Honorable Mention for Reporting on a
Significant Topic from the American Society of Journalists & Authors, 2006
To Hell and Back
Imagine the torture of Idi Amin. The torment of losing your soul. A place where you can find it again.
By John Rosengren
He would wake up
running. Slam into the wall. Flail about the closet hangers. Show up at work
the next morning with his face bruised or cut.
He woke – Uganda almost fifteen years away, but the bodies still
there. The mutilated forms of his companions. He packed the pieces into
bags. Loaded them onto trucks to be dumped into the crocodile waters.
Returned to scrub his companions’ blood from the barracks. Watched them
hacked to death again.
He couldn’t sleep. He washed dishes, cleaned house, read – anything
to stave off the nightmares. He dozed two, maybe three, hours a night,
trained himself to survive in a constant He would wake up running. Slam into
the wall. Flail about the closet hangers. Show up at work the next morning
with his face bruised or cut. He woke—Uganda almost fifteen years away, but
the bodies still there. The mutilated forms of his companions. He packed the
pieces into bags. Loaded them onto trucks to be dumped into the crocodile
waters. Returned to scrub his companions’ blood from the barracks. Watched
them hacked to death again.
He couldn’t sleep. He washed dishes, cleaned house, read—anything
to stave off the nightmares. He dozed two, maybe three, hours a night,
trained himself to survive in a constant sleep deprived state. The less he
slept, the more secure he felt. He passed numbly through the days.
The nightmares tyrannized his life. They almost ended it. Had he
run through the screen door instead of into the wall, he would have fallen
three flights. At times, he would have preferred it to watching the murders,
bagging the bodies again.
By accident, he found the Center for Victims of Torture. The first
time he walked into the house on East River Road in Minneapolis, a dozen
years ago, he sensed a foreign calm. He talked to a psychiatrist, a
psychologist, a social worker, and a medical doctor. His appointments over,
he stayed another two hours, simply sitting in the lounges comfort. He went
home and slept for three days.
Richard Oketch woke to a new life, one that he would slowly,
gradually assemble. “What the center did was remove this veil,” Oketch says
today. “They pushed back into my body the soul that wasn’t there.”
THAT’S WHAT THE Center for Victims of Torture has been doing for twenty
years. Torture—as the blatant Abu Ghraib prison photos reminded us—demeans
and destroys a persons sense of self. The experience occupies the psyche
long after the physical attacks stop. For those who've had their self-esteem,
dignity, trust—virtually their life—stomped, smacked, carved, shocked,
burned, raped, mutilated, or shouted out of them, CVT has provided comfort
and healing. The center, with its innovative and unique multidisciplinary
approach, has become a world leader in treating the trauma left in tortures
wake.
ON A SEPTEMBER after noon, Richard Oketch relaxes at the CVT. Sunlight
grazes the crisp blue sky outside the window. Oketch, fifty-three, is neatly
attired in a checked, tan and yellow African-style suit. He speaks somberly
of the dark days in Uganda almost thirty years ago. But occasionally his
lyrical voice lights on a happy thought and dimples crater his rounded
cheeks. He can talk now— even smile—about life. Watching him spontaneously
act out a scene from a British comedy—the routine ending in that large smile
and an elegant flourish of his hands—you would have trouble picturing him
leaping out of bed in a rush of sweat. Until he told you his story.
Remember Idi Amin, the “Butcher of Uganda”? Oketch’s father was a county commissioner
in the government Amin ousted; his uncle was a member of parliament. Amin’s
thugs killed Oketch’s uncle. They killed his cousins. They abducted his
sister and her boyfriend. They arrested and tortured Oketch when he tried to
find out what happened to his sister. He managed to escape after two months
with the help of high school classmates involved in the secret service.
The
second time, he was stopped at a roadblock and taken because of his name and
because he had a beard— only guerrillas wore beards, the government figured.
Everyone was a suspect at the time. This detention lasted almost four
months, until former classmates again helped him escape by getting him
reassigned to a less-secure detention center.
The third time was the worst.
The soldiers nabbed him in a morning raid and took him to Makindye, a
military barracks converted into an underground detention center. There,
drunken soldiers, like boys pulling the wings off flies, preyed upon the
prisoners for sport. They forced the prisoners to drink themselves into
stupors. They beat them with canes. They cut them with bayonets. They slit
their throats and sliced their bodies with machetes. They forced Oketch and
others to clean up the mess.
It was the stuff of nightmares.
“Seeing people
killed is worse than being beaten up yourself,” Oketch says. “The pain of
that sight, seeing someone killed in front of you . . . that pain lives
forever. If you survive that place, you don’t feel comfortable the rest of
your life.” He clenches his lips, brings his hand to his mouth. His eyes
look away.
