HMD RESPONSE PROGRAMME ACTIVITIES IN BOSNIA - TUZLA

HMD Response established its psychological programme in Tuzla in December 1995. Since then we have gone on to develop one of the strongest psychological programmes in Northern Bosnia. We have established a Women’s Centre which serves both the Croat and Bosnaic population, the focus being displaced women primarily from Sebrenica and Zepa. It is vital to remember that the vast majority of these women and children have no husbands or fathers; in a four day period in July 1995 over 6000 men were ‘executed’. The survivors of the ‘ethnic cleansing’ are now permanently resident in collective centers throughout the Tuzla Canton and will not be able to return to their land in the near future due to its annexation into Republika Srpska.

The HMD Response programme provides specialist training to local workers and health and psychological services to the women and children in the collective centers.

The programme objectives are:

1. To contact, identify, screen and offer counselling to traumatised women and rape victims;
   
2. To assist with the collection of testimony for the Sexual Assaults Team of the War Crimes Tribunal at The Hague (ICTY).
   
3. To monitor the health needs of the displaced persons in the collective centers and to provide free medical care;
   
4. To provide health education for women and children with a particular emphasis on preventative health concepts.

For the first year of the programme the Women’s Centre was funded by private donations and HMD Response funds whilst we secured long-term funding from Irish Aid for the Rape and Trauma Counsellor Training element of the programme; this training is provided by Dublin Rape Crisis Centre. In late 1996 we also sourced funds from the EU to support the Center’s running costs and the salaries of its professional and support staff.

HMD Response has one expatriate staff member, Sarah Maguire, dedicated to the running of the programme. Due to our close interest in the activities of ICTY, we felt it appropriate to appoint a country representative with a legal background – Sarah is both a trained nurse and a practicing barrister. Her remit is to develop the gathering of testimony from witnesses and rape victims and to support those witnesses preparing to testify at the ICTY, while also managing the primary health care element of the programme.

Tuzla Women's Centre

The centre and its staff can be accessed in two ways. Firstly, women and children from Tuzla and from a number of collective centers in the surrounding districts visit the centre on a regular basis. Secondly the fieldworkers attached to the centre, regularly visit the more remote and isolated collective centers on an outreach basis. The following article by Sarah Maguire, HMD Response’s country representative, identifies the needs of the people of Tuzla while explaining succinctly how the centre responds to those needs.

MAKING A DIFFERENCE IN TUZLA – by Sarah Maguire, HMD Response Country Representative

Srebrenica fell in July 1995. Although a United Nations protected zone, the people of that area were killed, “disappeared” and displaced. Thousands of lives were directly affected. Men were separated from their families and were “executed” and buried in mass graves; their wives and children were forced to flee or were forcibly removed. The whole area was ethnically cleansed. Many of the women and children had to survive in tents set up on the airfield at Tuzla, not knowing whether their relatives were shot, survived in camps or had managed to escape the Serb forces. The international community responded to this crisis by setting up collective centers. Some of these had already existed as a means of providing temporary, emergency housing for refugees while others were opened to cope with the new influx.

The centers which opened which opened during 1995 tended to consist of roughly adapted municipal provision; the majority were schools. Some collective centers have since closed but many remain open and full; others will reopen when Western Europe deports/ repatriates its refugees. Returning home is an impossibility for the refugees. Their homes are now destroyed or occupied and under control of the Serb government. The implementation of the Dayton Agreement in terms of the refugees returning home, is effectively a non-starter.

Meanwhile the women wait. They live in a split world of hope and despair. Hope that one day their relatives will turn up or that they may be able to identify a body. Despair that they will never go home or resume anything like their normal lives again. They have nothing but each other; though living in close quarters with 8 other women and their children does not engender community spirit. Even the situation at Mihatovici, a village built by Norwegian People’s Aid does not create community activism as it is now itself overcrowded.

There is no health provision in the centers, no adult education or recreational facilities. The women live on subsistence aid of beans bread and oil, supplemented only occasionally by some fresh fruit (1kg of apples per month, per person). The costs of provisions from the shops set up in the centers are, exorbitantly high.

Enter the field workers from the HMD Response International. All are trained in rape and trauma counselling by Dublin Rape Crisis Centre. All are experienced in dealing with people in distress and all are humorous, compassionate and mature women.

The Centre opens its doors every weekday, Mondays and Wednesdays are the busiest when the doctor and psychotherapist have their sessions. On these days it is standing room only in the 3 rooms of the centre. Coffee and conversation flow and the women talk and laugh. It is not a party however. During the course of the conversations, informal group therapy takes place. The fieldworkers and the psychotherapist almost imperceptibly direct and guide the women in their discussions to talking about their lives and developing strategies for coping.

