Table Of Contenteontact
A publication of the CMC-Churches’ Action for Health, World Council of Churches
REBUILDING PEACE
No 148
April-May 1996
REBUILDING PEACE
2 Editorial
3. Introduction
Violence: a new health
challenge
7 Reconciliation
Never too soon to start
forgiving
10 Therapy
Art creates community
in ex-Yugoslavia
13 Counselling
Creating an opportunity
out of a crisis
16 Resource materials
UPDATE
18 Useful publications,
Letter: Uganda says
“Vasl”
NETWORKING
19 Useful publications,
Announcements “overcome
violence!
EDITORIAL
*
Violence wounds and destroys lives. It The rest of the present issue of Contact
also destroys relationships and com- is a collection of experiences in non-
munities. Today, violence is escalating. violent witness. An anthology of inspir-
Everyone is touched by it, some are ing stories of healing the individual and
forced to live with it in their daily lives. A rebuilding the community.
culture of violence shouts at us fromth e
The articles provide case studies in
cinema and television screens andfrom
conflict transformation, healing and
the newspapers. Violence against
reconciliation. They are all women’s
women, child abuse, acts of racism —
initiatives describing women’s unique
such crimes have no cultural
role in peacemaking and health care.
boundaries.
First, isa description of howthe Christian
In January 1994, the World Council of
Health Association of Liberia (CHAL)
Churches (WCC) launched a
has integrated a programme of conflict
Programme to Overcome Violence. It
resolution and healing into its wholistic
has been established to “challenge and
health care programme. Executive
transform the global culture of violence
director Elizabeth Sele Mulbah says
inthe direction of a culture of just peace.”
that all countries, whether living through
It seeks to shift the terms of debate of
a war, as has been the recent experi-
Christian response to violence and calls
ence of Liberia, or not, should establish
for a change of consciousness. The
such programmes to ensure healthy
Programme to Overcome Violence
community foundations.
Concrete examples can focus is to build “a culture of peace
be a powerful witness that through practical means to overcome The next two case studies are of efforts
violence at different levels of society”, in empowerment, both spiritual and
the churches can build on.
and to encourage the churches “to place economic, of people during and after
a high priority on addressing violence in the experience of war. One is from
their own societies as well as the ex-Yugoslavia where women and
violence their culture and nations impose children are being healed and liberated
on others.” through self-expression in writing and
painting. The other is from Ecuador
In May 1995, the meeting of the Interna-
where Latin American Council of
tional NGO/PHC Group (non-govern-
Churches (CLAI) helps communities to
mental organizations in primary health
overcome the trauma that inevitably
care)—agroup whichis currently chaired
follows disaster.
by Margareta Skdld of WCC’s Churches’
Salpy Eskidjian
Action for Health (CMC) of Unit Il, took
WCC Executive Secretary
up the theme of violence and health.
International Affairs
The introductory article in this issue of
Contactis based on the presentation by
Anthony Zwi, of the London School of
Blunders of the world
Hygiene and Tropical Medicine, at that
that lead to violence
meeting. He outlines the health prob-
Wealth without work
lems associated with violence and calls
Pleasure without conscience
for all NGOs involved in health to play a
Knowledge without character
more active role in developing appropri-
‘Commerce without morality
ate and innovative responses. to
Science without humanity
violence.
Worship without sacrifice
What are the experiences that com- Politics without principle
munities of faith have in this field? Con- Rights without responsibilities
crete examples can be a powerful Technology without direction
witness that the churches can build on. Connection without community
It is those different, rich stories of local Teaching without joy —
and grassroots initiatives that speak Learning without hope.
COVER
louder than statements andaffirmations, ©
Child soldier
According to the Christian Science Monitor, Mahatma Gandhi
Peter Williams/WCC and that is where the WCC has begun. shared these thoughts with his grandson.
