I’m a little late to post this here but I am the Society of Christian Psychology’sguest blogger of the month. Here’s the post that I put up for today on how to parse the next hot new model of counseling you come across. Check it out at:
http://christianpsych.org/wp_scp/2009/07/20/evaluating-models-of-christian-psychology/
Our final day in Rwanda! We fly out at 7:45 pm. This was a day packed right up to the last minute to get to the airport. Just like the Bishop to make sure we use every second! We had lunch with the Commission to prevent Genocide and the rector of KHI to present the beginnings of our proposal to them. We proposed a 3 pronged response to the needs we observed:
1. Information dispersal: (a) 1 page informational statements to educate adults and children about the symptoms of trauma, simple things to do if one witnesses another having a trauma reaction (grounding), and ways to remember the genocide without creating more trauma. This would be sponsored by the Commission; (b) basic workshops for psychiatric nurses, doctors, HIV workers, and pastors), (c) helping community care givers, and (d) developing better ways to run the memorial 100 days using their own new theme of Hope.
2. Support the sending of key Rwandans to the US to complete MA/PhD in Counseling so they can return as teachers
3. Developing a Masters degree counseling programfor KHI to run that is Christian based (at least a track of it would be.
Our proposal was met with enthusiasm!
We thought we were going to end the day with a bit of shopping. I got a bit of coffee and a few trinkets. However, on our way to the airport, we detoured to see the Minister of Education. He had been unavailable earlier in the week and now wanted to meet us before we left. Though we should have been at the airport, we flew across the city to meet with him for 15 minutes. As an MD, he was able to give us some good guidance.
Got to the airport and through security (much laxer than the US). A large number came to see us off. Sadly, the Bishop was not allowed to get on the plane. Something wrong with his visa (he got back to the States where his family is staying til December two days later). Our plane left one hour late and very full of children (expats on the way to holiday in Europe). Going up the stairs to the plane I got what I hope not to be my last sniff of the cooking fires. After the doors closed the attendants went through the cabin spraying something to kill mosquitoes (repeated after our brief stop at Entebbe, Uganda). They said it wasn’t dangerous to us but I wonder just the same.
After a full day in Rwanda, we travelled to Belgium (10 hours), had a lay over of several hours (where I purchased some Belgian chocolate), and then another 8 hours to Newark. Sadly, I cannot sleep on planes so I enjoyed several “Bourne” movies. Our team was not able to sit together on the flight to the US and this was sad. As we got off the very full flight, we lost track of Leah. We went in the wrong customs line and she must have gotten through before us.
So, we end our trip with much to process, little time to do it, and no time to do it together. I have grown fond of my new acquaintances in Rwanda and teammates Leah and Josh. But, now it is time to sleep as 40 plus hours of being awake is taking its toll!
Started the day as usual with some quiet meditative reading on the porch overlooking the lake and the distant sound of many children getting water on the other side (yelling Muzungu (white person) to get my attention). Diane read us this quote from John Fawcett’s “Christ’s Precious” (published by W. Milner in 1839, p. 82)
I am but a stranger in this world, wherever I may be situated, or however I may happen to be distinguished. And such, it is my privilege that I am so. [However] when I look not upon myself as a stranger and a pilgrim, when I am captivated with anything in this place of my exile, I forget myself, and act far beneath my character, as a candidate for an immortal crown.
Fitting. It is easy in the US to forget our “exile” status. We focus, instead, on our own status. But here in Africa, there is little to do but remember how fragile life is and how we must depend on God for our daily existence.
Today we met with Justin Remera, a psychiatric nurse at Gahini hospital. The hospital was built in 1920s. He is the head of mental health. He sees some 30 patients per day and has a caseload of 500 with PTSD. He sees lots of “epilepsy” and has documented some 350 new cases in the past 2 years. But they have normal EEGs, thus it is trauma related not brain injury. Justin told us that there is an openness to therapy here because they see the benefits.
Problems noted by him? no medications other than Haldol. Infrastructure needs. His office is the size of a small closet and he has had violent patients and no escape (his desk and chair are away from the door). Also, next to his office are rooms where patients were screaming (while we were there). Seems they may have been doing some minor surgery without anesthetic. He also mentioned problems with demobilizing military and their own trauma as well as his own burnout.
