What is Social Justice?

There will be no humanity without forgiveness,

 there will be no forgiveness without justice, but justice will be impossible without humanity. 

- Yolande Mukagasana

As the following video clips will demonstrate the Gacaca courts were implemented by the Rwandan government in an attempt to limit international punitive and costly judicial systems. In addition, asking how would restoration be fostered?

 “Instead, the government proposed to set up community-based courts to try genocide-related crimes using the customary gacaca model. Aimed at speeding up genocide trials, reducing the prison population, and rapidly rebuilding the nation’s social fabric, the new form of gacaca, like its customary predecessor, would be run by local judges and would encourage participation of local community members. One of the government's aims in encouraging community participation was to make ordinary Rwandans the main actors in the process of dispensing justice and fostering reconciliation. A series of gacaca laws would regulate the genocide trials, mixing certain basic fair trial standards with more informal procedures”. 

Human Rights Watch, 2011 

Restorative justice uses a different lens to view reconciliation and self healing. As practitioners it is valuable to incorporate a methodology that uses the client perspective and innate understanding of their own ability to identity what they need for self healing, to find inner peace, restore joy in their lives, and to feel justice.

How often as practitioners do we ask:
“What justice do you require from society to support your personal healing?” (Mollica, 2006, p. 243)

Punitive judicial systems do not address reconciliation nor do they address social healing after gang violence, domestic violence, or other forms of person to person violence.


This is a complex topic with multifaceted perspectives and arguments. These videos are just scratching the surface, but it does challenge and promote thought. The gap in viewpoints can be the political and society systematic oppression and social inequalities based on ethnicity, race, and individualistic agendas. In addition to our domestic culture of punitive judicial systems that favors isolation vs assimilation, retribution vs reciprocity, and ostracizing vs reconciliation. In addition to taking into consideration the cultural value of indigenous population, where a collective society framework serves to promote social healing. Looking through this lens, it does challenge us to look at our own social norms in achieving “social justice” and the potential for short comes in fostering social healing.

Memorialization

Two Saturdays ago I did a day trip to Ntarama genocide memorial were 5,000 Tutsi were killed and Nyamata were 10,000 Tutsi lost their lives. Both memorial cites are churches were people fled for safety and solidarity in groups, consequently the mass deaths were perpetrated in the confines of the church walls.

Having visited Dachau concentration camp and the dungeons of Cape Coast castle were African slaves were held before walking through "the door of no return", I knew the potential  gravity of  memorials at the specific location were horrific violence was perpetrated. However, both cites were graphic and I left with residual uncertainty of the implications of the memorialization and the healing process of cumulative trauma. Essentially, at Ntarama the church is filled with the remains of everything that was found left after the execution everyone in the church. The far right wall is shelves ceiling to floor with skulls fractured, broken. The benches serving as pews are heaped in layers of clothing torn, blood stained. The far left wall is shelves with the belonging people brought with them "to wait out the violence" cook ware, school books, mattresses.

At Nyamata,  the second cite I visited 15k south of Ntarama, the church contained the bones and clothing of the victims, in addition, behind the church were to crypt that held grouped remains of families in coffins, their names typed out and tagged, some containing up to ten people, some whole families, gone. I was the only one there and after going through the first crypt the gravity of the mass loss and the trauma stories of survivors I have met since here began to play in my head. I walked over to the other crypt and peeked in, it contained endless rows of shelves filled with skulls and bones. I couldn't get myself to walk down the stairs into the collective burial of hundreds, I just stood there, overwhelmed. I heard a hissing sound, looked around, and outside the gate, on the road, a women was watching me and gestured for me to go down. She instructed me through hand gestures, I needed to see. I needed to witness. Witness what transpires when a global community negates to concede ethnic cleaning as genocide and genocide results in 10,000 in one rural community, 5,000 15k north, 800,000 nationally die in 100 days.

The historical trauma resides in mother to child transmitted HIV, in orphaned youth raised on the street  now impoverished young mothers selling sex to feed their child, in mother's who are fearful overtime their child leaves the house because they can not bare any more death. These are examples from the testimonies of a few.

Pictures were not allowed inside and to be honest I didn't want to take any overly graphic or exploitive of someone's loved one. This is a picture from the outside of the church in Ntarama. Explosives were used to blow holes in the barricaded building. The clothes are taken from the victims. 

Lesson in Gender Roles

Rwandan male with serious firm demeanor states "Men drink beer and women eat chocolate"
Me "Can't a person do both?"
He just looked blankly at me with no comment.

Welcome to challenging gender roles. My first family session this week was a mother and son in conflict over property disbursement. The older son received a house for himself, his wife, and children. The younger son has to share the other house with his male cousin. Were do the three sister live? I asked. "They are fine and do not need a house of their own". ....oh, interesting!


