Volunteer tourism: Help or Hurt?


[My trip diary will continue on Monday. But this blog presents a related topic.]

I heard a NPR news story about volunteer tourism and who it helps most (listen here). If you have gone on, heard about, or given to short-term missions projects, you likely have considered the question of whether it is really worth the expense. Are locals really being helped when huge amounts of cash must be used to fly and house outsiders on their trip. At times I have wavered. Should this 30,000 dollars be better used by giving it to local ministries and letting them hire local workers to do what outsiders might do.

Sometimes this is true. But there are a few things to consider:

1. The money probably wouldn’t be raised without sending the outsiders.

2. Having outsiders come and see provides much encouragement.

3. Developing world-minded outsiders (read Americans) can have significant and ongoing impact.

4. Some trips are better than others (as the news story suggests) in that giving goes to local ministries. On our recent trip we stayed at ministry guesthouses which support those ministries and provide jobs to local people. We paid small businesses for services whenever possible.

No doubt some trips are harmful, especially when they promise but do not deliver or continue to support imbalance of power. But many trips do significant benefit for all involved.

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GTRI 2014: Day 4


July 4. Transit day.

Today is a transit day. Breakfast of hardboiled egg, bread, and coffee. Talked with Klero of South Sudan. Discussed ideas of how to bring GTRI courses/materials and other counseling training to local areas here in Uganda and in S. Sudan. While Juba has great Internet per Klero, most people there do not have access to it. The same is true here in Uganda. I am very interested in finding a way to bring this training (videos, readings, exercises) to this region without it being in an online format as it is right now. Seems the areas of greatest interest are basic helping skills, trauma healing from the Bible Society, deeper understanding of impact of trauma and expression of PTSD across cultures, and exposure to psychopathology. My goal would be to give this material away and offer live conferencing sessions to the training mentor as needed. Then, possibly follow-up with a visit to “t0p-up” as Harriet Hill is fond of saying.

Anyone want to fund that or help me figure out how to get others to do so? (Smile)

After breakfast we made our way to a nearby Catholic college to talk with Sister Bokiambo and the dean of the counseling department, Fr Evarist Gabosya Ankwasiize. They were interested in future opportunities with shared learning (my bringing students here to engage and interact with their students and participate in joint training). I left with new ideas for this location (on the shorts of Victoria) and with the encouragement that the Bible Society might be able to begin some seminars here to improve the dialogue between Scripture engaged trauma care and traditional mental health trauma care.

After a lunch of fried fish on the shorts of Victoria, I said my good-byes to Justus and Esther at Entebbe airport. The added security was quite evident (3 bag checks and 3 metal detectors before boarding) but there were no problems. The flight to Kigali was under 1 hour on a very new Rwandair airplane. Just enough time for a Passion fruit drink from the steward. Arrived to significant upgrades to the airport.

Arrived at Solace Ministries Guesthouse, our usual haunts since 2011. Solace isn’t hotel level but I love it for many reasons: Simeon’s great cooking (he makes fantastic vegetable soups and dessert of fresh tropical fruit and ice cream tonight), my money goes to a ministry and not a behemoth corporation, the water is hot, the rooms are clean, and it is centrally located. Seems Internet is a bit upgraded since I was able to SKYPE with Kim and boys.  [For a 2012 video of Solace Guesthouse, see here.]

I arrived here after the major July 4 celebrations today. Today marks the end of the 100 day mourning period and celebrates the liberation of Kigali. This is the 20th anniversary. A number of fireworks were shot off tonight, which I was told later triggered some local people into thinking the city was under attack.

Tomorrow, Lord willing, the rest of the team will arrive from the US and other points and our GTRI immersion trip will begin in earnest.

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GTRI 2014 Trip: Day 3


[These are journal entries from my recent trip To Uganda and Rwanda during the first weeks of July.]

Day 3, July 3

Today was the 2nd and final day of the first ever Community of Practice for the Bible Society of Uganda trauma healing volunteers. Another long day as the program did not end until about 7 pm! Today I presented on an overview and update on the impact and treatment of PTSD. This is a group that likes to ask questions! We discussed the role of demonic in PTSD and how to know the difference. Many of the participants were quite interested in discussing how to educate local pastors in understanding the nature of dissociation. I also participated in teaching the new lesson (added chapter to Healing The Wounds of Trauma material) on domestic violence. In discussing why victims “choose” to stay in DV situations we had some lively discussion about whether the Bible teaches that women must stay. Very productive I think and gave some people a new perspective on the need to bring this hidden scourge out into the light.

