2
1.
Background:
A previous monograph has described the nature of the consequences to survivors of their experience
of organised violence and torture [OVT] 1. There the long-term sequelae of OVT were clearly described,
and it could be seen that these were multiple: physical disability, psychological disorder, and social
pathology. Here it should be remembered that this was an examination of a population of survivors
more than a decade and half after the traumatic events, which indicates that no-one should be
sanguine that survivors of OVT heal themselves: war veterans, activists and the politically uncommitted
were all affected by the Liberation War. It seems evident that Zimbabweans, in common with all other
people, do not cope well with the effects of OVT.
One of the more startling findings from the work of the Amani Trust in Mashonaland Central Province
was that the prevalence of OVT had been very high, and the morbidity due to the OVT was similarly
high: one adult in 10 was suffering from a significant psychological disorder more than a decade later,
and these survivors were suffering from serious psychological disorders as well as physical disability.
Extrapolated across the country, as there is no reason to believe that Mashonaland Central Province
was unique during the Liberation War, this translates into tens of thousands of victims. This is a
population that lives in poverty, and certainly since 1998, lives in extreme poverty, and mostly in rural
areas.
In order to provide appropriate assistance to such an impoverished population, the Amani Trust
developed a “holistic” strategy organised around a community-based approach. This was in
accordance both with best mental health care practice, and also with the views of a number of expert
symposia on the effects of organised violence and torture2.
The approach that was developed by the Amani Trust involved working within a District through 3
phases, as described below. The approach was negotiated with the Provincial and District Health
teams, and was intended to move throughout the Province, district by district. The programme began
in Mount Darwin District in 1996, after a pilot phase in 1995. The programme moved to Muzarabani
District in 1997, and into Centenary District in 1998.
Phase 1:
Phase 2:
Phase 3:
basic training of health workers.
identification, assessment & counselling of survivors.
home visiting, family therapy & networking.
advanced training in counselling skills.
district team building.
Networking and community work.
consolidation of district team.
community work.
Inevitably, there were revisions to the programme as experience showed that there were areas that
needed more attention, or new problems emerged as a consequence of experience. For example, the
Advocacy Programme grew out of the family visiting, which showed significant problems in survivor
families, and the community survey in 1998 also indicated that a community development component
was necessary in order to both deal with the poverty and the sense of disempowerment felt by survivor
1
See Amani (2005), The Medical and Psychological Consequences of the Liberation War. A report on survivors from
2
Here see PSYCHIATRIC ASSOCIATION OF ZIMBABWE (1991), Regional Workshop Report on the Consequences of Organised
Mashonaland Central Province, Zimbabwe. July 2005. HARARE: AMANI TRUST.
Violence in Southern Africa, HARARE: PAZ; PSYCHIATRIC ASSOCIATION OF ZIMBABWE (1990), Report on an International
Conference on "The Consequences of Organised Violence in Southern Africa, HARARE: PAZ Reeler, A.P (1991), The extent
and nature of psychological disorder in Zimbabwe, NATIONAL SYMPOSIUM ON MENTAL HEALTH: ZIMNAMH, 30 OCT - 1
NOVEMBER 1991; Reeler, A.P. (1995), Trauma in Mozambican refugees: Findings from a training programme for refugee
workers, TORTURE, 5, 18-21.
AMANI TRUST: Psycho-Social assistance to Survivors of the Liberation War.
A report on Mashonaland Central Province, Zimbabwe.