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Ex-Khmer Rouge get help for nightmares

Ex-Khmer Rouge get help for nightmares

M any former Khmer Rouge soldiers share the traumas of their victims. Fifteen are now in therapy learning how to deal with their histories.

Lo Sim, who is 47, can no longer strike a match. The mere smell of burned sulfur makes her hands tremble and her heart race, as it takes her back to a past she would rather forget. This frail woman was once a Khmer Rouge soldier fighting on the front-line. Today she is a wife and mother of two who needs help to light the kitchen-fire.

"I'll ask one of my children to strike the matches," Lo Sim whispers. "The smell makes me hurt-it is just like gunpowder."

Along with 14 other former Khmer Rouge soldiers living in Kandal province outside Phnom Penh, Lo Sim has been diagnosed as severely traumatized and in need of professional help to overcome the horrors of the past. All 15 are now taking part in a pilot project aimed at helping them cope with their traumas and learning how to function normally again.

The project is a joint venture by the Documentation Center of Cambodia (DC-Cam) and the Transcultural Psycho-social Organisation (TPO). DC-Cam is an independent center that has interviewed more than 40,000 former Khmer Rouge soldiers in order to collect evidence against the regime. TPO is the local branch of a Dutch NGO that carries out a variety of community mental health programs.

The participants in the pilot project were initially identified by DC-Cam researchers as mentally unstable, and later diagnosed by TPO's doctors as suffering from complex post-traumatic stress disorder.

"They are troubled people," says Dr Chhim Sotheara, a psychiatrist and the director of TPO. "They may be former soldiers but they are victims too."

The doctor explains that, just like the civilian survivors of the Khmer Rouge regime, many of the former soldiers are haunted day and night by the past. Some are psychotic, while others are depressed. Most are extremely traumatized. They share the nightmares and anxieties of their victims, but on top of that, many feel guilty about their deeds and are fearful of revenge.

For more than two decades the former soldiers in the project have struggled to overcome the past, but it still afflicts their everyday lives. One participant gets scared every year when the rainy season sets in. Years ago he was wounded in battle, and ended up lying in the pouring rain for seven days, unable to move.

Another faints from anxiety when he spots someone wearing the dusty green color of an enemy army uniform. And Lo Sim, who used to help carry the dead and injured away from the front-line in a hammock, today turns cold and panics at the sight of blood.

The process of bringing them back to a normal and peaceful life began in late January 2003, when a group of three TPO therapists started weekly home visits to the 15 former soldiers. They provide their clients with medicines, counseling and different techniques to help control emotions like anger and anxiety. To compensate for time away from work, the attendees get a small sum of cash for each session.

"It may seem a bit upside down, but many traumatized people don't realize that they have a mental problem," says Dr Chhim. "Therefore we have to go out to them, and we have to pay them for it."

He explains that the concept of therapy is unusual for Cambodians, who are not used to sharing their thoughts and feelings. In the beginning, the process often makes them feel uncomfortable and they find it hard to believe it will do any good.

"Now I feel helped," says 46-year-old Mey Chan, assuring the visiting therapist who wants to know how she is doing. "My thoughts have calmed down. I don't feel so afraid and I stopped having nightmares. I feel happy to be talking."

The two are sitting on the uneven floor of Mey Chan's modest bamboo hut surrounded by big-eyed children, neighbors and barking dogs. They are openly discussing her sudden attacks of anxiety, anger with the Khmer Rouge, economic worries and personal health issues. Mey Chan does not seem to mind the spectators, but Dr Chhim later confides that he would rather conduct the therapy sessions in private.

As the therapists take their place in the clients' homes, it is normal to have a crowd of seven to ten family members or neighbors listening in-they are curious, but also want to show their support. That makes it difficult to send them away, even though their presence can disturb discussion of sensitive issues.

Dr Chhim says the therapists' efforts to date have been aiming at building trust rather than revealing to the light every dark and well-kept secret from the past. Most of the former soldiers are terrified to confront their memories, while others are in denial. But the therapists have kept trying to get them to talk openly about what happened during the years of fighting in order to get the anxieties, guilt and anger out of their system, or at least under control.

Asked how he feels about helping the soldiers who took part in inflicting pain and suffering upon others, Dr Chhim falls silent for a moment.

"It's a difficult question," he says slowly. "As a doctor, I am obliged to help anyone in need and not to differentiate between an enemy and a friend. If I hadn't been a doctor ... I don't know.

"I too suffered during the Khmer Rouge," he says without elaborating. Then he points out that the former soldiers are not the only ones benefiting from the therapy-their families and children are also helped.

DC-Cam's director, Youk Chhang, agrees with Dr Chhim's assessment, and adds another benefit of the therapy to the list.

"The former Khmer Rouge are human beings and part of our society. They deserve the same treatment as everyone else," says Youk. "Besides, if their wound inside is mended, they will be able to speak more open, free and true. They all have important stories to tell."

Even though the pace is slow, many stories have already been told and progress made since the project started five months ago. As a psychiatrist, Dr Chhim sees big improvements in his clients' well-being. But others without his professional qualifications have also noticed important changes.

The neighbors of 41-year-old Sroun Srien have had trouble sleeping for 23 years. Ever since the Vietnamese drove the Khmer Rouge from power in 1979 and the then 18-year-old returned to his family, Srien has been sitting in front of the stilted house, howling and cursing his parents.

Srien left home at 13, eager to fight for the revolution. He returned five years later, lost in a deep psychosis. In January he was put on antipsychotic medicine and immediately calmed down.

He still has a long way to go before he can function normally again, but the medication has at least stopped his night-time screaming and scolding. That has allowed his family and neighbors to sleep in peace for the first time in two decades.

Dr Chhim believes that there are many Cambodians in need of such help. But assistance for most is unreachable, as there are only 20 psychiatrists in the country, and no hospital beds reserved for psychiatric patients.

A group of local doctors and psychology graduates have been trained to deal with psychiatric patients, but, says Dr Chhim, it is far from enough-there is a desperate need for more professionals.

The therapy sessions with the 15 former Khmer Rouge soldiers are scheduled to stop at the end of the year, when funding from the Netherlands ceases. But Dr Chhim hopes he can find a way to continue the program, and include more former soldiers who need help.

And if further funding cannot be found, he is happy simply to have helped these 15. He says they will be encouraged to come to TPO's office in Phnom Penh for future support, which he believes they will probably need.

"There is no quick cure to deep wounds like these," he says. "Healing is a long process, perhaps taking longer than a lifetime."

That is a long time to wait for Lo Sim, who struggles constantly to control herself and avoid triggering her anxieties.

"I want to forget but I can't. The memories will always be there. I feel bad and guilty when I think about how we were fighting and killing each other back then. Why did we do that?" she pleads with her therapist.

He has no answer, and instead asks her how she feels when thinking about the past.

"I think I am going to cry," says Lo Sim, lowering her head as her eyes fill with tears. "Talking about it almost kills me inside."

- Hanne Molby Henriksen is a Danish freelance journalist.


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