CISR Supports Expansion of Peer Support Activities to Burundi’s Capital

In April, CISR Peer Support Specialist Cameron Macauley returned to Burundi to assist in the training of new peer support workers for a program expansion into Bujumbura, Burundi’s capital. CISR’s Burundian partner since 2010, CEDAC (Center for the Education and Development for Ex-Combatants) operates a highly successful program for survivors of war-related violence in Muramvya, a community about 20 miles east of the capital. CEDAC’s peer-support workers provide counseling and psychosocial support to survivors who are recovering from traumatic experiences suffered during Burundi’s civil conflict, which ended in 2006.

With support from CISR, CEDAC implemented a new monitoring and evaluation system last June to assess the results of its work with 363 survivors. Preliminary data suggests that CEDAC’s services are overwhelmingly successful, with 99 percent of survivors reporting positive changes in their lives as a direct result of peer support.

With generous assistance from Action on Armed Violence (AOAV), a London-based nongovernmental organization, CEDAC will begin providing services in Bujumbura, where thousands of war survivors still need assistance. This most recent training prepared 30 women with disabilities to offer peer support in the capital. CEDAC’s supervisors were also trained to respond to issues related to disability, such as discrimination, domestic violence, and lack of access to schools, clinics and government buildings. Participants also learned how to help survivors overcome low self-esteem and how to build self-confidence.

“With help from CISR and AOAV we hope to eventually become a national organization,” said Eric Niragira, CEDAC’s executive director. “We look forward to the day when all war survivors can participate fully in Burundian society.”

~ Cameron Macauley, CISR Peer Support and Trauma Rehabilitation Specialist

Supervision of Peer Support Program for Burundi War Survivors Reveals Early Benefits

During the first week of October, CISR Peer Support Specialist Cameron Macauley visited Burundi to supervise the peer support program operated in conjunction with Action on Armed Violence (AOAV) and the Center for Development of Ex-Combatants (CEDAC). The trip included individual visits to war survivors receiving peer support services and a first look at a survey of 756 residents of communities in Muramvya, a province in northwest Burundi.

When the survey data is analyzed, it will provide a snapshot of mental health in this population, which was severely affected by war-related violence during the 15-year conflict. Survivors describe mass executions, rape, torture and forced conscription. Very little has been done to help survivors deal with their psychological trauma.

The peer support program consists of home visits by 30 peer support workers and has been in operation since June 2012. Survivors give enthusiastically positive opinions of the services they received. “No one showed much interest in my problems until the peer support worker began to visit me,” said Joseph Ntawanka, a 70-year-old who was the lone survivor of a massacre in which 32 people died. “Now I have help in solving my problems, and I am thinking in new ways about the past. I have hope that the future will be better.”

“I have been lonely and sad since I lost my arm during the violence that devastated my community,” said Languide Nsabiyumva. “A woman with one arm is nobody—people act as if she doesn’t exist. But my peer support worker cares about me, wants me to feel better. She has made me think about myself differently. When I talk to her I feel as if my life has meaning once again.”

For peer support workers the days are long and strenuous: Many homes are remote and accessible only on foot. However, the rewards of helping others make every step worthwhile. “Even when I’m not working, I think about the people that I’m trying to help,” said Candide Nsabiyumva. “Knowing that I can make a difference in their lives is an inspiration for me.”

Monitoring and evaluation data collected by CEDAC on hundreds of survivors will be analyzed during the next few months and used to improve program activities during 2013. “Each day brings new refinements to this program,” says CEDAC Director Eric Niragira. “We look forward to expanding into new communities and eventually helping the entire nation. We are assisting each other to recover from Burundi’s violent past.”

~ Cameron Macauley, CISR Peer Support Specialist

CISR Implements Monitoring and Evaluation for Peer Support in Burundi

In partnership with the British NGO Action on Armed Violence (AOAV), CISR staff created a system to monitor and evaluate the impact of a psychosocial support program for victims of armed violence in Burundi. The program, operated by the Center for Development for Ex-Combatants (CEDAC), a Burundian NGO, has been in operation since 2009 but has recently received significant funding which will allow it to enlarge its administration and implement a new system for monitoring and evaluation.

