Psychosocial recovery after trauma in East Timor

Recuperación psicosocial después del trauma en Timor Oriental

East Timor has been described as one of the most traumatized countries in the world. During the 25-year occupation by Indonesia, this small nation with a population of 700,000 suffered more than 200,000 violent deaths, as well as countless instances of torture and other violations of human rights in a context of organized violence and repression. In this context, the mental health needs of the East Timorese population were largely neglected. As a result, amongst many other pressing needs, the country has a substantial backlog of people with untreated mental health conditions, of both traumatic and non-traumatic origin, and enormous unmet needs in the mental health and psychosocial areas.

This paper describes an initiative by a coalition of Australian based agencies, largely from the torture and trauma rehabilitation field, to assist the East Timorese and UN administration to develop a capacity to address mental health and trauma related needs in East Timor through the development of the Psychosocial Recovery and Development Project in East Timor (PRADET). This initiative developed almost organically from a close relationship between the agencies that formed PRADET and the East Timorese community in exile in Australia.

The paper discusses the various logistic, practical, and cultural and language barriers that make this project such a challenging proposition. The philosophical underpinnings for the project are considered, as well as their socio-political and practical implications for both services and organizational structure. Particular attention is given to the cross-cultural issues that arise in defining and addressing psychological constructs in an East Timorese context, and their practical implications for the development of the project.

This paper concludes that the expertise and experience developed by the torture and trauma rehabilitation field in resettlement countries such a Australia can make valuable contributions to initiatives designed to address the effects of chronic violation of human rights in post conflict situations, provided that this happens within a framework that:

• Recognizes the inherent limitations of the expertise developed in a foreign context
• Utilises the transfer of expertise as a tool to assist empowerment
• Takes into account the cultural context in which this process takes place
• Recognises the central value of local knowledge and experience, as well as traditional approaches
• Ensures that the administrative structure reflects the principles of empowerment.