Providing health care to 1000s in Bujumbura slum

Report on two trauma healing workshops for Gender Based Violence survivors at Ntaseka Clinic on July 16 to 18 and July 23 to 25, 2018

I was born into a family where ethnic divisions have a special consideration. My father was a teacher at the University. My father did not put me in school. He continued to insult my mother saying that she was nothing because she was a Hutu. They divorced because of ethnicity and this was one of the reasons that prevented me from continuing my studies. I got married but I had the same problems as my mother. I was Tutsi and my husband was a Hutu. My husband abandoned me while I was pregnant. I did prostitution to survive. On the day of delivery, I was in the hospital and I lied that I was raped to accept me at the hospital. I thank God because my sister-in-law gave me something to eat and clothes for the baby. Indeed, she took care of me. After one year, she abandoned me because of her family. I greatly thank this training because I have seen that it is very important to reveal to someone else all the problems if one wants to heal from his hurts of the painful past. Participant’s testimony.

DESCRIPTION OF THE TARGET POPULATION
In these two trauma healing workshops, there were 20 women from Kamenge in each workshop, The vast majority of these women were women who were abandoned by their husbands and started prostitution just for their daily survival.

DAY ONE

Opening
The national coordinator of Friends Women’s Association opened the workshop and explained the need for such training. She then reminded the participants of the objectives of the training, which are, among other things: to help the participants to recognize and understand what trauma is, to understand that life continues even after the traumatic event, to build their relationship with their community and rebuilding society. She ended her speech by thanking the participants for coming to the training and the facilitators for their efforts and commitment during this three-day period. After this speech, the facilitation team of this workshop began to define the trauma, its causes and its symptoms.

1. Johari's window
We started to explore JOHARI’s window. After this presentation, participants gave examples of things they know about themselves and those they are unaware of. The facilitator said that we all have places that are private and hidden from others. She then underlined that it is very important to explore these hidden places and reveal them to others. This is one of the ways to recover from trauma. There is a Kirundi proverb that says Uja gukira indwara arayirata. This means that for someone to recover from his sickness, he has to tell about it to others. And from there, the participants said that they have just made a self-discovery of their identity and their lives.

2. Definition of trauma
We began to discuss the difference between normal stress and stress caused by trauma. The facilitator made an illustration by drawing two glasses on the flip chart and explained how the glass has a limited capacity to hold water. The normal stress is when the glass is edged but when it is overloaded the stress goes higher. The trauma can break the glass. She said that normal stress is tension, anxiety, and pressure that we encounter when we are in a situation that our ability cannot stand. She gave the example of a student who is doing an exam when his pen breaks down at the last minute and he does not receive another one. At this moment the stress comes.

Stress from trauma is caused by a terrible incident or a great emotion that is beyond our normal situation. For example children who lose all their parents by a car accident. After these examples, the facilitator gave a definition of trauma. Trauma is something you have seen, heard, done by yourself, or done to your life that has deeply hurt your heart.

3. Causes of trauma
To fully explain the causes of the trauma, the facilitator divided these causes into four categories namely: - the things that people can see (examples: the driving accident, the massacre of many people), to hear (a bad story of violence), do (do an abortion) and life (be kidnapped). She asked other questions related to the participants and they gave answers directly.

It was a good time to encourage participants to share their experiences with others and many of them gave examples of themselves. In closing this session, the facilitator said that the causes of the trauma can come from bad things that you can see, hear, do or live.

4. Symptoms and consequences of trauma
After the causes of the trauma, we saw the trauma symptoms that can be behavioral (what people do), emotional (what people feel), physical (what happens to people's bodies), and knowledge (what people think). Participants were asked to provide examples for each category. Many of them gave examples of their lives or that of their friends. We ended by saying that a single symptom does not justify an individual being traumatized.

To explain the consequences of the trauma, we drew an illustration of three concentric circles. Inside the first circle is the individual, the second isthe family or the community, and the third is the country. Participants were asked about the consequences of a person who is racist about himself, his family and the country. They gave answers. The facilitator asked them if, for example, there is war in the country, it can have consequences for the community and even for an individual. They noticed that there was back and forth discussion, understanding that there are consequences at the individual, family or community level, and at the country level.