CISR completes peer-support training workshops in Rwanda

Following up on training workshops CISR conducted in 2011 with its partner organization IBUKA, CISR is participating in a new series of workshops to prepare trainers and new peer-support workers. IBUKA is Rwanda’s largest support network for genocide survivors.

This past week CISR conducted a refresher course for four peer-support trainers, all of them experienced educators and program supervisors for IBUKA peer-support workers, who work with survivors in remote rural communities. IBUKA is expanding its program from 25 peer-support workers to a total of 65 operating in some 30 communities.

Following this training, CISR participated in a workshop for 20 new peer-support workers in the district of Rwamagana, about 50 kilometers east of Kigali. IBUKA had previously selected and trained the participants in trauma counseling prior to the April Genocide Commemoration ceremonies, when many survivors experience emotional distress as they mourn loved ones killed in 1994.

During the third day of this training, farmers accidentally discovered a mass grave containing a large quantity of human remains just outside Rwamagana. Many of the participants believe their family members are among the buried. A few of the remains were easily identifiable by clothing and personal items found in the grave.

While funeral preparations were being made, the participants elected to complete the workshop and used the opportunity to discuss the ongoing psychosocial effects the genocide has had on their community 18 years after the event.

In Burundi, CISR trains women with disabilities about peer support

During the first week of June, CISR conducted a workshop for 25 women with disabilities in Bujumbura, Burundi in partnership with the Burundian nongovernmental organization Centre d’Encadrement et de Développement des Anciens Combattants (CEDAC) and the British NGO Action on Armed Violence (AOAV). CISR Trauma Rehabilitation Specialist Cameron Macauley trained the women on peer support’s concepts and basic activities, focusing on the needs and challenges in the lives of disabled women in Burundi. AOAV is also providing training on the rights of people with disabilities.

Approximately 15 percent of the Burundi population is disabled, and women in this group often do not have access to education. Only about 25 percent of disabled Burundian women can read and write.

The trainees were women from several communities in which CEDAC offers services. Among other disabilities, women in the group had upper and lower-limb amputations, paraplegia and hemiplegia. Also included were five women who work with local NGOs that provide services to women with disabilities.

“This training has been very useful in showing us how to help each other,” said Ndagijimana Gloriose of Muramvya Commune. “We are usually considered to be the beneficiaries of services, but now we can provide support for each other. Thanks to CISR and CEDAC for giving us new skills.”

Mass Fitting for Amputees in Tam Ky, Vietnam

by Ken Rutherford

On March 9, my colleague, Trauma Rehabilitation Specialist, Cameron Macauley from the Center for International Stabilization and Recovery (CISR) at James Madison University, and I had the good fortune to participate in a mass fitting for amputees in Tam Ky, Vietnam. When we arrived, some 200 men and women were awaiting their turns to have plaster casts made which would then be used to manufacture new, durable and very comfortable prostheses. They removed their old prostheses, and I was astonished by these ancient, hand-made artificial legs constructed of wood, rubber, wire and cloth. Most of them were broken and were repaired numerous times.

We were invited by Mr. Ca Van Tran, President of the Viet Nam Assistance for the Handicapped (VNAH), a U.S.-based nongovernmental organization, who sponsored the outreach event. VNAH was founded in 1991 by Vietnamese-American philanthropist Ca Van Tran. Tran came to the United States in 1975 where he found work washing dishes at a Mexican restaurant; he was soon owner of the Taco Amigo chain in Northern Virginia. He also served in the U.S. Marines during the Vietnam War. Tran regularly visits communities in rural Vietnam to offer free prosthetic devices and wheelchairs to people with disabilities. He has used much of his personal money to support programs for people with disabilities in Vietnam and is now interested in opening new projects in Myanmar.

