Voices of Caregivers
We have an obligation to stick our necks out.
It goes with the territory…
Yassar Kanawati, MD, is a Board Certified psychiatrist, originally from Syria. She received her psychiatric training in Paris and at Wayne State University in Detroit, and now works with the Center for Torture and Trauma Survivors in Atlanta, Georgia. Yassar was interviewed for our forthcoming documentary, Refuge: Caring for Survivors of Torture.)
“They were treated as objects. If someone asks ‘How are you feeling? ’ it validates that ‘Yes, you are a human being.”
“I work with a group of refugees who all came from Iraq. I have a group of about 6 –8 people, sometimes more – most of the time more. I’m a child psychiatrist by training, so I always ask about the children.
“I will tell you about a kid who was himself kidnapped and tortured. He was six years old. He saw his best friend slaughtered in front of him, and the kidnappers told him, ‘If your parents don’t pay you’ll be like this.’ So the parents had to sell the house and pay a big ransom to save him. He would cry all of the time and his mother, who was part of our group, would say, ‘Please do something. This kid cries all the time and doesn’t want to leave me.’ Each time he would go to school he would have behavioral problems, emotional problems, fighting with the other kids. So the teacher would give him time out and yell at him, and he would remember the kidnappers and get more depressed and agitated.
“So I saw him and talked with the school, talked with the counselor and the teacher. The problem is no therapist would take Medicaid here, so there was no therapy. So I met with him and talked with him as much as I could, even though my job is with adults. But he needs much more support.
“Immigrants that were tortured would love for people to talk to them and ask them, ‘How are things?’ They might not talk about the torture, but it is important to just be there and not be afraid to talk with them. They went through horrors…horrors. They were humiliated; they were treated as objects, treated as nobody. If someone asks them ‘How are you feeling? Can I help?’ this means a lot to them. It validates that ‘yes, you are a human being’.”
Steven H. Miles, MD, is the author of Oath Betrayed: Torture, Medical Complicity, and the War on Terror. He is also a practicing physician, who works with torture survivors through the Center for Victims of Torture in Minnesota, and is on CVT’s Board of Directors. Steve was interviewed for our forthcoming documentary, Refuge: Caring for Survivors of Torture.)
“Just as physicians in training miss domestic violence because they don’t recognize that patterns of injuries and responses on the part of women coming to clinics and hospitals, they also very much underestimate the prevalence of torture. Every major teaching hospital now speaks about 70 languages a day. Torture is present in each of those hospitals, and it’s still way under-recognized and it’s not adequately emphasized in the medical school curriculum.
“People who are tortured don’t just have a personal psychological condition called post traumatic stress disorder, they also have occupational impairment because of their failure to have intimacy to network. They may have problems forming personal relationships, or difficulties with parenting, which affect the behavior and growth of children. So torture is something which is enormously costly to the whole society and is something that needs to be addressed on the scale it exists.”
“The prisoner knows that they cannot expect mercy from the government. They cannot expect mercy from the guards. They cannot expect mercy from human rights officials, who never get into the prison. The only place they can expect it is from the decency and the professionalism of the health care staff of the prison. And so when those health care staff side with the brutal guards and the interrogators to inflict torture, they convince the prisoner that they are utterly beyond any appeal to humane treatment. This is the report of people who have been tortured.”
Brandon Khort, MD, PhD, is a Resident in the Department of Psychiatry, Emory University, and the founding Director of the Atlanta Asylum Network, a program in which student volunteers work with attorneys and physicians to support applicants through the asylum process. Georgia has one of the lowest asylum grant rates in the country. Brandon was interviewed for our forthcoming documentary, Refuge: Caring for Survivors of Torture.)
“The body becomes the testimony,
the evidence of what they survived…”
“When we first started, the asylum approval rate in Atlanta was three percent. For the cases we’ve been involved in, our case approval rate has jumped to about 40 or 45 percent.
“In many cases torture survivors have no evidence on paper of what they’ve gone through, so the body becomes the testimony, the evidence of what they survived. The physician becomes the translator. It requires someone who’s an expert in identifying how the body works, how the nerves work, how the mind works, to be able to explain, ‘This is the result of torture.’ But even more important than that is how to deal with people who have gone through this experience. A lot of people who have been tortured have had a doctor present during that experience. So they’re very uncomfortable in the clinical setting.
“One case was a man who was beaten in the abdomen. The physician who was present observed some abdominal bleeding, so the prisoner was taken to surgery. Then he was brought back and was tortured again, with the physician present to make sure the bleeding didn’t recur.
“Growing up, my father was a doctor and I saw medicine as helping people when they were sick. After being involved in this program, I see medicine as a much different type of tool – as a tool of social change, a way to re-craft the way people experience their lives beyond just treating disease.”
