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Teachers as Therapists Bosnia 1999 Trauma team finds progress as Eastern Europe repairs the ravages of war By Wayne Anderson Columbia Daily Tribune, Sept. 26 1999 The expedition to Bosnia by plane and car took us 36 hours. There was, however, no longer the 22-hour drive over shell pocked roads with armed Serbian guards at checkpoints. This was an encore visit for our team from the International Center for Psychosocial Trauma-University of Missouri-Columbia led by Syed Arshad Husain, MD, child psychiatrist at the University Medical School. This time, was Husain's twentieth and my fourth trip. The team also included Dr. Barbara Bauer, Dr. Joseph Lamberti and Dr. Barry Jay. We ran workshops on the treatment of trauma for a hundred teachers and mental health workers from the Balkans. In addition our team attended an international conference on mental health.

The warm reception from the participants created the atmosphere of being at a family reunion.It was exhilarating to be back in Bosnia to see many old friends and to have the opportunity to make some new ones. The University of Tuzla, which was one of the sponsors, has become truly a sister institution to MU. Physical conditions for guests in Bosnia are much improved. The hotels in both Tuzla and Sarajevo are in good repair and have all the hot and cold running water anyone needs. There was only one power outage while we were there, a marked change from our earlier visits. War torn Bosnia and Croatia have little money for rebuilding but the visitor can see both positive and negative signs as to how well things are going. We are rewarded for what we do. Arshad Husain believes that the lack of mental health workers in areas with armed conflict can be compensated for by training teachers and others to work with groups of victims. It was rewarding to find that our undertaking has been successful. The proof was in the scientific papers read at the International Congress of the World Islamic Association for Mental Health. Supervised by faculty from the University of Tuzla, mental health workers and teachers in Bosnia have been studying the outcomes in the classroom and in the clinic of what happens when the therapeutic methods we have been teaching are used with traumatized children and adults. Study after study (15 in all) showed that what we have been teaching in the way of stress management techniques, play and art therapy, anger control and basic therapy techniques has made a significant difference in the mental health of victims of war. The MU team was especially pleased with the studies which showed that Children and adolescents who were trained in relaxation techniques and other psychosocial treatments had significantly fewer post traumatic stress symptoms. Smiles are frequent. Both Croatia and Bosnia are culturally European countries and the ambiance in the big cities is relaxed and congenial. In Zagreb, Tuzla and Sarajevo the centers of the cities have returned as gathering places where young couples walk hand in hand, older couples stroll, bands of teenagers gather, and everyone stops at one of the many sidewalk cafes for chi (herbaltea), potent coffee or local beer. Small combos play both pop and traditional music and everyone seems to have a smile for strangers. The women seemed very slender to me, but looked otherwise healthy and attractive. Their beauty was accentuated by the mod outfits they wore. The relaxed approach to life helps me to really enjoy the foreign atmosphere. The streets seem so much livelier and friendly than those in an American city, and it feels (and is) much safer. One evening the mayor of Tuzla and the Dean of the medical school were both in evidence blending into the warm ambiance of the street scene. Food was readily available. I relish Bosnian food and there is an interesting variety of dishes accompanied by their thick, tasty pita bread. Except for a building next to a memorial for a large group of young people who were killed by a shell, Tuzla shows few signs of war. Sarajevo, on the other hand, has large areas which are untouched by the repair crews. Work at rebuilding has started but to my eyes there has been much progress in the three years since shelling stopped. In the old part of town many shops are open which sell handmade objects. It was fascinating to see how many articles can be made from brass artillery shells. Fields, which had been marked with red triangles indicating land mines, are now growing good crops of corn and potatoes. Villages which had been skeletons of themselves have been fleshed out, and clothes again hang on lines outside the houses. Here and there a village still stands uninhabited and empty eyed. While on the surface people appear happy and adjusted, there are still memories that can be easily tapped that are loaded with pain. One of our translators had worked with Doctors Without Borders during operations, translating between the English speaking and the Bosnian speaking doctors. She recalled an incident under battle conditions where because of a shortage of medical staff she had to use her hand's to keep a patient's intestines in. When she got home her mother almost fainted when she saw all of the blood on the translator's clothes, blood which she had been completely unaware of . Our other translator, who has worked with us for over four years, described in detail the problem of getting in and out of Sarajevo by tunnel while it was being shelled and how the Serbs had their artillery zeroed in on the entrance to the trench leading to the tunnel. It was at that point many people were killed. This eagerness to share experiences, painful though they were, translated into good attention and participation in our training program, even under the 98 degree heat that existed for the first three days of our seminar. It was relatively easy to find people willing to be clients in our demonstrations of therapy techniques. I can recall only one other program abroad that has given me as much satisfaction. As trainers we have reactions to the strong emotions of the people we are training, but we can leave the situation and return to a relatively non-traumatic America. The teachers and mental health workers we are training have to go right back to the pressure. This of course, was especially true of the group who had joined us from Kosova. Competition Our team met with the mayor of Tuzla during our visit. A robust man, he is very popular with his constituents. He has an open door policy in which several days a week he attempts to solve problems of employment, housing and anything else that is bothering his people. One of the foreign visitors who was with us pointed out how much money his country had given to help develop a health center in Sarajevo. The mayor's response was to indicate how much more could have been done with the money in the Tuzla province since they have 150,000 refugees and many citizens returning who had gone to other places like Germany during the war. It was clear there is much competition for the limited amount of support and supplies that is available. Split loyalties One of the students in our program who spoke excellent English had a conflict I had not encountered before, despite the fact that it may be fairly common. Her father was a Bosnian Muslim and her mother a Serb. Her parents had divorced at the beginning of the war and her mother moved to Belgrade. Just before our conference she visited her mother and was now with her father. I could see the struggle she was having to rise above the hatred which exists between the Serbs and Bosnian Muslims so that she could remain attached to the families on both sides of the conflict. Religion I gathered that Bosnians had taken a relaxed attitude toward their Muslim religion before the war and that behaviorally there wasn't much real different between them and the two other religions groups in the country. The war has strengthened their religious beliefs and has been a support in their time of need. It has also drawn them closer to the nations in which a more fundamentalistic version of Islam is practiced. The future The United States has a strong presence in the area not only because of our troops who are with SFOR but because of our TV. Everywhere I go now there is international CNN and usually MTV. If people can understand English they may get more solid news from TV than we do. I have often wished I could see the international version of CNN because of the depth of the stories on nations around the world. Much is still needed for the Balkans to return to normal. The people are educated and hard working and are capable of repairing the physical damage which has been done. The emotional traumas will take much longer to mend. Source: http://www.muhealth.org/~umicpt/bosnia99.shtml