Between two worlds: DL woman travels to Rwanda to explore mental health issues
Five years ago, school counselor Julie Smith was visited by a 15-year-old girl who told her she had been raped.
The girl was looking for help; she needed help.
Smith did everything she could. She counseled the girl and tried to set her up with the proper mental health services. But she discovered barriers within the system. There was a lot of paperwork, and things took a long time. The girl was a Native American student living on the White Earth Reservation, and the legal processes involved in the wake of her rape were frightening and foreign to her.
Six weeks later, the girl committed suicide. It was a tragic ending to a tragic situation. And it was a turning point for Smith.
"She basically fell through the cracks," Smith recalled during a recent interview. "I felt like, if the people that were supposed to be getting the paperwork done had understood how things worked on the reservation and acted in a culturally appropriate way — knocking on the door and having a cup of coffee, say — things could have been different."
"At her funeral, I made a commitment to do whatever I could to help people on the reservation," Smith added. "It hit me personally and professionally. You freeze and you think, 'I have to do something different.'"
So she did, and she didn't waste any time. Smith enrolled in a PhD program at North Dakota State University. She made it her mission to create an understanding of Native culture within the mental health profession, with the hope that it would lead to more effective mental health care for Native Americans.
Born and raised on White Earth Reservation, Smith had always wanted to give something back to her community. Now, she felt, she had discovered a way to do that.
Smith's ideas about cultural immersion within the field of mental health were quickly embraced by her academic and professional peers. She soon found herself in Washington, D.C. as part of a minority fellowship program, talking to a leader of the National Board for Certified Counselors-International (NBCC-I). She learned that some countries outside of the U.S. already have established programs in place that encourage mental health workers to immerse themselves in other cultures—exactly the kind of thing she wanted to see happening back home. She started working with NBCC-I to develop a similar program for the reservation here.
"I gave them an overview of what counselors would do if they came to White Earth — eat some fry bread, go to church...," she said. "And we decided to create the first domestic institute on White Earth."
Since then, Smith has been working with mental health professionals at home and abroad to address the significance of "cultural humility," or, put more simply, making a conscious effort to truly walk in someone else's shoes. In her travels and presentations, she often talks about traditional Native American healing mechanisms and how they can be incorporated into mental health treatments. She also takes what she learns from others and, when appropriate, incorporates it into her work back home as a mental health professional at Lakes Crisis and Resource Center in Detroit Lakes.
Her most recent trip was to Rwanda, Africa, where she was part of a program aimed at improving mental health care access and quality in remote areas of the country. Offered through NBCC-I, the University of Rwanda Center for Mental Health, and the Global Engagement Institute, the program ran from Nov. 1 to 15.
Smith's role was twofold: first, as a mental health facilitator for the program, she trained other mental health professionals to become facilitators themselves and also supervised Rwandan psychologists as they trained local community members in counseling skills; after that, she visited remote tribal villages to work with female survivors of the Rwandan genocide.
Her goals were to share her professional and cultural knowledge with others in the program, as well as soak up all she could about Rwandan culture and contribute to the country's developing mental health care system. She also went intending to bring her experiences back home with her, to share what she'd learned with the Detroit Lakes community and start incorporating the principles of the program into her practice here.
"We were creating 'tiers of safety' there," she said, "so my vision coming back is that, instead of being inside these four walls doing individual therapy, I can be a mental health resource doing training out in the community."
She'd like to start visiting Detroit Lakes area businesses, for example, to raise awareness of mental health issues such as suicide. And she wants to work with local helping agencies and organizations to develop a common language and better connect people in distress with the resources that will help them best.
"We need to develop a systematic approach to mental health in our own community," she said. "We need to bridge gaps. There are so many great little pillars of help out in our community, so it's about being that linkage."
"Knowledge is power," she added, "so if we can spread that in our community, I think it would be beneficial."
Training mental health workers to become leaders in their field and local communities was a meaningful experience for Smith. Bringing together a diverse group of people and playing a part in their professional journeys was "amazing and rewarding," she said.
And spending some intimate time with Rwandan women, becoming immersed in Rwandan culture, made a deep and lasting impression on her.
Every day for about a week, Smith met with a group of 50 women, educating and empowering them on issues of mental health. Through an interpreter, she talked with them about stress management, listening and coping skills, PTSD (Post-Traumatic Stress Disorder) and other topics relevant to survivors of rape and genocide. She played her hand drum for them, and they sang songs for her. She wore traditional tribal garb.
