Sanjog’s Caring Connections: A Training Programme for Practitioners on Continuity of Care and Listening to Victims
Location: West Bengal, India and Bangladesh
Name: Roop Sen and Uma Chatterjee
Email: roop.sen(at)gdsouthasia.org, uma.chatterjee(at)gdsouthasia.org
Date of profile: January 2012
Programme: Caring Connections
Aim: To build restorative practices into rehabilitation programmes and to facilitate the continuity of care for victims of trafficking through the implementation of a training programme aimed at social workers, care-givers, organisational directors and managers working in NGOs or state run rehabilitation programmes.
Background and Context
Sanjog is an Indo-Bangladesh anti-trafficking programme initiated in 2003. Sanjog brings together various non-government organisations (NGOs) in Bangladesh and West Bengal to enhance coordination and collaboration on initiatives related to the prevention of trafficking, rehabilitation of survivors, mobilisation of civil society, creation of spaces for dialogue between NGOs and community organisations on either side of the border and in the joint lobbying of states.
The Caring Connections programme has been designed and implemented by Sanjog and is supported by Groupe Developpement, the European Commission and the Oak Foundation. The programme began in 2011 as a response to research on the impact of current systems of rehabilitation for trafficked victims called Where Have All The Flowers Gone? The research implied that current systems of rescue and family reunification did not work in favour of victims’ interests because of the custodial nature of rehabilitation. A needs assessment was conducted to examine factors leading to the nature of custodial care and to understand and learn from the current systems of care for trafficked survivors.
The needs assessment was conducted with seven NGOs across India and Bangladesh. 55 respondents including survivors of trafficking, frontline workers, such as those working in institutional care homes, managers and organisational leaders and directors of NGOs took part in the assessment.
The needs assessment highlights the following:
the institutionalisation of survivors and length of stay in institutions is often dictated by law enforcement and the judiciary, and that counselling often aims to try to ‘motivate’ survivors to provide accurate information about the traffickers and exploiters in order to expedite the legal process. Such a system means that survivors feel that they are in ‘custody’ rather than in a caring and supportive environment.
survivors want NGO staff to be ‘listeners’ rather than ‘advisors’ and to support their individual choices, not to always choose for them or ‘correct’ or ‘rectify’ their choices. NGOs expect counselling to bring alignment between the victims’ choices and the state policies, laws and procedures which NGOs must follow in their case management for victims.
the lack of systems to ensure the continuity of care for survivors was another pressing concern. Case management often involves multiple agencies, including the police, courts, law enforcement, health and child welfare committees, and many different variations of these bodies in different locations as the child moves from one place to another. For example, a survivor may move from the destination point where identified, to an intermediary NGO in the urban centre of the source state, and finally to a community-based rural NGO near their family. The study shows that the linking up between bodies in different areas is often led by NGOs, however there is little or no direct coordination by the other agencies involved in the case. The information that is often transferred from NGO to NGO relates primarily to legal and health reports and rarely includes other information on the survivor such as their individual plans, fears and hopes for the future. the language that reports are written in is often ‘foreign’ for local NGOs supporting the child once reintegrated. Reports may be written in English or Hindi rather than Bengali and the terms used, such as ‘passive-aggressive behaviours’ or ‘manic-depressive tendencies’ is not always well understood amongst those who have not been trained in particular disciplines. It is rare for there to be counsellors working in source states and therefore assessments done at the destination often simply stay on paper.
often home assessment reports simply satisfy the destination point organisations, and the purpose and capacity of NGOs in source areas mean that such assessments are of little use to them. Care-givers from different organisations see their work ending when survivors leave, they do not see that they are part of a larger process involving case workers in different areas and do not recognise the need for collaboration between those working at destination and source points. This lack of relationships means there is little empathy or respect for each other’s work and this can result in blame directed at other organisations.
frontline workers can feel that they know what survivors need and therefore could decide their path rather than actively listening to what survivors want and need for their recovery and reintegration.
The lack of regional bilateral instruments between India, Bangladesh and Nepal also often affects coordination, resulting in delays and incarceration of victims, and the lack of standardisation in repatriation and rehabilitation when the process involves multiple countries also has an impact.
In conclusion, the research shows there is a lack of understanding of the full victim care continuum from rescue to reintegration, and poor planning among NGOs at the source, transit and destination locations.
In response to these findings, the Caring Connections programme was developed. The basis of the programme is that care workers need to work ‘with’ survivors rather than ‘for’ them. By building the capacity of NGOs to understand how to work with survivors and empower them, and to work more effectively with other NGOs and CBOs, this will lead to a seamless movement among care settings that will ultimately benefit the survivor during their recovery and reintegration. Caring Connections also offers organisational development programmes for directors, founding members and boards of NGOs in the change-continuum to help align their organisational perspectives and capabilities to ensure victim-centered, case management-based rehabilitation programmes for trafficked survivors.
