Scarred
The Observer 01-05-1993
Britain is world-renowned for its skills in Post Traumatic Stress treatment. But unless we apply them in Bosnia there is little hope of lasting peace in the region, reports CHRISTOPHER LONG.
By Christopher Long
Trauma specialists in London say the government must help the 'living dead' of Bosnian genocide, either by setting up counselling teams in the field or permitting victims temporary entry permits for treatment in the UK.
"If we don't we'll soon be facing this all over again," says Funda Kansu who works with victims of torture at the Medical Foundation's specialist centre in North London.
Recognised internationally for its expertise in healing the physical and mental scars of torture and persecution, the Medical Foundation's specialist doctors and counsellors say that organisations like theirs could offer the most constructive hope for the tortured minds of Balkan victims if only the government and Immigration Service would co-operate.
Miss Kansu believes there is little chance of the Bosnian peoples living in lasting peace with each other unless those scarred by their experiences are helped to live with what's happened to them.
"If they don't, the pattern will just repeat itself."
"British troops in Bosnia-Hercegovina are already being offered counselling for Post Traumatic Stress Syndrome and it's regarded as the first priority for hostages like John McCarthy. But no-one seems to think we should do the same for people whose bodies and minds have been mutilated who've watched their parents, their children, their homes destroyed and who have no future. A lot of them will be a sort of living dead."
The Home Office says immigration officers have been authorised to permit entry to 1,000 ex-detainees and their dependents from Bosnia by arrangement with the UN's High Commission for Refugees and that it's already bending immigration rules in favour of Bosnians seeking asylum or medical treatment in the UK.
But critics say the government isn't beginning to address the full scale of the problem and that the most of the real victims scarcely have the price of a Bosnian bus fare, let alone an air-ticket.
Failure to apply the recently developed 'science' of stress counselling to war victims was tragically illustrated a few days ago (April 26) when an 81 year-old former Polish prisoner-of-war died, emaciated, in hospital. It was a personal 'final solution' after years of self-imposed imprisonment in his squalid North London council flat. Haunted by World War ll memories, he had been sleeping in a chained cage behind barricaded doors with grills on windows that he had nailed permanently open.
Mr Kasimerz Symanksi, who was said to be terrified that he would be gassed and irradiated, lived with no water or electricity and apparently refused any help from the social services. His tortured life, dating from more than 50 years earlier, ended with the bronchial pneumonia induced by hypothermia. His death was recorded as "by misadventure".
Sadly, Mr Symanksi, among untold thousands of others, never discovered the Medical Foundation just a mile away in Kentish Town. There psychiatrist Dr Derek Summerfield and a team of doctors and counsellors spend their lives dealing with tortured and abused minds and bodies from about 90 different countries, including Cambodia, Turkey, Iran and Argentina. Funded by private donations and no government grant, they are just beginning to see the Bosnian effect.
"The idea of a man in a dark, dank cell, being electrocuted and systematically beaten is a rather romantic notion," says Dr Summerfield. "It happens, of course, on a huge scale, but it's not necessarily the worst thing that can happen to you. After all, if you can see the scars people will at least believe your tale and being believed is everything."
"The most common reaction to physical or psychological abuse is a desperate need to relate the experience to someone who will believe it," say Dr Summerfield. "Doctors here offer medication, counselling and a range of therapies, but the client is first and foremost looking for validation of the events which brought him here."
"I remember a Moroccan, one of 43 political prisoners, who were incarcerated in subterranean cells for decades. He said he only managed to survive because he was determined others would know what had been done to them."
"It's impossible to predict how people will react to their experiences. It's a question of thresholds. Some can endure appalling circumstances, rationalise them, build their own defences and cope. The same experience can devastate others."
Without knowing the details of Mr Symanski's case, Dr Summerfield suggests that merely recognising the man's past experiences and his present terrors real or imagined would have helped him.
But the victims of Bosnia's destruction have no immediate prospect of such recognition. Indeed, Bosnia's situation parallels Mr Symanski's 50-year nightmare of neglect. Many believe that today's hatred, bigotry and vengeance in former Yugoslavia are the direct consequences of Tito's policy, 50 years ago, of enforcing political unity while failing to acknowledge the personal and national traumas of the bitter war and civil war in Yugoslavia in the 1940s.
"It's a very plausible view," says Dr Summerfield. "Time and again we see people who have appeared to cope well. Years later the ghosts re-awake. It could be anything a sound, a smell. They're shocked, devastated by something they've left unresolved. The whole edifice crumbles."
Some think today's politicians are repeating history by merely re-distributing Bosnia's rubble and papering over the cracks.
"I can only imagine how these millions of victims will react to the trauma. But it's in everyone's interest that we find out and do something before it's too late," says Funda Kansu.
The nearest British equivalent to the Bosnia effect was the experience of British prisoners of war under the Japanese in World War 11. Like the Vietnam veterans, many of them later failed to re-integrate, committing suicide or becoming depressives and alcoholics despite the fact that, unlike the Americans, they were universally acknowledged as post-war heroes and victims of war-crimes.
