Project: Capetown, South Africa
During the period of Apartheid, politically motivated violence was a salient feature of the social and political landscape of South Africa. This violence intensified in the late 1980.s /early 1990.s. South Africa has subsequently since the April 1994 been perceived to have made a .peaceful. transition from an oppressive racist system to a non-racial democracy. However, the path of the transition has not always been easy or peaceful.
The overall level of violence in the society has not diminished and the alienation and dehumanisation of South African society through Apartheid has had a long lasting effect on the Individual, Families and Communities. Many children and adolescents witnessed extreme violence; many parents have been and continue to be affected by traumatic experiences and suffer from individual or family related disorders. This trauma has had a lasting impact on future generations.
Almost 18 million of South Africa.s present population of approximately 40 million people are children. The children and adolescents in South Africa are exposed to many different forms of violence – personal, social, familial, political and community violence. They are exposed both directly through victimisation, and vicariously through ever-present community danger. Current data indicates that violent trauma, particularly sexual victimisation, is highly prevalent among children and adolescents. According to South African Police reports, sexual and property crimes and crimes involving interpersonal violence have continued to soar.
Children in Crisis
In 1997, an organisation called Children in Crisis (CiC) was established by the South African psychologist Umesh Bawa, and offered a free psychological service to children and youth affected by trauma. The project was first started and located in Langa (Xhosa for .sun.) – the oldest black township in Cape Town, which was initially established between 1921 and 1927 for approximately 80.000 black industrial workers. Currently, the township is home to more than 250.000 inhabitants. Since 1999, the project has been funded by the Children for Tomorrow Foundation.
The project began as a modest satellite clinic offering individual, group and family counseling to those affected by violence as well as offering psycho-educational workshops in schools and talks on a local radio program. Initially, the project was located at the Ulwazi Centre in Langa, before moving to its current clinic location at the Guga S.Thebe Art and Cultural Centre in central Langa. CiC has been collaborating with the Department of Psychology and the Institute for Counselling at the University of the Western Cape since 1999, and the division of Child and Adolescent Psychiatry at the Tygerberg Academic Hospital at the University of Stellenbosch since 2000. Many referrals and cases have been successfully counselled and shared with the health care networks in Cape Town. The services offered have subsequently been expanded, with further .Children in Crisis. clinics being established at the Institute for Counselling at the University of Western Cape in 2001, and at Tygerberg Hospital in 2003. Both these clinics now offer greater accessibility to those township dwellers in the greater Cape Town metropole and in some cases we use a mobile play therapy room. Referral sources include the Department of Social Welfare, the Family Advocate.s Office, community agencies, schools, hospitals and clinics all around Cape Town. Initially, the child cases were treated mainly by the founding psychologist and Master.s Psychology students of the University of the Western Cape. Since November 2002 a German child and adolescent psychiatry/psychotherapy registrar of the University Clinic of Hamburg, Dr. Kerstin Stellermann has been working for Children in Crisis in Cape Town, to complement the work of the South African personnel and team. To ensure effective clinical service and quality assurance, child and adolescent psychiatrist Dr. Sue Hawkridge and clinical psychologists Diane Sandler and Rashid Ahmed are engaged in providing in-depth and psychiatric supervision to the clinical staff members, as well as in the being involved in the overall development of the project.
Programme
Most children referred to Children in Crisis come from chaotic and disturbed contextual and family backgrounds with severe social stressors. These children have experienced abuse and neglect, witnessed severe violence and suffered various losses. They are the victims of multiple experiences of social and emotional deprivation in the past, and more are frequently affected by severe ongoing contextual deprivation and neglect. Poverty is a sad but enduring experience of these young people. The main presenting problems are sexual molestation (boys and girls), physical abuse, rape, loss in the family, exposure to violence, complications of TB and HIV and the witnessing of murder. The age range of the clients varies from mother-infant work, to pre-school, elementary and high school pupils.
Individual therapy:
Approx. 35 children and adolescents are getting free individual psychotherapy per week, with group therapy offered as the need arises. Most patients get seen in the afternoon due to their school schedules. The mornings are used for assessments (around 10 per week), family- and parent feedback-sessions and training (given and received) but mainly for the school project in Langa.
Cases
This is Thandi´s Story
Thandi is an 11-year-old girl who came to the attention of the Langa Clinic through her school. The class teacher noticed her aggressive behaviour towards the other children in her class. Thandi grew up in a rural part of South Africa, where her grandmother raised her since birth. They formed a close bond, as Thandi.s mother was living in Langa, Cape Town. Thandi.s father didn.t really form any kind of relationship with her, as he was also living Langa. In March 2004, Thandi was gang-raped by 3 men in her grandmother.s house one afternoon after she.d come home from school. When her grandmother found out, she had a mild heart attack, which precipitated Thandi.s move to Cape Town. She moved to Langa, to live with her mother. They share a small 2-roomed-house with 5 other relatives. Thandi found it difficult to adjust to her new environment, while at the same time coming to terms with the rape. Understandably, she became aggressive, argumentative, defiant and both her mother and the school found her difficult to cope with. She began stealing and it was at this point that the Children In Crisis project was approached. Although she.s been living in Langa for months now, Thandi.s father has not sought any contact with her. Her mother is reluctant to allow her to visit her father, as he abuses alcohol and drugs. From the first session, Thandi established a strong bond with her therapist. After 14 sessions, the school reported that Thandi.s behaviour had improved – that she was less disruptive in class and seemed more able to focus. At home, Thandi.s mother noticed less aggressive behaviour, although the relationship between the two of them was still strained. The therapy she.s received seemed to have provided Thandi with a space that she has slowly come to trust and feel safe in. Thandi has been attending therapy in Langa on a regular weekly basis since May 2004.
