This historic conference, first of its kind, was presented by the World's Veteran Federation under the auspices of the European Society of Traumatic Stress Studies and hosted by the Croatian Government and the Croatian Patriotic War Veterans Association.
Conference Demographics
The First International Conference on Psycho-Social Consequence of War in Dubrovnik, Republic of Croatia was attended by 328 participants representing various fields of professionals in the field of War and Trauma and War Veterans and Civilians. The representation is as follows;
They were from 38 different countries the world over:
Australia (5) Austria (2) Azerbaijan (1) Bangladesh (8)
Belarus (1) Belgium (1) Bosnia and Herzegovina (8) Canada (2)
Congo (1)Croatia (69) Czech Republic (2) Denmark (3)
Finland (10)France (12) Germany(8) Ghana (1)
Greece (1)Israel (5) Japan (1) Lebanon (2)
Liberia (1)Malaysia (1) Morocco (1) Netherlands (16)
Nigeria (2) Palestine (3) Poland (2) Portugal (2)
Russia (3)Rwanda (4) Slovakia (1) Slovenia (6)
South Africa (1) South Korea (4) Sweden (5) Switzerland (1)
United Kingdom (7) United States (18) Yugoslavia (Serbia - 2)
Major Conference Themes
Many studies and surveys done on children from the Persian Gulf War particularly Kuwaiti children and in the Bosnian War with the children of Mostar indicate that exposure to war has a devastating effect on children. If this is not treated immediately the damage could be irreparable. These children are called First Generation Victims of War. Without Proper therapeutic intervention they become a "lost generation, " in that they experience a disruption in their moral and emotional development. They are also susceptible to depression and complicated grief from losses they suffered. A case in point is Kuwait, 30% fewer post-war adolescents pursued higher education in Colleges and Universities. There were also more high-risk losses through driving accidents and the rate of suicide has remarkably increased. Post-war children generally fall into two categories - one group is more prone to develop problems with Substance Abuse and become juvenile delinquents, and the other group may become much more passive and go unnoticed developing serious problems with depression and other mental disorders. Early intervention is the key to therapeutic healing and many models used in dealing with Combat Veterans may be helpful in treating children and adolescents.
Secondary traumatization refers to others who come into close contact with a trauma victim which over time could cause tremendous emotional upset. It was reported that with the Vietnam experience 38% of marriages in Vietnam Vets were divorced within 6 months after their return from Vietnam. In a study conducted among traumatized parents either from the Holocaust or direct exposure to combat trauma the statistics show that:
In a study of 1,037 elementary school children of Slavonija in Eastern Croatia 387 showed more signs of traumatization from the war - 650 showed fewer signs of traumatization. This study shows that children have a tremendous resiliency and can normalize painful experiences and work through losses easier than for older adolescents and adults.
In the Netherlands for example, great care is taken to treat the Veteran and his or her family as a unit. They learned after the Dutch War in Indonesia during World War H that material as well as physical and psycho-social support was paramount for the Veterans and their partners. They realize that veterans need other veterans for support and camaraderie but if the partner in the marriage is not given education and support, the family system is doomed to failure.
American mental health professionals provided much statistical data relating the results of the National Vietnam Veterans Readjustment Study conducted a few years ago as measurable instrument to determine levels of Combat-related stress and the subsequent sequelae to readjust to civilian life. Basically the study indicates that exposure to multiple stressful events over an extended period of time, maybe even years, may drive current symptomatology and mandate a serious investigation of a single traumatic event. It also shows that access to intrapersonal interpersonal and environmental resources may serve to assuage the occurrence or persistence of reactions to severe stressors and thereby work to neutralize their negative impact on well-being.
History shows that societies tend to blame those who experience negative combat stress reactions. However, to experience war is to experience trauma. In the United States, there has been denial that PTSD has and still exists among Vietnam Veterans. The combat survivor with PTSD is a public health concern from many perspectives. There are significant links between PTSD and substance abuse. The largest single group of American homeless are Vietnam Veterans. Also, numbers of recently retired veterans are presenting PTSD symptoms 25-30 years after the Vietnam War. In the United States, the road has been rocky to have PTSD accepted as a legitimate mental and public health concern.
What about our younger War Veterans from other nations?
South Africa
Nearly twenty years of border wars and township violence has left South Africa with hundreds of thousands of war casualties of a psychological nature. In South Africa veterans with severe mental problems due to their war experiences add to the load of an already over-stressed social and medical system Misuse of alcohol and drugs is common among these men trying to numb the pain. in addition, the most serious problem hindering the development of a working democracy in South Africa today is crime. If veterans do not get the help for their problems, social as well as psychological they can continue to do what they were trained to do: kill. Some men may ready gunmen for the hundreds of crime syndicates now operating in post-apartheid South Africa.
