Monday, December 17, 2018

A Long Way Gone by Ishmael Beah - a review, and assessment


Armed conflicts around the world have many faces. From insurgent groups and terrorists, to veteran militants and professional combatants, over the years the presence of ongoing wars has left its mark on many generations. The most unfortunate aspect of which, however, is the use of child soldiers in estimated 14 countries around the globe. Currently, the United Nations Children Fund (UNICEF) defines a child soldier as any child under the age of eighteen who takes part in any regular or irregular armed conflict. Previously, this definition only applied to children under the age of fifteen; however, this was amended in 2002. Children and adolescents who participate in armed conflicts, whether voluntarily or involuntarily, are not only exposed to severe violence, but also struggle later on in life once the armed conflict ends. In A Long Way Gone by Ishmael Beah, the author, a former child soldier himself, presents a haunting narrative chronicling his early adolescence years in Sierra Leone armed forces where he participated in the fight against rebel forces from the age of thirteen until the age of sixteen. His subsequent rehabilitation and reintegration into society was, perhaps, more difficult than the armed conflict itself.

At the age of twelve, Beah survived a rebel forces attack on a village he was visiting with his friends. Unable to connect with his family members, he, along with a group of other children, embarked on a foot journey across Sierra Leone towards the last remaining safe zone, staying at random villages along the way, where he exchanged labor for food. After several months of traveling marked by imminent peril, he learned that his family was safe at a nearby village, but by the time he arrived there, it was already under attack by the rebels, who executed everyone in sight. The boys, however, manage to escape and seek refuge at another village protected by the national army. Several days later, with the rebels approaching, the army general in charge made all able bodies to join the fight, and Beah, along with his friends, was no exception. Thus, at the age of thirteen, Beah became a child soldier. Already traumatized by the violence he had witnessed from the onset of the war, Beah had seen first-hand what the rebels did to civilians, and he saw the need to take up arms not only as a way to survive, but as a tool of revenge as well.

While initially apprehensive and disgusted by the atrocities he participated in, Beah quickly lost empathy and devalued human life. After losing several ‘friends’ during combat, what could have been perceived as PTSD was replaced by indifference and rage, aided by the seemingly endless supply of drugs provided by the army. In between attacks, he lived in a perpetual state of high, smoking marijuana, and sniffing cocaine mixed with gunpowder. The drugs not only numbed his senses and his humanity, they gave him the energy to keep fighting. Over the next three years, he became proficient in killing, and enjoyed executing prisoners of war as he eventually rose to the rank of Junior Lieutenant. In charge of a small unit of fellow soldiers, he organized food raids to nearby villages, and engaged in the same atrocities he despised in the rebels, effectively switching from being a victim of war to becoming the aggressor.

In 1996, in an intervention by UNICEF, Beah was removed from active army service at the age of sixteen, and sent to a rehabilitation center in Freetown, the capital of Sierra Leone. Surrounded by fellow child soldiers from both sides of the conflict, he engaged in frequent fights amidst the former enemies. Dealing with drug withdrawals, he shut himself off from the efforts of counselors and the medical staff at the center, longing to return to the frontlines. Through the tireless work of one nurse at the center, Esther, Beah finally accepted that the war was over for him, and started making progress towards rehabilitation. It was at that time that he began to have nightmares of the atrocities he committed. Esther, together with other staff members, helped him establish contact with a lost uncle, who agreed to adopt Beah upon his release. Once he was cleared, Beah moved in with the uncle and slowly reintegrated into society and civilian life. At the recommendation of the rehabilitation center’s director, Beah went for an interview at the United Nations building in Freetown, to apply for a speaking position at an upcoming conference on the plight of child soldiers held at the UN headquarters in New York. Once accepted, Beah had traveled to New York where he, along with other former child soldiers and children affected by wars, gave a speech detailing their experiences.

Upon his return to Sierra Leone, Beah enrolled in a secondary school to complete his education, which was cut short by the war. Not long after, however, the rebels and a rogue faction of the army invaded Freetown, and overthrew the government in a coup. Faced with the possibility of either becoming a soldier again, or being killed if he were to be recognized by any of his fellow child soldiers, Beah fled the country to Guinea, and eventually to the United States, where he had a contact from his earlier UN visit. Once in the United States, Beah continued to work with the UN and wrote his memoir, and started a charitable foundation aimed at helping children affected by war to reintegrate into society.

The content of the book applies to Human Development in multiple ways. When Beah witnessed the first attack and subsequently became on his own at the age of twelve, his cohort effectively changed from that of his family and friends, to the army, which affected his future interactions with civilians at the rehabilitation center whom he perceived as incapable of understanding his experiences. During his formative years, he was affected by several adverse childhood experiences, which made him more susceptible to drug use and violence later on in life, especially since he did not have the support ecosystem that would help him build up his ACEs resilience score. It also confirms Watson’s theory that kids can be taught to love or hate anything – in this case, Beah, influenced by his peers, adapted to love killing and violence. This was further exacerbated by operant conditioning of reward in the form of drugs, when he did his job as a soldier well. It also illustrates Erikson’s theory of Identity versus Role Confusion, when his role changed from that of a carefree child to a sole provider responsible for his own sustenance.  Piaget’s principles of accommodation and assimilation could also apply here, as Beah adjusted his standards of right and wrong as the conflict progressed.