The conference ended with reports, public conference evaluations (loved the very direct and loving evaluation of my presentations: have me speak more, have me slow down!), the handing out of the certificates, and final words. One of the most moving items was that I received “thank yous” in every mother tongue present. Seemed like there were at least 30 different languages represented. It was hard not to be choked up. I recognized a few (Arabic, Swahili, Kinyarwandan).

Two take-aways I want to remember:

  1. We need special materials for ex-combatants. First, much of the focus in Uganda has been on child soldiers. But the country is full of adult ex-combatants who were in Amin’s military or subsequent militaries and who now feel disconnected and distanced from current society. Some report that if they get together for sharing with other ex-combatants, they get reported (falsely) for starting a rebel group. One reported being jailed briefly for such a matter. Several told me that they were suffering terribly from being in POW camps and from the violence they witnessed. But most importantly, they noted that much of the trauma healing materials only speak of soldiers as the cause of trauma and so they feel more isolated when they read about or attend trauma healing exercises. No one, they feel, speaks of the trauma of seeing comrades die, of being forced to carry out commands against their will.
  2. Trauma healing volunteers, financing, and the need for View from my roomtangibles. Some of the volunteers believe that they must bring tangibles when coming to do trauma healing work. Words are not enough and participants expect some sort of handout: soap, money for transport, etc. The discussion we had about this ranged from criticism of this part of Ugandan culture and the need to develop a donor rather than handout culture to recognition that this culture has been formed, in part, by well-meaning foreign (Muzungu) NGOs that offer handouts as a means to increase participation in projects. Some volunteers noted they had been falsely accused of pocketing monies intended for participants when they didn’t come with any “gifts.” In addition, many discussed the difficulty of funding the trauma healing groups and the need to find sustainable funding using micro-enterprise.

My day had three other stimulating experiences. First, I was interviewed by a journalist for television broadcast. Supposedly, it aired across the nation this evening, though I did not see it. Second, a woman told me of meeting Joseph Kony about 4 years ago (during the failed attempt to negotiate with him). She said that he was very winsome and crafty. If she didn’t know better, she could have fallen for his lines. I guess this is one of the reasons he is able to stay “missing” by convincing others to help hide him. Finally, I received a text from my wife letting me know that the US government warned of a terror plot at Entebbe airport tonight (about 10 miles from here). I’m planning on being there tomorrow to fly to Kigali. I guess I will evaluate the treat in the am.

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Filed under Africa, counseling skills, Post-Traumatic Stress Disorder

GTRI 2014 Trip: Day 1 and 2


unnamed[I've been back for a couple of weeks but just now getting to write about this trip. These notes from each day come from my journal and don't represent all that I did each day.]

Today (July 1), I landed midday at Entebbe airport just outside Kampala, Uganda. Entebbe is on the shores of Lake Victoria. I was met by Justus Rubarema of the Bible Society of Uganda as well as Klero Onuha of the Bible Society of South Sudan. Both men worth getting to know! We waited a bit for Margaret Hill’s plane arriving from Nairobi. Once gathered, we made for the Lweza Conference Centre about half way to the city of Kampala. Lovely grounds. Peaceful. Enjoyed the little monkeys eating flowers and looking for handouts (I had none).

I arrived at this conference (Community of Practice for Trauma Healing practitioners trained by the Bible Society) feeling fairly awake despite 26 hours of travel time. It may have helped a bit that I was unexpectedly bumped to business class on Qatar Airways from Philadelphia to Doha (a 13 hour leg). I suspect the lay flat seats had something to do with my feeling pretty good. Feeling good, I invited Margaret to go on a small walk around the area and on a quiet road outside the compound. Discussed some of her techniques to help quiet distress in participants where violence and trauma was ongoing (e.g., Bangui, CAR). We discussed the use of the “butterfly hug” as a means to calm. Also, discussed the use of drawing a place “bien etre” rather than a “safe place” since most participants she had did not have such a safe place at the present time. We finished our discussion of how to safeguard the mis-use of these calming techniques so that they would not be mis-represented as being more than they are, techniques used to help someone in the midst of distress.

Ended our day with a meal of rice, bananas, potatoes and chicken. Off to bed in hopes of getting on the right time zone quickly.