To end the day, participants were asked to say a few words about everything we learned and how to apply it in their personal lives. Many of them came back to Johari's window, where they talked about the second and third windows. Some people say that they have a lot of things hidden inside them but that from today they will begin to reveal them to others to relieve themselves.

DAY TWO

1. Gathering: Exercise: empty chair

The facilitator put an empty chair in front of the participants. She asked each participant to come and sit on the chair and say first his name. Secondly, she had to tell the name of a person who is still alive, is not in the room, and sincerely loves her or vice versa. After that, the participant must stand behind the chair and play the role of a person who loves her and explains why the person loves her. It is supposed the participant is still sitting on the empty chair. We noticed that there was a lot of feeling because some participants cried when they were saying why they are loved. This exercise helped participants to know that even those who have lost a lot of people can still find someone who loves them.

2. Good and bad listening

Firstly, two facilitators played the role of bad listening: one was a lady who had problems with her husband and the other was an administrator who was at work in her office. The woman came to tell her problems to the administrator and the administrator did not have time to listen to her or solve her problems. She interrupted her, she was talking to the other people who were in the office; she did not even look at the lady. The facilitator asked the participants to describe all the signs that showed that the administrator was a bad listener.

Secondly the two facilitators played the good listening and it was the opposite of the first. The facilitator recalled the importance of good listening and that on this second day they would do a lot of exercises on mutual listening and they should do everything possible to listen deeply while respecting the personal experiences of other.
 
3. Definition of loss, grief and mourning
Participants were asked to define “loss”. They said that it's about losing something or someone that is very important to you and that you will never see or own again.

She then asked to define “grief”. Participants responded that grief is the great sadness, despair and pain that result from the loss of a relationship, people, or things. In the end, the participants answered that mourning is a given period of time that we take to remember and honor those we have lost. These definitions helped participants remember their painful moments.

4. Personal loss
After the definitions of loss, grief, and mourning, we took time to share about the people or things that the participants lost. It was a good time to express their sorrow and commemorate their losses. We will see the results of this activity in the testimony section below.

5. The phases of sorro
The facilitator presented the stages of grief. After presenting these steps, she asked participants to give examples of each step. It was noted that participants gave examples of themselves. They noticed that these steps are general for any human who has grief.

6. Healing of sorrow
One of the facilitators had gone outside and she filled her pocket with rubbish, flowers, papers, pebbles. She came back into the room and asked the participants to guess what she had in her pocket . Some said that there was money, phone, and identity card. The participants noticed that they had said different things to reality. We finished this exercise by showing them that it is very important to reveal all the problems they had if they want to cure their trauma.

7. Definition of anger
A discussion about anger was started to make participants aware that anger is not a bad thing or a sin but a normal emotion. We have also seen that there is the normal anger of everyday life and the anger caused by the trauma.

Through the various examples given, participants noticed that there are constructive and destructive ways to manage and respond to anger.

The day was closed by identifying strengths and weaknesses of the day. The participants described what they appreciated in the training.

DAY THREE
The third day was focused on trust.

Meeting exercise: the mirror exercise: Two participants were invited to play the mirror game. One was the mirror of the other or vice versa. After this game, we asked for the lesson to be learned. They said that you have to trust someone because every person has something good.

1. Trust walk
We formed two groups. Some were blind folded while others were guides and responsible for their safety. We went for a walk and there were barriers in the road. Each had a partner. They were asked to come into the room and change roles. The one who was blind opened his eyes and led the other. After everyone had the chance to be blind folded and be led by the other who was not, there was a discussion about the game. Some said they did not trust their partners while others said they had no problem. The lesson learned is that when we have trauma, we need help/assistance. A traumatized person looks like a blind person and needs someone to guide or assist him/her.

 
2. The tree of mistrust
The facilitator drew the tree that represents mistrust. She asked participants if there are any roots of mistrust in our country. They answered: war, poverty, ethnicity, anger, and so on. The facilitator noted all of these root responses and showed participants that each tree has fruit and still asks for fruit from these roots. Finally, she asked participants if they can find this tree in their community. The answer was “Yes”

3. The tree of trust.
We did the same thing as the previous tree. Roots and fruits were found as peace, love, sharing of property, good cohabitation, wealth and so on. The facilitator ended this session by asking what could be done to build trust.

