Sunday, September 30, 2012

A Survivor Speaks: Peace Corps Volunteer Raped in Peru

The following piece has been written by a currently-serving Peace Corps Volunteer.  Mary Kate is a survivor of sexual violence.  The incident happened during her service.  The following was written by Mary Kate as a way to process and heal from the incident.  We applaud her courage and tenacity.  She also offers some solutions to issues that survivors face if they remain in-country.

TRIGGER WARNING - Please be aware that some of what Mary Kate writes may be triggering.  Please read with caution.

If you are a survivor and would like to submit your story for posting on this blog, please email Casey at firstresponseaction@gmail.com.




August 17th 2011 marked the day I officially swore in as a Peace Corps Volunteer in Peru. Now almost a year into my service has forced me to reflect on what this year has been like for me. Truth is I am not a normal PCV. 1 month into my service I was raped. It felt like such a normal day but it was my own September 11th. I had spent the morning running errands doing session planning; I was not supposed to do a lot of things that day. I had called the PCMO that morning because my leg had swollen up because of mosquito bites and the PCMO told me I should stay home. I however had classes and meeting plans and was determined to prove myself to my new community.
I left the café after I was done with my planning said goodbye to a fellow PCV without knowing that moments later my world would be changed. I got into a motto taxi and a few minutes later I found myself fighting for my life. I was in a horrible lonely trash dump not far from a prison and my pleas were being ignored. I thought I would die, the more I fought the stronger his grasps got and I stared at the far off sand dunes praying that this would not be it, that this would not be the last thing I saw.
After I escaped I no longer had the normal concerns of a PC. I sat in the police station worried about what this meant for my service, for me, how would I tell my family? There are not many things that I remember about that day. But I sat in the police station telling PC and telling the police every detail of my attack, I remember it being the 3 most difficult and exhausting days of my life. I would have to go back to the scene of the crime, I would have to look at my attacker 3 different times to identifying and although PC stood beside me I felt like the loneliest person on the planet.
I went home on med evac and returned to service 45 days later. I stayed because of the support I received from staff at post and returning and completing my service was important to me but it would not be easy. I chose to prosecute and I was still waiting on a trial date, a month or so after I was at my new site I began to struggle with nightmares, flashbacks, depression, and feeling alone and in pain. It seemed like I had lost so much. There were days when I was too afraid to leave my house and too afraid to reach out for help, and I spent a lot of time being afraid of what people at my site would think of me if they knew. I was not sure what I had to offer  in many ways I just felt like “that girl” and felt nothing but shame. I didn’t want to be feeling this way and I tried to ignore it. I tried to ignore the fact that I had developed PTSD. I just wanted to get back to me, the happy go lucky girl with a boisterous laughter. I just wanted to laugh again.
Finally I was at the point of no return, I had hit rock bottom and something needed to be done. I couldn’t complete my service feeling this way. Finally after months and months of thought, late night conversations with the Kellie Greene the Victims Advocate I knew I had commit to therapy, I had to be honest with myself about the pain that I was in. I had been receiving calls from a DC for support but I was really only doing it to satisfy others, to prove to the outside world that I was a strong as the front I was putting on. I thought if they knew, if they could see or feel the pain that I was really in they would know I was a fraud. I was in a beautiful country doing all of the things I had imagined but it didn’t matter. All I could focus on was the knots in my stomach, and all of the anger that I had pint up inside.
I would leave site for more than a month to stay in Lima as the trial date came closer and closer. I would become frustrated with the world around me and found myself getting angry at the very people who had been such a support to me. I was tired of putting my life on hold, I was tired of waiting, tired of being patient, tired of putting my life and projects on hold time and time again, tired of the walls I had built, tired of not feeling heard or understood but more than anything tired of feeling so alone.
Peace Corps volunteers and people in my community had known what had happened because my name and details of my assault had been printed and shown in the media but I remained tight lipped on the subject and in many ways suffered in silence even though those around me knew the cause of my suffering. I remember clearly having to act like my life was normal. Planning for camps and classes like there was no pending trial date looming over my head like a dark cloud. I would have to return to the life that I left behind and would walk back once more to the lonely and forgotten place where it happened. For the first time in months I would have to remember every detail, every touch of my assault. I could no longer deny that this has become a part of my service. The time had come.