Day 2

First full day of the conference (and FULL it was, 8am to 6:30pm). Attendees are all Ugandan plus Klero from South Sudan. Most are volunteers for the Bible Society, trained to provide healing groups using the Healing Wounds of Trauma materials. Some work with children, some with adults, some with ex-combatants, some with refugees, and some with women with HIV. The purpose of this conference is to add to their knowledge and skill base plus problem-solve as to how to provide more trauma healing experiences around the country—with almost no budget. Most of the country is well-represented including a number from Gulu and also the Nakivale refugee camp. More men than women. A couple of academic types are also present, representing both the Ugandan Counseling Association and the Ugandan Christian Counseling Association. Plus, one nun representing the faculty of a nearby Catholic college.

I presented on an update to listening skills which seemed well-received. This group is very willing to discuss, raise questions, and debate. I like it! It was requested that I offer some counseling sessions after dinner and so I did. Two men requested it and so I got a chance to hear about their ministries, their hearts, and their difficult struggles, both from the past and in the present. One of the things I am seeing here is that Ugandans need the wisdom of Solomon, the heart of David, and the integrity of Daniel, even when trying to deal with so-called Christian bosses. One fun fact is that the power went out right in the middle of one of the sessions. No problem. We could keep talking in pitch-dark! But by the time I fumbled with lighting a nearby candle, a generator kicked on and power was restored.

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Piercing Words From Cry, The Beloved Country


Just returned from 2 weeks in Uganda and Rwanda (more on that in subsequent posts). During interminable transit time to and from Kigali I read Alan Paton’s “Cry, The Beloved Country.” Missed reading that as a student and after last year’s trip to South Africa, I needed to read it. Without giving away too much of the story, one of the characters in the book is going through his son’s papers after his murder. His son had been an activist against the then mistreatment of Black Africans in South Africa. One of the papers said this:

The truth is that our Christian civilization is riddled through and through with dilemma. We believe in the brother of man, but we do not want it in South Africa. We believe that God endows men with diverse gifts, and that human life depends for its fullness on their employment and enjoyment, but we are afraid to explore this belief too deeply. We believe in help for the underdog, but we want him to say under. And we are therefore compelled, in order to preserve our belief that we are Christian, to ascribe to Almighty God, Creator of Heaven and Earth, our own human intentions, and to say that because he created white and black, He gives the Divine Approval to any human action that is designed to keep black men from advancement.

The truth is that our civilization is not Christian; it is a tragic compound of great ideal and fearful practice, of high assurance and desperate anxiety, of loving charity and fearful clutching of possessions. (p. 187-8)

This quote struck me so not because of the focus on Black/White relations but because it also fits other ways we struggle to respond to the “underdog.” We want to feel pity but rarely do we want to give up the power to enable the underdog to be one of us. For “other” to be one of us, we would have to cede power and that creates anxiety.

If you haven’t read the book for a while or never did, I commend it to you.

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July 16, 2014 · 4:26 pm

Military trauma and traumatic brain injury: Challenges and Opportunities


Colleague and veteran Steve Smith has let me know about this web article regarding the state of PTSD/TBI injury among active duty military personnel. The essay points to some very startling numbers:

  • 59% report no improvement or worsened symptoms after undergoing treatment for PTSD and TBI
  • 30% dropped out before treatment was complete
  • A large portion of patients are on up to 10 meds at a time

The news item goes on to summarize presentations made a few days ago at the American Legion symposium on care for TBI and PTSD veterans. What makes this worth reading is that the actual slides from the presentations are provided in links at the end of the piece. I encourage you to go and read up. You can see what is being done using complementary treatments, the numbers of veterans with head injuries (interestingly, 80% are NOT received during combat) and/or PTSD, what services are available and what recommendations are made to DoD and the VA system to improve patient care.

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Filed under Post-Traumatic Stress Disorder, Psychology, ptsd, trauma

What is your response to graduation?


Tomorrow marks the end of the road for students of the 8th cohort of our MA counseling program here at Biblical. After two years of hard labor, er studying and practice, they are now set free to do other things like read for pleasure or hang with family on Monday nights. Of course, some will transition to a few final online licensure courses and others will continue to accrue supervised hours to meet licensure requirements, but the intensity of learning and the cohort life will not be the same.

In thinking about my own graduation from a cohort some 15 years ago, I remember the strange feeling of having arrived at the finish line with an empty feeling. I think that feeling came from the fact that I still had a ways to go to get licensed and to land a job.