Next we went to Kigali and met with the the permanent secretary of Defense. One of the persons there talked about having 520 peer counselors in the military to deal with the problem of HIV. Nothing dealing with PTSD. They have NO chaplains in their military.
Next, we visited the National Council of Protestant Churches of Rwanda. Specioise told us that 52% of the country are protestant. They have a program to deal with gender based violence, to educate the the church about laws designed to protect women. Their booklet combines Rwandan laws and biblical passages.
For our final meeting, we visited with Jean Baptiste at World Vision. He is new to WV in Rwanda but not new to WV (previously in Mali). He is a tall man with much presence. He spoke very openly and honestly about the issues of NGOs in the country and the problem of lukewarm Christians. He suggested they were much more problematic than rank atheists or Muslims. He gave us some advice as how to work with both churches and government officials. Josephine, a woman Diane had worked in Rwanda on previous trips, was there and spoke of the continued need to train and care for Rwandan caregivers.
Our day ended in Gahini with a farewell dinner. Members of the church and community (the local mayor) attended a dinner at the Seeds of Peace retreat houses. The dinner was outside under a canopy. During dinner we watched the local youth perform traditional dances with drums, singing and costumes. The young women danced with wooden milk bottles on their heads. We learned their trick. A heavy stone in the bottom of the bottle helps it stay on their head. Ouch! The night ended with gifts from our hosts to us and a few words of thanks from us.
[Sorry for the delay. Recovery and vacation time to Maine took precedence to posting more Rwanda entries.]
In my last entry I spoke of our exposure to prisoners at a local prison–all innocent in their own eyes, or at least deserving of being forgiven and released. All had been convicted by either a federal court or a Gacaca (local) court of genocidal activities.
In the afternoon we invited victims and perpetrators to our retreat house to interview them about their experiences. Jared, a diocese employee, our driver, and wise man brought two victims and one perpetrator to us (in the same car!). We sat under a tree and drank Fantas together, first with the victims and later with the perpetrator. Here’s what we learned:
Victims. We spoke with a woman and two men. The following quotes are through a translator.
The woman told us she was hidden by a Hutu (this is one of the few times we heard this!). She lost her husband and some children in the genocide.
I saw it with my own eyes. People killed people who knew each other. Some of the criminals now live in the community. We share life. Their homes are close. Some of the criminal’s children are seen by me. Their father killed my family. I have forgiven him because he confessed. It is a formula…confess, be forgiven, and live together. But do I forget? No. I see him (the killer) hang back and hesitate to ask for help. Rwanda is a country of sharing but he hesitates to ask. I have to be the one who makes more efforts to connect than he does.
Older man.
I thank God I am alive. It is a miracle. I didn’t expect to survive. There was no place to hide because no friend was left. So, I hid in churches, bushes, and rushes. It was terrible to see. I lost 170 people in my extended family. Remembering is the problem not economical. I knew those doing the killing. I survived by some miracle by moving around and going to another town where they didn’t know if I was a Hutu or a Tutsi….Afterwards, we had to live with those who committed the crimes and now we are trying to cover. Among those who killed, some confessed. They blame the government’s teaching and mobilization. But now they thank God we have a government that wants unity. So, we have to forgive to live together.
Younger man.
I was 11 when the genocide started. Some teachers came to our class and told us, “Tutsi, stand up.” They counted the number of each. I was in the thicket when the killers came. Some Hutus covered me up. When it was over my father was dead. My brother was killed and my sister too in Kigali. Our family was nine. Now we are three. In 2005 I finished school. I have been a judge in the Gacaca courts. It is good that I survived but now I am head of my family and I have to support my mother and my two married sisters (their husbands have to support their own families of origin). But I have no job. I hope to go to university some day.
What is it like to live in the same village with those known to have killed family members?
We are taught to forgive by government but then we see the criminals with their family. So it hurts. His family can achieve what we cannot because they have their whole family. I can’t provide for my family because I am a widow. I could if my husband was still here.
They can hurt you with their words even now. During the three months of memorial they can say things that shows they are proud of what they did.