One young veteran representing South African, Marius van Niekerk sees the need to establish a Veterans Organization modeled after Vietnam Veterans of America that would be an inclusive and all-encompassing. This South African Veterans Association (SAVA) would include veterans who fought on opposing sides of the war to end apartheid:
+ MK and APLA - The liberation armies in South Africa
+ ZANLA and ZIPRA - The liberation armies of Rhodesia/Zimbabwe
+ SWAPO and PLAN - People's Liberation Army of Namibia
+ MPLA, FPLA and UNITA - The liberation armies of Angola
+ RENAMO and FELIMO - The liberation armies of Mozambique
+ SAP - South African Police - all those who served in all units
+ SADF/SANDF - South African National Defense Force - all those who served in all units
+ SDU - Members of the Self-Defense Units in the townships
+ SPU - Members of the Self-Protection Units in the townships.
This grass-roots organization is geared towards a self-help model and also to provide a unified voice to lobby government for veterans benefits. You can appreciate by reading the above how very complicated this war was and how involved it was bringing so many armed forces from the neighboring countries.
Republic of Croatia
On Wednesday evening, 29 April, 1998 we held an informal and informational "Rap Group" for our hosts the Croatian Veterans. They shared the following that the veterans of this Patriotic War for independence against their Serb aggressors resulted in very much the same symptoms suffered by American Veterans returning home from the war in Vietnam - isolation; rejection; unemployment; homelessness- substance abuse; divorces, etc. They also shared on how their government once the war was over did not want to hear or listen to any problems the Veterans were relating as a result of war. Those who need in-patient treatment for Combat Stress were placed in locked wards of mental institutions thrown into a mixed population of severely disordered and psychotic patients. They were treated as mentally ill. and were given heavy doses of drugs to keep them quiet, calm and often lethargic. PTSD was not taken seriously by the government and certainly no consideration to compensate these Veterans for such a disability as PTSD. Thanks to the medical advances of Post-Traumatic Stress Disorder in the United States, many mental health professionals in Croatia and Bosnia were trained to deal with PTSD and were able to put into place acceptable therapeutic models to begin treating the Veterans.
The Croatians Veterans started and organized the "Veterans of the War Club - April 3, 1992" founded in Valpovo, Croatia. Its aim was to find the most integral response to numerous requests of the war victims, i.e. the participants in the Patriotic war in Croatia. The Club is a forum for milieu therapy, adapting to their needs. Apart from the psychotherapists, the club includes a Priest, a Social Worker, Teachers, Nurses and an Attorney. In this way, an integral and holistic approach to the war veterans and their problems has been addressed and provided. The psychotherapists provide individual and group sessions to assist those who need it. The psychotherapist is responsible for the education of the other members of the Professional corps working at the Club. The participants realize the enormity of spiritual scars the Patriotic war has left them with and see Spiritual Healing as an integral part of their holistic approach to healing.
Russian Veterans of the Afghanistan War
There was a presentation made by Dr. Natalie Monbet from the Primo Levi Association in Paris, France who have worked extensively with the Russian Veterans and Mental Health Professionals in establishing a clinic entitled OPORA situated in Perm in the Urals. This clinic was staffed conjointly by a Medical Doctor, Psychiatrist, Psychologist, Social Worker and actual Veterans. The purpose was to treat the Veterans and their families in a holistic fashion. There was also a major educational component to the Center to teach them about the negative effects of war and combat experiences, particularly to family members who are primarily the first support systems returning veterans come home to. This multidisciplinary team reported that after 18 months in operation, many of their veteran clients were readjusting back to family life and resuming employment and educational opportunities. They also noted that in time these veterans were needing less and less clinic visits. Basically, the painful lessons learned from the American experience of returning Veterans from the war in Vietnam were learned and methodologies put in place so that early intervention in victims of other conflicts and wars could turn the tide of PTSD-related problems sooner in the healing process.
There were many presentations in this Conference dealing with women and the traumatic impact on them from war. These presentations covered a broad spectrum including women veterans, civilian women in government service during the time of war; mothers and wives of soldiers who have disappeared and are still missing; Gold Star Mothers and Gold Star Wives, and "Comfort Women" used during wartime with the approval of certain governments to maintain the morale of the troops.
