Seidu Swaray of Liberian Association of Psychological Services conducts a violence prevention workshop in Monrovia
SINJE, Grand Cape Mount County – Asata’s war experience would make anyone cry. In 1996, when she was 22 years old, Asata says a group of five older rebels from the ULIMO K faction gang raped her. She was left emotionally and physically scarred.
By Gloria Wleh with New Narratives
Before the rape Asata dreamed of having six children – three boys, three girls. But her prolapse – when the uterus falls out of place – caused by the rape, has made that impossible. After ten years of marriage and numerous miscarriages, she has just one precious child, a son, now 10. Asata has carried the rape and her injuries as a secret from everyone, including her husband.
Until today. Psychosocial counselors came to Asata’s house last year and convinced the now 52-year-old to join a special counselling session in her community designed to help war victims deal with traumas they have carried for decades.
“I used to be sitting down whole day I be worrying and crying that I will not get children,” Asata says. The group has been a big help. “God brought the counseling team to my house. They advised me take other people’s children to keep me busy and talking, so I can’t just be thinking.”
Asata is one of the hundreds of thousands of Liberians who experts say live with mental health problems as a result of the wars. According to the World Health Organization, one in five people exposed to trauma will develop post-traumatic stress disorder, depression, anxiety, bipolar disorders, and schizophrenia in the next decade. Evidence shows trauma can be passed down through DNA, so it is likely children born after the wars are impacted too.
Liberia has never done a comprehensive survey of the size of the problem but experts say it is likely that many Liberians are suffering silently or turning to alcohol, drugs and violence to deal with their symptoms. Experts worry that as the country begins to try those who perpetrated the horrors that left 250,000 people dead and millions injured and displaced, mental health problems will be triggered.
Lurd forces during the second civil war. Many of the fighters were children who took part in shocking crimes. Experts say so many Liberians were impacted by the war that post traumatic stress disorder is likely widespread among the population to this day.
“We need massive therapy sessions all across the fifteen counties,” says Seidu Swaray, executive director of the Liberia Association Psychosocial Services. “We have had too many traumatic experiences and now that we are going to the courts, people’s minds need to be prepared.”
Swaray says the first priority must be those working on the investigations and the court to ensure they protect themselves and, importantly, witnesses.
“Almost all the judges, lawyers and all those who will be a part of the court need to be trained on basic trauma informed approaches,” says Swaray. “There are so many ways trauma affected persons who are being engaged will communicate. And if you do not have that background training, you will not know. While you think that you are helping, you are actually harming the person.”
Mental health issues are on the mind of Dr. Jallah Barbu, head of Liberia’s Office of War and Economic Crimes Court. He says his office has set up a psychosocial and mental health section to handle war related mental health issues. Barbu says his team is making plans to offer psychosocial support services to everyone during the court processes. He says his office is working closely with psychosocial services and with victims’ and survivors’ groups to come up with mental health support plans.
“We want to ensure that we manage every individual in this process,” says Barbu. “These are some of the things we are currently working on and we are opened to more collaborations and partnerships.”
Mettie Zeineddine has been appointed to head the psychosocial division at the Office. She has long as experience as a mental health clinician in Liberian hospitals. She says there are existing mental health support structures setup by private psychosocial services and the government in all 15 counties in the country.
“These people have been providing services sporadically,” Madame Zeineddine says. “What we will be doing, we will be leveraging those structures.”
The World Health Organization recommendations for building mental health services
Funding for psychosocial support was not included in the budget that Barbu submitted to the government on May 1 for the second year’s operations of the Office. But that was before President Boakai’s surprise announcement that he had doubled the requested budget to $2 million a year. Barbu has not announced when he will reveal the new budget for the Office, but experts expect psychosocial services to be included. Local CSOs are also seeking support from donors including the European Union.
Survivors Say Counselling Is Helping Change Their Lives
Asata, (all survivor names are being withheld to protect them from stigma) has never had medical treatment for her injury. When she finally married, she and her husband spent a decade trying before she became pregnant. (Pregnancies with prolapse frequently result in miscarriages). The pregnancy and birth came with severe complications. Asata faced obstructed labor and the risk of uterine rupture. Doctors advised her not to become pregnant again, saying she could lose her life and the life of the baby.
Asata says, even 30 years later, she constantly struggles with flashbacks from the rapes, causing problems in their marriage. “Sometimes when he need me in bed, I can refuse him,” she says. “Because when that thought come to me, I can’t want him around me. I can’t want him touch me. Then it can cause problem. We can be fussing.”
Asata and dozen others are getting help here in Sinje, from a free psychosocial counseling service provided by Swaray’s association. Swaray says the sessions were taken to Cape Mount following a survey which showed that the county was one of the hotspots for massacres during the wars. Funded by the United Nations, the service is free in two counties.
The 8-week program puts the participants in a group of 10 people of the same gender, each with 2 counselors. Groups meets every week. Counsellors guide them through topics such as how people have changed because of the war, loss and grief. They also focus on happier times in an effort to build resilience.
Counselor Sarah Paye says the goal is to help participants “regain their hope, function well again and take charge of their lives.” Treatment caters to the individual’s needs. “Sometimes it takes up to 3 to 6 months, or even up to a year for a client to recover. Mental illnesses are in stages. So depending on the stage the client is at, it’s how long the treatment is going to last.”
Momo, 57, says he is also a war survivor who has been coming to these sessions in Sinje for more than six months. He says he was captured by the ULIMO-K rebels in 1996. He saw people being slaughtered and was forced to carry heavy loads for about a year.
Momo suffered a back injury that has made it difficult for him to bend over and stand up straight. He has lived that way for 29 years, with physical and mental pain. He lost his job and his wife of 11 years, leaving him alone to raise their 8 children. This made him depressed. Counseling has been a big help.
“I was down. I was really down. But since the counselors started talking to me, I gain hope again for my life,” Musu says. “I started doing my little backyard garden and from it I am taking care of my children.”
Momo tends his crops. Credit Gloria Wleh with New Narratives
Counselors persuaded Momo that what happened to him was not the end of his life. He says he now feels motivated and has found the drive to run his back yard garden and a pig poultry, where he grows and sells crops and livestock. He is also helping others. He established a local organization of farmers fighting hunger.
Psychosocial Services Needed Across the Country
Swaray says sessions like this will need to be held repeatedly across Liberia, as the War Crimes Court gets underway. He says psychosocial services need to be mainstreamed in all aspects of the courts’ processes—from investigation up to the point of judgment.
He also calls for blanket security for witnesses and their loved ones. He says failure to address this will see people targeted by the accused and it may discourage others from coming up to testify.
Momo is now an advocate for counseling services.
“Everybody some way, somehow was affected by the war,” says Momo. “The government needs to prioritize counseling. Counselors need to be sent in each and every county to help people.”
Part one of this series looked at the challenges of treating Liberia’s mental health crisis and its role in fueling drug and alcohol abuse and crime.
This story is a collaboration with New Narratives as part of the West Africa Justice Reporting Project. Funding was provided by the Swedish embassy in Liberia. The donor had no say in the story’s content.
