Fellow: Kimberly Ford
Fellowship Site: Center for Victims of Torture, West Africa
Brief History of Organization and Post-Conflict Context of West Africa:
Since 1985, the Center for Victims of Torture (CVT) has provided comprehensive mental health services to survivors of politically motivated torture who have resettled in the Twin Cities area. Aware that most torture survivors in the world are not seeking treatment in Western resettlement countries, but rather remain displaced in their homelands or in refugee camps of neighboring developing countries, CVT explored ways to intervene with this vast and underserved population. In 1999, the U.S. State Department presented CVT with an opportunity to develop a program to address the mental health needs of refugees from Sierra Leone residing in refugee camps in Guinea. CVT now operates programs in both Guinea and Sierra Leone. The recent civil and political upheaval in Liberia has led to a flood of Liberians fleeing to safety in refugee camps originally established in Guinea for war survivors from Sierra Leone. Because of the sheer need, CVT is incorporating Liberian torture survivors into their program fold. Four program sites now exist in both Guinea and Sierra Leone, strategically located near refugee camps.
Due to the massive scope of the traumas experienced by Sierra Leonean and Liberian refugees, CVT interventions are designed to encompass the entire community. A primary focus, however, is to reach refugees whose experiences have resulted in significant mental health consequences that impair their ability to function in important daily activities. Interventions target children and adults through community-wide, group, family and individual activities. Memories of unspeakable violence, social stigmas and shame often accompany those who were sexually assaulted or forced as children to become soldiers, leading them to develop the coping mechanism of forgetting what happened or being unable to trust enough to reveal their trauma. CVT’s focus with this population is the development of trust and safety so that these needs can be addressed and they can begin psychological healing.
CVT’s programs emphasize building capacity for the community. Thus a core component of CVT interventions are the training of Psychosocial Agents (PSA’s), or peer counselors from the refugee community. Should CVT be forced to leave because of violent outbreaks or a lack of funding, it is hoped that the West African programs will have a lasting impact on the larger society by leaving behind a cadre of individuals with intensive training on how to help individuals and communities recover from the traumas of war. Additionally, drawing on individuals from the refugee communities means that cultural elements are integrated into healing processes and limits dependency on agents outside of the community.
In total I spent ten weeks in West Africa. The day after arriving in Freetown, Sierra Leone I embarked on whirlwind a two-week trip with CVT’s Research Director, Jon Hubbard. We visited CVT program sites in Kissidougou, Guinea and Kenema, Sierra Leone. In both locations CVT program offices are located near refugee camps. This gave me an opportunity to visit the sites where I would be working independently after Jon left, to familiarize myself with CVT’s work with torture survivors, and to meet the CVT West Africa staff that I would be working with when I returned.
After this trip Jon and I returned to Freetown where we organized and then conducted a data retreat designed to build the data management and data analysis skills of the Liberian and Sierra Leonian data staff with a focus on using the SPSS statistical software program. In West Africa CVT has developed and implemented intake and follow-up assessment forms to track symptom changes in clients who receive CVT services. In addition to providing important information to guide mental health interventions for torture survivors, large donors increasingly require evaluation reports of client services for funding, yet they do not give additional funding to support evaluation work. This retreat was designed to build the skills of the local data teams so that the clinical staff can use the evaluation materials they already have in order to better serve their clients (who are torture survivors in refugee camps) and to allow West Africa staff to use the material for program and funding reports.. Five local staff members and the field coordinators for both the Guinea and Sierra Leone programs made the arduous trip to Freetown for the five-day intensive data retreat.
After the retreat, Jon and I outlined a work agenda for the remaining six weeks of my time, which was divided between Kissidougou, Guinea and Kenema, Sierra Leone. The primary tasks I accomplished across both sites include the following:
Follow up to Freetown data retreat: I worked closely with the data teams in Kissidougou and Kenema on SPSS training that began during the retreat in Freetown. I developed practice exercises in SPSS using the adult and child client assessment data as well as practice exercises using other data. Additionally, I assisted the data teams in developing data management and data cleaning systems, and spent many weekend hours cleaning the existing data. Finally, I created a binder of guidance documents and training materials for both sites, and left a document of recommendations to sustain the new systems for the management teams in Guinea and Sierra Leone.
Child and Adult Intake and Assessment forms: I designed child intake and follow-up assessment forms using the SPSS Data Builder program, and cleaned the existing adult intake and follow-up assessment forms.