Women Veterans
Dr. Christina Doctare, M.D. from Sweden is a Psychiatrist who served in the Swedish Army as a Psychiatrist gave a major presentation in a plenary session on her experiences in the military and the negative impact many women veterans experienced while in military service not only in combat settings but in peace time as well She determined that a good percentage of military women had suffered from a wide spectrum of sexual discrimination ranging from sexual harassment to outright sexual assault in many cases. Many of the women veterans fear reporting such incidents due to fear of retaliation or more importantly of not being believed. Therefore many women veterans walk in secrecy of these traumatic events. They caused them to have adverse reactions to living a normal healthy life. Oftentimes, it is only years later as in the case of Vietnam Women Veterans who are only recently coming out to disclose publicly on National television, incidences of sexual abuse and rape. Treatment modalities and user-friendly women's clinics with female doctors enable the women veterans to enjoy a safe environment in which to begin to report of the these traumatic episodes and begin the long and painful healing journey home.
Civilian Women employed by their government to work in a combat setting
Dr. Lynne Lawson of Australia, now a Psychiatrist, worked in Vietnam as an entertainer much like our USO workers. In a recent survey she conducted among '32 female participants who had entertained allied forces in Vietnam during the war took part in investigations of exposure variables that may be associated with trauma-specific and general psychological morbidity for civilian women in war zones. The study concluded that post-trauma responses can continue for decades when civilian women have been exposed to all the war zone stressors measured in this particular study. A glaring problem that surfaced in this presentation and one in which has been discussed in the United States is that veterans are eligible for compensation for their war-induced traumata - however, not so with civilians employed and deployed to combat situation by the Federal Government. More work needs to be done in this area to determine the feasibility of pressing for more rights and benefits for this category of "war veteran.
"Vukovarske Majke" - The Vukovar Mothers
The " Vukovarske Majke [pron. MY-KA]" or the Vukovar Mothers Association is patterned very much like "Las Madres de los Desaparecidos " (The Mothers of the Disappeared) that was organized by the Mothers of the thousands of young men who "disappeared" in Argentina during their revolution. The closest counterpart in the United States would be the National League of Families organized after the Vietnam War who keep alive the need to render a fiffl accounting of the POW/MIA's from the War.
The area of northeastern Croatia situated between the Danube and Sava Rivers has been inhabited continuously by Croats for the past thirteen centuries. During the 10th and 11th Centuries, the Vukovo settlement (later called Vukovar) arose at the mouth of the Vuka River. In 1231 Vukovar was awarded "Free City- State" status. Today, Vukovar is the seat of government for Vukovar County. Throughout the course of history, German, Serbian, Hungarian, Ruthenian, Ukranian and Slovak colonizers moved in to take over the land. Croats always remained in the majority. The land was rich and fertile and appealing to foreign colonizers.
With the fall of communist regimes in Eastern Europe in the late 1980's - Belgrade also fell. They were loath to lose their dominance over Yugoslavia and therefore set out for the creation of Greater Serbia. In response to it, Croatia held democratic, multi-party parliament elections in May 1990. The majority of seats in the Croatian Parliament (Sabor) was won and the Croatian Democratic Union (HDZ) and subsequently Croatia proclaimed its independence on 25 June 1991.
Serbian propaganda went out to convince the Serbs living in Croatia that their lives were endangered and instigated their rebellion against the Croatian authorities. The Serbs from some Croatian areas, including East Slavonia and Western Srijem, by decision of their self-styled authorities demanded an annexation to Serbia. Serb extremists were given weapons and started surging into Croatia. The Yugoslav Army (JNA) was siding more and more openly with Serbia and Montenegro.
By Easter, 1991 the town of Vukovar was encircled by Serbian barricades. Croatian authorities continued with their effort to calm the situation. The armed conflict in these eastern areas of Croatia started on 2 May 1991 when Croatian Serbs of Borovo Selo killed 12 and wounded 21 Croatian policemen. Croatia found itself in war, unarmed. The Croatian National Guard was only its making. Later, in the course of the war, it grew into the Croatian Army.
On 1 July 1991 the Croatian Serbs, aided by the JNA, attacked Borovo Naselje, the western suburb of Vukovar. The village of Celije, where Croats lived, was burnt to the ground. Other places were also attacked and Vukovar became a town under siege. Next came daily shelling and air raids.
The fateful battle for Vukovar lasted for three months, from late August to late November, 1991. Vukovar was in the grip of a multiple encirclement, vastly outgunned and outmanned. Several hundred thousand various missiles, including air bombs, fell on the doomed city. It was being systematically destroyed. The Vukovar Hospital was also heavily bombarded.