Once again, a sympathetic classmate aided his escape, and this
time, Oketch fled Uganda. He made his way from refugee camps in Kenya and
Zambia to Ireland, where he tried to dissolve the memories with alcohol. He
stopped drinking when he headed to the United States and enrolled in
graduate school to study educational psychology. After completing his
master’s degree, he found a special education job in the St. Paul school
system and moved to Minnesota in 1989.
Oketch had sought help twice before,
while living in Ohio and Iowa, but the medical staffs did not understand the
nature of his problems. They attributed his nightmares and other symptoms to
drug or alcohol use, despite his protestations that he had stopped drinking
and did not use drugs. They prescribed meds and referred him to psychiatric
centers. He had given up on anyone being able to understand.
In Minnesota;
he felt isolated, the way torture survivors often do. He avoided groups. He
didn't trust anyone. He craved security. Work offered it. He often stayed
late, until five or six in the evening, well after everyone else had left
the school building. He feared returning home to the scene of his
nightmares. In his car, alone and comfortable, he felt safe. He sometimes
spaced out and kept driving, imbibing the tranquility. One time he wound up
in Madison, more than 200 miles beyond his St. Paul apartment.
This might
have continued indefinitely had not a volunteer at the University of
Minnesota's Human Rights Center mentioned CVT to Oketch after seeing him
flinch at the casual mention of Idi Amin. "If you don't get treatment, I
don't know where these things will take you," he said.
THE CENTER FOR Victims of Torture started with a son challenging his father
to make the world a better place. Not an uncommon challenge, except in this
case the son was Rudy Perpich Jr., then an Amnesty International volunteer
at Stanford Law School, and his father was governor of Minnesota. Rudy
Perpich Sr. promised he would? use his position to do what he could. Tapping
local experts in human rights issues, he embraced their suggestion to
establish the first treatment center for victims of torture in the United
States. At the time, 1985, only Canada and Denmark had similar centers.
There are now 34 centers in the United States and 177 worldwide.
An
estimated 500,000 torture survivors reside in the United States. More than
30,000 of them live in Minnesota, according to a recent study. You wouldn't
know who they are simply by looking at them. They are men and women. They
are children and adults. They are black and white. They are from all over
the world—Amnesty International reports incidences of torture and
mistreatment in more than 150 countries.
More than likely, they were
professionals or community leaders back home. Of the more than 1,350 clients
served by CVT in the Twin Cities, more than half were students or
professionals in their native countries, as was Oketch, who taught
hearing-impaired children at an elementary school in Uganda; more than 50
percent have some college or vocational education; more than a third are
under thirty years of age; 60 per cent are between the ages of twenty and
forty. They are divided almost evenly between men and women, and almost all
female clients have been sexually tortured; a study of Somali and Ethiopian
refugees in Minnesota published in the American Journal of Public Health in
April 2004 found women were tortured as often as men in some communities,
more often in others. CVT clients were detained on average six times before
they managed to escape and seek refuge. A quarter of them were first
tortured as children, often to intimidate or punish their parents. They have
come from more than sixty countries. Currently, the overwhelming majority
are from West African countries such as Sierra Leone, Ivory Coast, Liberia,
and Cameroon.
In the twenty years since its inception, CVT has established
itself as the Hazelden of torture treatment, a worldwide pioneer and leader
charting the course in its field. "What's really important is that the
Center for Victims of Torture is based here in Minnesota and has a global
impact," says Robin Phillips, executive director of Minnesota Advocates for
Human Rights. "It is a way that people concerned about human rights issues
and torture can become involved in the world community."
CVT OPENED in May 1985 as an independent nongovernmental organization housed
in the International Clinic of St. Paul Ramsey Medical Center. Two years
later, the center moved into a small house on the University of Minnesota
campus. In early 1991, the center moved again, this time to its current home
on East River Road, rented from the University for $1 a year. Last May, a
St. Paul site in the city's Historic Hill District opened.
The center's
mission is fourfold: treatment, training, research, and advocacy. But its
work has not been confined to the Twin Cities. Since 2001, CVT has provided
its services to refugees in Guinea and Sierra Leone. It is contemplating
expansion to Liberia.
In 2003 (the last year for which complete numbers were
available), CVT trained 3,500 doctors, nurses, social workers, therapists,
teachers, and school psychologists to recognize signs of torture and respond
appropriately. The center trained staffs at most torture treatment centers,
in the country and another fifteen around the world.
Last September, CVT
organized a groundbreaking international symposium, New Tactics in Human
Rights, in Turkey that explored new tactics in human rights strategies. More
than 400 human rights workers from more than eighty countries attended.
