The danger of being re-traumatised

“How can I help myself if my children don` t have anything to eat? Give me bread and a place where we can sleep! (an Afghan woman to the employee of a humanitarian aid organisation)

The war is not over

The way a woman experiences the time after she has been violated is of crucial importance in coming to terms with traumatic experience. A safe environment, a good social network, sensitive and well-suited medical care, the feeling of being valued and respected and no longer at the mercy of others – these would be ideal conditions. However, all this can hardly be achieved in the aftermath of a war or in the countries that harbour refugees.

“War is not over with the last bullet” – this is the result of a study conducted by the Swedish women´s organisation, Kvinne till Kvinne, in which more than 200 women in Bosnia-Herzegowina were interviewed about their health and economic situation 5 years after the war had ended. It was made clear that the struggle for existence continues after and war and then goes on in exile. It does not take into account the injuries women are already carrying with them and within themselves and subjects them to a host of new insults.

Factors which endanger the success of a coming-to-terms with trauma

The family situation of women in post-war areas is very stressful in many cases. Family members have been killed, houses plundered and burned. Other members of the family, too, have been traumatised, so that many women are subjected to additional domestic violence. While fleeing or living in refugee camps, women and girls are confronted with insensitive uniformed helpers, a sensation-seeking press, and a bureaucracy which has little understanding of their needs. The sight of a soldier` s uniform, the smell of manly sweat, an attendant with good intentions who is too insistent when asking questions, the offer of “supplies in return for sex” in the refugee camps can cause survivors of sexualised violence to be overwhelmed with horrifying memories. Unfeeling behaviour during a medical examination, being questioned by the police or court of law can also cause the woman to panic and fall back into a state she has just overcome. This can lead to renewed trauma and a dramatic worsening of the post-traumatic symptoms and complaints.

Women in exile

In the countries that offer harbour, the special needs of refugee women – almost all of whom have suffered gender-specific violence – are rarely taken into account. It can by no means be taken for granted that they have female social workers, doctors, interpreters, and lawyers to turn to. Only a few of the contact persons and attendants know enough about the consequences of sexualised violence and psychological trauma, and often they are unsure of how to treat victims. The shelters, which are too small and too crowded and certainly do not provide any degree of anonymity, allow the woman hardly any opportunity to calm down and come to her senses.

In order to be granted residence for any period of time, the women have to report in detail what happened to authorities witnesses at hearings. For most women, this is an extremely difficult and stressful ordeal, as they are afraid of becoming outcasts of their families and of society. Often enough, their stories are not believed because – as is typical for trauma – they have memory blackouts and often give self-contradictory evidence. Thus, their applications for asylum in Germany are quickly refused on the grounds that they are “unjustified”. Medical opinions submitted thereafter are no longer taken into consideration.

medica mondiale is very involved in:

Making people sensitive to the problem and providing qualification
medica mondiale has successfully conducted training and qualification programmes in post-war areas for various professional and occupational groups (policemen, lawyers, gynaecologists, midwives etc.) The participants have been especially prepared for and made sensitive to the requirements of women and girls. At the same time, networking among participants has been improved. From 2004 on, medica mondiale has planned to train various occupational groups on the theme of “War Violence and Psychological Trauma” in Germany, too. The medica mondiale handbook on working with survivors of sexualised war violence, which will appear in 2004, also contains concrete tips and suggestions for various occupational groups on how to achieve a setting suitable to working with women traumatised by war.
Political lobbying specific to women
Their uncertain status of residence makes it almost impossible for women to come to terms with the violence they have suffered. Any progress made in therapy is undone when women are threatened with deportation or forced to return to their countries of origin. For this reason, medica mondiale has long struggled to achieve recognition of gender-specific reasons for fleeing in court decisions on asylum ( Human Rights). Women forced to flee in the aftermath of war lack every imaginable form of security. This is a great cause of concern and receives far too little recognition internationally or in Germany. Monika Hauser from medica mondiale therefore helped to develop recommendations and guidelines specific to women for the third UN Security Council Meeting on “Global Consultations on International Protection” which took place in Geneva in 2002.

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