The resistance was offered by about 1800 fighters at a time, of whom 60% from the town itself the rest from Croatian lands. Innumerable were the heroes of Mitnica, Trpinjska Street, Luzac, Sajiste and Bodanovac. They inflicted tremendous losses on the enemy, knocking out 300 tanks and armored vehicles, 24 aircraft, about 15,000 troops.
Meanwhile, from Ilok and other towns and villages the Croatian population was partly deported, partly massacred. Vukovar had 350 defenders and 1,100 civilians killed.
The world was protesting, but doing very little to prevent this aggression which has resulted in urbicide, ecocide and genocide.
The second act of the tragedy of Vukovar began on 18 November 1991 wen the occupying forces entered the town. Contrary to all international standards and agreements reached with the International Red Cross and European monitors, the non-Serb population was subjected to terrible repressions. Several thousand people were expelled, many deported for internment in prison camps in Serbia. Many Croatian fighters and civilians, including 300 wounded patients from the Vukovar Hospital were taken to unknown destination. Many murders were committed on the spot.
The outcome of it all is that half of Vukovar/Srijem County was occupied. Tens of thousands of Croats and other non- Serbs are living as exiles under humiliating conditions, scattered in more that 600 places afl over Croatia and abroad.
The Croatian authorities have organized a Bureau of Displaced Persons. Offices have been opened for the purpose of documenting and tracing the deported and captured Croatian fighters and civilians. In the beginning there were 13,000 applications were filed to trace deported and displaced persons. A series of negotiations were held with the opposing Serbs at the State level. Exchanges of prisoners have taken place. Today the Croatian government demands the return of 2,820 captured and deported persons, including 1,280 from Vukovar/Srijem County.
The Mothers of Vukovar and other family members have persevered from the very start. Their search began in late 1991, shortly after the fall of Vukovar and continued for four years up to now. Following the more or less individual actions, the "Vukovar Mothers Association " was founded on 24 April 1993. Their aim is make the public more acutely aware of its action. Over these last four years they have written hundreds of letters, knocked on many doors, held a series of protest rallies, talked to prominent personalities, the representatives of humanitarian organizations, embassies and Croatian authorities.
Mothers in the black of mourning, as they are often referred to, are kept afloat by the power of their faith and hope. Nothing could shatter them, not even the news of Ovcara and other mass graves coming in.
'Where are our dearest ones?" has become the prevailing motto of the Vukovar Mothers. They subjected themselves to humiliations by writing letters and traveling to the enemy side, just to learn the truth about their loved ones. They visited Vienna, London, USA and met with the ambassadors of a number of nations in Zagreb. They went on pilgrimages to see the Holy Father, Pope John Paul 11. They went on hunger strikes to soften the hearts of people the world over. They participated in raising the 'Wall of Pain" in front of the UNPROFOR headquarters in Zagreb. They spoke up in the Croatian Parliament on numerous occasions. They have appealed to Croatian and foreign leaders for help to bring back the deported and imprisoned Croatian fighters and civilians whose fate is still unknown after these four years. One can see them clinging to the photos of the dearest to their chest. They are going to bed and rising in the morning with the question " "Where are they? " on their lips. The question today still remains unanswered.
The Wall of Pain is a Memorial patterned after the Vietnam Veteran Memorial Wall in Washington, DC. The Wall of Pain is placed in front of the UNPROFOR headquarters in Zagreb, the capital of Croatia. It is comprised of a series of bricks, some painted red, the others painted black. Names written on the black bricks represent someone who was killed in the Patriotic War. Names written on the red bricks represent someone whose fate is still unknown - someone displaced and missing in action. The brick are laid loosely over each other with open spaces Eke lattice work. People come regularly and leave flowers, letters, photographs and other memorabilia much like what happens at The Wall in Washington, DC.
There were several presentations on the particular problems encountered by the multi-national United Nations military sent to hot areas for the purpose of humanitarian and peace-keeping efforts. The various issues discussed in these presentations dealt with Traumatic Stress; Substance Abuse; Suicide and other violent death rate among UN soldiers. In a Norwegian study, it was determined that from the period 1978-1991 they found a 43% increased mortality rate by suicide and a 28% increase in the mortality rate through other violent incidents of death. Another major German study, they determined that if units are kept together prior to and during foreign missions the group cohesion reduces the risk of individual soldiers suffering from major traumatic stressors than if the soldier was sent in as a replacement troop much like what happened during the Vietnam War. Substance abuse across the board seems to be an ongoing concern in the military. It is irrelevant whether the soldier is in a war situation or a peace-keeping mission.
