16 torture or trauma cases as ordinary cases of psychological disorder, but they had nonetheless seen a large [86 cases] number between them. One participant indicated that he had seen many patients and had no figures. Of the kinds of treatment offered by the counsellors, counselling was the most frequent. The majority [10] recommended this training to be part of all nurse training, whilst a small number thought the contrary [2]. A variety of reasons were offered for the recommendation, and a selection of their responses is shown below. “It equips one with the necessary skills in dealing with torture victims.” “Helps in use of resources i.e., we won’t prescribe unnecessary drugs in cases where counselling only can be effective.” “Every nurse meets a patient who needs counselling so it is easier when one has the skills instead of referring to nurses who did a counselling course who may be off duty.” “These skills should be incorporated into their training as nurses come across torture, rape and psychiatric patients.” “It enhances proper management of a patient using a holistic approach.” “It is useful in detection of anxiety and depression.” “Psychological problems can then be identified within the Community.” “A good guidance to correct diagnosis preventing patients from shopping around seeking treatment.” “A lot of patients seen present with psychological problems but nurses do not know how to manage them accurately.” “Counselling training gives the nurse an understanding of human behaviour and opens up channels of assisting clients with satisfaction and confidence.” 3.4 Rehabilitation technicians In Zimbabwe, as in other developing countries, access to an experienced physiotherapist is rarely possible for many patients in the community. To obviate this problem, Zimbabwe developed a cadre of health worker, the Rehabilitation Technician (RT), to assist the physiotherapist and occupational therapist. These workers are based at district hospitals, and provide the first line of care for patients with physical disabilities, providing basic assessment and rehabilitation. The RTs are supervised and supported by physiotherapists based at the Provincial Hospital, and these two cadres of health worker thus provide a rehabilitation service from the community through to tertiary care. The aim of this programme was to provide a training programme for Rehabilitation Technicians in the assessment and management of trauma victims, including torture and organised violence. All the RTs in Mashonaland West Province were trained in 1996/97. The project was developed together with the Provincial Rehabilitation Department of Mashonaland West Province. The project, which was based at Bindura Hospital, was in two phases, and lasted approximately 18 months. During Phase I, a manual, suitable for use by the rehabilitation technicians, was developed. This was based upon the manual developed by the Rehabilitation and Research Centre for the Victims of Torture [RCT] in Denmark, and adapted for local conditions and para-professional workers. This manual was adapted by local physiotherapists, and the assessment and management protocol developed by the physiotherapists tested in a pilot study. This involved assessments of a group of torture survivors by two independent physiotherapists. Patients were seen individually by a physiotherapist, an occupational therapist, and a doctor17. 17 For details of the assessment, see Amani (2005), The Medical and Psychological Consequences of the Liberation War. A report on survivors from Mashonaland Central Province, Zimbabwe. July 2005. HARARE: AMANI TRUST. AMANI TRUST: Psycho-Social assistance to Survivors of the Liberation War. A report on Mashonaland Central Province, Zimbabwe.