SUMMARY. In this article, the author shares both her personal and professional experiences in working with women and children who have been subjected to soul-destroying violence in the Former Yugoslavia in recent years. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com]
KEYWORDS. Bosnia, Tuzla, trauma, women's projects, refugees
Although one might argue that there is nothing unique or novel in the kind of soul-destroying violence that has killed so many in the Former Yugoslavia in recent years, what is remarkable is the fact that it took place in the heart of Europe, less than one hour by airplane from Germany. Also extraordinary is the solidarity shown by women from all over the world with their counterparts living in the war zone. In this article, I would like to share with you my own experiences in this regard.
THE CONTEXT
"Just start at the beginning," was the answer I received when I said that I did not know how to begin or what to write. But when did it all begin? I became aware of the escalating violence in the Former Yugoslavia in 1991, at the same time that Germany was reeling from a wave of nco-fascist militancy, characterized by numerous attacks upon immigrants and asylum seekers. Taken together, these events conjured up for me images of the Second World War, the stories my parents had told me, the flight of my mother and sister, and my shame and guilt for being German.
It was in this frame of mind that one day I visited some old friends from Kurdistan, and well remember my sense of anger and helplessness when I saw the fear in their eyes and the knives they kept on hand should skinheads attempt to burn down their home. It was precisely the same feeling that swept over me when I first read of the mass rapes being committed in Bosnia. Will we never learn anything from history? Is humankind fated to repeat the same mistakes over and over again until finally there is no one left to kill?
With these thoughts in the back of my mind, I did not hesitate for a moment when a friend asked me to become involved in a woman's aid project she was in the process of developing. It was no longer enough merely to attend demonstrations or engage in intellectual debate; the time had come to do something, and three of us, three women, sat down in order to plan what this would be. However, it soon became obvious to us that we would not be able to determine what was needed by Bosnian women and children so long as we remained in a living room in Germany. Instead, we would have to travel to the region and ask the women themselves what they needed and what they wanted us to do.
Thus, in June 1993 we set out for Tuzla (Bosnia). We had decided on this destination for two reasons, tirst because of the political situation-the town was under the control of a coalition (non-nationalist) government-and secondly, because we had a number of local contacts. However, our journey was not an easy one. In the first instance, we had to struggle to obtain a permit from the UNCHR headquarters in Zagreb to enter Bosnia. They asked us for evidence of support from an international aid organization, and smiled when we told them of our plans to implement a women's project in the war zone. In the end we did obtain the necessary permits, though only thanks to the timely intervention of DHH, a German humanitarian organization engaged in work throughout the region.
The next stage of our trip was equally harrowing. Landing in Sarajevo in the midst of shelling, we were transported by armored car to a United Nations base in Kiseljak, and from there by jeep to Zenica. This is where the waiting began, since Tuzla was being blockaded at the time and the main road was impassable due to fighting in the area. Eventually, we were able to secure a ride with a supply convoy organized by a group of ex-soldiers from Britain. Traveling along small mountain tracks with the sound of shelling and machine gun fire in the distance, we were very glad when we arrived safely at our destination. We were immediately struck by the apparent lack of life: no cars, no noise and no electricity. However, the town was not lifeless. Children were playing in front of their homes, and it seemed that every open area-even balconies and terraces-was being used for growing fruits and vegetables. Meanwhile, walking into the hotel lobby was like entering a man's world of Bosnian soldiers, UN personnel and French Legionnaires with rifles slung casually over their shoulders, talking with one another or sipping drinks at the bar. Everyone appeared to be astonished by our presence, and by the fact that we had come all the way from Germany to find a project or agency to which we could lend our support.
Although the level of need in Tuzla was obviously immense, most of the organizations that were active in the town were either strongly nationalist in character or only interested in providing support to maimed or injured combatants. We spent two months in the region evaluating the needs and wishes of local women, in the process meeting a wide range of individuals, from refugees and displaced persons, to politicians and psychiatrists. While area residents were clearly trying to lead as normal a life as possible under the circumstances, there was no doubt in our minds that the war was taking a dreadful toll upon their minds and bodies. The local hospital, for example, was chronically short of basic medical supplies, with doctors and nurses forced to work long hours under the most primitive conditions imaginable.
If this were not shocking enough, refugee camps in the vicinity of Tuzla were characterized by even greater deprivation. Hundreds of women, children and elders crowded into a large hall, without any privacy and everything they owned sitting in a cardboard box under their bed. "What do you want?," they shouted at us during our visit to one of the camps. "Did you just come to stare? Either go back home, or tell the world about us!" Their anger was palpable, as was their pain in the face of the terrible losses and atrocities inflicted upon them.