Or maybe we put too much expectation on the acquisition of a goal, on our accomplishments. Degrees, jobs, houses, marriages, children–all good things–do not provide lasting changes in our outlook on life, our level of happiness, our perception of self. Sure, these things do provide opportunities for re-evaluation of self, the world, values, etc. But they do not exert changes. You can find people with many degrees, titles, things, who are still searching for an elusive sigh of relief, of arrival at some new constant state.

Is there a better response to graduation?

Instead of only looking for arrival or to the future, what if we use this time to see what God has done in our lives over the last two years? Like climbing a mountain, you get time at the top to stop and look out and back to see how far you travelled. During the climb your head is down trying to avoid tripping over rocks or roots. On the journey, you had to keep a steady pace for fear of quitting. But at the top you can stop and ponder. The time doesn’t last long since you will need to climb down soon. But before you go, take a look at the things God has enabled you to do. You weathered losses, had many ah-ha moments, developed courage to try rather scary things, had to admit weakness, received unexpected support, were sustained and able finish tasks that you thought unnecessary.

If you have just reached a goal like a graduation, take a minute to write down what diificulties you survived and what unexpected blessings you experienced. Look back and then write it down. Otherwise, you may forget as you climb back down the mountain.

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My next two weeks in East Africa


Starting Monday I will be off traveling to Kampala, Uganda and then on to Rwanda for Global Trauma Recovery Institute. I welcome your prayers for myself, my students, and the attendees. In addition, Diane Langberg and myself will be leading a group of 12 Americans (10 GTRI students) on a listening/dialogue immersion trip throughout Rwanda. Some of the highlights of our trip(s) will include,

  • 2 day trauma healing community of practice in Kampala with the Bible Society of Uganda
  • 3 day trauma healing community of practice in Rwanda with the Bible Society of Rwanda
  • Afternoon mini-conference with pastors in Southern Province, Rwanda
  • Day with the newly forming Association of Christian counselors in Rwanda
  • Visits to NGOs working with trauma victims and street children
  • Church services
  • Visits to genocide memorials
  • Visit to a refugee camp
  • Numerous conversations, formal and informal over the next two weeks

I will make some attempts to update all on my trip as I go. You can follow me here and @PhilipGMonroe or @BTSCounseling. If you are interested in seeing more about the GTRI engagement model, check out this short video. And, if you would like BTS to continue doing this kind of missional work, feel free to go here and donate before the end of our fiscal year, June 30.

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Filed under Biblical Seminary, christian counseling, christian psychology, counseling skills, Diane Langberg, genocide, Rwanda, trauma, Uncategorized

Some thoughts on international trauma training


In just a few days I will be off to Uganda and then on to Rwanda to do some training with trauma healing workers in both country’s bible societies. In addition, a group of students from our Global Trauma Recovery Institute will join me in Rwanda to learn more about how to help without hurting. In light of this trip, I penned a few thoughts for those who have a heart to do something about the massive trauma needs around the world. Here’s a preview:

Trauma is a hot topic these days. We live in a world where we are aware of terrible traumas happening around the globe in real time. We hear and see tsunamis unfolding, towns being flooded when dikes are breached, mass shootings, bodies strewn about due to ethnic conflict, houses destroyed by errant bombs, and gender violence in almost every corner of the world. While humanitarian efforts to respond to the physical needs of those in trouble are not new, there is a recent push to have charity workers become “trauma informed” so they can also address spiritual and psychological distress.

Trauma is a hot topic not just because we have more evidence of it happening in real time. It is hot because we have better information about the impact of violence and abuse on the human brain, on human interactions, and on the fabric of a society (Mollica, 2006).

Christian counselors, many of whom want to provide cups of cold water to the hurting masses, undoubtedly wish to use their skills to bring hope, healing and recovery to traumatized peoples around the world. But just where should they start?

You can read the rest of my thoughts over at our faculty blog site.

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Filed under "phil monroe", Abuse, Biblical Seminary, Post-Traumatic Stress Disorder, Rwanda, trauma

Lies and stereotypes told by helpers hurt the cause of trauma recovery


I’ve written a piece over at the faculty blog on the shady side of bending the truth to get more attention on the problem of trauma and the need for trauma recovery. It is a common temptation for those of us who work with trauma victims, a temptation to use the stories of trauma to garner personal acclaim (“look what I am doing about the problems in the world”) and to stereotype to increase attention and funding for those who are hurting. Shaping the truth hurts the cause and hurts the victims.

Read at the above link for more.

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Filed under Abuse, deception, Post-Traumatic Stress Disorder