The violence and cruelty of war conflicts often supersedes that which people as individuals or as a society can psychologically and socially deal with. Rape and serious domestic violence are experienced as traumatic experiences which lead to existential threats and mortal fear. A psychological trauma destroys the feeling of security and it attacks primordial trust. Personal borders are violated, self-esteem is undermined and an overwhelming feeling of helplessness is created. As a result, panic attacks, depression, chronic pain or Post Traumatic Stress Disorder (PTSD) can impair the life of the victims for many years.
It is important to know about the possible health impacts of violence against women. Equally important is not to pathologize these women and to reduce them again to a victim status. To start with, a trauma is a “normal” bodily and mental reaction to an occurrence which is beyond “normal” human experiences. With good social integration, a safe environment and, if necessary, medical treatment, many people manage to deal with traumatic experiences without becoming seriously ill.
Difficult living conditions and lack of support
Unfortunately, the living conditions in areas of war and conflict and in post-war societies are usually characterised by existential need and by continued danger for women. Furthermore, many survivors try to hide the fact that they have been raped, because they are afraid of being stigmatised or in the worst case, of being rejected or killed by their family. Also, they meet people in clinics, refugee camps or from aid organisations who are usually totally unprepared to deal with their problems. For these reasons, the women are often isolated and on their own with their situation and do not receive the necessary and often life-saving support. In the worst case, insensitive and wrong treatment can lead to a retraumatization and to new injuries.
Trauma-sensitive counselling and support
Apart from the psychologists and psycho-social counsellors, all staff members of the local medica mondiale organisation (doctors, midwives, lawyers) need to be able to identify signs of traumatisation and of experience of violence even if the women do not talk directly about their experience, as the feeling of shame and the fear of stigmatisation prevents many women from doing so.
medica mondiale’s psycho-social trauma work
In our local projects, medica mondiale only works with indigenous psycho-social counsellors. In many countries, psycho-social and trauma-specific work methods are almost unknown, and there are therefore very few trained specialists on the ground. At the same time, there are usually no functioning traditional “healing rituals” or other approaches for women. This is why medica mondiale offers intensive further training to all of their local staff and invites them to share their experiences with colleagues from other mm projects.
Psychosocial work in counselling groups
One very successful approach is the psychosocial group work, which is particularly successful because the participants can discuss their problems within the group and support each other.
Individual psychosocial counselling and therapeutic work
In addition to the groups, individual counselling sessions are also offered. For many women, this is the only setting in which they can speak about their painful experiences. For women who are acutely threatened by violence, the initial focus is on crisis intervention and psychological first aid, which is then followed during the counselling with the recreation of security and with stabilisation.