In the end, having consulted widely, and profoundly moved by the suffering around us, we decided to focus our energies upon the development of a center that would provide psychotherapeutic counseling to traumatized women and children. Although we envisioned ourselves playing a key role in its genesis and early growth, it was to be a project that would be run by Bosnian women for Bosnian women. We returned to Germany in August 1993, and I spent the following months writing proposals and searching for funding bodies willing to support our initiative.
We made our next trip to Bosnia in December of the same year, after having secured our first funding commitment from a women's organization associated with the German Evangelical Church. However, their support was conditional upon one of us overseeing the implementation of the project in the field. Needless to say, we were all aware of the living conditions in Tuzla at the time, and we were all afraid. I, for one, spent long hours deliberating whether or not I should accept the assignment, and finally decided to do so during the course of our visit to a women's project that was already in place in Zenica. We spent five days here before traveling on to Tuzla, where the situation had clearly deteriorated since our last visit. It was winter, mortally cold, and we heard numerous reports of people dying of hunger or killing themselves. Still, we had much with which to busy ourselves: renting a building; preparing contracts and meeting with the local women who would work on the project with us.
I made one final trip to Germany before relocating to Tuzla on a more permanent basis. It was at this time that I quit my job as a hospital psychologist, as well as engaging in fund-raising and other tasks necessary for project implementation. When I was finally ready to set out in March 1994, I was fortunate enough to be able to take advantage of a new air service operating between Sarajevo and the American Air Force base outside of Frankfurt. As one might imagine, this cut down considerably on my travel time, allowing me to arrive in Tuzla while still in relatively good spirits. In possession of one lap-top computer and limited financing, the two Bosnian women and I began work immediately on the new Center. Looking back on these early days with the hindsight I now enjoy, I would say that I was strongly motivated, but very, very naive.
THE PROJECT
As previously stated, the aim of the initiative was to provide counseling to women and children traumatized by the war, regardless of their ethnic or religious backgrounds. In embarking upon this task our first priority was to establish a center that would function as both a hospital and women's shelter. Given the degree to which women were being re-traumatized on a daily basis, it was critical that a safe environment be created; only then would recovery become possible. When the center opened in June 1994, it became home for 18 women and 40 children, with the average length of stay being approximately eight months.
Once this phase of the project was operational, we turned our attention to two further areas of intervention. The first of these was centered upon the creation of a mobile unit of psychologists who would provide individual and group therapy, as well as support the development of self-help groups in the refugees camps surrounding Tuzla. The unit visited its first camp in August 1994, with an average of 90 women receiving counseling on each occasion. In 1995 the unit was provided with an ambulance, so that medical care could be offered alongside its counseling services.
Our third priority was to furnish the women who came to the Center with the means to become self-sufficient afterwards, so that they would not have to return to the refugee camps. To this end, we acquired three houses (with a total capacity of 40 women and 90 children), each offering its own distinct range of services. House objectives are summarized below:
All of the women involved in the project were integrated into a therapeutic model comprised of the following elements:
Medical care (somatic interventions and psychotherapy)
Therapies (psychotherapy, body therapy, art therapy, among others)
Social work (counseling by a social worker; help in searching for missing family members; assistance in planning life goals)
Education (day care services; training in literacy, sewing, computers and languages)
As much as possible, we attempted to involve everyone in the day-to-day operation of the houses and the Center. For example, residents were expected to help prepare meals and work in the garden, as well as being responsible for the upkeep of their own room. In the later stages of the project, once we had acquired sewing machines and looms, the women were also given the opportunity to make clothes or carpets during their spare time. Finally, staff and residents would assemble every week for a general meeting, in which disputes would be resolved, proposals tabled and schedules drawn up.
By the end of 1994, the project employed a total of 30 staff members, drawn from all ethnic communities and encompassing a wide range of competencies. Moreover, personnel were divided into four separate teams: Technical/administrative support, Therapies, Medical care, and Education. General staff meetings were held once a month, while therapists met on a weekly basis. I served as project coordinator, meeting with team managers on a regular basis in order to address key issues and engage in strategic planning.