2
contact n°148 - April-May 1996:
INTRODUCTION
s
VIOLENCE:
A NEW HEALTH CHALLENGE
Anthony Zwi, senior lecturer
at the Health Policy Unit at
the London School of
Tropical Medicine, believes
that political violence and
war should be seen as
significant public health
problems. He argues that
now is the time for health
organizations to actively
address the issue, drawing
on their experience of
dealing with violence against
women.
RFJLKo a huyann/d Aagtai on
Violence is universal.
While levels of violence increase, there Interpersonal violence and crime are a
is also much greater awareness of vi- reflection of widening injustice and
olence and less willingness to tolerate inequality in many countries. Not every-
it. In this article, political violence and one is affected by violence equally:
interpersonal violence are treated as people of different age groups, gender
equivalents. This may seem surprising, and ethnic and religious backgrounds
butit is based on an assumption that we face different risks, andthe marginalized
can learn from both types of violence and the poorest within a society are
and from the different responses to most vulnerable of all. Trends towards
them (“Violence” is defined on page 6). rapid globalization may well increase Violence associated with
the occurrence of violence within political conflict is growing.
Violence associated with political conflict
populations as social stresses increase,
is growing. Over 21 million people have
as consumer aspirations are aroused
died in the 150 wars that have taken
and as economic competition intensi-
place, mostly in the Third World, since
fies.
World War Two. Approximately 90% of
deaths during war are now among The costs to society of all forms of
civilians — and the types of violence to violence are massive: loss of life, injuries,
which these civilians are exposed are disability, physical and mental trauma,
becoming ever more horrific. Most of social and economic dysfunction and
these conflicts are between competing retarded development all occur. War,
groups within states, not between states. political repression and structural This article is based on a paper
presented by Dr Zwi at the
Expectations of massive declines in violence have forced huge numbers of International NGO/PHC Group
political conflict in the aftermath of the people to leave their homes. Estimates meeting at the time of the World
Health Assembly, Geneva, in
Cold War have proved empty. suggest that there are now a total of 40 May 1995.
contact n’148 - April-May 1996
INTRODUCTION
million displaced people worldwide, 25 Many have a wealth of experience with
million of them are refugees in other regard to violence and its impact on
countries. Globalization has fuelled the women, children, refugees, and on
extent of migration for economic health systems in general.
reasons.
Understanding the context in which
Despite an awareness of these growing violence occurs is paramount. For
problems and their consequencetshe,r e example, in relation to gender violence,
has been a failure on the part of it has been possible to identify the risk
Understanding the governments to respond. Limited factors and their determinants, as well
context in which violence changes to legislation and law enforce- as other reinforcing factors. Cultural,
occurs is paramount. ment are unlikely to be successful. economic, legal and political factors
Governments also need to commit them- also need to be taken into account.
selves to promoting public health policy Political conflicts invariably have both
and to seeing the importance also of a winners and losers; without appreciating
public health approach in which NGOs this, relief and development activity may
would play a major role. reinforce injustices.
The focus of a more comprehensive
NGOs have real-life experience of policy
approach must be to give attention to
analysis. They recognise the value of
those factors which contribute to
identifying and responding to community
violence such as inequitable distribu-
perceptions andattitudes. They are also
tion of resources, poor environmental
aware that seeking the support of a
conditions, a culture of machismo, wide-
range of different actors and
spread consumption of alcohol, the
stakeholders within societies is vital to
availability of firearms and other
successful intervention. NGOs are also
weapons. Wherever violence has
aware of which actors, both individual
occurred, attention needs to be given to
and organizational, can help push policy
providing relief and support, medical
forwardinavariety of different channels.
care, and rehabilitation services.
NGOs are integrated into a wealth of
This drawing by a former child Could NGO involvement be networks, coalitions and alliances which
soldier in El Salvador shows effective? are vital to the public health response to
the population trying to flee the Health NGOs have learned lessons in violence.They appreciate that a public
repression by crossing over
addressing issues of violence through health approach focuses not only onthe
the river into Honduras. There
their public health and primary health community and the individual but also
are soldiers on both sides of
the river, and Armed Forces care (PHC) experiences over the years. on the environment, and on the factors
planes overhead. influencing the occurrence of conflict:
both individual and contextual.