Since 1992, CVT has had an office in Washington, D.C. Its early efforts
pushed the first Bush Administration to pay the country's arrears to the
United Nations Volunteer Fund for Victims of Torture. More recently, CVT has
lobbied for an independent investigation of Abu Ghraib by the United Nations
special rapporteur on torture and to have the Torture Victims Relief Act
funded at the levels appropriated.
The centers work in public policy,
research, and training has extended from its original work treating victims
of torture, but healing work remains its primary raison d'être. "Our
intellectual core derives from our work with clients," says Douglas Johnson, CVT executive director since 1988.
THE FIELD OF treating torture survivors is relatively new, barely older than
the CVT itself. Rosa García-Peltoniemi, CVT director of client services and
a clinical psychologist at the center for sixteen years, has been learning
on the job as long as anyone. She dispenses her wisdom articulately and
carefully, with a faint Cuban accent.
Clients who seek CVTs services are
usually suffering anxiety and depression, universal consequences of trauma.
Like Oketch, they usually feel isolated and unable to trust. Many are
separated from their spouses and children, who were left back home in
dangerous situations when the torture victims fled for their own safety. The
trauma often interferes with daily functioning, such as the ability to
parent, hold a job, and form meaningful relationships. As émigrés, they
might experience heightened feelings of isolation because of language
barriers, not knowing people, being unfamiliar with surroundings, and
lacking the savvy to access social services. Furthermore, they may be
suffering physical pain, and often they are short on financial resources. To
classify their condition as posttraumatic stress disorder doesn't jibe with
García-Peltoniemi.
"We're not working post trauma," she explains. "We're
working in the trauma."
When Gregory Batey arrived at CVT in October of 2003, the torture had
stopped, but the torment continued. As is common among survivors, the former
journalist and political activist from Cameroon suffered from repeated
nightmares.
He worried about the well-being of his wife and their five
children, ages eight to eighteen, whom he'd left behind brutality he endured
had robbed him of his hearing in one ear, limited the use of his left arm,
elevated his blood pressure, and left him nearly paralyzed in his right hip.
He was broke, unable to work, and staying with an acquaintance from Cameroon
Survival had presented additional challenges.
At each intake meeting, the
staff asks a new client what his or her goals are. Identifying therapy goals
immediately involves the client and turns attention toward the future. Batey,
for instance, listed physical health as his first goal. Three-quarters of
CVT clients continue to suffer from physical injury resulting from torture
Batey’s therapy team—which includes a physician, psychiatrist, social
worker, nurse, psychotherapist, physical therapist, and sometimes a massage
therapist—arranged for a successful hip replacement, prescribed medication
to treat his blood pressure and other ailments, and made appointments with
an ear specialist.
A recent CVT study found that clients, who may come as
often as they like for as long as they need, usually visit regularly for
about eighteen months, using psychotherapy an average of twenty-one sessions
and social services an average of eighteen sessions. Oketch attended weekly
or monthly therapy sessions for one year, then came only once every three
months. He knows to call or stop in as needed, when events such as 9/11, the
Iraq war, or a nightmare trigger his trauma. He also visits the center as a
board member these days. Batey, who has been coming to the center for more
than a year, reports progress with the nightmares and regaining trust, but
he knows he's not ready to leave. The torment is not that quickly
terminated.
Batey, fifty-two, is a large man, six feet and more than 200
pounds. He sits in a room at the East River Road house, dressed in a gray
and white striped shirt, gray sweatpants, and new Fila tennis shoes CVT
helped him buy. A chrome cane rests at his side. "I wasn't born
handicapped," he says in a rich accent. "Now, I just sit in one place and
develop weight."
He suffers simple indignities. He can't bend to trim his
toenails, which have cut holes in his socks. "Who else can do that for you
other than a close relative?" he asks rhetorically. But when a CVT staff
member overhears this, she tells him the nurse will do it for him. He smiles
gratefully and expresses surprise that the staff is willing to "spend a lot
of time helping people with problems who are not their family."
The Cameroon
government imprisoned Batey seven times before friends managed to sneak him
out of the country. His "crimes" included reporting a workers' strike that
embarrassed the government and holding office in the opposition party. As he
leans forward to describe the situation, his eyes widen, his voice rises.
"Being in jail in Africa is not the same as in America," he says. "You are
locked in the nastiest cell you can imagine. Thirty men in a room this size
[eight by ten feet]. You shit in a tin bucket. If a white man like you was
put in there, they'd be packing out a dead man."
The policemen hung him
naked on a balançoire—"on a bar, like an animal ready for smoking." They
beat the bottom of his feet and shocked his genitals.
He constantly feared
for his life, even when he wasn't imprisoned. He eventually escaped his
torturers, but the experience pursued him.
ROSA GARCIA-PELTONIEMI names three major stages in recovery: safety and
stabilization, remembrance and mourning, and reconnection.
