Vietnam Trauma Survivors
“My interrogators wanted me to say I was the chairman of the Front for the Salvation of the Fatherland. I refused to say anything. They hancuffed my right hand to my left leg 24 hours a day and threw me into a small box – just enough for me to stand up and walk back and forth six steps. They put electric shocks on parts of my body, poured water in my mouth and forced my head into a sink full of water. They tried to suffocate me. They beat me savagely. I spent more than 14 years in 14 different re-education camps in both North and South Vietnam with my legs shackled for 4 years, 6 months and 15 days in total darkness. After they relased me, I contracted tuberculosis. Fortunately, I have clean lungs right now, but I still have headaches, arthritis, stomach ulcers, and nightmares.”
These were the painful public recollections of Tran Tu Thanh, a former South Vietnamese officer who spoke at the National Conference of Vietnamese Trauma Survivors and Seniors at George Mason University’s Johnson Center on May 24. He is presently the chairman of the Helsinki Human Rights Committee in the Washington area. His younger brother, Vong Tran, went through the same prison treatment and suffers from severe Post-Traumatic Stress Disorder (PTSD). Their father was a prominent lawyer and a former Minister of Information as well as Deputy Prime Minister and Chairman of the Board of Attorneys in Vietnam. As a result, Thanh and his brother were tortured and “re-educated” after the North Vietnamese took over the South in 1975.
Thanh and his brother are among 30,000 Vietnamese torture survivors who were left behind at the end of the Vietnam War. They and their families, a total of 150,000 people, came to the U.S. under a special program known as HO, for Humanitarian Operation, in the 1980s and 1990s.
Mr. Nguyen Ngoc Bich, chair of Boat People SOS (BPSOS), welcomed 150 participants from all over the country to the three-day Conference. He addresssed self-help, peer support, and community partnership. The objectives of the Conference were to promote access to health, mental health, and support services.
Scholars, health experts, service providers and the survivors themselves identified needs and developed a joint action plan to address them. The conference also offered training to caregivers, mental health professionals, social service providers, government officials, and representatives of community-based and faith-based organizations on cultural competency and best practices.
Action Plan to Address Needs
Dr. Richard Mollica, Director of the Harvard Program in Refugee Trauma (HPRT) of Massachussetts General Hospital and Professor of Psychiatry at the Harvard Medical School, is the author of a new book, Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World. He said, “The HPRT was founded in December 1981 and has treated over 10,000 survivors of mass violence and torture, with a large majority coming from Indochina (Vietnam, Cambodia and Laos). Over the past 25 years, our research and training activities have helped clarify the mental health sequelae of torture. The consequenses of torture are myriad. Physical effects range from major orthopedic problems, chronic pain, fractures, motor impairment and paraplegia to increased risk of cervical cancer, HIV infection and AIDS.
Due to the humiliation and brutality of the torture experience and the frequency of resulting traumatic brain injuries, major psychiatric diagnosis of PTSD and depression can be readily identified in all cultures. The humiliation and fear used to annihilate the individual are the most potent and damaging instrument; they can devastate not only the individual, but spread to whole communities.
The best model for HPRT is the primary health care system, involving indigenous healing systems and including community elders and family members, clergy and other religious professionals, and traditional healers. “Rarely do trauma survivors seek help from the psychiatric system,” Dr. Mollica revealed. “Our program is focused on building working and training capacity in the primary care system, with strong linkages to other community agents.”
Dr. Susan Salasin, Director of the Women and Violence Program in the Substance Abuse and Mental Health Services Administration (SAMHSA), said that critical issues that trauma raises are disempowerment and disconnection. Accumulated effects of trauma can set in motion personal violence, and PTSD can have an impact on civilian and domestic crimes. She said that the President’s Task Force on Crime Victims, established in 1982, concluded that “treatment for psychological injuries are as important as binding wounds or setting broken bones.”
Another expert, Dr. Robert Weigl, a clinical and cross-cultural psychologist who interviews and evaluates both re-education camp survivors and their spouses, added, “There is a peculiar failure to recognize the physiological impact of what the HO folks suffered. Sometimes, it looks worse among wives, who were never tortured or imprisoned. There is a host of factors that may account for what look like neurological problems as well as psychological symptoms for survivors and spouses, including moderate dementia and Parkinsons disease, cardiovascular weakening, minor strokes, and drastically premature aging. I have been shocked at the frequency of physical problems among the survivors.” He also agreed with Dr. Mollica: “Traditional western psychotherapies are of secondary importance.”
