Healing trauma in South Sudan through mental health programmes

 We define trauma as a wound. It is when something shocking or abnormal happens in your life, and it overwhelms you and you don't know how to respond," says Thor Riek, a 32-year-old South Sudanese.

South Sudan, the world's youngest country, achieved independence in 2011 after decades of fighting. The country has spent most of its short existence embroiled in conflict, after an internal armed struggle escalated into a civil war in December 2013 that continues until present day.

The civil war has displaced at least 4.5 million, or one in three, South Sudanese from their homes. Estimates of the death toll range from 50,000 civilians to as many as 383,000, according to a new report by the London School of Hygiene and Tropical Medicine.

The civil war has exacerbated a long-standing legacy of psychological distress and mental health issues left behind by decades of conflict.

While official national statistics on mental health are not available, different studies have shown that the conflict has had a severe effect on the mental wellness of civilians.

Almost 41 percent of 1,525 respondents showed symptoms consistent with post-traumatic stress disorder (PTSD) in a 2015 study carried out by the South Sudan Law Society (SSLS) and the United Nations Development Programme (UNDP).

Mental health resources are badly lacking in South Sudan, with as few as two practising psychiatrists available in the whole country as of 2016, according to Amnesty International. 

Many South Sudanese with psychological distress and trauma rely on workshops and programmes organised by NGOs such as USAID and World Vision, or a local church or community groups.

"Trauma that is not healed is transferred," says Thor, who grappled with trauma from his days as a child soldier in the 1990s. Now, he is a trainer for VISTAS (Viable Support to Transition and Stability), a programme funded by USAID, that holds workshops and initiatives to provide communities with practical tools to address trauma and the possibility of reconciliation. 

With the workshops, Thor hopes that it will help participants "to have a narrative that can move them forward from the cycle of violence and begin to walk on the healing journey."

We Shall Have Peace, the recent VR documentary produced by Al Jazeera’s Contrast media studio, explores South Sudan through the lens of trauma and healing. Watch how three South Sudanese are working for a better future by confronting their pasts.

Joseph, a teenager, takes part in the trauma awareness workshop. According to UNICEF, three quarters of South Sudanese children have known nothing but war, with as many as 19,000 of them recruited and associated with armed groups since the beginning of the civil war in 2013. Viktorija Mickute/Al Jazeera

Amid a lack of official government statistics and a persistent shortage of mental healthcare facilities in the country, experts believe that South Sudan’s conflict has been devastating to civilian mental health. Many who exhibit signs of depression or post-traumatic stress disorder (PTSD) remain untreated with little psychological support or mental care. Viktorija Mickute/Al Jazeera

Hayati hangs out in the church premises where her relatives are participating in a trauma awareness workshop. About three quarters of girls aged six to 11 are out of school in South Sudan and nearly half of the girls are married by the age of 18, according to UNICEF. Viktorija Mickute/Al Jazeera

'I was traumatised when my child passed away. She died inside my womb when she was seven months,' says Esther Namadi, 29, a participant in the Morning Star workshop who wants to work through her traumas and build a better life for herself. Viktorija Mickute/Al Jazeera

A close-up of one of the many photos in Esther’s album, showing her posing in a studio with her husband. Viktorija Mickute/Al Jazeera

Esther flips through her family album, filled with photos that are all taken in studios with a very distinctive style, using vibrant colours, sets and effects. Viktorija Mickute/Al Jazeera

A teenage boy in the Gurei neighbourhood of Juba builds small houses completely out of scratch from materials like cardboard to sell and give away. Viktorija Mickute/Al Jazeera

With a third of schools destroyed, occupied or closed since the beginning of the civil war, South Sudan holds the highest proportion of out-of-school children in the world at around two million children. The poor economic situation and continuing instability have left an estimated 1.1 million children under the age of five acutely malnourished and in need of life-saving aid in 2018. Viktorija Mickute/Al Jazeera

Taken as a child soldier at the age of 12, and a witness of decades of conflict, Thor is no stranger to trauma. After studying at the Kenya Methodist University, he returned to South Sudan and is now a master trainer for the Morning Star workshops, training other South Sudanese to identify and address their own trauma. Viktorija Mickute/Al Jazeera