"I would expect everyone in Bosnia to be marked by the experience. Some will cope and many will not," says Dr Summerfield. "And remember, the victims can include the abusers and torturers themselves. Occasionally they too come to us for help."
In Bosnia, Croatia and Serbia little or nothing is being done to prepare for the appalling psychological consequences which will emerge when hostilities cease. Indeed, in an 'everyone- for-himself' society, with a very poor record of social and mutual support services, the PTS syndrome is scarcely known or recognised.
As early as November 1991 I asked three leading women psychologists in the Croatian capital, Zagreb, what they were doing to deal with PTSS. They thought they had heard of the syndrome but no treatment programmes were then envisaged.
At the Rebro hospital [in Zagreb] where hundreds of young, wounded and limbless soldiers were crammed into wards with no curtains or privacy, doctors didn't think counselling was a necessity, despite the fact that some patients refused to see visiting wives and girl-friends in case they broke down in front of their comrades.
In the last year no-one I've met in dozens of swelling refugee camps and hostels had been offered any form of counselling. Surveying the mass of traumatised human misery at the Split sports stadium, Dr Ruza Pokrovac at least recognised the need but thought they would "do it among themselves" and would, in any case, feel better when they went home to Bosnia now a very slim possibility for most of them.
"Don't forget, they've been through this before, during the last war," she observed without irony.
Radio and television on all sides could encourage and sponsor the self-help healing programmes but have largely failed to address the issue.
At the front, the situation is worse. No-one has warned young soldiers that massive surges of adrenalin over long periods of time, coupled with alcohol and narcotics, will naturally suppress the libido. Rape and sexual atrocities are often all that will arouse them acts which may come to haunt them in the future, paradoxically leading to impotence with girl-friends and wives. The first convicted Serbian war criminal has already admitted in Sarajevo that he deserves no more than death.
"My wife and baby are in Makarska (Croatia) and I dream all the time of going back there," a charming Muslim artilleryman, Zenan Tabucic, told me in Kiseljak. "But I feel dirty after all this. I don't think if I can face them after all this."
Before the war he was a Bosnian jeweller in Makarska but left to fight with the 156th Croatian Brigade. When the war moved to Bosnia he went to defend Sarajevo where his mother lives. There he became deeply disillusioned and clinically depressed.
"This is a mafia war, not an honourable war. There are no ideals. People in Europe don't understand what is happening. I would die for the Bosnia I knew before this war but not for what is happening here now. I'm ashamed of all this."
He may well be dead by now because he couldn't face taking back to the innocence of his child the horrors of what he had had to see and do. [In 1994 I visited his neighbours in Makarska and discovered he had survived and escaped to the Czech Republic]
It doesn't require a psychiatrist to foresee that the crazed, genocidal 'soldiers' in Bosnia may have to create new excuses for future revenge in order the justify their unjustifiable pasts.
Merely witnessing such harrowing events, Dr Summerfield acknowledges, may leave even journalists (mere observers with passports to security and sanity at home) with painful ghosts to face in years to come.
About a year ago (July 1992), driving around newly 'liberated' Mostar late one evening, I met a young Muslim girl, aged about 16, standing at a check-point with a group of Croatian (HVO) soldiers.
Driving her to Jablanica with her belongings in plastic bags around her feet, I noticed her fingering another, smaller plastic bag on her lap while she explained that she had been thrown out by her mother after being gang-raped by a militia squad of 'neighbours'.
What most distressed her was that one of her attackers was the former boyfriend of her own best girl-friend a boy whom she knew intimately from her friend's detailed accounts of her affair with him.
It emerged that the plastic bag on her lap contained a 9mm Mauser hand-gun, worth more than a family's annual income, with which she hoped to confront him in Jablanica.
She appeared ominously self-controlled merely deeply insulted by that one attacker and wavering about what she would do if she found him. I even had the impression (such is the insanity of war) that she might hoping for his protection.
We threw the gun out of the window on the next bridge: if it were found in a journalist's car at another check-point it could have cost us our lives.
She disappeared into the night on a hill overlooking Jablanica. Just one of thousands.
Others will have to contend with guilt.
Felicitas, a refugee from Osijek, in Eastern Slavonia, then under bombardment from southern Serbian positions spent many days in a cellar with about twenty other terrified young women and their babies.
They ate, slept, cried and washed together, taking it in turns to risk the shooting to collect water. Some women breast-fed the babies of others too traumatised to produce milk of their own.
When the Serbian JNA arrived, they were put into lorries and driven to a disused meat-packing factory and lined up for inspection.
"Which of these women is Ustache ?" a Serbian officer demanded. There was silence. To have been a World War ll 'Ustache' fascist sympathiser you would be a great-grandmother today. So he asked again.
This time a woman stepped forward, pointing to three of the women with whom she had shared so much and so little for so long.
"Her, her and her," she said.
The three were taken away and their whereabouts are still unknown.
"How can she live with herself ?" Felicitas asked me. How indeed.
Christopher Long has been reporting from the front-line throughout the Balkans since the Kosovo conflict in 1989.
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