Thursday, March 1, 2012

"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 


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