Truth is none of us knew what to expect I didn’t know how I would feel how I would react. I sat in meetings with the prosecutor, a Peruvian social worker, and an attorney all there to support me all who did a fantastic job but I was desperately seeking answers and would have to be happy with hypothetical situations. None of it felt real to me. My family could not attend the trial; they could only support me from affair.  The Victims Advocate, my security officer, medical officer, and two fellow PCVs were with me but it didn’t stop me from feeling alone and afraid…but just before I walked into the courtroom me griping the hand of my PCMO (who acted as my translator) something happened. I was not afraid and a strange calm rushed over my body. I had nothing to fear. All I had to do was speak the truth. The outcome didn’t seem that important anymore. It was my chance to take back some of which was taken
There is nothing more unique than being a Peace Corps rape survivor. I had met other survivors but who more than a PCV could understand the challenges we face: faraway legal systems, magnified loneness and isolation, being away from family in your greatest hour of need, and the unique form of mental health support we receive because of limited in country resources volunteers receive if they chose to return to service. Peace Corps has made some great progress since the Volunteer Protection Act but there are many ways Peace Corps  could increase their support to PCVs and become a leader in women’s rights. Many of these are simple and would require empowering the survivor and giving them a voice in the process from the beginning and this means a voice that is stronger than the bureaucratic rules of Peace Corps.
·         Strengthening the privacy of PCVs who are victims of crimes among PCVs and PC staff both in post and Peace Corps Washington. It is a well-known fact to any PCV that gossip spreads around the PC community like fire. While most of the time it is harmless. For survivors whether or not their case has been made public to the media having there tragedy passed around like news can be very dehumanizing.
·         Providing special support to Victims who are home on Med Evac, asking them what they need and finding a way to provide it. Connecting them with a PC survivor support network, and giving them a stronger voice in their choice to return or leave service.
When I was on medevac the greatest and probably most helpful part of my healing process was the PCVs I met  who could relate to what I was feeling what I was experiencing.  I struggled during counseling because I was never ready for it at the time but I could open up, cry, and get angry around other survivors because I felt safe I felt understood. Group therapy rather than individual therapy or at least a combination of the two would have meant so much. PCVs are a community and we are use to relying on each other, no matter how long we serve or where there is a very powerful connection that should be utilized to help PCVs heal.
·         Communicating and keeping PCVs informed during their medevac. Once a PCV accepts a Med Evac the decision to return is not entirely their own. Keeping PCVs informed of their progress and if and when they are returning to country. Sometimes med evac becomes conterproactive because with any PCV who wishes to return this creates added anxiety and pressure to say the right things during therapy and the process becomes forced rather than helpful and I personally resented therapy during med evac but did not feel like I had the right to refuse it if I wanted to return to county.
To make Med Evac more helpful to the PCV give them the right to refuse therapy. Some of us are not ready right away. I was removed from my support at post and was still grieving that, I was grieving not being in Peru,  I was grieving the fact that I was raped and at times I felt the only place I was heard was in Kellie Greene office where I was allowed to express my concerns without consequences. If the PCV is not open to counseling respect that, give them time, no one can heal from this in the 45 day time line. It might require offering alternatives, it might require providing a grace period so that they can adjust and be ready, and it might involve allowing the PCV more than 45 days so that they do not become medically separated. It requires being patient and understanding with the PCV and putting the power back where it belongs with the volunteers.
 We are what makes the Peace Corps possible and need to be partners and have a voice in our treatment plan. Sitting down with the PCV making them aware of their rights, the medevac process but most importantly asking them what they want and give them the right to say NO. Rape survivors already feel powerless and frustrated and some policy and rules can unintentionally retruamtized the PCV instead of helping them
·         Providing better mental health support to PCVs in country.  PCVs are incredibly brave and intelligent but we have challenges that the average survivors do not face.  We live in isolated communities we speak languages that are not our first, and are away from our families sometimes unable to talk for months at a time. I have cell phone reception in site I am lucky enough to receive 2 weekly counseling but even this presents limitations in terms of what can be discussed. Making sure medical staffs are trained to provide subsidized support specifically to sexual assault survivors and providing increased training to the PSN network in regards to the needs of sexual assault survivors whether it occurred during or before there Peace Corps service.
  While another PCV could not provide professional support PSN representatives should have special training on what a rape survivor may face during their service, and being able to use that knowledge to support the survivor. While some who has never been raped could never fully understand that does not mean that their own life experiences and hardships can help a PCV during his or her healing process. Sometimes as survivors the one thing we can do to reduce our own sense of isolation is to help those who couldn’t possibly understand.