The cultual lessons are fascinating. I am enormously enjoying the challenge of learning the language of family relationships in the Rwandan context. Every family brings their own history of beliefs and social norms, the challenge arises with my feminist perception of egalitarianism meets traditional patriarchal  social structures. Hence, my Rwandan co-facitiltor stopped the session and in English gave me a lesson in Rwanda culture of traditional beliefs. Good stuff!


Two bus rides, two moto taxis, and a bike taxi later I arrived in Gashora in southern Rwanda close to the border of Burundi. There were supposed to be hippos in the lake, but I didn't even see a fish jump. Beautiful though, with great birdlife.

"Everything is fine"

Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life.

- Judith Herman

To generalize, Rwanda is reserved, formal, and conservative. Emotions are to be contained, hidden, and kept silent. So, as a counselor, you find yourself always second guessing statements of “everything is fine”. 

In the last month, two youth in the WeAct program have attempted suicide, which the staff are reporting is a new phenomena they have not experienced at the clinic. As a case consultant I have been working with the staff to have proactive, preventative responses. The interesting part of the situations is the family and/or caregivers initial crisis reaction is then followed by an “everything is fine now, it is over”  statement and attitude. To be honest, at first I was shocked, confused, how is this call for help so quickly minimized? 

Lesson #1: Removing myself from my own norms about suicidal ideation, the pieces started to fit. Rwandans are living under the context of historical trauma, their responses are bent, skewed as a result of facing mass violence. After seventeen years post genocide, trauma responses are dulled, numbed, and overextended. They have faced the worst in humanity and are not surprised when faced again with someone’s attempt at self harm. Not to anyway infer they do not care, have less concern for their loved one, but the residual need for continued support does not seem to be relevant which can challenge counselors partnering with the youth and their family to create a safety plan.

Lesson #2: My knee jerk reaction of how can we keep this youth safe, frustration of why is this so slow to make an appointment for counseling, and why does no one else on staff feel an urgency?  I continuously have to remind myself that I am working with counselors who are also survivors. I have had to take a few steps back in my interactions and training with the staff and realize that I not only have to meet my client’s “where they are at”, but this applies to working with a cross cultural staff, particularly in a historical trauma context, otherwise like with clients I will do more harm than good. 

Lesson #3: One family missed the last follow up appointment which was aimed at gathering info to assess suicidal ideation. The family member stated she will not return for services, that she was “bewitched”, she has since been prayed for, and is it over, the evil spirit is gone. Yep....how about that for cultural context! Not to say that you can’t find that is Western religious sectors. I meet with the psychiatric nurse, who has the case, to get his thoughts and perception on how to move forward. His response was “we have to help them mix the old traditions with the modern way”. Interesting...challenging, Rwandan counselor meeting their clients where they are at in true social work form!

So as you can tell from my blogs, I end up divulging all of my “aha” moments. I am just hoping I give back a remotely small amount to what I feel like I will be vastly taking with me from this experience. 

** The last Saturday of every month the entire country shuts down from 8am-12pm for cleaning. Everyone citizen is expected to stay home and clean their community. There are police checkpoints everywhere, and if found out and about you are fined! So, being that Rwandans have a rather adverse feeling toward cameras, I took the opportunity to go around the city and capture a few things to give you a flavor. 

WeAct Clinic 

Intermission

So I am half way through my time, started slow and calm, now building momentum. The interesting aspect of my internship is the not so apparent cultural undertones that coincide with body language, eye contact, and lack of emotive. I am learning slowly, in addition to realizing my assumptions are often wrong.

As a response to the genocide, in 1998 the Rwanda government's Ministry of Rehabilitation, at the urging of a British citizen Rwandan women (who lost fifty members of her family in the genocide and returned to help bury the dead and help survivors), developed the Funds for Support of Genocide Survivors (FARG) which, among other objectives such as housing and education, recruited and trained the first lay trauma counselors. As reported by someone who was within this initial group training, their role was crisis intervention, going into schools and places of work, when a genocide survivor was having acute flashbacks or trauma stressors. In 1998, there were only 30 counselors nationwide, on call 24/7, providing counseling for both survivors and perpetrators. It was a daunting task. In resource limited countries lay counselor are trained to address the trauma of post conflict or natural disasters. In recent years over 10,000 Rwandans have accessed trauma counselors and the number is growing.

Part of my placement is working with WeAct's psychosocial team to provide case consolation in using Cognitive Behavioral Therapy (CBT). The complications arise when trauma counselors are trained in a specific active listening and trauma narrative training, so using CBT can be confusing and cumbersome to navigate at first, although it has been surprising me how quickly the youth grasp and apply cognitive restructuring as benefiting themselves and their relationships. As a way to help the youth counselor utilize CBT, we have been doing joint sessions together, beginning with me modeling CBT and will change over to her taking the lead and debriefing afterwards.

