TRC Final Report

Volume 5

Chapter 4

Subsection 5

Treatment in the South African context

47 In South Africa, the area of mental health has been historically neglected. There are few trained psychologists and clinical social workers, and few attempts have been made to provide culturally appropriate mental health care to all South Africans. At the time of reporting, mental health care still consisted largely of institutionalisation.¹²

48 Moreover, dire social circumstances have made it difficult for individuals to deal with past psychological traumas. At times, current problems are merely symptoms of long-term traumatisation, compounded by impoverished living conditions. In South Africa, successful therapeutic interventions are difficult, because of the inability to protect the individual from further trauma.¹³

49 Mr Lennox Mbuyiseli Sigwela was paralysed during a police shooting and attack by Witdoeke vigilantes in Crossroads in 1986. Once the family breadwinner, he became dependent on family members. His situation provides an example of the inter-connectedness of psychological, physical and economic consequences of human rights violations. At the KTC hearing, he told the Commission:

KQUOTE> We are struggling, we are struggling. The children at my home are suffering for new school uniforms, for clothes. That is why I will never - although I have accepted this - I will never, I will never forget what happened because, when I look at the way we struggle at home, sometimes I feel like committing suicide. KQUOTE>

50 It is therefore difficult to distinguish between the response to the psychological effects of the violation and other stressful events in the life of the victim. Studies do, however, provide evidence that, in some individuals, exposure to violence has psychological effects independent of other associated factors causing stress.

51 It is also suspected that diagnoses of mental illness were also used to silence activists or opponents by condemning them to institutions where they were under the control of the state. Doctors and mental health professionals are alleged to have advised torturers on how to identify potential victims, break down their resistance and exploit their vulnerabilities.

52 The above factors led to resistance to seeking formal psychological treatment. Statement takers found that the suggestion of a referral for psychological treatment was often met with a rebuttal such as, “I am not mad”. Mr Robert David Norman Stanford, a victim of the attack on the King William’s Town Golf Club on 28 November 1992, agreed that there is a reluctance to recognise that one is psychologically damaged. He described the difficulties he had experienced in connection with his psychological problems at the East London hearing:

KQUOTE> No one is prepared to accept that you’re not quite normal. And you tend to fight against it and you tend to try and uplift yourself; you tend to try and show that you’ve returned to a state of normality whereas, in fact, you haven’t done so. KQUOTE>

53 Others who sought treatment found difficulty in obtaining it¹⁴. Mr Sean Callaghan (see above) told the Commission:

KQUOTE> Around that time, I remember phoning my mother and telling her that I wasn’t sure if we were actually going to survive the night because we had got to the point of being completely suicidal. We had come to the end of our tether. We had been involved in that kind of thing - seeing patients, seeing people killed for twelve months already - and all I wanted to do was go and heal people and not kill them ... KQUOTE>KQUOTE> We went to see the local psychiatrist who was resident in Oshakati and the major in charge of South African Medical Services up there, and we were basically told to grow up and carry on; there was nothing wrong with us ... There was no debriefing. There was no “what happened to you?” There was no “this is what you can expect when you go home. This is how you should try and integrate yourself back into society.” KQUOTE>KQUOTE> I do remember a letter, I think, being sent to our parents with ten points on it, saying something like: “You had better lock your alcohol and your young girls away because these young boys are coming back home”. But that was the extent of the support we got ... KQUOTE>KQUOTE> I saw a psychiatrist ... He declared me fit for battle and sent me home [saying] that there was nothing wrong with me. The point is that I wasn’t fit to be a father and I wasn’t fit to be a husband, but I was certainly fit to pull the trigger of a gun. KQUOTE>KQUOTE> Essentially, I think I am pretty healed. I think I have come to the point of being whole. I have my emotions back. I am a father. I am a husband and I can do those things pretty well. But no thanks to the SANDF or SADF for helping me. KQUOTE>

54 In order to heal, trauma victims must ultimately put words to their experience and thereby integrate the traumatic experience in order to find new meanings for themselves and their place in the world. An essential feature of recovery from trauma is re-establishing and normalising relationships of attachment with others.

55 Yet, while many victims of violations spoke of psychological problems that resulted from trauma, many others spoke of the strength and resilience they drew from friends and comrades in times of hardship. Courage, love and support networks kept many families and communities functioning and intact.

12 See chapter on Institutional Hearings: Health 13 Hamber, B & S Lewis, ‘An overview of the Consequences of Violence and Trauma in South Africa’ CSVR (full citation please) 1998. 14 See chapter on Institutional Hearings: Health.