7
Many NGOs are sensitive to the impor-
a sf
tA ‘ AM
ee Aa tance and value of facts and figures.
Data may be gathered for surveillance
hi “
/ an 7 and monitoring, but may also play a
ra ef aN \\
powerful role in bringing about changes
~ = aS SL o—g e3 -e4 a, in attitudes. Data and research may
help place issues on the agenda, and
will also be of value in formulating
appropriate policy responses and inter-
ventions.
: NGOs are an important element in the
further development of civil society.
Building civil society, and strengthening
i ¥ da PA Sade sal Srceg representative and accountable
structures generally, reinforces the
_ Rio Lem Po be Nis capacity of a community to respond to
violence at the local and national level.
LWFuoetdrhelredar taino n
contact n°148 - April-May 1996
INTRODUCTION
At a time of increasing concern with
- equity - itself a response to some of the
negative consequences of globalization
- NGOs could stimulate an informed
debate as part of their response to
violence.
Is violence a priority?
- Within the PHC approach, there is a
- clear commitmentto equity and personal
security. The health organizations, along
with the broader NGO community and.
many of the multi-lateral organizations,
often identify equity as one of their key
priorities. Violence and conflict is often
the result of obstacles to the effective
distribution of resources. In the interna-
tional context, UN documents, such as
the Agenda for Peace and the Agenda
for Development, recognise social
‘inequities as major factors in promoting
conflict and in reducing personal
security. Within the home, the control
by men over economic resources is an
important factor perpetuating gender —
violence.
Second, health development NGOs are
acutely aware of the need for
sustainability. There is increasing
concern at the large sums of money
going into emergency relief in the after-
math of conflicts. Funds invested in
emergency relief are squeezing the
amount of resources potentially avail-
able for longer-term development
activities. Such development might,
|G ues/UNHCR
however, have helped prevent disasters.
“Landmines are the single
Mobilising resources for identifying the health sector alone and towards
biggest factor hindering the
vulnerability to conflict and addressing creating supportive environments and development of Cambodia’,
the root causes before violence erupts strengthening community action. It according to Phnom Penh
would be a key intervention. This requires defining and building healthy NGO Forum.
approach is probably equally valid for public policy.
interpersonal, inter-group and interna-
‘Another reason why health NGOs should
tional levels. have violence on their agenda is be-
Concern about war and violenshcouel d cause people turn to the health services
Data may ... play a
‘in times of crisis. Those affected by
be focused not only on the relief phase
conflict, criminal violence or gender powerful role in bringing
but on the entire continuum of insecur-
violence often turn to available health about changes in attitudes.
ity, conflict and rehabilitation. NGOs
services for support and attention. In
could encourage looking at relief, re-
many settings, there is a legitimate ex-
habilitation and development as inter-
pectation among communities that
related issues requiring an overall
violence be taken seriously by the
strategy. At present, there is inadequate
primary health care community.
emphasis on seeking out and
addressing thé root causes of problems. Responding in the aftermath of conflict
A public health approach looks beyond and violence is obviously crucial.
contact n‘148 - April-May 1996
INTRODUCTION
which promotes resolving the issues
behind the violence.
What NGOs need to do is to find the
sorts of symbols that are needed to
mobilize attention on the issues of
violence and community safety. Exam-
ining the economic dimension of the.
problem may assist in stimulating a
policy response. Providing the data to
show that something can be done will
E put pressure on the politicians to take
the issue more seriously. Evidence that
interventions against gender violence
can be effective, for example, has begun
to find some recognition and to generate
further action elsewhere.
JI ssac/WHO/Unicef
In the aftermath of war, health
workers have a key social role Recognising violence as a public health
However, anticipating the danger at an
to play. concern requires recognising the need
earlier point and developing inter-
for health worker training. Health
ventions which avoid the violent event
workers need to learn how people
is challenging and very important.
respond to disasters and how to deal
Although there are no simple answers
with the psychosocial needs of the
and no easy lessons on appropriate
people affected. Equally importantly,
interventions, health NGOs do have
. On appropriate they need simple and effective skills to
some valuable experience.
help them recognise and support
interventions, health
What are possible areas of action? psychologically distressed victims.
