April 26, 2000
For the ethnic Albanians who endured years of persecution and then war in their Kosovo homeland, rebuilding their lives requires more than just bricks and mortar. It requires nurturing the spirit, providing hope for the future and coming to terms with the horrors of the past, says Tulane's Leslie Snider, assistant professor of psychiatry and international health and development.
Snider helped to develop a program to accomplish these goals as project adviser of a psychosocial project to help Kosovar children and their families recover after the trauma of the recent war. The project, sponsored by the Christian Children's Fund (CCF), is based at local schools and provides education, information, material and emotional support to parents and teachers to help their children and foster their own recovery.
Snider spent four months in Kosovo last fall working with the program. The program focuses on helping civilians, who were 90 percent of the casualties in the war, she says. In contrast, only 5 percent of World War I casualties were civilians. Schools were an obvious place to start, says Snider, who directs the mental health and medical anthropology track in the international health and development department of the School of Public Health and Tropical Medicine.
During the previous 10 years of social and economic apartheid in the region, Serbs denied Kosovar Albanians access to education. The Albanians, in turn, set up their own parallel educational system, which they consider a source of pride and community spirit.
"They are very important institutions," Snider says. "They were one of the few institutions that were still running."
When Snider arrived in the country last September, she assembled a group of local professionals to serve as trainers in the schools. Headquartered in the central city of Prishtina, the group set up training programs in six schools in Prishtina, the western Kosovar city of Peja, and the rural town of Vushtrri. (Snider uses the Albanian, rather than Serbo-Croatian, spelling and pronunciation of these cities and towns. She also refers to the country with its Albanian name, Kosova.)
"What we wanted was a trainer in each school to help parents and teachers get mobilized," she says. "There were other organizations that provided counseling."
The trainers started their project by explaining normal responses to trauma in adults and children and strategies for coping. They also formed focus groups of parents and teachers, asking them what they needed to rebuild their schools and bring civilization back to their own lives and the lives of the area's children.
"We encouraged the parents and teachers to voice their own ideas for helping their children and tried to help them carry out those plans," Snider says. Sometimes the ideas were simple. In one school, the teachers described the awe in the eyes of one young boy as he entered their school's crumbling gymnasium. In his view, it was a beautiful structure.
"That struck everybody's heart," Snider says. "So they decided to paint the gymnasium and CCF provided the funds to help them do that."
At other times, the teachers' necessities were more immediate. At the school in the poor, rural town of Vushtrri, for example, teachers reported their students' greatest need was one slice of bread each day. "We thought this one over pretty hard," Snider says. "We linked up with an organization that provided food for a brief period of time and then helped the school's parents' council draw up plans for a bakery."
The bakery could serve as a self-sustaining enterprise that will eventually provide both nutritional and emotional sustenance, she says. "What's most needed for recovery is that people need to feel they are still effective," Snider says. Providing psychosocial services to war-ravaged communities is a fairly new endeavor, she adds.
The Christian Children's Fund plans to maintain its program for years to come and will evaluate the program's effectiveness throughout that period. Most humanitarian projects end after six months, Snider says.
"Humanitarian agencies know how to measure nutritional status or track diseases over time," she says. "But for psychosocial work, nobody really knows how to measure success. It's a matter of measuring spirit and recovery."
The measurements Snider helped develop include such qualitative techniques as focus groups that gauge how the themes of people's conversations change over time. The program also developed questionnaires for the teachers and parents with whom they worked to measure their emotional health and their feeling toward their progress in the workplace and the community.
Other, more quantitative measures include school attendance, grades, absenteeism, domestic violence, alcoholism and general health statistics. Above all, Snider says the program will try to measure the Albanian Kosovars' hope for the future.
"Hope is a really good measure of recovery," she says. Snider, who returned to Kosovo in March to visit the trainers and help analyze the program's data, says living in the war-torn region for four months and hearing horror stories from survivors has changed her life. "There are some stories you don't get out of your head," she says. "It changes the way you look at life."
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