Counselor helps organize a local visiting team to rebuild Rwandan medical system, help heal post-genocide trauma

Compelled by her Jewish faith to “do something to heal the world”—tikkun olam—Adie Goldberg taught counselors in Rwanda last summer about treating post traumatic stress disorder, which many have suffered since the 1994 genocide there.

Adie Goldberg and her daughter, Maggie

Her daughter, Maggie Yates, spent six weeks in 2007 on a human rights young-adult delegation in Rwanda.  As part of her international studies and cultural anthropology major at Macalester College in St. Paul, Minn, she worked with Amani, a group promoting reconciliation through sports.

While there, she met a physician who is the director of the United Nations’ Millennium Village Project. 

Maggie learned that just $27 per person spent on infrastructure can help a community.  She also told her mother of the need to rebuild the medical infrastructure.  In 1994, 50 percent of medical students and 75 percent of medical school faculty were killed in the genocide.  The medical system was in shambles.

In 2005, Maggie had also brought her mother a reminder when she visited Poland and Israel for a March of the Living and the post-Holocaust commitment: “Never Again!” 

Adie was frustrated that genocide happened again in Rwanda. 

“We need to remember so it won’t happen,” she said “With my people’s history, we have an obligation to humanity to do work to prevent human rights abuses.”

“We do not need to look for our place to heal the world,” said Adie, who was education and youth director at Temple Beth Shalom for eight years.  “It will find us.  Maggie brought my place to me.”

Because Adie has worked part-time for 22 years as a clinical social worker at the WomanHealth medical practice in the Deaconess Education Center, she knew she had skills needed. 

She has dealt with post-traumatic stress of veterans, and victims of sexual assault, crime and domestic violence.

After earning a bachelor’s degree in psychology and Russian studies at Grinnell College in Iowa, Adie trained to be a midwife and health volunteer in French-speaking West Africa. 

From 1977 to 1980, she served with the Peace Corps in Togo, where she met her former husband and father of her three daughters.  They then lived in Fairbanks, Alaska, where she did child-abuse prevention for five years with one of the tribes.

She also has a master’s degree in education at the University of Alaska Fairbanks (1984), a master’s of social work at the University of British Columbia in Vancouver (1985), and a post-master’s certificate in marital and family therapy. 

So Adie was ready to respond when she learned of the need in Rwanda.  She began to correspond with the doctor and plan the trip.

“We formed Ujama, which means ‘extended family,’  to take medicine, physicians and ancillaries to rebuild the medical infrastructure,” she said. 

From June 17 to July 3, 2008, a medical mission of 19 people from Spokane went to Rwanda.  The Health Development Initiative Rwanda—a Non-Governmental Organization (NGO) that provides community health care development to build alliances between health care providers—invited the delegation.

“We were from diverse and strong faiths,” Adie said.

The team included an oncological surgeon, an obstetrician-gynecologist, a urologist, a neonatologist, a nurse midwife, a nurse practitioner, a public health educator, a cardiology specialist, a surgical technologist, an ultrasound technician, a cardiology technician, a registered nurse, an environmental engineer, a psychiatric social worker, a medical student, two pre-med students, and a high school student.

It included members of Unity Church, the Church of Jesus Christ of the Latter-Day Saints, and other Christians and members of the Jewish community.

Adie shared her story, and as the project develops, others will share their experiences.

In 2008, the team delivered $75,000 in medical equipment donated by Deaconess, drug firms and physicians. 

One goal is to raise money to stock Rwanda’s 300 clinics. 

Another goal is to train Rwandan physicians to do heart surgery, other surgeries and deliveries, so they can sustain their medical system without the U.S. doctors.

They found other needs.  In a Twa hunter-nomad pygmy community, they started a well project, weighed and measured babies and children, de-wormed children and gave them shoes to prevent worms and to wear to school.  About 30 percent of Twas, who are one percent of the population, were killed in the genocide.  The team took photos of them so they could have ID cards to gain access to health care.

Adie led a two-day workshop, training mental health workers who do post-traumatic stress disorder treatment. She said the session became group therapy for the counselors, who are also trauma survivors.

Today, people no longer refer to themselves as Hutus or Tutsis, she said, but as Rwandans.

“They are reconciling by establishing their national identity.  While people do not ask about ethnic origins, there is still tension below the surface,” she noted.

Hutus and Tutsis are mixed in the government, which is a “democracy” with a president for life, she said.  Because of intermarriage, distinctions such as Hutus being shorter than Tutsis are no longer identifying features. 

Rwandan genocide memorials disturbed Adie.  There were piles of skulls, books or clothing filled with bullet holes and stained with blood, such as in a church where some fled and were massacred.

“Traumatic memories, activated by a smell, sound, sight or anniversary, may lead survivors to recurring dreams, alcohol abuse, depression or other stress symptoms,” she said. 

“Talking about the trauma in groups and sharing experiences can be healing. Rwanda’s oral tradition is conducive to storytelling, so the U.S. treatment modality works there,” she explained.

Some seek reconciliation with neighbors through “gacaca,” grassroots courts that meet outdoors in villages, Adie said.  Elders hear about genocide crimes, which are too extensive for the national government to deal with.

Usually if someone pleads guilty, elders give a sentence of jail or community service.  Because many claim innocence, some find no closure.

“Proceedings may reactivate trauma and memories when victims see the perpetrators,” said Maggie, who saw a gacaca court session in 2007.

In theory, Adie said, if those who suffer PTSD have their day in court they could heal, but without treatment many are left with unfinished business, especially if the perpetrator is found not guilty.

“For many victims, there is no healing,” she said,”  Everyone is a survivor and has a story.

The need to rebuild the medical infrastructure comes not only from genocide losses, but also because many households are headed by older children who missed adult guidance.  The median age is 18.7.  There are few old people.  Older siblings, who were 13 to 15 when their parents were killed, work to help their siblings go to school.  They are trying to figure out how to reconstruct the country, she said, impressed by the people’s resilience.

While some people question sending resources abroad when there is suffering here, Adie is drawn to Africa.

“We need to serve and witness where we see pain.  Not everyone needs to go.  I happen to have seen pain in Africa,” she said.

Because the group found Rwandans they met gracious, polite, humorous people, they have done much soul searching since returning, Adie said, wondering how such delightful people could have participated in a genocide. 

“We each have questions to answer about how to explain evil,” she said.   “These are fundamental questions all religions have to answer.  We struggle to have answers.  Academic answers did not apply readily after we visited the memorials.”

Concerned by what she saw in Rwanda, she is returning Feb. 17 to March 18 with six others to finish a well, train hospital administrators, physicians and counselors, and bring equipment for seven clinics. 

In April, a Spokane doctor will host two Rwandan doctors. 

Ujama is planning another trip in the summer.

For information, call 939-0800 or email adieleeg@hotmail.com.

Copyright © February 2009 - Th Fig Tree