"It was wonderful," she said. "I didn't think I would feel as at home as I did in those remote tribal communities, but I felt very connected to the women."
Smith said her days in the villages "was just a really good time"—a little unexpected, maybe, given the nature of her visits and the most prevalent topic on everybody's tongues, the genocide. A brutal and horrific event, the genocide could have easily bred a culture of fear and anger amongst the survivors. But instead, Smith found, Rwandans are focused on forgiveness.
"Survivors believe that calling the people who killed their families animals makes them as bad as they are," Smith explained. "After they (the killers) serve some time, they are often forgiven by the families and live and work next to them. That's helped the country develop. They're united. There's no division; they're one... You could feel the kindness on the roads of Rwanda."
She said the nation's people are an example of "the epitome of forgiveness," and they showed her the power of collective healing.
"So many of us find it hard to forgive others," she said. "I think of the word forgiveness differently since coming back. I saw another depth of forgiveness, and the beauty, collaboration and kindness, generosity and gratitude that comes from that."
There are profound life lessons coming out of Rwanda that could easily be applied elsewhere, Smith said. Wherever there is conflict, or wherever remnants of past conflicts remain, there is always the option to forgive rather than continue toxic cycles of anger and violence.
"We can use our pain as weapons or tools, the choice is ours," she said. "Division creates hate; unity creates love."
Smith drew parallels between her experience in Rwanda and her day-to-day life back home. Making the physical and mental switch from her trainings at the University of Rwanda to her real-world sessions with the Rwandan village women reminded her of the "two worlds" she walks between in Minnesota—that of her academic and professional life in Detroit Lakes, and her roots and family on White Earth Reservation.
"I work at Lakes Crisis and Resource Center and live in Detroit Lakes, but I grew up on the reservation," she said. "I walk in two worlds. I'm working on a PhD but my real teachings come from my elders. In Rwanda, it was similar—academic teachings versus real life teachings in the villages. I was walking in two worlds there, too."
Smith plans to bring what she learned in Rwanda home, for the benefit of not just crisis center clients, but the community as a whole.
"I don't want to be selfish with my experience over there; I want to bottle that up and give back, to create something in our community that is going to replicate community healing and filling cultural gaps," she said. "Whether those gaps are economical, or whatever.... We need to wrap around our arms around the women here and help them, not just when they're here (at Lakes Crisis and Resource Center), but when they leave here."
The Rwandan Genocide
A brutal mass slaughter of the minority Tutsi ethnic group, the Rwandan genocide claimed the lives of an estimated 500,000-1,000,000 Tutsis and their sympathizers within a 100-day span in the spring and summer of 1994.
The ruling Hutu majority and a rebel front of Tutsis had been engaged in a civil war since 1990, creating tensions between the two ethnic groups and fueling a spate of fear- and hate-based anti-Tutsi rhetoric and propaganda. Backed by the Hutu government and spread through government-approved channels, the propaganda fueled the fires of conservative Hutu extremists.
In April of 1994, the Hutu leader was assassinated (it's still unknown whether rebel Tutsis or extremist Hutus were responsible). In the ensuing chaos, mobs of extremist Hutus formed anti-Tutsi militias, and their rage exploded into violence. The genocide began almost immediately.
The killings were horrific, and no Tutsi or moderate Hutu who crossed paths with a militia was likely to be spared. Men were the most common and immediate targets, but as the violence spiraled, women and children were also at risk.
Machetes were the preferred weapon of the militias, and beheadings and hackings were common. In some cases, Tutsis watched helplessly as their family members and other loved ones were killed, sometimes at the hands of Hutus they once considered their friends, neighbors or colleagues.
Today, almost 25 years later, Rwanda is still dealing with the aftershocks of the genocide: Some 500,000 women were raped, causing a spike in HIV infection, including in babies born to the victims. Households are often headed by widows or orphaned children. Survivors commonly suffer from PTSD and related disorders. And the economy is still recovering from the severe depopulation and destruction.
The genocide ended when rebel Tutsis managed to gain control of the country, and the new ruling population made a conscious, collective decision to stop the cycle of violence and not seek hostile retaliation against the Hutus.
The Rwanda of today is focused on forgiveness: its people are moving forward as one to put the pieces of their country back together and rebuild their lives.