·         Use of technology: Because we don’t often get face to face contact with therapist accept maybe in our country capital which often requires time out of site away from projects and 12 hour plus bus rides finding more creative ways to provide emotional support to PCVs. This could look like many things. One of the websites that I have found helpful during my healing process is www. Pandys.com   which is a large survivor support network that uses technology to help survivors heal. Survivors can share their stories, connect with other survivors, find healing exercises, ect . Using forums like Pandora’s Aquarium to connect PVCs around the world so needed. As all survivor communities have specific needs creating a safe social networking system that PCVs can use to help them before, during, and after their service.
·         Providing PCVs with self-help resources and materials. After I was assaulted I remember craving materials I didn’t want to talk about it I just wanted to understand it intellectualize it make it into something concrete. I wanted a manual I wanted to know when this was going to be over, what were the steps, what the hell was I supposed to do? Pandys also has a library of resources that is accessible within the states but providing PCVs with access to these materials is even more important because at some point we have to return to site and deal with things the best way we can which is sometimes on our own but by providing these materials even from afar PC can still be of support to PCVs.
·         Better on going Safety and security training and SA: Since the passage of the Kate Busey Volunteer protection act I have seen and tremendous efforts from my own post to increase our safety and decrease our risks during service.  We receive a great amount of training on this during pre-service training and even at our Early in service training but it needs to be on going and reiterated to PCVs once they get to site so that they become aware of the risks in their specific sites.  This can be done in several ways.
During monthly regional meetings let PCVs take the lead on their own security risk and concerns.  During ISTs and Pre Service trainings PCVs are overload with information and the stress of training but PCVs often listen and learn better from real PCV experiences. I know of PCVs that because of my assault refuse to take motto taxis and take extra precautions when traveling either in or out of site. I was not the first PCV to get assaulted in a motto taxi and I had no knowledge of their dangers before I got to my site where mottos taxis are the main form of transport. Had I been made aware of this my assault may or may not have been prevented.  Making PCVs aware of circumstances under which incidents occur by still respecting confidentiality is very important but I do feel that at times these things work better when they are volunteer led with the support of PC staff.
·         Gender and cultural conflicts: Peru is a bit of a match making culture. It is very common for PCVs to have romantic relationships with Peruvians during their service. My circumstances were unique in that I was raped by a stranger but most PCVs are attacked by people they know and feel they can trust. In a culture that is heavily entrenched in machismo inviting a man into your room extra might have different implications than it may have in the states. But rather than putting all of the responsibility on women to prevent rape and SA which has proven ineffective. Teach PCVs how to have these conversations with their male counterparts, and enomoradas. As females we are faced with specific challenges we have to deal with the cat calls, maybe the creepy counterpart whose Latina kiss on the check was not so checky. Rather than telling us that this is something we should get use to empower us. Help us share our own culture. Because unwanted sexual attention no mater how culturally acceptable it may be, is never ok. Provide us with the tools we need so that it does not add to our added sense of frustration and helplessness.
In essence, I fully believe that Peace Corps is committed to helping volunteers in fact I would not be the same person had it not been for the response I received from post. They have become instrumental in my healing process from the beginning. All PCVs deserve that.  They promised to always be there and they have but it has been a process for the both of us.  There are times when I get frustrated with them, there are times when I feel like I am not being heard, but I also know that they care and are dedicated to helping me complete my service  so I have learned to communicate with them instead of keeping it all inside, I have learned to become my own advocate and tell people what I need from them without making apologies for it.All survivors are unique and we can help others understand how to help us.  So keeping open communication with your post and not being afraid to be honest and put all of your worries concerns, ect is freeing important and has been crucial to my healing because all post no matter how responsive can always improve always do better.
I got nothing I expected out of my service, nothing I deserved. But because of the passage of the Kate Puzey Act and the fight of PCVs before me. I have been able to heal and get services and the legal help that I needed and because of that my rapist is spending the next 28 years of his life in prison. I am 26. That is one for every year of my life and two to grow on. and add my own voice to the same fight for a better, stronger Peace Corps. I don’t think I would have been able to do this without the men and women before me like the ones in First Action Response who turned their pain and struggle into something incredibly powerful and I would not be able to do this without the continued support from PC staff. My message to other post is this you cannot always prevent horrible things from happening but you can control your response. Remember why Peace Corps exists…because of us.
Remember what it is we sacrifice to be here and remember how powerful a compassionate and caring response can do both for the volunteer and Peace Corps. And most importantly remember how powerful a PCV can be in county and those who return home. We have strength, skills,, and a dedication to the Peace Corps unlike any other volunteer.
I leave you with links that I have found helpful and with this poem from Robert Frost that has helped me through my own process and be the voice behind my own story.
MY OWN PERSONAL BLOG ABOUT MY SERVICE IN THE PEACE CORPS
VERY HELPFUL RESOURCES FOR SURVIVORS
Chose Something like a Star
O Star (the fairest one in sight),
We grant your loftiness the right
To some obscurity of cloud --
It will not do to say of night,
Since dark is what brings out your light.
Some mystery becomes the proud.
But to be wholly taciturn
In your reserve is not allowed.
Say something to us we can learn
By heart and when alone repeat.
Say something! And it says "I burn."
But say with what degree of heat.
Talk Fahrenheit, talk Centigrade.
Use language we can comprehend.
Tell us what elements you blend.
It gives us strangely little aid,
But does tell something in the end.
And steadfast as Keats' Eremite,
Not even stooping from its sphere,
It asks a little of us here.
It asks of us a certain height,
So when at times the mob is swayed
To carry praise or blame too far,
We may choose something like a star
To stay our minds on and be staid.
Fuerza!
Mary Kate

