Diagnosis and Treatment of Sequels of Torture

July 4 juillet 16:00 – 17:45

Room NCDH–201

Chair:         Pierre Deschamps , Canadian Human Rights Tribunal, Ottawa

Discussant:  Thomas Wenzel , University Hospital for Psychiatry, Vienna

Building community support for survivors of torture

Teresa Dremetsikas , Mohamed Ahmed  

Canadian Center for Victims of Torture, Toronto

This paper will give an outline of the experience of the Canadian Center for Victims of Torture (CCVT) in rebuilding support networks for torture survivors trying to resettle in Canada. It will make reference to the programs at CCVT with emphasis on the volunteer program as a core program. It will describe the methodology and findings of a four-year research project conducted in partnership with the Faculty of Social Work at the University of Toronto.

Changes to broad social structures can disrupt human relationships and the reconstruction of human relationships contributes to social change. The initial research project qualitatively evaluated the “Befriending” component of the Volunteer Program at CCVT. The importance of reconnecting with the surroundings is paramount to the process of heeling from trauma, but this “reconnection” presents challenges such as, forming relationships among individuals, forming relationships in the context of trauma,·cross-cultural communication, the need for safety and protection and connecting with the wider picture. During the presentation, these five aspects will be explored in depth. Audience participation in the discussion will be encouraged.

One of the outcomes of this project was a training workshop (two-days long) that included a manual for volunteers, staff and clients. The materials displayed in this presentation will relate to the images chosen in the Manual “Befriending Survivors of Torture” in an effort to accurately communicate the issues encountered during the data gathering portion of the project. The images also address the preferences in learning styles suggested by the researchers and other participants of the project. The CCVT has always been aware of the need for going beyond tolerance and arriving at respect for human rights in order to attain harmony. Therefore, the presentation will aim at sharing our findings on the importance of community support for the mental health of survivors of torture and to achieve social change.

Treatment implications of acute v. chronic PTSD: A comparative study of three groups of rebel traumatised college students in Uganda

Eugene Kinyanda  

Butabika National Psychiatric Referral Hospital, Kampala

Seggane Musisi  

Makerere University

J. Rozermeijer  

University Hospital for Psychiatry, Vienna

This is a retrospective comparative study of three groups of students following a rebel terrorist attack on their school. During the night attack, the rebels set fire to the school dormitories in which about 80 students died, 50 suffered burns and 80 were abducted for recruitment into the rebel ranks. The rest (250) escaped with no physical injuries. The severely burnt victims were rescued and transferred to Mulago Teaching Hospital where they received immediate and intensive physical and psychiatric treatment. Months later, some of the abducted students escaped and five presented for psychiatric treatment. Attempts to organize treatment for the non-physically injured students failed. This study compares profiles, treatments and prognostic outcome of the three groups of survivors (1) the burnt but immediately treated; (2) the abducted who received delayed treatment; (3) the escaped, never injured and never treated. A modified Arcle’s IRCT standardized questionnaire comprising symptoms of depression, anxiety, somatization, trauma events as well as a DSM IV PTSD was used. Results showed that the burnt but immediately treated group recovered completely with no residual PTSD symptoms despite significant physical injury (burns); those who were abducted and tortured, but eventually escaped and later received treatment developed chronic and often complex PTSD symptoms; and the escaped uninjured group had minimal symptoms, although one subsequently became severely depressed and killed himself. These findings underscore the need for immediate psychiatric intervention for all traumatized victims and call for the establishment of a crisis response team to handle the victims of mass traumatization due to rebel attacks or bomb blasts. Lastly, we found that supportive social networks and economic empowerment enhanced the victims’ confidence and recovery. We, therefore, recommend this intervention in all rehabilitative programs for traumatized victims.

The psychological consequences of prisoner labour–The Kanungu case

Seggane Musisi  

Makerere University

Eugene Kinyanda  

Butabika National Psychiatric Referral Hospital, Kampala

Introduction: On March 17th, 2000, the world woke up to the horror of what came to be the largest cult instigated mass death–1000 dead at Kanungu in Southwestern Uganda. Prisoners from a nearby prison were used to excavate and rebury these bodies without concern about their psychological traumatization. Objective: To investigate the psychological trauma suffered by the prisoners who were forced to excavate mass graves of decomposing dead bodies at Kanungu. Methods: A previously tested research instrument was administered to all the prison inmates of Rukungiri Prison in Southwestern Uganda. This research instrument identified socio-demographics, physical and psychological trauma, charges, sentence and legal status and psychological assessment batteries. Results: For purposes of analysis, the prisoners were divided into two groups: the “Exposed group”, 30 (28.3%) who participated in the mass grave excavations and reburials and the “Non Exposed” group 76 (71.7%) who did not participate in this exercise. The Excavation Group had significantly higher GHQ scores (p=0.0011) and significantly more patients who met the criteria for Post Traumatic Stress disorder (PTSD) 23 (76.7%) compared to 4 (5%) in the Non Excavation Group (p=0.000). Conclusions and Recommendations: Prisoners who participated in the excavation of mass graves suffered significant psychological traumatization. There is therefore a need to improve prisoner conditions in Uganda including the observance of the Human Rights. References: 1. Beebe G.W. (1975) Follow-up studies of World War II and Korean War Prisoners. Part II Morbidity, Disability and Maladjustments. American Journal of Epidemiology 101:400-422. 2. El Sarraj, Punamaki R.L., Summerfield D, et al (1993). Experiences of Torture and ill treatment and Post Traumatic Stress Disorder symptoms among Palestinian Political Prisoners. Journal of Traumatic Stress Disorder 9: 595-606.


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