Safety and
stabilization. CVT staff considers no detail too small in putting a client
at ease. Staff will ask if a person wants curtains in a room drawn or open,
where the client would like to sit, how to leave phone messages. "Every
interaction has implications," García-Peltoniemi says. "Our staff is trained
to be thinking about that and acting accordingly."
Even the buildings are
designed to be welcoming and noninstitutional. Walk into the Minneapolis or
St. Paul house, both hundred-year-old restored Victorians, and you find warm
dark wood, soft carpets, muted angles, hanging art, and flourishing plants.
There's nothing clinical or institutional about the place—"You don't smell
hospital," Oketch says—it feels like a home.
Remembrance and mourning. Every
Psych 101 student can tick off the five stages of grief made famous by
Elisabeth Kübler-Ross, who first identified these, stages through her work
with European concentration camp survivors. The grieving process that
García-Peltoniemi witnesses, however, is complicated by culture and
conditions. Much of it comes in spurts. CVT clients grieve bits at a time,
their energies become consumed by responsibilities of their new life, then
they may encounter another loss and grieve some more. Many suffer ongoing
loss—60 to 80 percent of CVT's clients are separated from children and/or a
spouse.
In his third week, Oketch delved into a grief he'd long avoided. He
had not let himself cry when he witnessed the murders in prison. Nor had he
let himself cry over the death of his family members. At CVT, he finally let
go. He wept the entire hour with his therapist. Huge sobs that shook his
body. He went home and wept through the night. The next morning, he started
to feel better.
Reconnection. Oketch still had a long way to go. He had left
behind, four children and a wife, who later died of a heart ailment. It took
him two years before he was able to start connecting with others. Survivors
begin to reestablish normal social relationships once they have learned some
skills in managing their symptoms, says García-Peltoniemi. Oketch began
socializing with groups of other Africans. He met a woman and fell in love.
The healing process is more spiral than linear. García-Peltoniemi points out
that there are triggers that can vividly bring back the past, causing the
survivor to feel emotions, even sensations, felt at the time of the trauma.
Gunshots, television violence, even a car accident can bring on another wave
of grief or nightmares. The ability to see a nightmare for what it is and
carry on with the day serves as a measure of progress.
Not all of CVT's
clients' Stories have happy endings. There are those who struggle with guilt
and shame even years after the torture. Some clients consider taking their
own lives; a few have succeeded.
But that's unusual. The people who reach CVT are survivors. They've survived the torture, escaped their country, and
made it to safety. They credit faith and family for helping them survive.
"They're a highly selective group," García-Peltoniemi says. "They've gotten
to the United States, and not only the United States, but to the middle of
the United States and our god-awful climate." She laughs.
BEIGE PAINT flakes off the side of the East River Road house. Inside, on an
August afternoon, most of the offices are vacant. Most of the staff is out
on a two-week furlough, an effort to trim $600,000 from CVTs $7.2 million
annual budget. Like most nonprofits in the post-9/11 economic downturn, CVT
has seen its donations and investments dwindle. During the past two years,
the center has cut sixteen positions, reducing its staff by more than 20
percent. It drastically reduced its training program and has had to limit
the number of new clients, taking on only the neediest.
Yet, the center is
thriving. It opened its new house in St. Paul last May. This past summer,
the UN granted the center special consultive status. The New Tactics
symposium thrust CVT to the front of the international human rights effort.
Necessity has mothered another CVT invention in the form of group therapy at
the St. Paul house. In the face of budget cuts, group therapy has become a
cost-effective alternative to individual therapy, but research shows that
groups offer particular "curative factors" as well. When someone hears
another person describe a similar experience, the member realizes he or she
is not alone, not terminally unique, but that there is a universality to the
experience. In a group, members also experience a sense of belonging, a
powerful antidote to the isolation most torture survivors endure. Groups
also lead to socializing, an important element of forming connections.
"There are therapeutic benefits of being in a group that make a strong case
for working with clients in more of a group approach," says Chuck Tracy, a
clinical social worker at CVT. He sees the groups not as replacing
individual therapy, but complementing it as an evolution of services. The
Minneapolis house is considering the implementation of more groups.
RICHARD OKETCH HAS stopped running. He hasn't healed—perhaps no one ever
heals completely after being tortured—but he has progressed. His symptoms
have lessened. His coping skills have increased. He can go to bed at night
and sleep a full nights sleep.
The nightmares still visit, though less
frequently. He no longer dashes out of bed and injures himself.
When the
machetes slash again— Oketch bolts upright, soaked in sweat. Eyes wide.
"Richard," says his wife. The woman he loves. The mother of their two
children. "Richard, it's all right." And it is. He knows it is.
© John Rosengren
© 2008 John Rosengren. All Rights Reserved.