Of course, in assessing the project's structure and objectives, it bears emphasis that our original plan, when we first set out for Bosnia in June 1993, was more narrow in scope than that upon which we subsequently agreed. How so? In short, while we had intended to focus our efforts solely upon those women who had been raped or sexually assaulted, it quickly became obvious to us that women in Bosnia were being victimized in any number of ways, sexually, physically and psychologically. Although it was this awareness that prompted us to refer to our project as a psychotherapeutic center for traumatized women and children, we were also aware of the dangers inherent in such a name, most notably that of obscuring women's suffering on account of rape and other forms of sexual violence. In the face of this risk, we have made it a priority to bring the issue out into the open whenever possible, both with the women who were taking part in the project and the public more generally.
When we first began work in the Tuzla area, we did not have a clear sense of how many of the women who came to the Center or whom we visited in the camps had been raped.Wedid not ask, though in some cases they would broach the topic themselves; in others we would simply guess. However, as we became more and more familiar with local conditions, we were left in no doubt of the full extent of women's victimization. Quite simp!y, not only had almost all of the women living in the camps been forced to flee their homes, but most had also witnessed the torture and killing of family members. Indeed, we know of several cases where individuals had lost 30 or more male relatives, including husbands, fathers, brother and sons. If this were not traumatic enough in itself, many women were subsequently raped and tortured by militia forces, as well as being subjected to psychological humiliation by government officials and others.
Given this context, it is not surprising that the women bore terrible scars, at both the physical and psychological level. Among those who came to the Center, their symptoms were usually quite similar, encompassing loss of self-esteem, depression, mood swings, somatic illnesses and flashbacks, to name but a few. While in some instances we also encountered individuals with a distorted perception of reality or suffering from dissociative identity disorder, in all cases the scope for destructive behavior was considerable: many were addicted to one or more pharmaceutical drugs, while outbursts of extreme anger toward their children or other residents were not uncommon.
Although we had hoped at the outset to focus much of our attention upon the recovery of women and children traumatized by war, we soon discovered that the need for crisis intervention was such that at least some of our energies would have to be reoriented in this direction. Not only were there relatively few relief agencies operating in the area, but the refugee population was immense, consisting of roughly 300,000 individuals (predominantly women, children and elders) living both in camps and in the town itself.
THE REALITY
I spent my first three months in Tuzla engaged in a frenzy of activity: obtaining permits, hiring staff, arranging for telephone and electrical hookups, buying furniture and countless other tasks. It was also at this time that I became aware of the size of the challenge that lay before me. Not only were bribes routinely demanded of us by public officials anxious to enrich themselves at our expense, but we were initially faced with considerable hostility on the part of refugee camp administrators, who were either unwilling to let us into the camps in the first place or insisted that any woman who returned with us to the Center would immediately lose all of her rights as a refugee. Needless to say, this placed us in a ditiicult position, which we only managed to resolve with the assistance of Tuzla's mayor.
In the end, the Center welcomed its first residents on June 15th, 1994. The initial complement consisted of 18 women and 40 children; all were from the region surrounding Srebenica and most had lost the majority of their male relatives. From the very first day of the Center's operation, the work was at once difficult and empowering. Most of the staff had other jobs, and thus would spend part of the day working elsewhere, and part of the day at the Center. However, for all those whom we hired, the hard currency they earned played a crucial role in helping them meet their families' basic needs.
In light of the working conditions, not to mention the anxiety which many staff members experienced when thinking about their children at home or family members in other parts of the country, it should come as no surprise that we were forced to contend with interpersonal cont1icts within the organization, either between myself and employees, or between employees and residents. As one might imagine, language differences were especially problematic in this regard; only three staff-members could communicate in English or German, and my own language training was proceeding at a frustratingly slow pace. Thus, not only was it impossible at first to engage in casual conversation with employees (since a translator was necessary for interaction to occur), but the risk of misunderstanding was omnipresent. However, the situation improved substantially once we began to offer personnel foreign language training, and once I became more confident about my own language abilities.
As I have already suggested above, the relationship between residents and stati members also proved to be problematic. In large part, this was due to the fact that most of our employees were from cities or towns, whereas the overwhelming majority of refugees, including those taking part in the project, had lived inrural areas before being displaced by the war. On the one hand, this meant that there were significant cultural differences between the two groups, with city-based women generally having far more scope to travel, obtain an education or pursue a career than their rural-based counterparts. On the other, the Bosnian countryside suffered disproportionately from the wartime violence, causing many of the refugees to resent city dwellers for escaping relatively unharmed, with their homes intact and their family members alive.
