The trauma concept of medica mondiale

“medica mondiale is a project very friendly to people: it came to the right place at the right time. It is the kind of work that will have its place in our history. It is like giving eyes to the blind, ears to the deaf, speech to the dumb. I hope this project will have a long life in our country.” (a Kosovarian staff member of mm)

Sexualised violence is an attack on the innermost self. A number of factors e.g. the taboo on the subject, fear of being disowned or threatened by one` s family, society and the sensation-hungry press are all reasons why women can never talk about their experiences and are thus forced to bear psychological and physical wounds for an entire lifetime. In its long years of working with these women, medica mondiale has developed a holistic concept designed to enable women to master their daily existence, to face the traumatic incident step-by-step and finally to come to terms with it in a safe and sheltered environment.

This mainly includes:

medical aid (gynaecological and general treatment)
psychological and social support as well as psychotherapy, legal counselling
making women's existence safe by providing living space and vocational training
protection from further insults and the risk of being re-traumatised by informing institutions (legal, administrative, medical) and the media, but also by training staff
developing criteria to ensure quality for work with traumatised women and girls
networking among expert services in order to provide interdisciplinary offers for victims through local staff members
political efforts to gain rights for women, publicity and disseminating information so that women and girls are granted political recognition and residency
development of concepts sensitive to the culture and suitable to location for working on trauma with women and girls
education and training of qualified locals to work with traumatised women and girls

Conditions necessary for effective work on trauma

Since 1993, medica mondiale has built up three counselling and therapy centres in Albania, Bosnia and Kosova. The conditions for the development of the concepts for work on trauma were very different at all three locations; the common denominator was to offer women low-threshold access to a broad spectrum of activities so that they could accept help at all. The social and psychological consequences of sexual trauma are varied depending on the country and its social structure. So does the possibility of coming to terms with it by means of therapy and psychological integration.

Setting up a wide variety of offers for support

This was far more difficult for traumatised women living in the patriarchal structures of countries such as Kosova and Albania than for Bosnian women, who were ready and willing to have the crimes publicly prosecuted. While the Bosnian women made intensive use of Medica Zenica`s offers from the very beginning, Medica Kosova had to help women overcome the silence and taboos in order to pave the way for aid and offers of help. Cooking courses and legal counselling were initially methods of gaining the trust of women and girls affected. When they had become psychologically more stable and had overcome their inner fears, it was at least possible for them to allude to the psychological injuries they had suffered in the presence of people outside their immediate clans. Today, the subject has more publicity in Bosnia-Herzegovina.

Creating Security in Shattered Surroundings

“The basic prerequisite for intensive work on trauma is not fulfilled until clients have the chance to gain control of their lives and to give it a direction,” says Ingeborg Joachim, bodyworker, psychotherapist and staff member of Medica Kosova. The first step toward progress is when counsellors succeed in providing a little bit more security and in breaking down barriers to social isolation through material support, health care and attentive discussions even under terrible living conditions.”

Have patience and do not expect quick results

For the clients at Medica Kosova, dealing with grief at the loss of loved ones who were missing or killed was the preliminary focus. Only then was it possible for the women to speak cautiously to counsellors about their experiences of sexualised violence. Some of the former victims are just now seeking contact to counsellors since the Kosovarian public has become more open to the subject. This development has been supported by the growing confidence of the Kosovarian counsellors, who have themselves been traumatised to some extent and have benefited from intensive in-house training over the past few years.

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