Nguyen Dinh Thang, Ph.D., Executive Director of BPSOS, devised cluster workshop sessions of 90 minutes each for participants to discuss various topics ranging from parental involvement, women’s health, counseling the elderly, nutrition, abuse, media training, and peer support to retirement training and emergency preparedness.
As the workshops’ moderator, he said that several Vietnamese-American doctors would discuss health risks and diseases with high prevalence among Vietnamese, such as cervical cancer, prostate cancer, Hepatitis B, liver cancer, lung cancer, strokes, and diabetes. Dr. Toan Pham of New York told attendees that besides medication, psychotherapy and supportive therapy as well as concrete services are a must. Dr. Nguyen Y Duc from Dallas concurred that besides physical therapy and a healthy diet, family TLC – tender love and care -- helps patients recover faster than isolation and seclusion.
Basic principles, practices and skills in providing counseling to elders were discussed in the context of how family members could contribute to their care. How can they access services? How can they get family and community support in terms of translation, transportation and navigation?
Dr. Fred Bemack, professor of Counseling and Development Program at George Mason University, said that he, Dr. Rita Chi-Ying Chung, Dr. David Anderson, Dr. Robert Weigl, Mr. Richard Spector and Dr. Nguyen Dinh Thang had designed a new module called STEP – Senior and Trauma Survivors Empowerment Program. STEP is a community-based program to help older Vietnamese adults and their families recover from postwar trauma and adapt to life in the United States. STEP provides resilience, hope, empowerment, friendship, dignity, value, and self-respect through a series of programs offering family support, peer support, and health and mental health promotion.
STEP is training volunteers from the Vietnamese community in a 9-month 3-tier program to be peer companions. These certified specialists, precursers to primary health care professionals, serve as ambassadors who identify depressed seniors. They reach out to them and their family members with friendly home visits and community support services. They don’t treat diseases, but help patients regain their self-confidence and self-esteem, then refer them to the right professionals.
Preventive health care and collaboration between health professionals and community organizations are the best healing processes. Dr. Salasin concluded that trauma was a public health issue and a top concern for mental health services. Therapy and peer trauma services such as STEP help survivors gain new energy and purpose from healing. Transfiguration, healing that flows from the self, is the most important force for recovery.
Several nutritionists also explained the dietary habits of the Vietnamese and how to eat in a healthy way and prevent disease. As the elderly are among the most vulnerable population in a situation of emergency, American Red Cross and FEMA representatives shared best practices on how each individual, family, and community could prepare for the next emergency.
Conference participants attended a banquet May 24 at Lucky Three restaurant in Falls Church, Virginia, to honor Cong. Chris Smith, who for the past ten years had campaigned for the resumption of the HO program, the protection of victims of human trafficking, the resettlement of Amerasians, and the promotion of human rights and religious freedom in Vietnam.
Other honorees included Deputy Assistant Secretary of State Kelly Ryan, who negotiated the resumption of the HO program with the Vietnamese government; Cong. Tom Davis, co-author of the McCain-Davis Amendment, which resettled the adult children of HO refugees; and Senator Frank Lautenberg, the author of the Lautenberg amendment, which established more generous refugee adjudication criteria for the HO and HR programs. BPSOS also honored Sen. Jim Webb, a former American officer, who had shown that he still cared for his allies.
To cap off the Conference, the Academy of Asian American Performing Arts in Virginia, choreagraphed by Asa Trinh and her troupe, took the audience back to the mythical birth of Vietnam, the Indochinese and Vietnam Wars, the exodus of North Vietnamese to the South in 1954, and the wave of boat people fleeing Vietnam in the aftermath of the Communist takeover. Accompanied by dramatic music, songs and dances, the story evoked the heroic sacrifices of the South Vietnamese and their American allies and the tough times Vietnamese refugees had endured to rebuild their lives. That musical odyssey took place at the George Mason University Center for the Arts.