetuates the poverty. Apparently it is illegal to give them money in some places, and people who do so are fined.
Also, there is no social security in Rwanda, except for people who work for the government, so people work till they die.
Thursday, July 15, 2010
Thursday, July 15, 2010
I'm back from Butare, and this is the first time I've had access to the internet. BTW I've just learned it is possible to buy a modem and get internet access that way. I'll do that soon. I'm slowly learning all the little ways of coping that make it possible to get around. Probably there will be more hassles and more learning coping strategies.
The visit was a success. I got a letter of invitation from the National University which I can use in support of my Fulbright. Speaking of coping strategies, this is quite a story. When I arrived in Butare I immediately called Vincent Sezibera, the head of the department of clinical psychology at NUR (the national university). He showed up to greet me at the hotel where I stayed, said he would be right back and vanished. I called him a bit later, and he explained he didn't want to bother me, but said I could meet him at his office at 2:30. Again, he wasn't there, and again I called. It turned out he was in a meeting and arrived at 3:30. We had a good talk about our mutual interests and my teaching, and he said he would be glad to write a letter, and ask for administrative approval. He also introduced me to the Dean of the Medical School who was approving of the application. It was important that the Fulbright committee would pay all expenses, so that the university had nothing to lose by having me. The dean introduced himself as Patrick - I think everything is on a first name basis because of the way Rwandans are given names. If I want an honorific i address him as Dean Patrick.
By this time I had learned what I could count on from Vincent and what I couldn't, So I said I would write the letter myself, and have him edit it. My assistant, Sylvia, who is absolutely amazing, dug up the name and phone of the rector and vice rector and made an appointment for me the next day at 11. I actually met the vice rector at 12 - after his other meetings were delayed. His name is Professor Martin O'Hara, and he is a displaced Englishman, I think, or perhaps Irish. In any event he was enormously courteous and helpful. He told me just write the letter, bring it to his office, and they will print it out on official stationary and sign it.
I called vincent told him this, and he agreed to meet me at his office at 4:30. By now its clear what was going to happen. He wasn't there. I left a note, we drove off, and as it happened as we were pulling into my hotel Sylvia and Eric saw Vincent driving past in a green van. I said let's follow the van and we did. After a short drive Vincent pulled off the road into a small building that turned out the be the University clinic. Other people were waiting for him there, too, apparently wondering why he hadn't kept his appointment with them. He had the grace to look embarassed.
Sylvia says he is on African time. I think she trusts me enough to say this. Eric says so too, but doesn't think African time is a good thing. We joked that if he had an appointment with Kagame at 4:30 he would sleep in his office, for fear of missing it. I'm not sure why it occurs. I don't think "African culture" per se is a good explanation. Sylvia says it is a culture of come back tomorrow. She also says that in Uganda requesting bribes for services isn't done, you just simply tell people come back tomorrow until they pay.
But in any event, I finally did meet with Vincent, we did write the letter together, we took it to O'hara's office, and he signed it and gave me a hard copy and also scanned it into a file for a permanent record. I'm going to keep it in several different places.
We drove back to Butare, and on the road I had a very interesting conversation with Eric and Sylvia about the role of group pressure in Rwandan behavior. To make a long story short, they don't like it. They are aware of the pressure to follow the norm, marry just to be married, etc. Eric says that group pressure is the negative of Rwandan culture.
The visit was a success. I got a letter of invitation from the National University which I can use in support of my Fulbright. Speaking of coping strategies, this is quite a story. When I arrived in Butare I immediately called Vincent Sezibera, the head of the department of clinical psychology at NUR (the national university). He showed up to greet me at the hotel where I stayed, said he would be right back and vanished. I called him a bit later, and he explained he didn't want to bother me, but said I could meet him at his office at 2:30. Again, he wasn't there, and again I called. It turned out he was in a meeting and arrived at 3:30. We had a good talk about our mutual interests and my teaching, and he said he would be glad to write a letter, and ask for administrative approval. He also introduced me to the Dean of the Medical School who was approving of the application. It was important that the Fulbright committee would pay all expenses, so that the university had nothing to lose by having me. The dean introduced himself as Patrick - I think everything is on a first name basis because of the way Rwandans are given names. If I want an honorific i address him as Dean Patrick.
By this time I had learned what I could count on from Vincent and what I couldn't, So I said I would write the letter myself, and have him edit it. My assistant, Sylvia, who is absolutely amazing, dug up the name and phone of the rector and vice rector and made an appointment for me the next day at 11. I actually met the vice rector at 12 - after his other meetings were delayed. His name is Professor Martin O'Hara, and he is a displaced Englishman, I think, or perhaps Irish. In any event he was enormously courteous and helpful. He told me just write the letter, bring it to his office, and they will print it out on official stationary and sign it.
I called vincent told him this, and he agreed to meet me at his office at 4:30. By now its clear what was going to happen. He wasn't there. I left a note, we drove off, and as it happened as we were pulling into my hotel Sylvia and Eric saw Vincent driving past in a green van. I said let's follow the van and we did. After a short drive Vincent pulled off the road into a small building that turned out the be the University clinic. Other people were waiting for him there, too, apparently wondering why he hadn't kept his appointment with them. He had the grace to look embarassed.
Sylvia says he is on African time. I think she trusts me enough to say this. Eric says so too, but doesn't think African time is a good thing. We joked that if he had an appointment with Kagame at 4:30 he would sleep in his office, for fear of missing it. I'm not sure why it occurs. I don't think "African culture" per se is a good explanation. Sylvia says it is a culture of come back tomorrow. She also says that in Uganda requesting bribes for services isn't done, you just simply tell people come back tomorrow until they pay.
But in any event, I finally did meet with Vincent, we did write the letter together, we took it to O'hara's office, and he signed it and gave me a hard copy and also scanned it into a file for a permanent record. I'm going to keep it in several different places.
We drove back to Butare, and on the road I had a very interesting conversation with Eric and Sylvia about the role of group pressure in Rwandan behavior. To make a long story short, they don't like it. They are aware of the pressure to follow the norm, marry just to be married, etc. Eric says that group pressure is the negative of Rwandan culture.
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