There were several presentations on the unique stressors felt by aging veterans. These stressors combined with diminishing health and quality of life issues when a veteran retires either from Active Duty Military or civilian employment compounded draws a very complex picture. War-related stressors from World War II and other earlier wars, for example the colonial wars France and Portugal fought in Africa, the Dutch in Indonesia, or the Civil War in Spain, when untreated in the early years do not disappear. Studies have shown that upon retirement from regular employment, these symptoms will resurface in the aging veteran.
There were many older Veterans in attendance for this conference. There were World War II Veterans from several nations - French Veterans from the Algerian and Indochina Wars - Portuguese Veterans from the wars in Angola, Guinea and Mozambique - Dutch Veterans from the Indonesian War.
One significant factor learned from the aging Veterans was the PTSD is a universal experience of any war and the process of healing psychologically and spiritually is the same the world over.
Although, the situation on the African Continent was not the subject of any particular research in this Conference, the African representative made themselves known and presented their chief concerns to the Conference.
Rwanda
There were women from Rwanda who attended the Conference. These women represent a mere fraction of the Mental Health providers in that country still trying to recover from the trial wars between the Hutus and the Tutsis. They shared over overwhelmed they felt in their country because the need of services is far greater than the meager availability of professional Mental Health Services can provide.
In speaking with these women, I learned that what I read in the newspaper is not always "the truth, the whole truth and nothing but the truth. " I was looking at the struggle and violence merely as tribal wars but there is more to the reality than what met the eye. The Rwandan women, who when asked what tribe they belonged to, cleverly avoided the question and rightly so. If we remember from our stamp-collecting days the nations of Rwanda and Burundi were known as Belgian East Africa - a Belgian colony. When Rwanda and Burundi gained their independence and they began to form their own government, the colonialists and their descendants did not leave the country, by and large. They still maintained great influence and economic power over the native population. These women informed me that the Hutu and Tutsi Peoples lived peaceably for generations upon generations - they share the same culture - the same language. What happened then was the white European settlers began to feel threatened that they were losing ground and influence over the native population as they became more adept in governing themselves. In order to maintain influence, the European settlers began a propaganda campaign arming the Hutu tribe against the Tutsi tribe. It was a systematic campaign to instill fear and paranoia among the Hutus against the Tutsis. This became an inflammatory campaign that resulted in the outbreak of violence, systematic rape of the women and children and the genocide that resulted.
The genocide of the Tutsis at the massacres of many Hutus opposed to the Regime which took place in April 1994 resulted in the deaths of over one million Rwandans in the most atrocious and horrible deaths. The genocide of April 1994 left this little nation totally devastated. Thousands of widows and hundreds of thousands of orphans were left behind. They were able to organize the Association des Veuves du Genocide d'avril 1994 (The Association of the Widows of the April 1994 Genocide). Their motto is "Que les cris des martyrs empechent le silence et l'oubli (May the cry of the martyrs prevent silence and forgetfulness). They have organized to fight for justice and begin a new life for themselves. The main objectives for this organization is to provide health care; human rights for women; education and vocational rehabilitation and assistance in the basic needs of life, housing, food, etc. Unfortunately, the need is great and the shortage of Professional staff in all fields and food and medical supplies is also great. They are hopeful that International agencies will provide for their basic need until they can be able to provide for themselves.
Liberia
I met an exiled Pentecostal pastor, Wilfred Ifeturoti from Liberia. Because of the instability of that nation and continued conflict among the various revolutionary groups, he needed to take up residency in Nigeria. He is beginning a Center called Remedy International to provide aid to refugees from neighboring African nations. The aid consists of medical housing, food - the basic necessities of life - as well as education. He is appealing to America for aid in the way of money and supplies to build up this center.
Nigeria
I met the Commissioner of Veterans Affairs from Lagos, Nigeria and he also appealed to me for assistance in sending Medical supplies to his nation. They have become a haven for refugees from their troubled African neighbors.
The World Veterans Federation is an international organization founded in Paris, France, in 1950 on the heels of World War II. It is a non-governmental organization and is partly funded by the United Nations and mostly by dues paid by membership organizations. The WVF invites Veterans Service Organizations all over the world to become a part of its organization for the primary purpose of promoting peaceful relations in the world and reconciliation among former enemies. They hold regular meetings all over the world.
Report respectfully submitted by Father Philip G. Salois, M.S.,
National Chaplain - Vietnam Veterans of America
Chief Chaplain Service - Veterans Affairs Medical Center, Boston, Massachusetts