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.