CRISIS CARE FOR VICTIMS OF WAR - FORMULATION POLICY

In April 1992 sinister tales were seeping into the media of genocide and forced migration of whole communities of Muslims and some Croats form Eastern Bosnia. This forced migration was later to become known as ETHNIC CLEANSING- egregious euphemism was Bosnia's contribution to the language of war.

From the most remote settlements with no transport, no protection, along mountain paths and mule tracks they trudged mile after mile, no possessions but what they could carry, mothers with babies, younger people carrying and helping old, frail and disabled people, often carried in wheelbarrows. A trail of tears. For though all suffered, it was the women that the most savage and reprehensible crimes were to be visited.

These facts were enough known and documented by May 1992 in eyewitness reports and photographs on television. To a large extent the West averted its gaze. The reaction of the world powers was pathetic and shameful. The reports were speaking the unspeakable to an audience that didn't want to hear.

As the months went by the enormity of the suffering being inflicted on the civilian population almost defied expression. A repeated feature of the Serbian attacks on Muslim towns and villages was the use of mass rape in public, followed by the destruction of homes, mosques and churches. All were perpetrated with the conscious intention of demoralizing and terrorizing the power of the invading forces.

In ethnic cleansing close parallels between what the Serbs were doing and what the Nazi's did in Germany could be drawn.

The initial exploratory visit by the Rape Crisis Centre to Zagreb found a great need and demand for basic, broadly based counseling skills. Our first training course took place in Dublin in June 1993. The participants comprised doctors, psychologists and community workers. We focused on crisis counseling with particular emphasis on rape. In August 1993 in Zagreb, we assessed the training in terms of transfer to the local situation. It was extremely positive and we decided to continue with further programmes in Croatia. We also held four residential courses in Split, with participants traveling from all the war torn areas of Bosnia. The women we train pass on the skills they learn to their colleagues. This training has enabled us to share our experience of rape and sexual abuse with a community whose sufferings have been brought to a point which we still find difficult to comprehend or accept.

We were invited by HMD Response to establish training in Tuzla. These programmes will be ongoing.

Can we now believe that war is ended- almost four years since it began. Everyone has lost, nobody has gained: yet 2.5 million people have been displaced, 250,000 dead, thousands upon thousands raped and tortured. Untold numbers missing.

The formal signing of the Dayton agreement in Paris triggered military and financial intervention on a scale which would have saved much bloodshed if it had been available before. It is estimated that it will cost US$ 3.2 billion to reconstruct Bosnia's war shattered housing and infrastructure.

WHAT IT IS LACKING, IT SEEMS TO ME IS THE BASIC INGREDIENT OF PEACE - A SPIRIT OF RECONSILIATION

"Rape represents for these women one trauma among many. The majority has been subjected to forced deportation, have been shot as, shelled, abused and tortured. They have witnesses' mass killings and have been subjected to psychological and physical torture"

To expect refugees who were cleansed out of their towns and villages to return home as if nothing had changed is hard to imagine. Not even the most naive optimist could envisage almost more than two million people returning to live among neighbours who, when war began, turned into murderous executors overnight.

UNHCR has always maintained that the cornerstone of any repatriation policy is that it has to be voluntary. The ground has to be prepared to encourage refugees to return.

The enormity of the pain yet in store for returning refugees (the majority women, children, the old and frail) must not be underestimated. At a minimum, refugee women face emotional difficulties resulting from loss of family and community support. Serious health problems arising from torture, rape, forced pregnancy and mutilation are common. Acts of unspeakable brutality have somehow now to be forgiven and forgotten.

Returning refugee women are very vulnerable to protection violations; those particularly at risk are unaccompanied adolescent girls and women and the elderly and disabled. Refugee women who are with strangers and where traditional, social protection systems no longer exist will face greater dangers than those returning with family or friends.

They will face special problems in making their case to the Authorities. Their experiences are so hard and painful to describe. Their male relatives may be unaware of what has happened as they may be too ashamed to talk about it. Rape, even in the context of torture, is seen by many families as a failure on the part of the girl or woman to preserve her virginity or marital dignity. The woman may be shunned by her family and isolated from other members of the community. Retelling her experience becomes a further source of alienation.

Raped women and children require a range of skilled psychological therapies which take into account the complex and long term nature of the problems experienced the reluctance to disclose sexual violation, the social stigma associated with rape and the unwillingness to accept help because they do not want to be identified.

Counselling services need to be put in place alongside other health services. A range of services must be made available to refugees wherever they are located. Outreach must be in place to ensure that these vital needs are addressed within their social and cultural context. Healing models as well as clinical forms of care are needed and, of course, healing can only take place in an atmosphere of trust.

There are many other serious health problems suffered by refugees, especially those who have spent long periods in concentration and detention camps. A study of 1,000 people (men and women) attending the University Hospital in Zagreb showed a 30 per cent increase in hepatitis A and B and in sexually transmitted disease (syphilis, gonorrhoea and HIV).

Without intensive care the effects of severe, human induced trauma are long term and debilitating, not only for the victim but also for children and generations to follow.

In regions where ethnic strife is often fuelled by accounts of traumas endured by previous generations, the world must pay careful attention to encourage the processes of healing so as to break the cycle of ethnic violence.