testimony : a new hope for survivors of torture and organized violence in india

8/14/2019 Testimony : a new hope for survivors of torture and organized violence in India

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Testimonial Therapy

Among survivors ofTorture and Organized Violence

in IndiaInger Agger, PhD, Psychosocial Adviser

RCT, Denmark

Lenin Raghuvanshi, Convenor,

Peoples Vigilance Committee for Human Rights, India

Peter Polatin, MD, Health Program ManagerRCT, Denmark

Presented at the Symposium:

Peacebuilding: Psychological Perspectives

European Congress of Psychology,Oslo, July 2009


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A collaborative project of

Peoples VigilanceCommittee on HumanRights (PVCHR),Varanasi, India

&

Rehabilitation andResearch Centre forTorture Victims (RCT),Copenhagen, Denmark


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Testimony as a Brief TherapyIntervention

First project in Varanasi, India with thehuman rights organization:

Peoples Vigilance Committee on HumanRights (PVCHR):

Capacity building project on testimonialtherapy for Human Rights Organizations

in India


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The objectives of the

project Context specific manuals for using theTestimony Method developed

Capacity built in using the TestimonyMethod among human rights defenders

Psychosocial wellbeing of survivorsenhanced

Impact and outcomes analyzed through anM&E system


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What is Testimony?

A testimony is a story or a narrative about anevent

The story is usually told by a person who

suffered an injustice, or something painful orterrible

It is a map of pain, a trauma story, it tries totell the truth, convey what really happened

In Hindi it is the self-suffering story It can be told in many different ways in

words, music, art


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What is testimony?

It can be told to many different audiences: tothe family, to friends, to the community, to theworld, to a therapist, to a lawyer, to a priest

It can be used for many different objectives: asa record, as evidence, as an expression ofemotions, for advocacy

Testimony in different variations has been used

by mankind for thousands of years Here we are using testimony as a healing or

psycho-therapeutic method


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What is Testimony?

Has a double meaning (in English):

Objective, legal, public, official

(evidence, attestation, proof) Subjective, cathartic, spiritual,

emotional, private (expression ofdisapproval, condemnation,

protestation)


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Interpretation of Testimony(Dr. Jhawar , clinical

psychologist, Varanasi) T- Truth E- Emotions S- Sentiments

T- Tortured I Individual M- Magnifiable

O- Operations N- Never Y- Yielding their rights


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Testimony Model

Developed for IndiaFour sessions:n Session one: Opening the story

n Session two: Closing the story

n Session three: Delivery ceremony

n Session four: Follow up

n Meditation and Mindfulness integrated

n Community-based delivery rituals introduced


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PVCHR Human Rights

Work Investigate & Document Violations Advocacy

Folk Schools in People Friendly modelVillages

People can give testimonies and receivesupport from the group

Concerns of health and education


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Manual

A manual on testimony therapy for community

workers and human rights defenders was

developed (published in English and Hindi):

Giving Voice Using Testimony as a Brief

Therapy Intervention in Psychosocial

Community Work for Survivors of Torture

and Organised Violence


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Testimony Workshops

Three two-week training-of-trainersworkshops conducted:

1. May 2008: 12 human rights defenders from PVCHR2. January 2009: 14 Human rights defenders from four

states: Uttar Pradesh, Uttarakhand, Bihar and Madhya

Pradesh.

3. February-March 2009: 14 Human rights defenders fromthree states: Jharkhand, Manipur and Chattisgarh


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Schedule of Workshops

Two parts:

2. First week:

Theory and exercises (through role plays)

2. Second week:

Practise: Participants take testimonies withsurvivors under supervision


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Testimonies collected

Period of data collection:12 months (May 2008 toApril 2009)

On average the first testimonial session is held 1

year and 5 month after the date of the moststressful event

Average number of testimony sessions per victim:2,39


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Background of survivors

A total of 85 primary and secondary victims ofwhich:

Male: 64 (76 %)

Female: 20 (24 %)

Average age: 39,2 yrs; age-ranging: 16 - 70 yrs


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Category of survivors Primary Victim: 59

Secondary Victim: 24

Secondary victims most often reported relation toprimary victim as either wife (29 %), father (14 %)or brother.

Religion: Vast majority are Hindus (86 %, n= 72) followed

by christian (7 %, n=6).


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Caste Upper Caste: 9 % (n = 8)

OBC: 46 % (n = 39) (Other Backward Caste)

SC: 21 % (n = 18) (Schedules Caste)

ST: 24 % (n = 20) (Scheduled tribe)


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Education No education: 28 % (n= 24)

Primary education: 19 % (n=16)

Secondary education: 19 % (n= 16) BA: 11 % (n=9)

Other 24 % (n =20) high school, intermediate, BAMS


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Background of survivors Occupation:

Agriculture: 37 % (n =31) Business: 6 % (n =5) Household: 6 % (n =5)

Public service, journalism, teacher: 6 % (n=5) Lawyer, doctor: 2 % (n=2) Government or political position: 2 % (n=2) Other 40 % (n = 34),

primarily landless labour, or having own business such asshopkeeper, tea stall, making plates or rickshaw driver