“A new arm, leg or wheelchair makes all the difference in the world for these people,” said Tran. “It makes work, play and everyday activities possible and allows them to live with dignity and self-respect. Nothing gives me greater joy than to see an amputee walk with grace, pride and comfort. Even though the situation is improving for people with disabilities in Vietnam, much more needs to be done.”

Today’s event was an opportunity for amputees to be fitted for new prostheses, which will then be manufactured in a VNAH-supported prosthetics workshop in Danang. The community of Tam Ky is home to many people affected by the Vietnam War and the UXO resulting from it, however access to modern mobility devices is difficult. Of the 200-plus amputees who appeared at the event, nearly all used worn, outdated, home-made prostheses constructed from wood, rubber, wire and cloth. Poorly-made devices of this type are uncomfortable to use and often lead to skin breakdown on a residual limb, as well as chronic back pain and joint problems.

After being fitted for a new prosthesis by having a plaster cast made of their residual limbs, many of these amputees will be transported to the workshop in Danang. where the new prostheses will be carefully customized to their needs. They may also spend some time undergoing physical rehabilitation and learning to walk with the new device. Amputees who require upper-limb prostheses will learn to use their new hands to dress and feed themselves and to ride a bicycle or a motorbike. All of these services are provided free of charge.

These amputees were men and women who had lived for decades without the benefit of tough, comfortable prosthetic limbs that would tolerate physical abuse and exposure to weather. Their residual limbs were calloused and scarred from chafing inside poorly-fitted sockets. I could see the look of joy and relief at the thought of working, playing, and taking a relaxing stroll without feeling the pinch and cramp of a barely-adequate prosthetic leg.

I lost both my legs to a landmine in Somalia in 1993, so I know what it means to walk on artificial legs. I have met thousands of amputees in countries around the world, and I know how important these new limbs are to them. VNAH is providing mobility, comfort, safety and even beauty in the lives of these Vietnamese, many of whom never dreamt that they would ever be lucky enough to get a new prosthesis. It is a wonder and a profound delight for me to see such kindness in action.

Ca Van Tran recognizes the value of walking with dignity and grace, of running after a soccer ball, of having a leg that will not buckle under your weight. Thank you, Mr. Tran, for your dedication to people with disabilities in Vietnam and around the world, and to your efforts to making their lives easier and better.

Kenneth R. Rutherford, Ph.D.

Director

Center for International Stabilization and Recovery

James Madison University

CISR Director visits prosthetics distribution in Tam Ky, Vietnam

On 9 March CISR’s Director Ken Rutherford visited a mass fitting for amputees in Tam Ky, Vietnam, accompanied by CISR’s Trauma Rehabilitation Specialist, Cameron Macauley. The event was sponsored by Viet Nam Assistance for the Handicapped (VNAH), a U.S.-based nongovernmental organization founded by Vietnamese-American philanthropist Ca Van Tran. VNAH regularly visits communities in rural Vietnam to offer free prosthetic devices and wheelchairs to people with disabilities.

After being fitted for a new prosthesis by having a plaster cast made of their residual limbs, many of these amputees will be transported to the workshop in Da Nang where the new prostheses will be carefully customized to their needs. They may also spend some time undergoing physical rehabilitation and learning to walk with the new device. Amputees who require upper-limb prostheses will learn to use their new hands to dress and feed themselves and to ride a bicycle or a motorbike.

All of these services are provided free of charge by VNAH. Its President, Ca Van Tran, served in the U.S. Marines during the Vietnam War and went to the United States in 1975. He found work washing dishes at a Mexican restaurant and was soon owner of the Taco Amigo chain in Northern Virginia. He has used much of his personal money to support programs for people with disabilities in Vietnam and is now interested in opening new projects in Myanmar.

“A new arm, leg or wheelchair makes all the difference in the world for these people,” said Ca. “It makes work, play and everyday activities possible and allows them to live with dignity and self-respect. Nothing gives me greater joy than to see an amputee walk with grace, pride and comfort. Even though the situation is improving for people with disabilities in Vietnam, much more needs to be done.”