Today I’m writing from Kigali, Rwanda, where for the past 9 days I have been at a training for Burundians, Rwandans, and Congolese to become facilitators of Healing and Rebuilding Our Communities (HROC) workshops.

At the same time, I’ve been reading Rethinking the Trauma of War, a book critical of programs that intervene in post-conflict situations for trauma healing.  The effect of the juxtaposition has been to strengthen my appreciation for the approach I was learning in the training, and to highlight the strenghts of the HROC program.

kigali-soccer-fieldThe critique is aimed primarily at the trauma healing programs that were deployed after violence, such as in the Balkans and here in Rwanda after the genocide, in which large humanitarian NGOs supplied Western-trained psychologists/psychotherapists for short 6-month or 1-year stints.  During this time, they conducted individual counselling sessions to help people deal with trauma, and then after a year or two the whole program was wrapped up.

To summarize briefly the critique, such a program:

1. imports Western (culturally relative) ideas and values, such as individualism and a focus on trauma as a mental/cognitive state.  In brief: yesterday they brought the church to Africa, today they bring the doctrine of PTSD.

2. disrupts and displaces local resources for psycho-social healing

3. is attractive to donors because it implies no long-term commitment to changing the situation on the ground as is the case with other development projects

4. aims at a need that doesn’t exist, or at least which is unimportant relative to other material needs (a point I have responded to in previous posts).

I think that all these critiques are correct, as far as they go, but what’s interesting is how the book completely misses the possibility of a trauma healing project like HROC.

Our workshops are faciliated by local people, not just from the same country but from the same region of that country and, often, from the same community.   The workshop structure has been adopted by each local culture and continues to be revised to match the needs perceived by those at the community level.  And as far as the content goes, it is not presented in lecture format by the leader but is rather elicited from the participants themselves, so the possibility of importing foreign values is minimalized.

Such a program cannot be said to displace local resources, since it is precisely built around creating such resources — rebuilding communities by connected family members to each other, neighbors to neighbors, and communities to their own members who have experience facilitating trauma healing — as well as the ongoing process of healing from trauma themselves.  And the program is also aware, and is constructed so as to capitalize on, the long-term approach that such a community-based approach requires.

Of course, you might object that a rural peasant farmer with a little training cannot provide the sort of care that a highly trained professional can, even if the latter suffers from disadvantages of language, culture, and context.  Perhaps this is true in some circumstances, still I’m not about to start promoting a change in our program.  I am reminded of an empirical study that compared different therapeutic approaches (Freudian, cognitive, behavioral, pharmacological) with respect to their effectiveness in treating various psychological troubles – schizophrenia, depression, etc.   Although there were some minor differences between approaches, the outcome for all methods was roughly similar, as was simply having a friend or pastor who was a good listener.  Oh, and did I mention that each workshop includes a session on good listening, and that we also refer to our facilitators as “healing companions”?

Of course, I don’t claim to be unbaised; I just spent the last 9 days with some of the most inspiring people I’ve had the chance to meet, who have no book learning in trauma, but whose own journeys of healing give them a unique personal strength and a compassion they hope to share with others.2009-feb-tot-028