The Sanjog Training Programme
The Sanjog Training Programme strengthens and ensures victim care continuity systems through empathy building, skills building and information sharing. The training addresses problems that arise in the care process and has developed action plans and resources with inputs from the victims themselves, victim’s families, frontline social workers, counsellors, government officials and community members.
The programme is designed for social workers, care-givers and managers working in NGOs or state run rehabilitation programmes and is in three phases.
Phase 1 Empathy and Role Clarification
A trafficked victim asked how she would define trafficking and rehabilitation programmes, said ‘Trafficking was when someone forced me to become bad, and rehabilitation is when NGOs and the government is trying to restore me as a good person again’.
Custodial approaches in rehabilitation are often experienced by victims as corrective and remedial programmes, where much of the focus is on their correction and their remedy. The first phase in the Caring Connections programme is to help every professional who offers services and care to victims to understand the girls and women they work with, their aspirations and doubts, their anxieties and fears that they experience post rescue and in the course of rehabilitation. This is to help them respond to victims and their responses, emotional and behavioural difficulties, and to help social workers and care-givers build relationships of empathy and support.
The first phase of the programme also helps care-givers and social workers contextualise and identify their roles in the process of rehabilitation and recognise and accept what may be beyond their capacity to solve or resolve. This is expected to have an impact in several ways:
Help social workers and care-givers realise that the pace of rehabilitation must be determined by victims themselves and cannot be determined by service providers, laws or policy statutes
Help social workers desist from punitive measures towards victims who may challenge the social worker, caregiver or the NGO’s authority and control over her by breaking norms or rules in shelter homes
Help participants adopt a helper-client relationship with victims rather than an adult-child relationship. Participants are helped to understand and clarify their personal biases on sexuality and prostitution which often lie at their core of their own discomforts in dealing with victims.
This phase of the programme comprises of the following workshops, each group has an average of 16 participants:
A seven-day residential training on ‘knowing the survivor’
A seven-day residential training with source area organisations on ‘resilience building in victims’.
A seven-day workshop with destination organisations on sexuality. This is also covered in the resilience building workshop with source area organisations.
A seven-day workshop with source area organisations on advocacy strategies, such as: working with family, community and duty bearers to address social inclusion and assertion of a victim’s rights to reparation, social welfare and health.
A seven-day workshop with destination point organisations on working with survivors in groups in institutional care, and on how to build programmes where there are few counsellors, and where social workers are not trained in group counselling skills. Positive disciplining is an issue focused on in this workshop.
Phase 2 Empathy between organisations, building communication and coordination systems:
Lack of communication between multiple agencies results in lack of understanding of each others’ perspectives, motivations, resources and opportunities while managing a case. The second phase of the programme focuses on helping organisations know each other, on social workers from organisations in source and destination points building a rapport with each other, and on understanding the context each of their work, thereby understanding each other’s resources and limitations, both organisationally and contextually.
The second phase comprises of two methods:
A five day workshop to develop documentation tools for case management to be commonly used by source and destination point organisations, including case plans, home and family assessment reports. A follow up workshop for three days to review use, modification and re-clarification.
Exchange visits by teams of case workers and programme managers between source and destination point organisations. Each organisation is to visit a minimum of one, but preferably three counterpart organisations that they share their case management programme with.
Phase 3 On Centrality of Victims
The third phase, Centrality of Victims, reinforces participation rights of survivors in all levels of decision making in case management. The principle is reinforced, as much in the case of children as it is for adult survivors, in resilience building workshops in the first phase. In the third phase, the programme offers three five-day workshops to survivors, covering resilience building, demystifying shame, guilt and sexuality, and training on advocacy with duty bearers and key influencing agencies.
Concurrently, OD interventions with directors and organisational managers are targeted at building systems within organisations and between organisations to develop alignment in processes of rehabilitation from pre and post rescue operations to post family-reunification assistance to victims.
In 2011, 56 care-givers and social workers are undertaking the programme. An evaluation will be completed at the end.
Changes observed in the process so far are:
For community care-givers in source and transit area organisations:
change in attitudes towards the survivor from a victim with no agency to a partner who will determine the care processes and action plans.
undertaking restorative practices in case management plans, such as listening to the survivor and giving importance to her voice.
identifying resilience and resources in the girls and working towards strengthening those.
understanding the significance of prioritising stakeholders and designing concrete realistic advocacy strategies for effective change.
For care-givers in institutional care in destination and transit area organisations:
understanding the experiences of the survivor and the impact of sexual violence and trauma.
creating supportive groups of girls within shelter homes to ensure greater participation and agency of the girls.
exploring and applying positive disciplining techniques with the girls inside the institutions.
dealing with the personal stress and demands of working with survivors of sexual violence and exploitation.
For all care-givers across the care continuum (source-transit- destination):
greater understanding and empathy of each others’ roles, responsibilities and challenges leading to more effective coordination and communication.
Changes at the advocacy and policy level are anticipated after the second year of the training and hence the need for continuation of this programme.
Programme Drop Out
The Caring Connections programme has been well supported by all partner organisations, and especially participants with a projected 2% drop out.