Not working 2 % (n =2)


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Activities: Humanitarian/ Solidarity: 29 % (n =25)

Political: 6 % (n=5) Religious: 6 % (n=5)

Trade Union: 2 % (n=2)

Press: 1 % (n=1)

No activities: 49 % (n=42)


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Type of Violations

Types of Human Rights violations: Psychological torture: 82 % (n=70)

Physical torture: 48 % (n=41)

Sexual torture: 4 % (n=3)

Custodial death of primary victim: 2 % (n =2)

Extra-judicial killing of primary victim: 1 %

(n=1)


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Identity of Perpetrator

Identity of perpetrator: Police: 80 % (n =68)

Armed forces: 5 % (n =4)

Intelligence Service: 2 % (n =2)

Prison authority: 1 % (n =1)

Other: 34 % (n =29),

primarily neighbours, village leader and uppercaste


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Injured Part of Body

Most frequently injured parts of body one or both legs 25 % (n =21)

back 24 % (n =20)

one or both arms 20 % (n =17)

one foot or both feet 15 % (n =13)

face 13 % (n =11)

head 9 % (n =8)

chest/breast 8 % (n =7)

not injured: 28 % (n =24)

On average primary victims report 2,4 injured body parts


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Nature of Injury

Most frequently types of physical injuries: Pain 26 % (n=22)

Loss of function 26 % (n =20)

Loss of sensation 20 % (n= 17) Open wound 20 % (n =17)

Loss of strength 18 % (n =15)

Bruise 11 % (n=8)

Fracture 9 % (n =8) Not injured 24 % (n=20)


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Psychological Symptoms

Most frequent symptoms

Anxiety 54 % (n=46)

Cant sleep 53 % (n=45)

Memories 52 % (n=44)

Fear of going out 45 %(n=38)

Nightmares 41 % (n=35)

Self isolation 32 % (n=27)

Panic attacks 17 % (n =14)

Depression 15 % (n=13)


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Treatment before TestimonialTherapy

Legal aid: 33 % (n=28)

Testimony before tribunal: 31 % (n=26)

Public hospital: 19 % (n=16)

Counselling: 19 % (n=16)

Medication: 17 % (n=14)

Private hospital: 11 % (n=9)

Physiotherapy: 4 % (n=3) Surgery: 2 % (n=2)

None: 29 % (n=25)


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Use of Testimony

Survivor wants: 80 % want it published or used for human rights work

Other interventions by PVCHR or other actors:

Medical: 8 % (n=7) Social: 55 % (n=47)

Legal: 60 % (n=51)

Reading of testimony at Folk School Meeting: 53 % (n=45)


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Changes in wellbeing

Changes in psychosocial wellbeing indicatedthrough the WHO5*:

WHO5-average pre-TT score (n=84): 8,46

WHO5-average post-TT score (n=38): 12,82:

*The higher the WHO5 sum the better (range 0-25)


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Changes in Participation(WHO Participation Scale)

Overall improvement in participation. 17 questions Range 0-85

0: same participation as peers 1: No problem 2: Small problem 3: medium problem

5: Large problem Pre-participation Scale mean value:

31,25* Post mean-value: 13,25*


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Changes in Participation(WHO Participation Scale)

2,00 used as cut-point: Participation perceived as medium or largeproblem. Most commonly found problems were in:

P1: Do you have equal opportunities as your peers to find work?

Mean: Pre: 2,61 Post: 1,85

P3: Do you contribute to the household economically in a similar

way to your peers? Mean: Pre: 2,22 Post: 0,78*

P4: Do you make visits outside your village/neighbourhood asmuch as your peers do?

Mean: Pre: 2,87 Post: 1,15

P11: Do you move around inside and outside the house andaround the village/neighbourhood just as other people do?

Mean: Pre: 2,25 Post: 1,15*

All dropped below 2,00 post testimony


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Types of Delivery Ceremonies

At public demonstration in front of Government

Head Quarters

At Folk School meetings

At community meetings

At street performances & singing


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Delivery Ceremony atFolk School Meeting


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Delivery Ceremonyat Street Theatre Performance


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Delivery Ritual atCommunity Meeting


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ConsultationVaranasi, India, September

2008 Interesting part of this therapy is that it has bothWestern element of Anger Management, ClassicalConditioning and Eastern approach of relaxationmethods and Meditation.

A cost effective model of psychotherapy which doesnot require clinics or hospitals but can be donedirectly at the doorsteps of the victim, e.g., in hishouse, in the community, in a forest etc.

The economic costs of the whole approach seems tobe very less than regular psychotherapy session in aclinic or hospital.


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Facts

There are around 3,000 adequatelyqualified psychiatrists and 1000 clinical

psychologist in the entire country of India

with a population of more than one billionpeople.

The state of Uttar Prades , where PVCHR

works is the most densely populated statein India with a population of more than 166million people. However, there are less than100 psychiatrists and 100 psychologists..

testimony : a new hope for survivors of torture and organized violence in india

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