Monday, September 24, 2012

Warning about Lariam

A supporter of Health Justice for Peace Corps Volunteers, the newly formed grassroots organization to advocate for better treatment for sick and injured volunteers, recently had a story published about his very negative experience with Lariam, or mefloquine, at newsworks.org.  Read more here.

If you took mefloquine while you were a Volunteer, or for any other overseas posting, let us know about your experience.



A Peace Corps volunteer from Philadelphia says Lariam had a devastating impact on his health.

Patrick McClanahan signed up for the Peace Corps after graduating from college. He arrived in Mozambique in late September of 2010 and took his first dose of Lariam on Oct. 1.

"We had to sign a waiver saying that we had read the safety information sheet, but it was the typical, anything can happen to you when you are taking this medicine," recalls McClanahan. "If you read the safety warnings on Tylenol, you will probably have the same impression of its safety."

Even though laundry list of Lariam's side effects include anxiety, depression, mood changes, panic attacks, forgetfulness, confusion, hallucinations, aggression, psychotic or paranoid reactions and suicidal thoughts, McClanahan was not overly concerned.

"I was thinking, 'Oh, this has been used by thousands of volunteers in the past, it's FDA-approved, there's no reason this is going to cause a problem,'" he recalls.

The following week, McClanahan started experiencing dizziness and stomach problems, but he blamed unsanitary conditions and the water, not Lariam. He noticed symptoms in other volunteers -- especially a young woman.