The risk of drop out depends on the following factors:
NGOs that run shelter homes or institutions in destination point organisations, who work with victims post-rescue are more prone to being caught in emergency situations and may have to drop out of the training at the last minute
women who have very young children and inadequate childcare support structures may find it difficult to commit to residential training courses or out-station training programmes
some participants may have resigned from their jobs. However, it is evident from this project experience that if the training programme, schedules and dates are prepared well in advance, and participants are well informed and well briefed about the nature and design of the training and the required commitments from their part.
Non-discrimination and individual response
The training ensures that social workers and care-givers look ‘inside’ themselves and connect with the victim and survivor within themselves. This leads to greater empathy and easier trusting with the survivors. Such a process focuses on the ‘uniqueness’ of each person’s individual inner world, the peculiarities, the ‘sameness’ and the tools that one can use to sustain this self-reflection. This will sustain the significance of working and walking ‘with’ each girl on her journey rather than ‘to’ all those who have been rescued.
In the training programmes undertaken the flow of the sessions is from ‘the within’ to ‘the without’, that is, participants move from the awareness and acceptance of one’s values, judgements, biases and prejudices towards confronting and challenging them in safe and supportive spaces. Application of confronting and changing one’s usual biases and values, learning from that and internalising the consequences, is thus an integral part of the programme.
The number of survivors involved in the training would depend on the organisation and the number of survivors they work with. For the Caring Connections programme implemented in India and Bangladesh, the number of survivors targeted are 30. However, this would vary between organisations. Given that, currently in 2011, there is a near absence of survivors in any planning, monitoring or evaluation of rehabilitation programmes for trafficked survivors, the Caring Connections programme aims to build survivor’s capacities in resilience, internalised guilt or shame and advocacy so as to firstly enable survivors to participate in planning, monitoring and evaluation initiatives of the organisational programmes, and secondly, to build peer leaders, peer supporters and peer educators for other survivors.
There are two aspects of protection:
the training with survivors is conducted in separate spaces from the care-givers, social workers and directors. While the content, substance and voices of survivors are presented to directors, management and care-givers in review and coordination meetings, the details of ‘who said what’ is kept confidential.
The training is conducted by mental health professionals (psychotherapists and psychologists) who avoid reliving of any trauma, and they are skilled at managing any triggers that arise for individuals, this.
Sustainability and replication
Through the programme training, participants have been invested in and will achieve professional personal development . The selection of the participants by individual organisations also considered factors of attrition, and majority of the participants have been working in their organisations for a long time. Refresher courses would be useful to strengthen the programme over the next five years.
A process document of the programme, and an evaluation will be useful to share the programme and its learnings with other agencies supporting rehabilitation programmes for trafficked survivors including international NGOs, NGOs implementing or involved in case management programmes with trafficked survivors, and state departments. It is hoped this will stimulate similar programmes or replication of the programme with other agencies building its reach and moving towards a common standard system.
There is a high incidence of over-identification between care-givers who are themselves victims of sexual violence. Any similarity in experience between a care-giver and victim may trigger identification which certainly may facilitate empathy, but at the same time, there is a risk of over-projection. The awareness of this identification helps participants understand the link between their experience and their response to the victims and that they need to work with their issues separately. There is a strong need for therapy for care-givers.
Justice, as defined by the criminal justice systems and understood by care-givers and NGOs, does not necessarily match ‘justice’ as defined or understood by victims themselves. The lack of victims’ interest in prosecution of traffickers is due to lack of information, participation and the ‘perceived benefits’ of such processes. While, for most social workers and activists, justice is equated with conviction of traffickers, and rehabilitation is equated with livelihoods and family acceptance of victims, victims often do not experience justice from the criminal justice system. The victims’ needs in terms of justice are often unheard.
In the needs assessment, care-givers and NGOs defined the objective of ‘counselling’ as helping victims adjust to the new set of controls (by law, policy and systems) that they are subjected to after being rescued. While the NGOs and care-givers or people within the ‘system’ do not view these norms as ‘controls’, victims have an expectation that NGOs would be an advocate of their rights, needs and wants and a voice to the system.
In a system where efficacy of the rehabilitation process is measured through numbers of rescues, family reunifications and the ‘retention’ of victims in the family, investment in quality of care is limited to developing manuals and other ‘products’ that are assumed to benefit care-givers and frontline social workers. Changes in care processes however require time, belief and conviction.
Unless rehabilitation indicators are changed to assess progress and efficacy of programmes, the focus of such actions will remain on controlling victims towards ends decided for them instead of on their participation, agency and empowerment.
A transformation from custodial to restorative care cannot only be facilitated by NGOs. It requires changes in law and policy, and also changes in attitudes and behaviours of duty bearers in the state system – social welfare, law enforcement and the judiciary. The change has been initiated by a group of NGOs, and for continued change in the future it needs to be scaled-up and widened to include the state agencies. Bilateral instruments between India, Bangladesh and Nepal are essential to support victims’ rights to timely and safe repatriation, and prevention of forced deportation.