190 SCIENTIFIC ARTICLE with their fellow participants indicates that they have put this into practice. These findings would have been strengthened by an independent assessment of the social bonding that took place, but this was both difficult and risky to undertake. Clearly this would be a priority when the political situation allows more open follow-up and meetings within the community, but this was not possible here. The act of witnessing stories in a contained circle which has agreements of equality, respect, and security, has an empowering effect on the participants. Because of the simplicity of the process, it can be translated into every sort of community issue where the intention is to heal and empower in the aftermath of trauma. Recent workshops carried out in Mabvuku with community leaders had the same efficacious effect of increasing trust and co-operation and a deeper sense of empowerment in groups working with the effects of HIV/AIDS on orphans, widows and youth groups. T O R T U R E Vol um e 1 9 , Nu m be r 3 , 20 0 9 Conclusions On the basis of these results, it seems fair to conclude that the Tree of Life offers both effective healing and empowerment for victims of torture in Zimbabwe. The findings are similar to those found in the Namibian setting20, but it should be pointed out that this Zimbabwean work has taken place in what can only be described as a seriously de-stabilized situation, effectively similar to a lowintensity conflict or a complex emergency. This work took place in a setting in which there remained appreciable risks for all the victims. The participants rated the workshop process as efficacious, and this was supported by the follow-up that demonstrated a significant decline in psychological dysfunction. 36% of the sample improved below the threshold for psychological disorder, a score less than seven on the SRQ-20. However, it is fair to comment that this was not a case-control or waiting-list design, and more comprehensive empirical testing should use one of these designs before it can be conclusively asserted that the Tree of Life is beneficial. Nevertheless, these are impressive preliminary results, and certainly indicate that the Tree of Life is deserving of more attention as a method of assisting victims of torture. As regards the approach itself, it commends itself to ordinary survivors, is easy to implement, and can make use of survivors themselves as facilitators, which is important in the current Zimbabwean setting where the health services are in disarray and mental health professionals are extremely scarce. The approach was culturally acceptable and followed traditional methods of dealing with psycho-social problems. The participants gave high rating to the sessions dealing with witnessing the trauma and empowerment. Whilst the process of re-engaging with one’s trauma is undoubtedly distressing, this study did not suggest that it was unduly so or noxious in any way. It should be pointed out here that, as Mollica and others have suggested in respect to mental health services in complex emergencies, care for the caregivers is an important aspect of any system that is put in place.21 This was observed here: the Tree of Life team met regularly to process the work and their own response to it, both in the immediate aftermath of the workshops and subsequently. Here the team used the same methodology of the circle to process their feelings and understandings about the effects of the work under the guidance of two supervisors who were highly familiar with the methodology, but who did not participate in the actual workshops with the survivors.