Walaa Awwad, senior physiotherapist, CVT Jordan
How lucky you would be if you were able to make a living doing work that is in alignment with your values and your beliefs, where you have an opportunity to make a difference in people’s lives, where there is often no sharp distinction between your interests and passions and your job description. How happy you would be if you started your day knowing that you are part of something important.
I count myself very lucky working in CVT.
How is physiotherapy (PT) changing the life of torture/trauma survivors?
Trauma affects the body as much as it affects the mind, and those who suffer painful and harmful experiences share similar physical and emotional reactions. The focus areas in which torture survivors typically experience difficulties are chronic pain, bodily (psycho-physiological) reactions to the emotional trauma, sleep disturbances and functional limitations.
As a physiotherapist, my work in CVT is to facilitate the healing process of torture and trauma survivors. Our clients present with a wide range of musculoskeletal symptoms, some of which are a result of injury and damage and some symptoms which are more closely connected to their psychological health. It’s important that I guide them in making connections between their physical symptoms and psychological health, since we are not only addressing the physical scars but also the physical expressions of the emotional wound that cannot otherwise be seen. In our physiotherapy sessions, clients gain a clearer awareness of the body-mind connections and thereby are able to better understand how to reduce/cope with their pain.
We also help the client understand chronic pain, where there are several factors contributing to maintaining the pain: continuing emotional stress, poor sleep and a high degree of avoidance of activities and movements. Because pain can act as a reminder of the torture situation, many torture survivors try to avoid pain-provoking activities. This behavior may lead to physical deconditioning and further aggravation of pain, with a gradual social withdrawal and minimal involvement in activities of daily life. By helping the clients control their pain, we help them get back to their lives and their normal activities.
“It’s like meeting my body for the first time.”– A survivor of torture.
After developing our PT assessment measure, we were better able to see just how much the physiotherapy sessions helped the clients in so many different ways. We saw great results in our six-month follow up assessment.
We are not only helping the clients to physically function well during their daily activities. It’s more than that. We help them improve their social participation and functioning, where they become better able to leave their houses and visit their friends or relatives, becoming more connected to their families and friends. We also help them in their social interactions and activities and to be able to have positive relationships with people in their houses (their children, spouse or other people living with them). We also help them to be more able to participate in community events (such as meetings, weddings, religious events, sporting events), help them to be able to work, look for work or go to school. The coping strategies that we teach them help them cope now and in the future. Knowing specific techniques that help them to deal with their physical discomfort or pain helps them achieve their goals to improve their physical condition.
I will always remember one of my clients who had limited movement in her shoulder and who used to take three or four pain-killer pills daily. She was not able to carry any light weights or raise her arm above her shoulder, which affected her ability to perform her daily activities. This made her more isolated and depressed; she lost confidence in her role as a mother and became more dependent on other people. Once we finished the therapy, she was able to move her shoulder functionally again. She told me that physiotherapy did not only improve her function and help control her pain, but she said “It helped me to regain the trust in my body and myself. It improved my psychological situation for I have stopped taking my anti-depressant medications and my pain killer. It improved my social interaction because I am more active, more able to support my family. It helped in improving my relationship with my daughters who noticed how much I have changed and how I’m more able to support them now.”
I saw tears in her eyes when she expressed how happy she was when she carried her grandchild in her arms for the first time. She showed me pictures of her carrying him and playing with him.
And that has always been my motivation: the look of gratitude that sweeps across their faces.
How working with torture/trauma survivors changed me as a person.
Working with torture survivors is interesting, challenging and rewarding with a feeling that what we are doing is contributing to making the worlds of those clients a better place.
“We came to CVT, and we have a listening ear, a smile and a hand to guide us through the way. You treat us like humans again, and I thank you for that.’’ – A survivor of torture.
Hearing that from my clients makes me believe more in the work that I’m doing and in CVT’s mission of “Restoring Human Dignity.”
Our clients have taught me so many things. They taught me patience, kindness, gratitude, appreciation, understanding of life and humility. They show me how strong, courageous and resilient a human can be. They give me hope when I see how much they are holding on to their dreams and ambitions despite all the suffering, the loss, the struggles – how they are still smiling and believing that things will work out at the end, that things will change to the better soon. They taught me to continue to persist and persevere.
There are so many great books that I have read that encouraged me, inspired me and enriched my soul, books that gave me hope and changed me, but nothing has touched me and ignited my soul as much as hearing my clients’ stories of hope, surviving, strength and resilience, hearing their spoken words and seeing the unspoken in their eyes. I believe that the most powerful lesson I learned is the gift of seeing through the eyes of another.
They inspire me every day with how they are still fighting for better lives. I am grateful to have met these amazing people and for the experience and all the lessons I have derived from working with them. Working with them has changed my life in so many different ways. I think I’m a better person as a result.
Funding for CVT’s work in Jordan is provided by the United States Department of State’s Bureau of Population, Refugees and Migration and the United Nations Voluntary Fund for Victims of Torture.