NGOs do have some
NGOs generally are already actively
valuable experience. involved in developing personal and Many NGOs have already recognised
organizational capacity, and in building violence against women as an issue
community and civil society. Health which warrants a public health response.
NGOs are involvedin reorienting health If the International PHC/NGO Group —
services towards health promotion, and working in collaboration with WHO and
at looking at some of the determinants Unicef — became more involved in
of health problems rather than just the tackling violence and conflict, it could
health problems in their own right. In play a major part in developing appro-
addition, NGOs in primary health care priate and innovative responses to an
could easily become part ofamovement increasingly violent world.
What is violence?
A narrow definition is “the use of physical response of oppressed groups to the
force with the intent of causing harm, injury violence to which they are-exposed, or
or death”. A broader one is “any avoidable by the privileged class against reformist
action that constitutes a violation of ahuman or revolutionary governments;
right in its widest meaning, or which prevents Combative, that is the use of force,
the fulfilment of a basic human need”. violence and military means to effect
e “Private” violence such as coercive change or to maintain the status quo.
sex within marriage : e Criminal violence such as assaults,
¢ Collective violence can be categorised murder and rape
as Structural, that is violence in which ¢ Non-criminal violence such as
some groups are denied basic needs, suicide and accidents
~ access to power and the means of influ- ¢ Gender-related violence: relating to
encing policy; Repressive, which is usu- and reinforcing the power imbalances
ally imposed by the state; Reactive —the inherent in patriarchal society.
contact n° 148 - April-May 1996
RECONCILIATION
NEVER TOO SOON TO START FORGIVING
sy
Within thirteen months of the
war breaking out in Liberia,
Elizabeth Sele Mulbah,
executive director of
Ah nae oaNo em —
raat
Christian Health Association
of Liberia, and all available
staff had started to build a
healing and reconciliation
programme with support
from their friends abroad.
They believe that it is never
__ too soon to start the process
which helps people to grieve,
then to repent and forgive,
and finally to start working
together again.
For a few months after war broke out in family stayed until 25 July when they
Liberia in December 1989, Elizabeth . were led first to University of Liberia,
Sele Mulbah andher staff at the Christian and then to the Bong Mines and the
Health Association of Liberia (CHAL), Phebe Hospital and School of Nursing,
did not feel its impact directly. They Suakoko, Bong County on 21 August
knew that CHAL members in Nimba on 1990. According to Elizabeth, the
the northern border with Guinea and journey was risky, tedious and danger-
Ivory Coast were under attack but calm ous with little or nothingt oe at. Hundreds
remained in many other parts of the of people died, both old and the young.
country, including the capital Monrovia
Starting again
where they were working. They wor-
Undaunted by these experiences, within
ried, however, about the extent to which.
a few days Elizabeth had decided that it
this could last if not controlled. Then, in
was time to “start something”.
early July 1990, the war spread to
Communications were poor but she was
Monrovia. As Elizabeth tried to return
abltoe fin d out that about half of CHAL’s
home from the CHAL office, she was
stopped by government soldiers.
All efforts to make her way back to her
family in the Paynesville area failed.