Does it help to talk about it?
Yes and no. You have to be selective who you talk to. Some one might be happy or proud that I am hurting. I don’t tell it in public because it might be used by someone without good intentions.
How are you feeling about your country?
Today we should build Rwanda together by using Gacac courts to build trust. We try not to be aggressive. Unfortunately, some confess only to get absolution.
Finally, we interviewed a man who is a confessed killer. He is admitted to kill our female victim’s husband. (Remember they came in the same car from the same village. We thought was hard by the woman didn’t think anything of it! EVEN MORE AMAZING, we learned that this man also killed Jared, our translator’s father. Jared didn’t bat an eye when this was revealed to us!).
Since 1967 we learned who is Hutu and Tutsi in school. In 1990 the RPF (rebel Tutsis from Uganda who later became the government) it became worse. People said Tutsis were snakes and taught us this division. “Cut bushes” meant to cut Tutsis with a machete. For me, the genocide started 6 April 1994. When the president was killed I thought Tutsis killed him. They asked us to take revenge and killed the Tutsis. We started the same day. I killed different people. I remember each and every one. It lasted one week. Only a few survived. The RPF stopped us. I was exiled in Tanzania. We came back in 1996. I was arrested and imprisoned. In prison, they mobilized us to ask for forgiveness. I learned that I could be forgiven by God if I confessed. In prison, there were two parties–those who confessed and those who wouldn’t because they wanted to finish the job. Those who sincerely confessed had charges dropped. I was given only 9 years. But in prison, some (we learned later that some meant his own father) some tried to stop me and said the government was tricking us. Now, I’ve been here for 6 years with no problems.
What did you hear in prison?
Some confessed in order to get free. Some wanted to kill me for telling the truth. But I don’t care, I just want to tell the whole truth.
What helped you tell the truth?
The church taught me that you must confess the whole truth to the victim so you can be forgiven by God. Also, once you do this, you have to tell it many times to get it off your heart and to realize what you have done. Yet, it is difficult to come back and live with people whose relatives you killed.
What is the hardest thing for you to deal with?
I’m responsible for their pain. I have flashbacks. I hear them (the victims) crying in my memory.
Today we visited Nsinda Prison (population 8000) to interview those convicted of genocide. As we pulled up to the prison we met a large group of prisoners returning to the prison from the fields. They had only 1 guard with a machine gun and another with a stick. Many prisoners carried produce. Again, it felt like we were transported back a century. It was a dusty ancient looking place with shirtless male prisoners carrying huge logs on their shoulders (for firewood for their cooking fires). We were ushered to a bare cinder block room with a log and metal roof. 4 stools were brought for us. One of us noticed several wasp hives attached to the roof. In walked 19 prisoners all accused and convicted of mass murder. Quite a few were women and two had babies. One baby nursed throughout the session. The one guard stood outside the room with the door open to the out of doors. We asked them about their experiences. These individuals denied much wrongdoing, felt their former government led them astray, confessed, asked for forgiveness but felt they were denied it. They espoused genocidal ideology in that Tutsis were accused of killing the president and succeeding in forcing out the Hutus in the country.
Oh, as we entered the prison, we were greeted with “Nothing but the Blood” in native tongue over a loudspeaker. Apparently, there was a church service going on. What a contrast between the song (which recognizes guilt and the need for cleansing and the perceived innocence of the genocidaires (“I only mutilated dead bodies.”)
Spent the day traveling around Kigali. First stop was Ndera hospital, the only psychiatric hospital in the country. It sits atop a dusty hill just outside the city. Upon entering the gate and getting out of the cars, we were welcomed by patients asking for water and money. The hospital has a 19th century or impoverished cold war era feel about it. Sterile cement block buildings set in a square. Sparse is an overstatement. We learned many staff and patients were murdered during the genocide. This hospital has over 200 patients (but just 12 beds for children). Psychiatric nurses provide the bulk of the care. Their “intake” room had one chair, one table and very little light. Patients lie on the grass outside in various states of unhealth. They have many with PTSD and schizophrenia diagnoses. Their only medication is Haldol. No “atypicals” or newer medications. A woman started screaming just outside our door. Translated: “Why does everyone hate me?”