For many youth the living situation consists of a combative relationships with his/her mother or caregiver, unknown father, HIV+ status, and living in chronic poverty. To be honest, I understand how anger could be a major player and a negative self identity could be established. Although I felt like we were making progress in session with a young man, from what I gathered during the session, he would rarely make eye contact, never smiled even at my horribly cheese attempt to be funny, and seemed utterly bored and ready to bolt. At the end of our last session we were rescheduling for next week, he said he can't come next week, to be honest I was not surprised and thought at lest he is letting us know now instead of not showing up, I asked why, ready for him to make up an excuse, he said he didn't have bus money, I asked if you had the bus money would you come, he said yes, I said how much is it, 1000 Rwandan francs ($1.50). He said "I want to change, I want my family to change, I want to work on my anger". I choked back tears and gave him the money.......all the assumptions I was making during the session fell short of incorporating a cultural competent understanding of body language!
 Again, I learn ;)

Wish you all well, thanks for the feedback, it is both reassuring and inspiring.

Gives you an idea of the landscape,

May be little, may have a funny mohawk and a seemingly extra long tail , but wakes me up very morning at 5:30am. 

Coasting

All over Rwanda, rural or urban, there is a massive number of moto (motorcyle) taxis. Much cheaper than car, they are the primary mode of transportation for shorter distances. It is no exaggeration to say there is never a flat area in Rwanda (except maybe for the Eastern Provence), therefore in an effort to conserve gas, the moto drivers change to neutral gear when down hill coasting for miles. In another life, I would love to be a moto driver in rural Rwanda!

So it has been some time since I last updated you, no specific reason, but simply articling thoughts and feelings about my everyday experience here has been difficult, they range on the hour so pinning them down feels complicated.  Although, my scope of work is consistent, for the most part, since my last update, the fluidity of cultural norms, my western perspective, and the background of historical trauma keeps a consistent ebb and flow of hopeful and discouraging feelings.

 Once again, I am reminded international work provides a platform for intense personal reflection and awareness. Putting academic endeavors in the midst and my own fueling of goal objectives while at WeAct has provided a complex assortment of pressure to be organized, goal oriented, and a clear outcome to substantiate my time here was productive. When voicing my frustration and fears to a wise friend, she reminded me of our innate cultural need as Westerns to set a goal and measure our accomplishments, contrary to African culture (and many others) who value the process regarding relationships and fostering a sense of community (Thanks, Kim!). Therefore, instead of speeding to a goal telling me I have arrived thus confirming my contribution, I am working at coasting, conserving my self serving need to check off a goal obtained, and focus on partnering with WeAct staff and youth to assure to meet them where they are most in need, to take time to understand the cultural perspective of care and where I can help contribute, support, or just listen.

Oh...and over the weekend visit to Lake Kivu, I took an amazing moto ride along the coast although it was mainly up hill, so we didn't get to coast :)

Lake Kivu, North Western Province

Home made pottery from a local co-op.

Sixth largest fresh water lake in Africa. Really nice swimming, this is an inlet, the lake is vastly wide you can not see the DRC on the other side. 

Fishing village

Hitching a ride!!

Heading out at dusk. The fishermen collectively sang rhythmic traditional songs on the way out and the way back home. Amazing moment to witnesss.  I have video, but my internet is too slow :(

Taking Shape and Getting Started

So you have an idea of how WeAct was started and the mission of the organization, this last week has provided for additional assessing of needs and has provided a scope of work for me to begin. But first I will give you a little background info.....

WeAct's HIV+ youth population is struggling with adherence to their medication. For those of you unfamiliar with HIV treatment (which I am learning as I go). There are levels of medication (ART) 1-3. Level one is one pill daily and which most people are able to stay on for roughly four years before having to move to the second level, however if you do not take your medication on a daily basis than your body can not fight the virus and you are moved to the second line to get the virus under control. The second line is 9 pills daily ( 4 in the morning and 5 at night). For a large group of WeAct (a global problem not specific to WeAct youth) is having multiple barriers in taking this on a daily bases, thus many are putting themselves at risk of shortening their life span and risking death within the next few years if not adhering. In addition level 3 ART is not available in Rwanda. So if level 2 is not working for you any longer, you are essentially out of options.

Focus groups and psychosocial assessments have established that barriers to ART adherence are too many pills, pills are to big, and bitter tasting; depression, hopelessness, and self deprivation; gender based violence; and social stigma. For many youth they live in fear of disclosure of status, many have not told anyone, they fear someone seeing them take meeds, hearing the pill bottle rattle in their school bags. HIV is still shrouded in myths and misconceptions of transmission. Many live with caregivers (1 out 4 are orphans) that isolate them by making them have separate dish ware or treat them differently then non HIV youth in household by not sending them to school for example.