She therefore went back to her office in
Sinkor, Monrovia, which became her
“home”, shared with many other dis-
placed people including members of
staff, for two weeks. On 18 July, she
finally joined her family on the ELWA
Hospital ground which had become a
Mrs Elizabeth Sele Mulbah
centre for displaced people. There, the with friend and relatives
contact n’148 - April-May 1996
RECONCILIATION
hospitals, health church workers to be involved in the
centres and clinics programme. After all, these were leaders
were functioning to and role models who. constantly faced
some extent. Many the personal conflict of remaining pro-
were in vital need of fessional when expected to be non-
emergency supplies. judgmental towards patients, students
She contacted Ameri- or members of the congregation who
cans who had been had traumatized their own life or the
evacuated home and lives of family or friends.
ii deej a encouraged them to
Reconciliation and healing
form a support group
THERE You SEE AMMAN DuTTING A BAgy Today, the Reconciliation and Healing
ENTO A’ wel, WEY HER FATHER Apo thatwouldsend drugs
MMOTHER Kriced- programme of CHAL forms a major
and other require-
HE ~ZS. AN 9 AEL, Sotore 4 component of CHAL’s wholistic health
ments. to her CHAL
care efforts. The main emphasis of the
sub-office at the
programme has been in developing
Phebe hospital.
training manuals and materialst oe nable
For the next few months, establishing member units of CHAL to implement
emergency services consumed all the programmes of Reconciliation and
time and mental energy of reassembled Healing. Of special interest has been
staff. But quickly the team began to the development of the Trauma Healing
acknowledge that their nerves were and Reconciliation Training Manual
wearing thin. During the period since (details available on page 17) which
the war had begun, a CHAL secretary provides an excellent guide to all the
and a production clerk had been killed, components of the programme.
and not a single staff person had been
These are now reflected in three
unaffected by the loss of loved ones or
expanded areas: —
Staff felt that what they had property. As well as coping with their
learned should be passed own losses and providing emergency Health and peace: This programme
caters to trauma victims (especially
services to the injured, the staff were
on to their families and
also responding to the many people women and children) through health
communities.
who were turning to them for mental as institutions. Health workers are trained
well as physical support. to identify psychosomatic cases and
apply various trauma and healing
Recognizing the problem, Elizabeth
activities. Play is one major activity used
wrote to the CHAL Support Group
to help children cope with traumatiza-
expressing a need for counselling. for
tion.
herself and her staff. In 1991, a
3-member Mennonite team from the Children as peacemakers: The goal
US arrived. Two were from Mennonite of this programme is to empower young
Board of Missions and one from people to apply non-violent alternatives
Evangelical Lutheran Church in in conflict resolution. An organized con-
America. This team was involved in flict management programme called
three workshops not only with the Student Palaver Management (manual
available CHAL staff but also with
participants from six of the 13 counties
fore
in Liberia. After a follow-up visit during
Dating ye Kea
which further workshops and an evalu-
ation took place, it was decided by the
available CHAL members that there
should be a Reconciliation and Healing
programme. Staff felt that what they
Drawings are taken from The
had learned should be passed on to
Liberian Civil Crisis through
their families and communities. In
the eyes of children published
by The Education Secretariat, addition, in order to rebuild Liberia’s
Catholic Archdiocese of social foundations, there was aparticular ©
Monrovia in collaboration with need for health workers, teachers and
Unicef.
8
contact n° 148 - April-May 1996 .
RECONCILIATION
available, see page 17) is establishedin Elizabeth’s philosophy is that as well as
schools. Through mediation skills, young the psychosocial approach to healing
people are promoting a culture of non- wounds and promoting understanding
violent conflict resolution. for reconciliation, it is also important to
identify quick impact development
Church in action for peace: This
projects in which all can work together.
programme provides churches with the
It was this approach that won her praise
opportunity to identify broken relation-
from the United Nations. For 10 months
ships and to seek to intervene skilfully
of the war, she was seconded to work
and spiritualle. It also provides informa-
with UNOMIL in Liberia.
tion about the effects of war trauma and
strategies for healing, reconciliation and
healing. Finally, it organizes special
meetings in which spiritual guidance is
given to members (including national
leaders).
When training begins, the process often
starts by addressing the grief and loss NS
moof upranritincgi patnhtes .d eEaldi ziasb eatnh imbpeolriteavenst ptahartt C l i i i i a s
#
of the process of reconciliation and
healing. She says that people need to
be able to mourn and to come to terms
with their grief before they are ready to
start again. She describes movingly
one experience. “Towards the end of
this process, we ask everyone to bring
something which provides a symbolic
A Peighbor’s house being burnt
reminder of what has hurt them most.