From this hospital we traveled to the National Memorial Center to tour the genocide museum and grounds where some 300,000 have been interred. I couldn’t handle the room filled with poster size pictures of young children in happier days. The small print told of their favorite foods and activities…and how they were hacked to death.
Another lunch with a Christian counselor, Ms. Paulette, who told of her counseling work and training of lay counselors. After lunch, we met with the executive secretary of the Commission to educate about and prevent genocide. This handsomely dressed man shows the signs of his own trauma. he desires our help to guide the country to remember in healthier ways. Right now they play videos of the actual genocide and so during their 100 day memorial (April to July) they see so much trauma responses. He wished us to start right away.
Here’s a thought in my head: Does Rwanda need us or do we need Rwanda. I am amazed at how community minded this country is. They have no choice. People sacrifice for the good of all. They make do with a little. They are action oriented and start doing things rather than waiting to get it right. Risk calculation is not part of their thinking. What amazing things we could do in this country if we would learn from these people on how to put neighbor ahead of self.
Awoke to the call to prayer by the local imam. Did not sleep well. Sinus headache due to the ever present charcoal smoke. We left Butare for Kigali to meet with with the president of the senate (2nd in command of the country) but he was suddenly unavailable. Something about the presence of UN VIPs. I guess that trumps us. Instead we met with the a key person at the ministry of mental health. She lamented the need to use BA level psychology grads and lay helpers to do the vast majority of their counseling. Lunch at Moucecore where we learned more about their ministry to prevent HIV, to protect children’s rights, teach the bible and train individuals to be community leaders.
After lunch we met with the rector (dean) of Kigali Health Institute. They confirmed the need for masters and doctoral counselors with knowledge of mental health problems. They have no problems with specifically christian counseling training and would like us to help them create a masters program and also teach or do distance ed for them. From this meeting,we drove across the city to Barakabao Foundation another ministry of the Bishop to care for over 5000 orphans. These orphans are in either foster families or child-headed homes–and they do it all with 12 staff. As some of the staff spoke, you could see their own stress and trauma. When it comes to orphans, they see 5 different types: genocide orphans, orphans whose parents died in refugee camps in the DRC, orphans born through rape, those whose parents died due to HIV, and those whose parents are in jail.
The day ended in Gahini at the retreat house. The hot meal and bed are welcome sights after such a long day of meetings. On the good note, I had a 2 minute call home. Sam answered and was overjoyed to hear me. Told Kim I was fine. Not sure if I’ll get further opportunities. I admit I’m homesick. I’ve not gone this long of a time without talking to Kim.
Filed under christian psychology, counseling, Psychology, Rwanda
We arose early pumped up with adrenaline if not with good sleep. Our retreat house sits on the eastern end of Lake Muhazi–a long lake with many nooks and crannies. Just across the water are several red dirt paths leading to the lake. Children and women walk the paths from the banana treed village to the lake to fill their jerry cans with water. The plan is to travel first to Kigali and then on to Butare, some 2 hours south of the city. We were told this trip would be a breeze in comparison to a few years ago as the road is now paved.
Our first daytime views of the country reveal a lush green world with many hills and valleys. Everywhere people are working in their fields or walking to and fro. Most noticeable are the numerous children on bikes. They are carrying multiple cans of water, milk cans, 3 or 4 huge banana clusters. We are told these young children are not in school as they cannot afford to go beyond 6th grade. So, they make a living (less than 1 dollar a day) delivering water to the villagers to support their families One young man has balanced a table on his bike. Women are walking with bundles on their heads and babies wrapped up on their back. Life seems to be all about procuring enough water and food for the day.
In Kigali, we tour Moucecore, a nonprofit lay counseling ministry started by Bishop Alexis to train up community leaders to lead their fellow villagers to improve life for all. We’ll learn more about this ministry later this week. The trip south to Butare continues through beautiful, rural hills and sharp valleys (many vistas) filled with banana plantations, small knots of goats or cows, mud brick houses in all shapes of repair. We note a group of pink garbed prisoners working in a field. These are “genocidaires”. The trip included many hairy moments when passing slower vehicles or just missing pedestrians.
