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8/14/2019 Testimony : a new hope for survivors of torture and organized violence in India
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Testimonial Therapy
Among survivors ofTorture and Organized Violence
in IndiaInger Agger, PhD, Psychosocial Adviser
RCT, Denmark
Lenin Raghuvanshi, Convenor,
Peoples Vigilance Committee for Human Rights, India
Peter Polatin, MD, Health Program ManagerRCT, Denmark
Presented at the Symposium:
Peacebuilding: Psychological Perspectives
European Congress of Psychology,Oslo, July 2009
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A collaborative project of
Peoples VigilanceCommittee on HumanRights (PVCHR),Varanasi, India
&
Rehabilitation andResearch Centre forTorture Victims (RCT),Copenhagen, Denmark
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Testimony as a Brief TherapyIntervention
First project in Varanasi, India with thehuman rights organization:
Peoples Vigilance Committee on HumanRights (PVCHR):
Capacity building project on testimonialtherapy for Human Rights Organizations
in India
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The objectives of the
project Context specific manuals for using theTestimony Method developed
Capacity built in using the TestimonyMethod among human rights defenders
Psychosocial wellbeing of survivorsenhanced
Impact and outcomes analyzed through anM&E system
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What is Testimony?
A testimony is a story or a narrative about anevent
The story is usually told by a person who
suffered an injustice, or something painful orterrible
It is a map of pain, a trauma story, it tries totell the truth, convey what really happened
In Hindi it is the self-suffering story It can be told in many different ways in
words, music, art
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What is testimony?
It can be told to many different audiences: tothe family, to friends, to the community, to theworld, to a therapist, to a lawyer, to a priest
It can be used for many different objectives: asa record, as evidence, as an expression ofemotions, for advocacy
Testimony in different variations has been used
by mankind for thousands of years Here we are using testimony as a healing or
psycho-therapeutic method
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What is Testimony?
Has a double meaning (in English):
Objective, legal, public, official
(evidence, attestation, proof) Subjective, cathartic, spiritual,
emotional, private (expression ofdisapproval, condemnation,
protestation)
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Interpretation of Testimony(Dr. Jhawar , clinical
psychologist, Varanasi) T- Truth E- Emotions S- Sentiments
T- Tortured I Individual M- Magnifiable
O- Operations N- Never Y- Yielding their rights
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Testimony Model
Developed for IndiaFour sessions:n Session one: Opening the story
n Session two: Closing the story
n Session three: Delivery ceremony
n Session four: Follow up
n Meditation and Mindfulness integrated
n Community-based delivery rituals introduced
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PVCHR Human Rights
Work Investigate & Document Violations Advocacy
Folk Schools in People Friendly modelVillages
People can give testimonies and receivesupport from the group
Concerns of health and education
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Manual
A manual on testimony therapy for community
workers and human rights defenders was
developed (published in English and Hindi):
Giving Voice Using Testimony as a Brief
Therapy Intervention in Psychosocial
Community Work for Survivors of Torture
and Organised Violence
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Testimony Workshops
Three two-week training-of-trainersworkshops conducted:
1. May 2008: 12 human rights defenders from PVCHR2. January 2009: 14 Human rights defenders from four
states: Uttar Pradesh, Uttarakhand, Bihar and Madhya
Pradesh.
3. February-March 2009: 14 Human rights defenders fromthree states: Jharkhand, Manipur and Chattisgarh
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Schedule of Workshops
Two parts:
2. First week:
Theory and exercises (through role plays)
2. Second week:
Practise: Participants take testimonies withsurvivors under supervision
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Testimonies collected
Period of data collection:12 months (May 2008 toApril 2009)
On average the first testimonial session is held 1
year and 5 month after the date of the moststressful event
Average number of testimony sessions per victim:2,39
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Background of survivors
A total of 85 primary and secondary victims ofwhich:
Male: 64 (76 %)
Female: 20 (24 %)
Average age: 39,2 yrs; age-ranging: 16 - 70 yrs
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Background of survivors
Category of survivors Primary Victim: 59
Secondary Victim: 24
Secondary victims most often reported relation toprimary victim as either wife (29 %), father (14 %)or brother.
Religion: Vast majority are Hindus (86 %, n= 72) followed
by christian (7 %, n=6).