An old man carried a leaf, and wept /ilBi1ri9n g.W Mti h e dCeircvsh }i dbhoheave ovoibsi nbde,2r 4~ i~Sp oa nd
bitterly. Afterwards, he told me that this
workshop had been the first time he had
Is violence the answer
been able to grieve the death of his
to injustice?
daughter.” Like many others, this man
had not even been able to talk about his Liberia’s annual military
daughter for fear that his own life would bill is now approaching
be taken. These workshops thus provide US$ 450 million, while
an opportunity to go through a process official development aid
which is often denied, and. which The Healing and Reconciliation accounts for less than
prevents people from moving forward. programme has had success beyond 5% of this figure. One
jet fighter costs US$20
Liberia’s borders. Because so many
An equally important process is helping
Liberians are refugees in Ivory Coast, million - the cost of
people to understand each other. Ina
40,000 village clinics.
activities have been initiated there with
workshop which brought together
One modern tank costs
a view to peaceful resettlementin Liberia
ex-combatants and members of the
US$1 million - the cost
in the future. The approach has also
community to which they were returning,
of 1,000 classrooms for
been introduced in Sierra Leone where
it emerged that there were huge differ-
30,000 children. This is
wounds from the war that started in
ences in expectations over their home-
outright injustice, but it
coming. The young men expected to be 1991 still remain. Elizabeth says that it
cannot be cured by
received home as heroes. The com- is better not to delay the healing process
violence.
munity expected them to come back on because over time people form “false
Source: Reach! newsletter of
bended knees asking for forgiveness. scars” which have to be opened up Healing, Reconciliation, Media-
Working out a compromise and identi- before healing can start. She believes tion and Counselling
Community (HEREMECCO),
fying projects in which they could all be that the sooner programmes can begin c/o CHAL, PO Box 10-9056,
involved together offered some hope the better, but that whenever they begin 1000 Monrovia 10, Liberia. Tel:
231 223 131. Fax: 231 226 187. |
fora reconciled and healing community. the key to the process is forgiveness.
contact n°148 - April-May 1996
THERAPY
ART
CREATES COMMUNITY IN EX-YUGOSLAVIA
The NONA Multimedia Women’s
Centre in Zagreb, Croatia was
developed as a response to the
needs of women who were
refugees and displaced from
Bosnia-Herzegovina and within
Croatia. Natasa Jovicic, who works
at the centre, says that women
needed a place where they could
meet, to celebrate their creative
expression and to find support in
each other regardless of age,
ethnic groups, social or
educational background.
EPD/WCC
A soldier in ex-Yugoslavia
Despite all the diplomatic talks and existence. Yet, the women have
handshaking, the situation for women | tremendous need for support. We there-
in Bosnia-Herzegovina and Croatia fore decided that a programme should
does not change. Many have lost their be started which would encourage and
homes and members of their families. support women who are trying to regain
Some have been victims of rape and control over their lives.
witnessed genocide. They are now
We offer a place where women who
stigmatized as refugees and displaced
have been traumatized by war can
Women in these isolated
persons in new and unfamiliar environ-
come, and in a creative way, express
situations lose their self- ments. They dream of the day when
their own.experience, their own
confidence. they can return home in dignity and
concerns and their own talents. At the
safety to resume their lives in their own
centre, women who have survived the
land.
horrors of war find a wide range of
Womenin these isolated situations lose physical and psychological resources
their self-confidence, feel anonymous with which they can help themselves
and become depressed. While waiting and build community. We are also able
for the war to end, and waiting to go to help women secure medical andlegal
back home, they find daily life hard to advice, and we have our own advisors
bear. who work with women with special
social problems.
The existing social service agencies
are overburdened by the refugees and NONA centre
migrants. They cannot address anything The goal of the NONA project is to
more than the basic needs of daily foster the empowerment and healing of
10
contact n‘148 - April-May 1996
