The Center for Rehabilitation of Survivors of Acid and Burns Violence (CERESAV) is a non-government organization established in 2012 to address acid violence in Uganda. The organization was founded by Hanifa Nakiryowa, a Ugandan acid attack survivor. The organizations motto, ‘unveiling the scars’, embodies the idea that survivors should be able to live without shame or discrimination. I spoke with Dr. Angie Vredeveld, a clinical psychologist in Cincinnati who serves as the CERESAV Executive Coordinator. Within this role, she runs an online training program for CERESAV’s mental health counselors.
You had traveled to Rwanda, South Africa, and Uganda as a psychologist; did you experience something during your work in those countries that drew you specifically to the issue of acid and burns violence?
As a psychologist, I have always been interested in how the ‘average person’ can commit atrocities, whether genocide, war, or acid violence. I don’t believe in the idea of good and bad people. I think there are factors whether psychological, familial, economic, or political that moves a person in the direction of becoming a perpetrator of violence. Understanding those factors has always fascinated me, particularly when they occur in conditions of extreme poverty (defined by the World Bank as subsisting on less than $1.25 per day.)
I had heard about acid violence, but did not have any particular tie or investment in it. But in early 2014, I worked as a psychologist at a nongovernmental organization (NGO) in Uganda. The group I was working with said they wanted me to counsel an acid attack survivor who had not left her house in two years. At first, I thought something was lost in translation as it often was in Uganda. An acid attack survivor in Uganda? But sure enough, meeting the survivor, Christine, was an introduction to the reality that acid attacks do in fact happen in Uganda.
When I met Christine, one of her questions was, “Can you help get me pro bono surgery?” This surgery would not only help improve her appearance, but also correct some functional limitations caused by the acid attack (for example, frequent fluid collection in one of her eyes that had been badly burnt). Christine mentioned how her friend Hanifa, also an acid attack survivor, was able to obtain pro bono surgery. I told her I would try, but tried to keep her expectations low. Surgeries can cost hundreds of thousands of dollars, and I was just Angie from Cincinnati. I didn’t have any special access to anything.
When I got back to the U.S., I got in touch with my friend that I used to work with at the U.S. Department of Veteran Affairs (VA). He had served in the military and helped an Iraqi burn victim get pro bono surgery at Shriner’s Hospital here in Cincinnati. Being that Christine was too old to be treated at Shriner’s (she was 21 and Shriner’s works exclusively with children under the age of 18), we were directed to Grossman Burn Foundation in Los Angeles. On our first call with them, they agreed to provide the surgery, which was amazing. Now I had to help Christine travel to the U.S., which took almost a full year. I helped her through the process to get a passport, visa, letters from doctors, coordinating volunteers in Los Angeles, etc.
During this time, I was contacted by Christine’s friend Hanifa, who had thanked me for helping Christine. I learned that Hanifa had started an organization in Uganda to help acid attack survivors. She said it had a name: CERESAV and was registered as an organization in Uganda but was in its infancy. I asked how I could help, thinking maybe I would do a few trainings. A few months later, I found myself as the only American on the board of the organization! Although it has taken an enormous amount of time, I am so grateful to be part of CERESAV. I had been looking for a way to do international work and be involved in human rights advocacy while living and working in the US and this seemed like a wonderful opportunity.
What kind of training do you provide to the counselors involved with CERESAV?
I have so far provided three Skype training sessions on basic counseling or listening skills, trauma, and social skills training. I’m also part of an organization called the Global Psychosocial Network (GPN), an international team of psychologists who provide online therapy and training to people working in conflict zones around the world. Several of the other GPN members from across the country (and world; some of them are in Croatia!) have generously offered to help with this training. They will now pick up where I left off, doing onetime training of counselors. The topics will include substance abuse, domestic violence, and the psychology of facial disfigurement. In addition, the GPN psychologists will talk about vicarious trauma or secondary traumatization, which is a reaction counselors can develop when working with trauma survivors. Essentially, counselors can develop symptoms of post-traumatic stress disorder (PTSD) based on working with survivors and hearing trauma stories over and over.
I have not been to the Burns Unit at Mulago Hospital in Uganda where survivors are treated, but the counselors have told me that it is very depressing. The ward is understaffed and under-supplied. Victims are often without fresh drinking water and have limited food. The dressings are rarely changed, because there is not enough gauze, and infections develop. I’m told the ward has an almost overwhelming stench due to the infections.
You mentioned in a blog post on the website, thelifeyoucansave.org, about how when you were working in Uganda as a psychologist, there was an issue with people wanting financial help, rather than psychological help. Is this true as well with the acid burns victims the counselors in CERESAV treat?