The US consultants (a medical physician and a psychologist) have been working on a substantial grant that would implement an intervention using Trauma- Informed Cognitive Behavioral Therapy to train Youth Leaders to run peer groups to work on changing the negative thinking surrounding HIV, social stigma, depression, and trauma. For resource limited communities this has been a way to intervene and provide psychosocial education and support.

So, essentially my role will be multifaceted. In part, (a) I will be working with the youth counselor to consult on using TI-CBT with the youth she sees in individual counseling. There are a few youth who speak English, so I will be sitting in on the sessions (I was able to sit in one a session yesterday to get a feel for the process and have to say I am very much looking forward to client contact). For other cases, we will be doing case consolations weekly. (b) I will be working with the child psychologist to develop a psychosocial assessment for children 6-11 to help build preventative care for younger children with depression or other mental health indicators. (c) I will be developing a curriculum for the TI-CBT intervention psycho educational section (cross your fingers that the grant is approved) for both the Youth Leaders and corresponding parent workshops. and (d) provide follow up CBT training for the WeAct psychosocial counselors. Did you get all that? cause I'm not sure I do!!!

In the meantime, I ventured out of the city about 5 hours southwest to Nyungwe Forest National Park this last weekend and hiked through the rainforest, no wildlife, but the foliage was incredible. Here are some pictures to share...so beautiful, refreshing to be in nature!

Let me introduce you to WeAct

Although this week has been filled with the time consuming task of grant writing in an effort to be able to keep services up- and- running and to branch out... instead of going into details, I would rather tell you about the my placement organization.... in the mean time just keep your fingers crossed that the grants are approved!

The 1994 genocide perpetrators utilized rape as weapon to infect Tutsi women with HIV. The result  continues to effect the women and youth of Rwanda seventeen years later. Post genocide, an influx of ART (antiretroviral treatment) was given to the Rwandan government to address the HIV pandemic. However, the government decided to give the ART to male prisoner, genocide participants.

 Rwanda has a long  history of women collectively forming associations to address the betterment of their communities, so several associations made an effort to address this social injustice.  In response, The Women Equity for Access to Care and Treatment (WeAct) was established in 2004 with the mission to provide HIV medical care to all women and their children (mother to child transmission).

With U.S. AIDS research and medical physician collaboration with the women's associations,  began the journey to establish a clinic to serve the HIV infected victims of the genocide. Once the intake process began, the emotional trauma was an apparent need to be addressed, in addition to the medical care. Often in post conflict regions, lay counselors are trained in trauma counseling. So, partnering with Heartland Alliance (a Chicago based non profit) providers of trauma services both domestically with torture survivors and internationally with various post conflict regions, biannual training continues to take place with a staff of all Rwandan psychologist, psychiatric nurse, and three trauma counselors.

WeAct currently works with over 2,200 patients providing holistic medical and psychosocial care, income generating training, and legal advocacy.

My internship role is still in the works of being fleshed out, in the meantime, we have another grant for this week to write.

Hills of Rwanda

Ahh..... So we begin the narrative of my experience interning in Rwanda. However, my internship starts next week and I have only had a brief visit to the organization to make acquaintances. Monday will begin my emersion and hopefully, after meeting with staff, a clear project plan will emerge for my time here.

In the meantime, the geographic beauty surpasses my expectations, I have yet to leave Kigali ( the capital) yet am surrounded by lush foliage, beautiful flowering bushes, and the birds here have a sound of their own (which I will try to video... you have to hear this). I am so anxious to explore the rural areas, but have to say that the city life ain't half bad :)

This week I attended a conference by World Learning on Conflict, Memory, and Reconciliation. I went with the expectation that they would be discussing applied case studies or interventions, however, the content was more theoretical and conflict analysis. Interesting, to be honest a bit over my head, but I came away with some insightful questions surrounding using testimonies, the manipulation of historical narratives as truths, and that memory has individually, collectively, and nationally variations that can create both silence and conflict. The critical analysis application to various global conflict should me my own limitations or lack of seeking to understand the side of all participants in a much broader realm ( which embodies social work principle but can often be negative without sufficient background analysis). However, the lack of application was a disappointment due to lack of tangible illustrations.

Today, I had the opportunity to present a research proposal on behalf of a clinical psychology graduate student ( and fellow Kovler intern) to the National Rwandan Ethics Committee. Although, the panel was gracious in their feedback and questions, it was a bit stressful in the hope that they would find the research significant. The proposal is to conduct a 6 week module on Compassion Fatigue for trauma counselors with WeAct ( the organization I will intern with). I have taken on the role of research assistant and am hoping that this comes to fruition.


Plan to takes some picks over the weekend to at least share me lodging (which is amazing) and share the scenery.

Best Regards