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Background of survivors
Caste Upper Caste: 9 % (n = 8)
OBC: 46 % (n = 39) (Other Backward Caste)
SC: 21 % (n = 18) (Schedules Caste)
ST: 24 % (n = 20) (Scheduled tribe)
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Background of survivors
Education No education: 28 % (n= 24)
Primary education: 19 % (n=16)
Secondary education: 19 % (n= 16) BA: 11 % (n=9)
Other 24 % (n =20) high school, intermediate, BAMS
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Background of survivors Occupation:
Agriculture: 37 % (n =31) Business: 6 % (n =5) Household: 6 % (n =5)
Public service, journalism, teacher: 6 % (n=5) Lawyer, doctor: 2 % (n=2) Government or political position: 2 % (n=2) Other 40 % (n = 34),
primarily landless labour, or having own business such asshopkeeper, tea stall, making plates or rickshaw driver
Not working 2 % (n =2)
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Background of survivors
Activities: Humanitarian/ Solidarity: 29 % (n =25)
Political: 6 % (n=5) Religious: 6 % (n=5)
Trade Union: 2 % (n=2)
Press: 1 % (n=1)
No activities: 49 % (n=42)
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Type of Violations
Types of Human Rights violations: Psychological torture: 82 % (n=70)
Physical torture: 48 % (n=41)
Sexual torture: 4 % (n=3)
Custodial death of primary victim: 2 % (n =2)
Extra-judicial killing of primary victim: 1 %
(n=1)
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Identity of Perpetrator
Identity of perpetrator: Police: 80 % (n =68)
Armed forces: 5 % (n =4)
Intelligence Service: 2 % (n =2)
Prison authority: 1 % (n =1)
Other: 34 % (n =29),
primarily neighbours, village leader and uppercaste
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Injured Part of Body
Most frequently injured parts of body one or both legs 25 % (n =21)
back 24 % (n =20)
one or both arms 20 % (n =17)
one foot or both feet 15 % (n =13)
face 13 % (n =11)
head 9 % (n =8)
chest/breast 8 % (n =7)
not injured: 28 % (n =24)
On average primary victims report 2,4 injured body parts
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Nature of Injury
Most frequently types of physical injuries: Pain 26 % (n=22)
Loss of function 26 % (n =20)
Loss of sensation 20 % (n= 17) Open wound 20 % (n =17)
Loss of strength 18 % (n =15)
Bruise 11 % (n=8)
Fracture 9 % (n =8) Not injured 24 % (n=20)
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Psychological Symptoms
Most frequent symptoms
Anxiety 54 % (n=46)
Cant sleep 53 % (n=45)
Memories 52 % (n=44)
Fear of going out 45 %(n=38)
Nightmares 41 % (n=35)
Self isolation 32 % (n=27)
Panic attacks 17 % (n =14)
Depression 15 % (n=13)
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Treatment before TestimonialTherapy
Legal aid: 33 % (n=28)
Testimony before tribunal: 31 % (n=26)
Public hospital: 19 % (n=16)
Counselling: 19 % (n=16)
Medication: 17 % (n=14)
Private hospital: 11 % (n=9)
Physiotherapy: 4 % (n=3) Surgery: 2 % (n=2)
None: 29 % (n=25)
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Use of Testimony
Survivor wants: 80 % want it published or used for human rights work
Other interventions by PVCHR or other actors:
Medical: 8 % (n=7) Social: 55 % (n=47)
Legal: 60 % (n=51)
Reading of testimony at Folk School Meeting: 53 % (n=45)
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Changes in wellbeing
Changes in psychosocial wellbeing indicatedthrough the WHO5*:
WHO5-average pre-TT score (n=84): 8,46
WHO5-average post-TT score (n=38): 12,82:
*The higher the WHO5 sum the better (range 0-25)
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Changes in Participation(WHO Participation Scale)
Overall improvement in participation. 17 questions Range 0-85
0: same participation as peers 1: No problem 2: Small problem 3: medium problem
5: Large problem Pre-participation Scale mean value:
31,25* Post mean-value: 13,25*
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Changes in Participation(WHO Participation Scale)
2,00 used as cut-point: Participation perceived as medium or largeproblem. Most commonly found problems were in:
P1: Do you have equal opportunities as your peers to find work?
Mean: Pre: 2,61 Post: 1,85
P3: Do you contribute to the household economically in a similar
way to your peers? Mean: Pre: 2,22 Post: 0,78*
P4: Do you make visits outside your village/neighbourhood asmuch as your peers do?
Mean: Pre: 2,87 Post: 1,15
P11: Do you move around inside and outside the house andaround the village/neighbourhood just as other people do?
Mean: Pre: 2,25 Post: 1,15*
All dropped below 2,00 post testimony
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Types of Delivery Ceremonies
At public demonstration in front of Government
Head Quarters
At Folk School meetings
At community meetings
At street performances & singing
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Delivery Ceremony atFolk School Meeting
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Delivery Ceremonyat Street Theatre Performance
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Delivery Ritual atCommunity Meeting
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ConsultationVaranasi, India, September
2008 Interesting part of this therapy is that it has bothWestern element of Anger Management, ClassicalConditioning and Eastern approach of relaxationmethods and Meditation.
A cost effective model of psychotherapy which doesnot require clinics or hospitals but can be donedirectly at the doorsteps of the victim, e.g., in hishouse, in the community, in a forest etc.
The economic costs of the whole approach seems tobe very less than regular psychotherapy session in aclinic or hospital.
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Facts
There are around 3,000 adequatelyqualified psychiatrists and 1000 clinical
psychologist in the entire country of India
with a population of more than one billionpeople.
The state of Uttar Prades , where PVCHR
works is the most densely populated statein India with a population of more than 166million people. However, there are less than100 psychiatrists and 100 psychologists..