At Butare, we meet with the Dean of the faculty, a PhD in psychology. They have just begun a masters in psychology program and have their first group of graduates. Not sure thye really have much training. They have needs for help improving their program and for CE or grand rounds training. It will be possible to do such activities live as they will have fiber optic capacity by October.
After this meeting, we meet with 60 some pastors to hear about their experiences. They speak of those they fear are demon possessed, of young children traumatized by the videos of the genocide or by learning their parents took part in the killing. They have to deal with those infected by HIV due to rape and wonder how best to teach about forgiveness. We ended the day with some moving worship in the church. Though we could not translate the exact meaning of the songs, they still spoke to the heart.
[Returning home from Rwanda 2 days ago I am now trying to process what I saw and heard. So, I will post for each day. Pictures will be forthcoming as well.]
First impressions of Africa after traveling for 20 plus hours? The smell of charcoal cooking fires. Stepping of the plane onto the tarmac at Kigali airport your nostrils immediately detect the thick smell of smoke. Many people, even in the city and even if they have wealth, cook their meals out of doors. We were met at the door by Bishop Alexis Bilindabagabo of the Gahini Diocese. The bishop and some of his staff welcomed us and drove the four of us to our retreat house (The House of Tranquility on the east edge of Lac Muhazi). Since we arrived after dark we couldn’t see much of what we passed on our 1 plus hour ride. But we still had our experiences along the way! Picture an undivided highway with a mass of people walking or biking along the road and no street lights or reflective clothing. People of all ages and under all sorts of burdens. Even in the rural sections, we never went more than a few yards without seeing someone walking along the road. Further, people drive quite differently there. When a car approaches, use your left turn signal to let them know where your outer edge is. Also, use your horn as a constant means of communicating–brief honks to let the moped drivers that we were passing by. Oh, and though they drive on the “right” side of the road, our car had the driver on the left side. Since I was in the shotgun position, I had a wonderful view of oncoming traffic when we drifted across the lanes and around sharp turns while passing slower traffic.
Our group (Diane Langberg, Josh Straub (of AACC), Leah Herod (Columbia International University), and myself) had our first meals and meeting together on the plane ride but now we were glad to arrive at our destination–a stucco 2 story building with dining and living space and 4 nice bedrooms with shared bathrooms and the requisite mosquito nets (this picture was taken some time ago as the bushes are very much bigger than this).
A quick meal of vegetable soup, fried bananas, fried tilapia, cassava, rice, and potatoes (notice the heavy emphasis of starch) and off to bed. Tomorrow will begin our serious work of fact-finding, discovering the current resources, needs and possible interventions we might bring to deal with the problem of trauma due to the 1994 genocide of nearly 800,000 people in just under 100 days.
Already I am well aware of my self-centered life. I love Jesus but also comfort. I am struck by the level of sacrifice and hardship and the impossibility of turning a blind eye to dangers (moral, physical, etc.) in this country.
Tomorrow we are off to Butare, a university city in the South of the country.
Filed under christian psychology, Christianity, Rwanda
Ever had the experience of having your brain work overtime to try to make sense of some action, something done to you?
Some things make no sense and we know it–things like the premature death of a single parent, a genocide, impulsive choices that make matters much worse, etc. Yet our minds keep trying to figure it out. Why? How come? What does it mean? If only I could understand what God was up to then I could…
Sometimes, trying to understand the incomprehensible compounds and adds to our present sufferings.
We then tend to respond in one of three ways, (a) give up and stop functioning, or (b) develop antiseptic conclusions (e.g., God is going to use this to bless me later), or (c) put our heads down, ignore the pain and do the thing in front of us.
Response b may in fact be true but often it is used to help the person dissociate from the incomprehensible in a way to keep living and moving.
What do you find most helpful when dealing with an unsuccessful attempt to make sense out of suffering? How do you avoid giving in to ruminations about unanswerable angsts or hopelessness or its opposite, baseless optimism that denies the present reality?
Filed under christian counseling, christian psychology, Christianity, suffering, Uncategorized
Musings on Faith and Psychology 