"Every time she laughed, she'd cry, someone would say something funny, and she'd be laughing and then tears would be streaming down her face," he said.

Dealing with debilitating mental anguish

McClanahan's problems got worse. Bouts of dizziness increased, he started to develop severe skin rashes, a cough, and slight fever. He noticed a drop in energy -- and a change in his mood.

"For example, I'd be walking to school or to the market, and suddenly I would feel really sad," said McClanahan. "My thoughts would turn very negative, I kind of felt like I was dragging weights around, or you're driving a car with parking breaks on, and then it would go away."

He had never experienced mental health issues before, or sudden negative moods that were not directly related to what was happening in his life. During a weekly phone call home, McClanahan asked his parents to look up this medication. After they told him alarming information about the side effects, he decided to stop taking it.

All of his symptoms were getting worse, but his Peace Corps medical officer told him to stay on the drug and take smaller doses twice a week instead of once. That didn't help. He finally switched to a different medication in February of 2011.

Some of his physical problems improved, but his mental health issues remained.

Exhausted and worn down, McClanahan decided to leave. On his last night in Africa, he was deeply ashamed and disappointed

"I was in such mental anguish that I realized for the first time why somebody would commit suicide," McClanahan said. "I wouldn't say that I was suicidal, but I had this profound understanding of why somebody would rather kill themself than continue living, which is something I could never understand before."

Problems known about for a decade

The severe psychological side effects of Lariam or mefloquine -- its generic name -- have been known about for years. The drug has been implicated in suicides and homicides. Most recently, Lariam made headlines when news surfaced that a U.S. Army sergeant accused of killing 17 Afghani villagers was taking the drug.

Dr. Remington Nevin is an epidemiologist and preventive medicine physician who researches mefloquine at Johns Hopkins University where he is earning his doctorate in the department of mental health. He's been interested in the issue since his deployment with the U.S. Army in Afghanistan in 2007. He says the military has since reduced its use of the drug, but not soon enough.

"It was known in 2002 that there were unacceptably high risks associated with taking mefloquine, but it took fully seven additional years before the U.S. Army restricted the use of mefloquine appropriately," he said.

He says soldiers who have mental health issues or traumatic brain injuries are not supposed to take Lariam, because reactions to the drug can easily be mistaken as combat-related stress. He says the same holds true for returning soldiers, because the effects of mefloquine can last for years.

"It's very possible that many users suffering from mefloquine toxicity have been misdiagnosed with PTSD or traumatic brain injury," Nevin said.

He says several hundred thousand American soldiers have taken Lariam. While many civilian doctors no longer prescribe this drug for travelers to areas where malaria is a problem, it is still widely used in the Peace Corps.

Nevin says the fallout could continue for decades.

Trying to warn others

When McClanahan returned home, he began a very slow recovery. He has since learned that mefloquine can cause permanent brain damage, but he has returned to work and says he continues to improve.

He repeatedly tried to reach out to the Peace Corps to inform them about his experience with mefloquine, but the replies he got were noncommittal.

"You signed the warning document, so it's essentially your responsibility to take care of yourself," quoted McClanahan from an email he received. "They ignored the fact that I had reported these warning signs, and they should have taken me off the medication long before they did."

Representatives from the Peace Corps did not respond to repeated requests for interviews for this story.

McClanahan has reached out to other volunteers who have had similar experiences, and they're spreading the word through a grass-roots campaign.


Article: It Happened to Me: I Was Sexually Assaulted While in the Peace Corps

Another brave survivor of sexual violence in Peace Corps posted her story on xojane.com.  Read the beginning of her piece here and continue to the site to read more.



