Restoring Hope, Building Local Capacity
The Healing Project of the Center for Victims of Torture, in the Dadaab Refugee Camp, Kenya
“They told me, ‘You’ll be alone with this for the rest of your life. You’ll die with this alone.’ But when I heard about the Center for Victims of Torture, I knew the torturers had lied.” —A survivor of torture
There are 353 refugee survivors of torture, war trauma and gender-based violence in the Dadaab refugee camp in Kenya—213 of whom are women—who are thankful to United Methodist Women for remembering them not only in prayer but in deed. These survivors, mostly Somali refugee women, received direct mental health counseling in 2012 to help heal the psychological wounds of torture and other war abuses perpetrated during the protracted civil war in Somalia.
This project is one of the many healing and training initiatives worldwide developed by the Center for Victims of Torture (CVT), an international nonprofit working to heal the wounds of torture and build local capacity for mental health services.
At the CVT Dadaab project, United Methodist Women Mission Giving directly supported the salaries of nine local women from the refugee population as well as from the Kenyan community. These women received about 155 hours of intensive training from mental health clinicians with expertise in torture and war rehabilitation, and the women in turn provided the majority of psychosocial services to survivors of torture in the camp.
CVT Dadaab, Kenya: Project Summary
Healing the Psychological Wounds of Famine and War Among Somali Refugees in Dadaab, Kenya: A Service- and Capacity-Building Approach
United Methodist Women Mission Giving has supported the much-needed work of CVT in Africa for the past seven years, helping provide direct mental health care to survivors in Guinea (to Sierra Leonean and Liberian refugees); in Sierra Leone (to returning communities and Liberian refugees); in the Democratic Republic of the Congo (for local community members); and now in Dadaab, Kenya.
Originally designed for 90,000 refugees, the Dadaab camp is home to nearly 500,000—97 percent of whom hail from war-torn and famine-stricken Somalia—making it the largest refugee camp in the world. The camp is located on the Kenya-Somalia border. CVT works to heal the psychological wounds of torture and war trauma experienced by so many in the camps—experienced to such an extent that survivors of these atrocities may feel numbness, anger, hyperarousal, shame, guilt, self-hatred and a variety of traumatic feelings that prevent them from participating effectively in their daily family and community lives.
Through this work, CVT can change the direction of an entire family, because when the primary caregiver in a family heals from her traumatic experiences, she can again be an effective mother and spouse, and the family can together begin to address its own problems and participate constructively in community.
Somalia: Political Situation and Mental Health Effects
Many of us stopped following the news about the Somali war after UN peacekeepers withdrew from the country in the mid-1990s and as the images of starving children eventually disappeared from our media coverage. Yet the Somali civil war continues. While the country’s government largely controls the capital city, Mogadishu, militant rebel groups such as al-Shabab still attack many regions of Somalia.
Somalis cannot forget the horrors of war. For those who manage to escape the mayhem and survive the harrowing journey to refugee camps, the horrors are not over either. They discover that often the refugee camps are overcrowded and riddled with violence, and lack the resources to provide adequate health, nutrition, education, shelter and protection. Yet even when the physical needs of refugees are met, a vital need often ignored is mental health services.
The mental health consequences of conflict remain long after the events are over. David McGraw Schuchman, a licensed clinical social worker who served Somali immigrants and refugees, states, “Often Somali women and men endured torture or rape, both of which were widely used as a means of terrorizing the population into submission. They have either experienced violence directly, witnessed it with their own eyes or have close relatives or friends who have. Many Somalis suffer from traumatic memories, flashbacks, depression and anxiety. ... [T]he severity and extent of trauma is likely to have had a considerable psychological impact.”< http://ethnomed.org/clinical/mental-health/somali-mental-health>
CVT Project in Dadaab, Kenya: Details and 2012 Accomplishments
The goal of CVT in Dadaab is twofold, reflecting the direct services provided to clients as well as the capacity-building initiatives for the broader community: address varying levels of mental health problems experienced by survivors of torture and war trauma through the provision of psychological care; and strengthen the community’s capacity to meet mental health needs beyond the tenure of the project through the training and supervision of local mental health paraprofessionals, called psychosocial counselors (PSCs), and through targeted training of other community members with a stake in community health. Below are the 2012 project details.
CVT recruits , PSCs from refugee and local communities to provide the majority of psychosocial services to survivors of torture. The objective is to build local capacity by teaching mental health and rehabilitation skills to the local refugee population so that the community can continue to meet its own mental health needs beyond the tenure of the project. In 2012, 17 PSCs, nine of whom were women, were trained. CVT provided 155 hours of formal training in addition to the informal training that takes place daily through case consultations, pre-counseling preparation and post-counseling feedback.
CVT cites the trainings as a great strength of the program, which enables the community to become the true owners of the project. With more women trained as PSCs, they become responsible for their own healing and that of their community, ensuring that culturally appropriate concepts and customs are incorporated into the therapeutic process. Projects are therefore able to continue long after CVT’s tenure ends. In the past, local counselors have launched their own healing programs in their communities, and they continue to provide mental health care in the long term.
Mental Health Counseling
The core of CVT’s project in Dadaab is mental health counseling, which addresses the mental health needs of survivors of torture. Counseling services include psychological first aid for newly arrived refugees, group therapy for those who are severely traumatized and individual therapy for those who are unable to participate in group sessions. These services help reduce high levels of distress and help clients function more effectively in their families and communities.
Psychosocial counselors identify clients through community sensitizations and referrals from other local entities or former clients. Potential clients then receive an extensive intake, and an individual treatment plan is subsequently developed. Group therapy sessions usually consist of 8-10 adults or 12 children, if appropriate, according to their gender, age group and history. Others are seen in individual counseling sessions if appropriate. Group sessions meet weekly for about two and a half months, and clients receive follow-up treatment for up to one year.
Community Sensitization & Capacity Building
Each year, CVT provides sensitization trainings for more than 1,000 community members, and specialized trainings and support to more than 100 non-CVT staff working at other agencies.
In order to operate a mental health rehabilitation program for torture survivors, the target community must understand the basics of human rights; torture and its effects; mental health; and mental health services. Community sensitizations therefore seek to build community knowledge and understanding in order to involve the community in the healing process by becoming more supportive to survivors. CVT conducts sensitization trainings targeting local community members and leaders from a variety of sectors, including government, business and nonprofit leaders.
CVT also coordinates with social service agencies/organizations to conduct trainings for staff working with torture survivors and affected populations (e.g., adult and child ex-combatants, primary- and secondary-schoolchildren and survivors of sexual violence). Specialized support sessions for non-CVT psychosocial workers are also held to reduce the risk of vicarious trauma.
These activities enhance the capability of individual agencies to provide sensitive and appropriate care for survivors, help expand their capacity to facilitate torture recovery and lead to greater community sustainability.
CVT is thankful to United Methodist Women for its continued support of CVT’s healing and capacity-building activities in Africa. For more information about CVT’s work, visit http://www.cvt.org/.
Amy-Jo C. Versolato is the institutional relations officer for the Center for Victims of Torture.