To answer this question well, we formed two groups. Each group should answer the following questions:

1. Does the tree of mistrust exist in your community?
     If so, what can be done to uproot it?
2. Does the trust tree exist in your community?
      If no, what can we do to plant it?
      If so, what can we do to help it grow?

In comparing the two trees, the participants found themselves attached to the tree of mistrust. To eradicate this tree, they have suggested the following:
- To give family affection to the children;
- Prayer
- Mutual aid
- Love
- Honesty
- Peace
- Unity
- Fighting against ethnicity
- Faithfulness in homes
- Be responsible

4. Closing and evaluation
The training was closed with the evaluation, the recommendations and the closing word.

In the evaluation, participants expressed strong points of training like Johari's window, good and bad listening, personal loss, and healing of grief. A weak point was especially the limited time.

Recommendations
- FWA was asked to follow up on the trained women
- Collaboration between trained women

To close the training, FWA coordinator clarified how we will strengthen the collaboration between the association and women trained by supporting them to organize themselves into self-help groups.
 
Testimonies
 
Participant 1: What really hurt me was that there was a man who raped me. I went to the hospital. The pregnancy test was positive, but I did not have HIV/AIDS. This man came to visit me when I had a new baby. He asked me to be his wife to help me. I did not accept because this man was married to another woman. I went to ask where I could spend the night at the neighbors. They accepted but they gave me a lot of work to do until I suffered at the spinal cord. I left the house and went to ask where I could still spend the night. There was a woman who greeted me but on condition of accepting to be a sex worker. I refused and went to another place. After four months, I married another man. After two and a half years, he abandoned me. What hurts me still is that my neighbors say that I give poison. Now I pray the Great God so that I can get away from all these problems. I thank again those who organized this training because the window of Johari has just helped me where we say things that I know but that others do not know.

Participant 2: My mother abandoned me when I was two years old. Because of that, I suffered from skin diseases. Then I got married at an early age. Unfortunately, my husband died when I had two children. I went back home (Karusi province), but I was not accepted with my kids. That is why I came back to Bujumbura and looked for a house to rent. What affected me today is that I do not have the money to pay the rent and to make my children survive. I’m thankful for this workshop because I did not know that I am traumatized. The symptoms of the trauma and its consequences helped me a lot.

Participant 3:  I was married in 1991. After three months, my husband was not killed. He left me two month’s pregnant for. I went home and was able to register my child in the commune. After five years, I went to Bujumbura to look for housework. After two years, I became pregnant and did not have the opportunity to continue the work. I gave birth and I was not able to take care of my child.

My family was against me again falling pregnant because it was a man who was married with a lot of women and I was not aware of that. Until today it is my mother who continues to help me despite the hatred of other members of my family. I only meet them at funeral parties. I greatly appreciated these lessons acquired especially the window of JOHARI who helped me to recognize meself.

Participant 4: I lost my mother when I was ten. She left 3 children including a six-month baby. My father had tuberculous. I could not continue my studies because I had the responsibility of taking care of the baby. My father married another woman who mistreated us. In 1993 when I was 13 years old, my entire family was killed. Fortunately, I survived alone. I had a soldier who was in charge of feeding. Every day, he gave me lunch and dinner. Unfortunately he is the one who raped me. Then I became pregnant.

This soldier rented me a house to have me as his wife. After a while, I got pregnant with a second child. The time came when my husband was sent to work far from me. He left reassuring me to support the second child also. It was a trick. I lived by prostitution to survive. I could not go to my family for reasons of ethnic exclusion. I was lucky to find where my partner lived and I gave him his second child. I headed to Bujumbura to look for money. Again, I became a prostitute due to lack of work. One time a certain man cheated me by taking me to his house after promising me that we will be legally married. I got pregnant again. But the man did not accept his child and he rejected me. After four years, this man came back to me. He told me he wanted me to be again his wife pretending that he had changed, but I refused. After some years, I found another man with whom we are living together until now. But he is not supportive. It is as if I am not married. Today I have problems in my mind because I don’t know knowing where my first two children are. Thank you very much for this training workshop that helped me to talk about these things that have wounded me for so long.

Facilitators:

1. DUSABE Joselyne
2. IRYIVUZE Berenice
3. NIYOKINDI Caritas