Psychotherapy is a relatively new t1eld in Bosnia. Individuals who wish to specialize in this discipline must travel either to Zagreb or Belgrade for the necessary training. As such, I had absolutely no luck in t1nding psychotherapists living in the Tuzla area who would be willing to become involved in the Center's work. In order to overcome this difficulty, I located a number of psychologists, social workers and educators and told them that I would help train them providing that they were willing to learn, and would be supportive of the life contexts of those with whom they would be working.
The first therapy session took place shortly after the Center opened. Needless to say, everyone involved was anxious and insecure, ensuring that we had plenty to discuss during our initial staff meeting. However, despite the fact that I was taking part in these meetings every week, it took some time before I realized that many key issues related to the work and the patients were simply not being addressed in an adequate fashion. It took even longer before it dawned upon me that I was part of the problem. Quite simply, the therapists were struggling with a number of challenges, the risk of secondary traumatization not least among them, and they needed a safe place where they could work things through without constantly feeling the need to prove themselves (as they did when I was present).
However, even as I acknowledged the importance of providing the therapists with adequate support and positive reinforcement, I lost touch with my own needs and boundaries. That is to say, I was so absorbed in fult1lling my responsibilities to the project-as coordinator, fund-raiser, psychotherapist, referee and resident strong woman-that I ignored the warning signals my body was sending me. In the end, it took a series of setbacks, including a medical operation in Germany and an attack by six soldiers in my home in Tuzla, before I started asking why I was not taking better care of myself. Although this awareness did not lead me to make an immediate change in my lifestyle or activities, I began to devote more and more time to writing in my journal, as well as making a number of weekend trips to the coast in order to visit with a friend from Germany who was working with another organization. Also helpful in this regard was the decision to restructure the work teams, with the art and physiotherapists transferred from Therapies to the Education and Medical Care teams respectively. In so doing, the therapists were placed in a position where they could meet as a small group every week in a closed session, and discuss work-related problems, as well as other pertinent issues. Finally, it was also roughly at this time that I organized a "self-experience" retreat for all staff members in a Tuzla area hotel. It proved to be a good experience for all of us. Not only did the change in venue make it easier for people to open up and be frank with one another and me, but the exercise helped to engender a new atmosphere of mutual respect and understanding.
Needless to say, it was largely this atmosphere that provided the basis for the project's success and growth over the first two years of its existence. Not only did the purchase of an ambulance substantially increase our capacity to serve the needs of refugee camp residents, but we started increasingly to plan and implement new initiatives, such as computer and language training for the women living at the Center and in the houses. However, at the very moment we were registering these successes, the political situation in the region was becoming inc,'Teasingly unstable, with the kidnapping of United Nations peace keepers, NATO air strikes against Bosnian Serb military targets, and, in July 1995, the capture of UN safe havens in Srebenica and Zepa by the Bosnian Serb militia. In all, 40,000 people were forced to ±1ee, of which a significant proportion ended up in the Tuzla area.
As the new refugees arrived, we began to make arrangements to accommodate additional residents at the Center. However, we were immediately struck by the fact that these women had substantially different psychological profiles than those who had ±1ed to Tuzla previously. Although many had emerged from their ordeals severely traumatized, having been subjected to rape and other forms of physical and psychological torture, the memories were so fresh in their minds that they had not had time to repress them. Given this finding, we launched into counseling as quickly as possible, and found that, for a significant number of women, a series of regular meetings for debriefing proved quite helpful, obviating the need for long-term therapy.
However, as horrible as the attacks upon Zepa and Srebenica undoubtedly were, the real turning point in the conflict was not until December 1995, when the Dayton peace agreement was ratified by the warring parties. Although the refugees and residents of Tuzla were happy that peace was at hand, the vast majority were exceedingly disappointed by the terms of the Dayton accord, most notably its willingness to recognize Serb sovereignty over the Srebenica region. In effect, this meant that the bulk of Tuzla's refugee population would never be able to return home again.
While the Center's social worker continued to devote much of her energies to the task of locating missing family members on behalf of residents, others' husbands began slowly to trickle into the Tuzla area, many having not seen their wives for well over two years. Not surprisingly, this was often the source of considerable tension, since both wives and husbands had undergone significant traumatic experiences, and many women were loathe to give up the relative autonomy and independence they had enjoyed during the war years. In this way, spousal abuse rapidly became a serious problem within refugee families, as men sought to compensate for their low self-esteem by assaulting, raping and sometimes even killing their marital partners.