For these women, the trauma of war is far from over. They are not recovering from a past event and learning to put it behind them. They are still living with the horrors they have experienced.

The doctor, a caring, vibrant, laughing woman sees as many women as she can fit into her 3 hours non-stop consultation session. The women press at the door of the room she uses as a surgery, anxious that their trip to Tuzla, which may have cost a large proportion of their monthly allowance will result in an examination, reassurance or medication which they want. The psychotherapist sees women both on an individual basis and as a group and tries to encourage them to lift themselves out of the post traumatic stress disorder that threatens to envelop them. It is perhaps an indicator of the value the women place on the visits the Tuzla that they always come in their best and cleanest clothes. It is a day out in all senses of the word.

Fieldwork

In addition to their work at the Centre, the fieldworkers go out to the collective centers every week. They visit individual women and counsel them, or organize various activities, such as trips into Tuzla by minibus (hired). They give them information about resources available and keep a watchful eye on their health. When they consider that a woman is in particular need, they will encourage her to come for medical or psychotherapeutic help – an offer that is usually taken up.

Our child psychologist also visits the collective centers, working with individuals or groups of children and their mothers to break the children’s isolation and to help them to express their experiences and hopes. Through group an individual work with her own inimitable style and panache, the psychologist helps the children and their mothers to address difficult patterns behavior patterns, reduce aggression and teach them to be able deal with life’s challenges without recourse to violence – often their only or most enduring experience.

The Centre and its staff are not sitting still. Very soon, we will have a small mobile clinic that will visit the collective centers, bringing gynecological and other health needs and other health needs to thee women, dispensing health advice as well as palliative care. Staffed by nurses, fieldworkers and a doctor, this service has been universally welcomed before it even starts!

A training course in basic health care, hygiene and the prevention of illness is at the planning stage. The Center’s staff have an impressive range of skills and experience that will be fully utilised to educate and influence the refugees about avoiding the need for medical intervention.

Play therapy for the children of the centers is also to be developed. Building on the work of the child psychologist and some general play therapy training, this is an area all are committed to increasing.

Mental and physical health are rights. The women have other rights too that they are unable to identify, let alone realise. To this end, HMD Response are working with other NGOs towards the setting up of a mobile law centre for women refugees; an idea that already has support of the Minister for Justice, the international community and the NGOs.

Psychological provision is less fashionable in Bosnia no. Widespread ignorance about the effects of war trauma and the situation for the refugees contributes to an idea that everything is okay now. Nothing could be further from the truth. Without psychosocial care in all its manifestations, Bosnia will be left wit a population that cannot contribute to the development of its own society. Recovery as a country can take place.

1997/8 will be a very challenging year. We cannot cure the country, but we at HMD Response are confident that we can make a difference at least in Tuzla.

Rape and Trauma Counsellor Training

Grants totaling £92,228 (IR £96,280) were made by Irish Aid to provide trauma counsellor training for HMD Response fieldworkers. Since Spring 1996 three counsellor training programmes have been conducted by Dublin Rape Crisis Centre in Bosnia, inducting 28 counsellors/ fieldworkers. A further 5 courses are planned for 1997/8. Twenty percent of the places of these courses have been allocated to fieldworkers from other NGOs, including CARE Austria and Medecins Sans Frontieres

Future HMD Response

HMD Response remains committed to the future development of the centre and its facilities.

The intention for the coming year is to move the centre to larger premises to facilitate an expansion of the medical services available at the centre. The professional medical have already expanded to include a GP, adult psychiatrist, child psychiatrist, and gynecologist.

Mihatovici Village – plans are at the initial stages for the provision of a women’s centre at Mihatovici Village outside Tuzla. There are currently almost 2000 people resident here, with no access to medical or educational facilities aside from those provided by the Women’s Centre outreach programme. Notwithstanding the benefits of leaving Mihatovici for a few hours to attend the centre, it is felt that it would be appropriate to provide the women resident there, with a centre where they could engage in several activities:

• Workshop- activities such as knitting are both of psychological and income generation benefit to them. Some of the women are already actively engaged in knitting, earning DM29 for each sweater produced, valuable income when eggs cost DM5.
  
• Education- Additional activities include literacy classes (most of the women in Mihatovici are rural women from Srebrenica and Zepa).
  
• Music and Dance Therapy- Women need relaxation and fitness classes, both to relive much of the boredom of the environment and to improve their overall health.

Future training possibilities- Discussions between HMD Response and DRCC have been held as to the direction future training should take. Future courses will also take place on an outreach basis and may include Gorazde and Sarajevo. It is also envisaged that language classes (English, French and German) will be provided, primarily for those who had instruction before the war. Finally, typing and computer classes will also be available.