This is Graham´s Story:
Graham is a 14 year old boy who got referred to the Tygerberg Clinic by his social worker. Graham.s grandparents asked her for help as Graham was suffering from nightmares and flashbacks since he moved in with them in December 2003. Graham is the second child of his parents, he was unplanned and unwanted. The mother left him at the hospital after he was born and only after a couple of days he got fetched by his aunts. He lived together with several aunts, cousins and other people in a tiny house in Soweto. In 2000 Graham.s mother died of AIDS, he took care of her and was found approx. two days after her death, sitting next to her, trying to feed her. He started living on the streets afterwards, his aunts busy and his father imprisoned. End of 2002 he tried to hang himself and got rescued by neighbors. They informed his paternal grandparents and a year later he moved to Cape Town to live with them and his older sister who has been living with them since birth. He presented with symptoms of PTSD, severe scholastic problems and adjustment difficulties. Graham and his grandparents described the situation at home as tense and the grandparents were very worried that Graham could be HIV positive (luckily the test result was negative). Graham has been attending weekly therapy since January 2004 and he, his grandparents and his sister were motivated to come for family therapy also the concept of talking seemed strange to all of them. The home atmosphere gets described as less tense and since July 2004 Graham has been attending a school for pupils with special needs as his IQ assessment showed that he was functioning in low Borderline range. He has found some friends, discovered new hobbies: playing the piano and drawing comics and his appearance changed from a boy who didn´t make eye contact for the first four month to a charming teenager with his own fashion code. The frequency of nightmares has decreased. Therapy seems to provide him and his family with a safe and contained space where they can think with the therapist and with each other.
PSYCHO-SOCIAL / PSYCHO-EDUCATIONAL WORKSHOPS
From January 2004, the Children In Crisis Team in Langa embarked on conducting psycho-social workshops in schools within the community. Two primary schools were identified, namely, Zimasa Primary and Thembani Primary. The aim of these workshops was to provide disadvantaged children with the opportunity to develop a sense of personal and community identity. Throughout the year the psychiatrist and the psychologist working on the project worked with different classes in the two schools. They worked with grades ranging from Grade 3 to Grade 7. The classes were often overcrowded, ranging from 37 to 54 learners per class. Initially the programme was created to run for 10 weeks per class per term. However due to the incessant logistical difficulties encountered within the school system, this was modified to a 5 week programme, per class, per grade. The programme gave learners the opportunity to work in pairs and often to work for the first time in larger groups of 6 to 8 learners. The workshops also gave learners the space to think and talk about issues they wouldn.t normally discuss. One of the enduring achievements was getting learners to talk to each other in a non-threatening environment. As the weeks progressed, the learners eagerly participated in the programmes and often expressed regret that the programme was so short.
Fire Groups:
In March 2004 more than 2000 shacks burned down in a region of Langa that was home to a number of children from our collaborating primary schools. Fires in the informal settlements are a recurrent danger in the overcrowded townships. The teachers observed a high negative impact on the children’s school performance viz. many presented with lack of concentration or withdrawal, while others were in a process of grieving about the loss of property. The community approached Children in Crisis to offer a support group for the children/youth impacted by the fire. These weekly support groups were well attended and have been a valuable source of social support and trauma counseling.
Therapeutic Materials:
Together with local crafters at the Guga S.Thebe Art and Culture Centre, the project started to build their own therapeutic material (anatomically correct and culturally adapted dolls and doll houses). The aim of this endeavour is to build local capacity and to supply other projects and therapists with local therapeutic supplies (as most of these materials are still imported from Europe.) This community development effort will be expanded to include other therapeutic stock for use by the professional therapeutic community worldwide.
Children in Crisis is involved in different research projects including the evaluation of the project.s efficacy, exploration of needs of the recipient community in Langa as well as on the issues of trauma and reconciliation. Parts of the work have been presented at international conferences in Africa, Europe and USA and collaborations with other South African, African and European projects are flourishing.
Poem to “The sun” ( .Die Sonne. in Xhosa .Langa.)
von Erin Mothibi
At the foot of the great blue-grey
Where my body lives and my heart forever will stay
Hope whispers through the doors, sits with the old and
plays with the children
Sweeps doubt from the streets with the south-eastern broom
Impurities are sneezed out and dispersed to the furthest…
As the enormous flame is extinguished in the deep blue
Little bright lights of prosperity covers the landscape
To preserve the quality of its contents
Even when clouds interrupt and pose a threat
With each drop that meets the soil
A seed of endurance is fertilized
For storms have come.
And still will.
Langa will remain shining.
(Erin is a student at the Department of Psychology at the University of Western Cape, she wrote this poem after being involved in a need analysis of Langa in 2004.)
I am a general practitioner interested in traumatized children. i live in Cape Town. Do you have a centre here that I can visit and do you have training for doctors on this subject?
Regards,
Elaine
[...] Trolig var hun i Cape Town for å gjøre mer enn å bare bo på hotell: Steffi Graf støtter et prosjekt for traumatiserte barn i Sør-Afrika. Det kan du lese mer om her. [...]