In the midst of these developments, we continued to carry out the mandate of the Center to the best of our abilities. Moreover, we were particularly gratified to learn that a German organization had agreed to provide specialized training to our therapists during the first half of 1996, as well as offering body therapy to Center residents. Finally, it was also at this time that we started to prepare for my own departure from Tuzla in February 1996. Having originally planned to stay for one year, which was subsequently extended to two, the time had come to step out of the way so that project staff could take charge themselves. However, we agreed that I would continue to serve in an advisory capacity from Germany, and would endeavor to ensure continued funding for the project until such time that it became wholly self-suft1cient.
THERAPY
When I first arrived in Tuzla, I was simply too busy with project logistics to spend much time thinking about the implications of undertaking therapy in an unstable environment in which traumatization was ongoing. Moreover, even when I did become sensitive to this issue, there seemed to be little that could be done. I was immersed in a cultural context with which I had little familiarity; my colleagues were for the most part inexperienced and not confident; and there was essentially no scope for bringing in outside experts so long as the town was under a state of siege. Thus, we had no choice but to attempt to find our own way of working with clients and overcoming the challenges inherent in the environment in which we found ourselves.
As one might imagine, these difficulties were themselves exacerbated by problems in adapting therapeutic approaches to the life contexts of clients. That is to say, whereas the therapies had been designed for work with individuals who were well-educated and lived in a Western industrialized country, the women involved in the project had little formal education and emerged from a cultural background that was at once highly traditional and patriarchal in its orientation. Sensitive to these differences, the challenge we faced was one of making contact with the women while at the same time resisting the urge to force our theories, structures and techniques upon them.
Given my own background as a German woman who had no previous work experience in the Former Yugoslavia, I found this to be particularly dift1cult. In short, not only was I forced to modify many of my expectations and assumptions, but it also became clear to me that I would have to have the courage to leave the "normal" structure of therapy if I was to reach the women with whom I was working. This latter point was brought home to me in particularly stark terms in August 1994, when the husband of one of the residents returned to Tuzla, having managed to escape from a Serb-run concentration camp. His description of the atrocities committed there left all of the other women in a deep state of depression (as many had relatives who were being held in the same camp), and there seemed to be no way of making contact with them. At wit's end, I decided spontaneously that I would organize a special evening of music and dancing, having noticed previously how much the women appeared to enjoy singing and listening to the old traditional songs. The evening proved to be a remarkable success, with everyoneeven those who had until that point been entirely non-communicative and apathetic-taking part in the festivities. For me, the night also brought understanding, highlighting as it did the extent to which something as seemingly mundane as music could bring the women back to their roots, and give them the sense of being on common ground.
After this evening I began to notice myself interacting with the residents in a ditierent way, as I placed more and more emphasis upon uncovering their feelings, relationships, and ways of understanding the world around them. For example, in the sessions I held with women living in one of the Center's houses, I suggested that we rearrange the meeting room, replacing the tables and chairs with pillows on the floor in traditional Bosnian fashion. Having done so, everyone felt more at ease, and increasingly willing to talk about their lives prior to the war, whether their childhood, their family, or their first contact with men. Like the music and dancing, storytelling offered the women a means of regaining a lost sense of identity and stability.
Still, this is not to suggest that the latter was the only therapeutic technique used in the sessions. On the one hand, we engaged in a number of exercises
involving imagination and dreams, though I was always careful to avoid references to images (such as forests) that might bring back unpleasant memories of the war. To the extent that I was successful in doing so, participants found the exercises to be quite helpful, particularly those involving the seaside and inner helpers (e.g., wise women). On the other hand, I also made ample use of drawing and painting as a way of helping the women to come to terms with their pain and shame, feelings that had led many of them to abuse or mistreat their children. Needless to say, this latter behavior was especially disturbing in light of the fact that the children were often severely traumatized themselves, forcing us to devote considerable energy to the task of working through this issue with both parties.
However, regardless of the therapy used, it quickly became apparent to us that the degree of traumatization, among both women and children, was immense by any standard. Indeed, many could only make sense of their suffering by placing it within the context of a plot designed specifically to punish them, at a personal level, for misdeeds which they had committed in the past. In other words, they were incapable of grounding their trauma in the wider political and social structures of which they were part Thus, our aim in working with the women was to help them overcome their sense of helplessness and guilt. However, as strenuously as we tried to empower and reenergize them, we were often unsuccessfuL In these cases, we simply attempted to provide the women with a set of structures around which they could organize their lives, and support them step-by-step in their journey towards independence and autonomy.
Of course, an important element in this regard was the fact that we were there to bear witness for them, and to affirm them in naming those who were responsible for their suffering. This was neither the time nor the place for neutrality; the crimes were too horrible, and the women were simply too much in need of someone w