I think that this is relevant to anyone in the mental health field working in impoverished settings. The good news is that I don’t have to prepare the CERESAV counselors for that. They already ‘get it’ far better than I do and are accustomed to working with survivors in more of a social work capacity. It’s harder for me, coming from the U.S., where all of my basic needs are met. I have to re-calibrate the way I think about things and remind myself that basic needs must be addressed before someone is prepared to engage in therapy. Survivors have to provide for their children feed them, get the money to send them to school. They have to try to find jobs, reestablish housing. All of these things take precedence over mental health treatment. Also, while burns victims are receiving initial treatment in the hospital it’s a fight for survival. It wouldn’t be appropriate or effective to start trauma therapy at that point.
Since there is only one facility in Uganda to treat acid burns victims, is there a lack of family relations and support due to distance for those who have traveled far for treatment?
Definitely. The main place where survivors get treatment is Mulago Hospital in Uganda’s capital city Kampala. Often these victims are traveling from far away, and transportation is difficult. While there are some other hospitals with the capacity to treat acid burns, most victims cannot afford the care at those facilities. Not to mention that there are times during the recovery process where even if families can make it to Mulago, they may not be able to see their loved ones due to risk of infection.
The GPN website lists that one of your goals is to provide the counselors involved with wifi, computers, and printers to help facilitate their training. How far along are you in achieving that goal?
Right now, CERESAV’s office administrator shares a computer and printer and has limited access to email and other online activities. We are in need of more computers. CERESAV has wifi now; however, the power goes out frequently in Uganda, which of course makes wifi impossible. You can be in the middle of a Skype call or training, and then the power goes out and the meeting ends. We are looking into the possibility of having solar powered generators installed on the CERESAV grounds so when the power goes out, we will have a personal supply from which to draw in order to continue Skype calls. One of our guiding principles is empowerment. We work hard to ensure that when people in the US or other parts of the world are donating, that the money or item is used to empower the survivors. Donating clothes, for instance, does not help their situation. But donating a smart phone can change the life of a survivor in very big ways. They can get email, join Facebook, join support groups for acid survivors online, access resources in their local communities, and look for opportunities for surgical sponsorships. In fact, that is how our founder Hanifa ended up getting two extended rounds of pro bono surgeries. She googled and applied to places, and was eventually accepted.
Do you have a large volunteer base here in the U.S., and are you currently looking for volunteers? How can they get involved with CERESAV?
We have a very small volunteer base in the US and in Cincinnati. We are definitely looking for more volunteers! Part of what we’ve tried to do is provide potential volunteers with practical ways in which they can get involved. We have an ongoing list of practical things that people can do, including calling tech companies in the area to request donations, calling medical supply companies to discuss donations of certain medications that are not available in Uganda, doing Skype interviews of the survivors for publication on our Facebook page, etc. We’re also trying to reach out to student organizations.
Given that my work as a psychologist often puts me in contact with others in the medical field, we have designated Cincinnati as a ‘health hub’. The idea is that Cincinnati will focus on supporting the growth of CERESAV’s health program. In Vancouver, there is a board member who is an attorney. He is in charge of CERESAV’s legal program. All of our branches deal with advocacy work. But in reality, Cincinnati has a variety of activities, some of which just depend on our volunteers’ areas of interest and expertise.
Is there any message you would like to give to our readers?
The most important thing that I have learned through this process is that each person the capacity to make a difference. Christine, who is still in Los Angeles getting treatment, often messages me little ‘thank you’s’ or other expressions of gratitude. She talks about growing in confidence and feeling more empowered. I’ve told her, “Well, you’re welcome, but thank YOU. Knowing you and being able to help you has really helped me believe in my ability to make a difference.” I think most people in Cincinnati and around the world are greatly affected when they hear about people in such dire need. I think they really do want to help but are so far personally removed from the situation that they don’t know where to start they feel helpless to do anything. So to me, it is not that people don’t care. It’s that people don’t know what to do. That’s why with CERESAV, we have tried to offer very practical ways of getting involved. It not only helps the organization on the ground in Uganda, but personally impacts people involved to feel more empowered and more confident in their ability to affect change.
- Those interested in volunteering or donating can contact Dr. Angie Vredeveld via email, email@example.com.
- Some of the Cincinnati volunteers for CERESAV are helping to organize a ‘tech drive’ from September 16 – October 3 at Pangaea on Ludlow Avenue. You can drop off an old laptop or smart phone, and one of the Ugandan board members will be here in Cincinnati in October, and will carry them back with her.
- You can also shop at Pangaea on Ludlow Avenue on September 30 and 10% of proceeds will go to CERESAV.
- CERESAV will be hosting a fundraiser at Rohs Street Café in Clifton on October 15.
To learn more about CERESAV, click here.
To learn more about GPN, click here.
Dr. Vredeveld’s bio.
Written by: Danielle Ott, GCWAC Data and Web Management Intern Fall 2015 & Undergraduate Student at Northern Kentucky University studying Criminal Justice and International Studies