In March of 2012, I was a Peace Corps volunteer and I was falling apart. In case you don't know, Peace Corps is an organization that is funded by the US government to send volunteers overseas for two years. During their time living abroad, volunteers are assigned projects to help the communities where they live. They live in cities and small towns, by the ocean and in the mountains, with host families and by themselves. The variety of experiences are as varied as the volunteers themselves.
I first heard of the Peace Corps when I was a freshman in high school.  A visitor spoke to my US Government class about his experience as a Peace Corps volunteer in eastern Europe and I was hooked. From that moment on, I knew that I would graduate from college and join the Peace Corps. As cliche as it sounds, it was my dream.
After an 18-month application process, in March of 2010 I received my acceptance letter and was told I would be leaving for Peru on June 10, 2010. I was elated. My dream was finally coming true.
In August of 2010, after 10 weeks of training, I moved into my home for the next two years. I was living close to Huaraz, in the department of Ancash. Huaraz is in the Andes mountains at approximately 3,000 meters (10,000 feet). My town consisted of approximately 500 people and electricity and running water were luxuries. I didn't have a toilet, just a small hole at which to aim. Transportation to the city was hit or miss and a trip to get groceries usually started with a 45 minute hike. I thought it was perfect.
Fast forward 19 months and my dream had become my nightmare. My host sister was stealing money and jewelry from me. Peace Corps refused to let me switch towns even after I told them I was severely depressed due to lack of work. I was showering once every two weeks. Two of my close friends were barely talking to me. Rats were slowly taking over my bedroom. I was cutting (again). Someone was spreading rumors that I was trading sex for cocaine. Peace Corps had told me I could only leave my town once a month and, subsequently, I could only get groceries once a month. I was barely eating.
I was damn near suicidal.
So I decided to do something for myself. In Peru, I had discovered that I loved hiking and, even better, getting lost. I relished the feeling of trying to get to Point B from Point A with no directions, no maps, no ideas. I loved walking and getting lost in the music and my surroundings and, for once, not thinking about my problems and stress.
So on March 9, 2011 my Golden Retriever puppy, Gulliver, and I hit the trails and tried to figure out how to get from our town to the town of another volunteer. I didn't even know if it was possible, if I could make it in one day, or if I remembered the name of their town. But it was an adventure.
Continue reading this story at xojane.com.

Monday, September 17, 2012

Take the Survey: Healthcare During and post-Peace Corps

A new organization has been formed to support RPCVs with medical issues during and post-Peace Corps service.  That organization, Health Justice for Peace Corps Volunteers, is looking to hear from Volunteers who were injured as well as those who were not injured.

Check out the survey on their site and pass it along!

Nancy Tongue: Advocate for RPCV Healthcare

The National Peace Corps Association named RPCV Nancy Tongue their Featured Advocate for the month of September for her work with RPCVs with health needs.  Here's a snippet from the article:

Nancy says unfortunately, there are volunteers who continue to return home seriously sick and injured who still face issues of being unable to get the care they need, obtain general health insurance, or struggle to live on the disability income that the Peace Corps “pay scale” qualifies them for.

These concerns led her to form Health Justice for PeaceCorps Volunteers in March 2012, a growing group of advocates whose stated mission is “to ensure that Peace Corps Volunteers who become sick and injured due to their overseas service obtain the support and benefits to which they are legally entitled.” It also provides a built-in support group for one another. The group is now launching a survey which all RPCVs are encouraged to take, in an effort to better assess the depth and scope of the problems.
 

RPCV Nancy Tongue 

You can read the entire NPCA article or help with the Health Justice for Peace Corps Volunteers' survey about medical  issues during Peace Corps.

Nancy, founder and director of HJPCV, says:
Health Justice for Peace Corps Volunteers is an organization formed in 2012 dedicated to seeking increased medical and disability support from both the Peace Corps and the US Department of Labor (USDOL) for returned (or current) sick or injured Peace Corps Volunteers whose illnesses or injuries occurred during Peace Corps service. As the Peace Corps expands, it must also protect those of us who have served. We are working in conjunction with the National Peace Corps Association to gather information to help make the necessary changes at the federal level. Take the survey about your experiences with Peace Corps medical, USDOL, etc.

We are looking to hear from BOTH RPCVs who were injured or became sick because of their service as well as Volunteers who had NO trouble. Please help us to better the system by contributing to our survey! Also, we would appreciate it if you would pass on the survey link to other RPCVs or to NPCA groups. Thanks!