Rachel Boersma, PhD, RN, is a forensic nurse and the Chair of the Graduate Program in Forensic Nursing at Fitchburg State College, Fitchburg, MA. Dr. Boersma interviews torture survivors who are seeking asylum, and testifies on their behalf in immigration hearings. Rachel was interviewed for our forthcoming documentary, Refuge: Caring for Survivors of Torture.)
“We have an obligation to stickour necks out.
It goes with the territory.”
“My first case was a woman from Africa. I had been a psychiatric mental health practitioner for years, I had been the nurse manager of a psychiatric trauma unit, so I really thought I understood what trauma was. But as this young woman’s tale started to unfold: how the rebels basically razed the village and her family was killed – some of them, in front of her – I was absolutely overwhelmed. Overwhelmed with what? With my own ignorance, my own cockiness, thinking that I understood trauma. This was beyond anything I had ever heard before.
“The lawyers were expecting a forensic psychiatrist and here I was, a nurse showing up. But the judge, when he heard my background and looked at my CV, said, ‘Let’s hear what she has to say.’ I had never been in that setting before, I’ve never had to give expert testimony. So it was kind of birth by fire, but we won the case. That day we knew that she was going to be allowed to stay. And I think at that point, I was smitten. This was something that allowed me to use my nursing skills, my forensic training, to potentially make a dramatic difference in the health and well being of someone, in a way that you don’t get the opportunity to in clinical practice.
“As nurses we have really a social mandate and an obligation to do good, to promote health, and to sometimes stick our necks out and get involved in things that are unpleasant, uncomfortable, uncompensated. But that is the area of practice, the discipline we chose. This goes with the territory.”
Patricia Shannon, PhD, LP, is a Clinical Psychologist at Minnesota’s Center for Victims of Torture, where she developed and managed the New Neighbors / Hidden Scars Project. Working in a neighborhood which has received more than 15,000 African immigrants, the project brought together schools, clinics, churches, law enforcement, and other organizations to help the new residents heal, and adapt to life in the U.S. (Patty was interviewed for our forthcoming documentary, Refuge: Caring for Survivors of Torture.)
“Unless they see it in action that they’re treated respectfully
by the police, they won’t believe it — so situations escalate.”
“We have many stories of clients who’ve been here for years — they know they’re supposed to stop at a red light, but if a police car comes up behind them they panic. It’s a PTSD reaction, and they go through the light and the police stop them…Our clients think that if they get involved with the police they’re going to be put in jail or imprisoned and tortured. You cannot convince them that they’re not going to be tortured at the police station. Unless they see it in action that they’re treated decently and respectfully by the police, they won’t believe it, so all kinds of situations escalate.
“I had a client in jail – his friend was driving drunk so they were both put in jail. He had a flashback that he was back in Palestine and he started doing what they do in Palestine which was to bang on the doors and do all this stuff to try to get released. But this was in a suburban police district where they thought the guy was crazy and they eventually put him in restraints.
“A lot of times they don’t understand how things work and I don’t want them to get in trouble right away. If there’s any DUI charge that comes to a felony level, or any abuse charge, any domestic conflict they might be having, that’s grounds for deportation. And if they get deported back home – our particular clients – they may get killed.
“Our clients had a huge reaction to 9/11 and Abu Ghraib. They almost uniformly said they came here for safety, and after 9/11 they felt like it was just like back home – that there’s no place they can go to be safe. And then Abu Ghraib had a terrible impact on everyone’s sense of safety. I think it made it a much grayer issue for them. “How do I know, even though I’m in the United States, that I’m not going to be tortured here?” And how could we reassure them of that? We couldn’t, really, so it was difficult.”
Eva Solomonson, MSW, LICSW, is a social worker and Healing Team Leader with Minnesota’s Center for Victims of Torture. She was interviewed for our forthcoming documentary, Refuge: Caring for Survivors of Torture.)
“I have one more question for you. Why are you
doing this for me? Why are you helping me?”
Just the other day, I had a client who I’d been working with for a year and a half. We were finishing up the session, going over our six-month care plan, and he paused and he said, “I have one more question for you.” I said, “Okay,” and he said, “Why are you doing this for me? Why are you helping me?”
One of the reasons I stay in this work is that it’s rehabilitative and you see change. People who’ve gone through the worst of the worst, if they’re still standing and they’re still able to walk in our door, they’re still capable of getting their lives back. It might not look like it used to, and it might not look like the dream they had of what their life would be, but they have much to offer and they can have a really meaningful life, I think.
I had a client fromCentral Africa, who was a very capable person but highly traumatized. When she first came to us, she used to cry and cry through entire sessions. One of the few things she would say was, “I think I’ve lost myself.” When we help people get reconnected with theircommunity, it also helps them reconnect with themselves – with their healthy self before the trauma.