Training in trauma therapy for local counsellors

Atrocities and brutal crimes, exerted by the Lord’s Resistance Army (LRA) have recently spread from Northern Uganda to the neighbouring countries where they cause large-scale humanitarian suffering. Specifically in the border regions to South Sudan and the Central African Republic children in DRC experience massive brutality and forced abductions. The LRA criminals kidnap minors and force them under life threat to fight their own people, carry heavy loads through the bush or serve as sex slaves - often children and youth have to kill their own families in order not to be killed themselves.

Based on vivo’s long-lasting expertise in rehabilitation and successful building of mental health support structures for former child soldiers, we were called in to Congo by our partner organisation Invisible Children to assist with the development of a rehabilitation centre for former child soldiers and other children and youth affected by the LRA violence in Dungu. The specific aim of vivo’s initial steps was to suggest adequate intervention strategies for child soldiers to recover from Traumatic Stress and associated mental suffering, and then to conduct a 4-week training to build local capacities and help children to integrate into civilian life.

The conducted vivo-training was twofold: First, we trained 12 community screeners to detect symptoms of mental ill-health in children and youth in the Congolese communities aiming to select the most vulnerable ones for trauma-focused therapy and second, we trained Master-Counsellors in conducting individualized trauma therapy to children in need. Given accessibility and security challenges in the area, vivo also tried to strengthen referral pathways for the children. Right after the training, both community screeners as well as Master Counsellors began to offer their services to the affected communities and traumatized individuals. vivo-follow-up missions for further capacity building of psychosocial support staff as well as for supervision provision are envisaged in the near future.

Demobilizing the Mind

The Democratic Republic of the Congo and the greater Great Lakes Region of Central Africa have suffered from armed conflicts for almost two decades. Combatants, often child soldiers, in this war keep committing horrendous crimes targeting the civilian population.
Often abducted or seduced as children and subsequently abused within their own groups, many of the fighters have never had a chance for completing their socialization, have limited or no education and never in their life have experienced periods of peace. They grow up admiring their commanders and learning, that exerting violence is the a way to fulfill basic needs.

"We were sitting together, my uncle and me, we were talking about our glorious fights and then the need for fighting, the urge came up in us. It could be even at 7 o'clock at night, when it was already dark, that we took the guns then and went to kill.”

A former FDLR combatant interviewed by vivo in Goma

When the combatants decide to leave their armed groups, they frequently have to desert under life-threat to enter formal demobilization procedures (DDR). As they are discharged into civilian life their violent pattern of behavior, their anger and aggression as well as trauma-related mental dysfunction stay with them.
For this reason many former combatants struggle to participate in training, uphold loving relationships and solve everyday conflicts without using violence. As their reintegration into civilian society fails, nothing but re-joining an armed group or at least a street gang remains as option.

To break this vicious cycle vivo is piloting an intervention in Goma (North Kivu) to treat former combatants, who suffer from post-traumatic stress disorder and/or report a significant interest in continuing with aggressive behavior. During treatment former combatants talk about their experiences and feelings as fighters, often for the first time in their lives. By reflecting these experiences together with a therapist, they learn to understand, how they got trapped in violent behavior and understand the need for developing alternative response dispositions in order to change from a combatant to a civilian live. This vivo intervention is the first ever therapy in the DDR context. It will be followed by a six-month post-test to establish its effectiveness. Violence against civilians, including massacres and agonizing forms of sexual violence, will only stop, when mental suffering of combatants is addressed and when the minds, of those who resort to violence all to quickly are demobilized.

vivo starts up in Congo

Violence against civilians is rampant in the Democratic Republic of the Congo’s War. Women and girls are raped on a daily basis and their life is determined by the fear of being victimized. The women and girls, who have survived rape are often left stigmatized and physically and psychological injured for life.

From January to March 2009 vivo has trained nurses doctors and social assistants from various health organisations and state institutions in NET. Among the 31 participants was staff from the Panzi Referral Hospital, Sosame Psychiatric Hospital, the International Rescue Committee and V-Day, located in the South and North Kivus, Eastern Democratic Republic of Congo. vivo visited most of the course participants again in April 2009 to follow-up the training and provide supervision. We were glad to see, that the participants were implementing NET therapies and provided much need psychosocial support to survivors of violence.

All participants brought a wealth of experience on working with victims of gender-based violence to the 21-day workshop, as well as a genuine interest in understanding and mastering a trauma-focussed counselling technique. Discussions were lively and due to the seniority and curiosity of participants much learning was enabled on all sides.

A first supervision followed suit, where we visited our trainees at the various places of work, i.e. Bunyakiri, several service provision points in Bukavu, Minerva and Goma. We left our first DRC batch with a sense of pride about their achievements, in fact this was also felt by the trainees themselves; they also were greatly motivated to get started with their work with traumatised patients.
A second supervision visit followed towards the end of April and the momentum to implement trauma-focused therapy in the DRC could be reinforced. The former training participants had started to deliver NET and to see first successes. Once again vivo was touched by the counsellors’ courage to continue their work in the dangerous ‘red zones’ of the Eastern DRC. Their commitment to assist survivors of violence is a deeply impressing sign of hope for the region. vivo is therefore currently seeking ways to continue its work in the Eastern DRC.