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The
consequences of truth: Post-traumatic stress in new South Africa
(continued) Part 3 of 7 |
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Thandi's Story In July 1997, the TRC held a women's hearing in Johannesburg. The hearing began with mournful songs and poems that ended in a burst of applause. Archbishop Desmond Tutu, clad in his signature crimson robe, thanked the reader, saying “we are grateful for whatever it is in our culture that has produced someone like you so that we can talk about our pain, share our laughter and our sadness as well.” It was a sentiment Tutu would repeat often throughout the hearings, and revealed his underlying philosophy of reconciliation in South Africa. Blacks, Tutu believes, have a special capacity for love and forgiveness. Tutu then introduced Thandi Shezi. “Mama, thank you for coming today,” he said. Shezi sat before the commission and an audience of listeners, leaned into the microphone in front of her, and told her story, including each horrible detail. When she was finished, Joyce Seroke, the briefer assigned to help Shezi with her testimony, asked her how the rape made her feel about her womanhood. "I was very deeply hurt," Shezi answered. "As a result, there's nobody I've been able to relate the story to. My mom is hearing this for the first time." Shezi says she thought making her story public might begin to heal her memories. "When you lock your past inside your brain and mind, when this thing explodes, your life would be in tatters, like mine for the past ten years," she says. But her experience testifying before the TRC has left her feeling hollow. "You rip open the closed wounds and you are left with a gaping wound. The TRC was there just to get the information, not for the healing." After her testimony, Shezi said her symptoms worsened, and she sought counseling at the trauma clinic at the Center for the Study of Violence and Reconciliation, a non-governmental organization funded primarily by foreign donations. Shezi was referred to clinic by Khulumani (Speak Out), a survivor's support group created in response to the TRC. The counseling Shezi has received at the clinic, she believes, has helped her learn how to manage her rage. She admits she sometimes feels violent urges toward her children "when the trauma comes," but credits the self-care she learned at the clinic to help her through those periods. "Now I can manage," she says, offering a thin smile. Mary Robertson, 34, is Shezi's psychologist and director of the trauma clinic, which offers free, short-term individual and group counseling to people who are having traumatic stress as a reaction to violence, both political and criminal. A total of 1264 new patients were referred to the clinic in 1997, and about 120 new referrals come to the clinic each month. Robertson leans back on a puffy gray chair in one of the clinic's carpeted therapy rooms and runs her thin fingers through her cropped blond hair. She says the number of referrals has steadily increased since the TRC completed its human rights hearings in June 1998. Over 21,000 people submitted testimony, and 2,500 were invited to publicly testify in hearings held throughout the country. “A lot of people are starting to recognize that they are still dealing with the same post-traumatic stress, they still can't get along with people, they're still irritable, they're still having flashbacks, and they're not better even though the TRC has happened.” Counseling in South Africa, Robertson says, should be viewed as a necessity, and not a luxury. "If people can get healing, and go for counseling, and work through their anger and work through their resentment, it's very likely to stop the chance of re-victimization happening and also to stop the victimized from becoming the perpetrator." PTSD has no cure. There is no pill that can make all the symptoms go away. Sometimes tranquilizers are used to reduce anxiety and insomnia, though these medicines tend to be habit-forming and have potential for abuse. Some doctors try to limit mood changes and suppress angry outbursts with lithium, a drug frequently prescribed for bipolar disorder, an illness characterized by drastic mood swings. So far, therapists report the most success with anti-depressants. There is debate whether these drugs are specifically effective for PTSD symptoms, as some doctors claim they only relieve the secondary symptoms of depression exhibited by many patients. However, recent research out of the Veterans Administration Medical Center in Dallas has found that serzone (nefazodone hydrochloride), a drug used as an anti-depressant, specifically relieved PTSD symptoms by almost 30 percent in patients with PTSD. The drug is one of the newer anti-depressants that inhibits the brain's re-uptake of both serotonin and norepinephrine, neurochemical transmitters. But here at the clinic and throughout South Africa, drugs are a luxury. The clinic cannot even afford to employ a psychiatrist to dispense medicine. Another new clinical treatment, which has been scientifically evaluated primarily with trauma survivors in the United States, is Eye Movement Desensitization and Reprocessing (EMDR). The treatment has generated intense research and controversy in the United States and Britain in the past couple of years. In EMDR, a therapist guides the client in recalling distressing past experiences and helps her develop a new understanding of the traumatic events and the thoughts and self-images associated with them. The "eye movement" aspect of EMDR involves the client moving his/her eyes back-and-forth while recalling the traumatic events. The practice has proven effective in several recent scientific studies, and might be a relatively low-cost alternative to drug therapy in South Africa. Robertson said it's time for corporations to step in and help fund programs like the clinic, because the reality of South Africa's resources prevents the government from offering financial assistance. "Mental health is always at the bottom of the barrel," she said, "You always get the dregs." There is a commitment on paper from the Departments of Welfare and Mental Health to a so-called victim empowerment program, but Robertson says the money has never followed. Besides, she says, "victims" are categorized as those who have suffered present-day crimes. "I fear that victims of past human right abuses will fall through the cracks." |
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