Tackling Trauma in Casamance

SENEGAL, 20 May 2010 - Hundreds of children and adults in volatile Casamance are not even aware of the mental trauma they suffer, let alone how to get help to banish sleepless nights, empty days and learning disabilities.


One young student who used to be top of her class in high school is now completely withdrawn, her academic performance in free-fall, said Demba Ba, former director of the regional social centre in Casamance's main city Ziguinchor."Suddenly she started isolating herself, she no longer participated during class and her scores plummeted. "She had seen someone slit her father's throat."
In Casamance, hit by sporadic violence since a secessionist uprising 28 years ago, people live with the post-traumatic stress of being injured by landmines, seeing relatives raped or killed and living in constant uncertainty."We see children who have seen their parents tortured, their mothers or sisters raped, their villages razed," Ba said, pointing out that this severely jeopardises their ability to concentrate and learn. Whether the trigger is direct, such as a landmine accident, or indirect, such as witnessing violence, trauma is costly for individuals, families and the society as a whole, survivors and psychological experts said.
"If trauma is not treated properly it can... block a person from living normally, maintaining normal relations with friends and family and staying in a job or in school," said Mamadou Lamine Diouf, head doctor at the psychiatric care centre in Ziguinchor. Some people are referred to the centre from the Ziguinchor hospital, some by Handicap International or the Senegalese Association of Mine Victims (ASVM), Diouf said.In 2009 the National Anti-Mines Action Centre (CNAMS) launched a programme for landmine victims; the centre says of 751 landmine survivors, 160 civilians and 171 military suffered mental repercussions. The UN Children's Fund (UNICEF) supports ASVM's work, in collaboration with the regional social centre. "For us it is about getting people to pour out the negative emotions that have a grip on them," Diouf told IRIN. "For that we must create conditions in which they feel welcome and assured of total confidentiality... Above all we cannot push them, otherwise they will withdraw again."
Suffering in silence
But first people must come forward for help. "Many suffer in silence," Diouf said. Some people assume their problems - migraines, nightmares, lack of concentration, social anxiety - are not treatable, experts said."It is important to note that in our region - if not across all of Africa - people are not familiar with the domain of mental health," Diouf explained. "So we have to work to educate communities and the authorities."Ba said educating teachers was critical. People often see a psychiatric care centre as "strictly for crazy people", so they do not see how it could help with their symptoms, Diouf added. Many people burdened by trauma turn to marabouts, thinking that their afflictions stem from a curse, doctors in Ziguinchor told IRIN."I have received many people suffering mental troubles," marabout Tidiane Dieme said. "I try to heal them by mystical means; sometimes it works, sometimes it doesn't."He added: "Many people know there are special structures to deal with mental issues. But you know, Africa has its realities. When one suffers such problems, one immediately thinks of the mystical side of things."
Finding hope
Some do not see a way out; ASVM's Mamady Gassama said this underlines the importance of helping people to find work and rejoin society."Sometimes I want to kill myself," said Awa Bodian, 79, who stepped on a mine in 2002. "Life no longer has meaning for me. When I think about how I was able to work before the accident I question whether it's worth going on."Her son, Lamine, said she often screams out at night. "I often see landmines in my sleep," she said.

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