Evaluation focus group interviews: In Kissidougou I worked with PSA’s (peer counselors from the refugee community) to develop and conduct evaluation focus groups with parents and guardians of children who had participated in short-term trauma counseling. The goal of the evaluation focus groups was to assess wider impacts of CVT services. For example, what types of impacts do CVT interventions have on families of clients who have undergone CVT counseling or on the community at large? We conducted two focus groups in the refugee camps. The focus groups provided valuable feedback to CVT and offered a chance for the PSAs to develop new skills. Additionally, the report I wrote contains evaluation material that can be used in future reports to donors. In Kenema, time restrictions prevented me from conducting focus groups. However, I did trainings with PSAs and the clinical staff on evaluation focus groups.
Accomplishments , Challenges and Learning:
My time in West Africa was incredibly rewarding, personally and professionally fulfilling, and heartbreaking-often I would experience all of these feelings in one day. I was fortunate to have an excellent mentor and supervisor in Jon Hubbard. CVT’s clinical and management personnel come from a many countries including South Africa, the Democratic Republic of Congo, Kenya, Japan, and the U.S. I learned an extraordinary amount living and working with them.
I also established wonderful work relationships with the local data staff in Kissidougou and Kenema. In Kissidougou we encountered power generator failures almost daily (there is no electricity in Kissidougou so electric power during business hours is dependent on generators) and had to contend with old quirky computers. In spite of the constant frustrations, we managed to work hard and laugh together, and to accomplish a significant amount in terms of SPSS training and the development of new systems. I felt like I was able to make a significant contribution in a short time. Not only did the data teams develop skills that can support their work with CVT, I believe they will be able to utilize these skills in different contexts in the future.
I think I learned the most from the data staff that I worked with so closely, most of whom had been refugees themselves at one point, surviving circumstances that we cannot imagine here in the U.S. One particular story illustrates this point. Catherine, a woman from Liberia who is part of the data team in Kissidougou, and I spent the lunch hour talking together one day. Somehow we started to talk about why she first came to Liberia. She said that she was forced to flee her village on a moment’s notice when rebels began firing on her village and killing people. She had no chance to go back to her house to get things. She was separated from her husband and the rest of her family; she only had her very young daughter with her. They had to hide for days in the bush with no food or water, and had to travel while hiding in the bush, hoping to cross the border into Guinea where they could find some kind of safety. After nearly losing her daughter to sickness and starvation, she finally snuck across the Guinean border and reached a refugee camp. She found out later that her husband and most of her family were killed. Unfortunately her story is the norm rather than the exception in Guinea and Sierra Leone, and almost daily I would here stories like this, sometimes from people like Catherine whom I had gotten to know.
In spite of this, I found many reasons to be inspired. The people I met and worked with met new challenges with grace and humor. Most of the data staff that are now using Excel, SPSS and other computer programs had little formal education and had only first touched a computer a year or two before. Their life stories humbled and inspired me.
Back in the U.S.
The story of women, men and children whose lives have been ravished by brutal civil wars in West Africa has largely vanished from our national consciousness, to the detriment of international aid efforts that bring relief to these war torn communities. Throughout my life, my own first hand experiences and learning have fueled my activism and understanding of the world. I will unquestionably use this fellowship opportunity to share the story of Sierra Leone and Liberia in both formal and informal settings, and to advocate for refugees here in the U.S.
Additionally, I am now in the PhD program in the School of Social Work at the University of Minnesota. I plan to focus my doctoral research project on the impact of social welfare systems on immigrant and refugees, focusing on children. Working in West Africa has increased my understanding of the complexities of the refugee experience, and will influence the course of my research and human rights activism.
Full Name of Organization:
Center for Victims of Torture
Abbreviation and initials commonly used: CVT
2356 University Avenue West
St. Paul, MN 55114
Telephone number: Home office in Minneapolis: 612.436.4800
Fax number: 612.436.2606
Email address: firstname.lastname@example.org
Names of Executive Director and Senior Staff:
Executive Director: Doug Johnson
Research Director: Jon Hubbard
Objectives of the Organization:
Mission statement from the CVT website:
The Center for Victims of Torture (CVT) exists to heal the wounds of government-sponsored torture on individuals, their families and their communities, and to stop its practice.
As many as 500,000 torture survivors are living in the United States. These individuals were brutalized by repressive regimes abroad because of what they believed, what they said or did, or what they represented. Many survivors, their families, and their communities suffer the lingering, debilitating effects of their horrific traumas in silence.
CVT has pioneered a comprehensive assessment and care program that is unique in this country. In recent years, CVT has expanded its services to include research, training and public policy initiatives in order to develop strategies for abolishing torture worldwide.
CVT Sierra Leone
Date of Information: October 1, 2004
Information Supplied by: Kimberly Ford
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