Having taken part in atrocities, is it possible for an adolescent to develop into a healthy adult capable of leaving the psychological trauma behind? Beah’s first defense mechanisms to deal with his trauma were Dissociation and Displacement. During the war, he displaced his anger at the loss of his family towards both rebels and civilians alike, essentially targeting the weaker ones to ‘punish’ them for his loss. After the war ended, dissociation became clear, because he had lost track of time and events that had taken place during his years in combat. Because of his involvement in armed conflict, Beah would have struggled with his development of identity as well.

The first research article, The Guiltless Guilty: Trauma-Related Guilt and Psychopathology in Former Ugandan Child Soldiers (F. Klassen, S. Reissmann, C. Voss, J. Okello – Child Psychiatry Human Development 2015), shows a clear correlation between child soldier experiences and future psychological disorders, mainly PTSD and Major Depressive Disorders. Interestingly, it shows that the majority of former child soldiers (50.8%) see themselves as victims, while only a minority (19.1%) see themselves as perpetrators. A greater number of traumatic experiences as a self-identified perpetrator is associated with the feeling of guilt, which is a predictor for externalizing psychological problems and resulting in aggression, cruelty, law-breaking, property damage, and conflict with others. Self-identified victims, on the other hand, tend to internalize problems, which correlates with a greater occurrence of major depressive disorders. Applying these results to Beah’s case, it confirms his initial aggression at the rehabilitation center, followed by withdrawals from interactions as he began to internalize his trauma.

The second research article, When Combat Prevents PTSD Symptoms – results from a survey with former child soldiers in Northern Uganda (R. Weierstall, I. Schalinski, A. Crombach, T. Hecker, T. Elbert – BMC Psychiatry 2012) explores the link between increased exposure to traumatic events and lower occurrence of PTSD. The study found that there is a clear dose-effect correlation between organized violence, as carried out by child-soldier units, and an appetite for aggression. Appetitive Aggression, such as the enjoyment of a victim struggling, has been found to lower PTSD scores in perpetrators. This, applied to Beah’s case, confirms his transition once he started enjoying killing prisoners of war as he went from a victim to a person responsible for violence and, especially, his lack of PTSD. While this study was limited in its sample, I felt it was relevant and important to include here, because it aids in understanding Beah’s mental health.

Wednesday, October 10, 2018

Vaginal Fistula Paper

I know I'm shifting gears here, but I think it is important to post this.

A few weeks ago, I had an assignment in one of my classes. The assignment was to watch A Walk to Beautiful documentary, and submit a written response on the topic of vaginal fistulas.

The documentary itself was very well done. The topic was not only slightly disturbing, but also very eye-opening. The more research I did, the more it became clear to me that this is a topic that should be brought forth, should be discussed, and that more education on this is sorely needed.

You can watch the documentary: A Walk to Beautiful YouTube

or visit the https://www.fistulafoundation.org/ to learn more

Without further ado, here is my humble paper on the topic:


Vaginal fistula is an operable tear in the vaginal wall that results in a hole between the vagina and another organ, frequently leading to fecal or urinal incontinence. There are six types of vaginal fistulas:
·         Vesicovaginal fistula – an opening between the vagina and the urinary bladder.
·         Ureterovaginal fistula – an opening between the vagina and the ureters (ducts that carry urine from kidneys to the bladder)
·         Urethrovaginal fistula – an opening between the vagina and the urethra (the tube that carries urine out of the body).
·         Rectovaginal fistula. – an opening between the vagina and the rectum.
·         Colovaginal fistula. – an opening between the vagina and the colon.
·         Enterovaginal fistula – an opening between the vagina and the small intestine.
Vaginal fistulas are usually caused by an injury; however, they can also result from both radiation treatment and infection, although this is less common.
The most prevalent cases of vaginal fistulas develop due to obstetric trauma during prolonged childbirth, which, in some instances, produce a double fistula, also know as a vesico-rectovaginal fistula. This is particularly common in the developing countries in northern Africa, Asia, and Middle East, where access to healthcare is either extremely limited or nonexistent altogether. The lack of accessible hospitals, combined with strong religious beliefs and low levels of education, only exacerbates the impact these injuries have on the lives of the women affected by this medical condition.
Additionally, sexual violence in conflict zones such as Congo, Sudan, or Rwanda, a second leading cause of vaginal fistula, cannot be overlooked. There are recorded instances where soldiers sexually assault women with broomsticks, rifles, or even bayonets, inflicting traumatic injuries to the vaginal and pelvic regions. This horrendous practice serves to not only demoralize the population, but also as a population growth control tool since the victims of sexual violence are less likely to bear children in the future.
The prevalence of obstetric vaginal fistula cases in South Asia and sub-Saharan Africa can be traced to several factors, such as young child-bearing age, malnutrition, lack of accessible healthcare, and women’s status in traditionally misogynistic societies. Women in Pakistan, Bangladesh, Mali, Ethiopia, Niger, Kenya, Uganda, Nigeria and other countries, are frequently subjected to hard labor since young age, which results in growth retardation or poorly developed skeletal structure. Furthermore, despite laws adopted to prevent child marriage, these women are often married off before their bodies mature, with almost one third married by age fifteen, and sometimes before they turn ten years old. Additionally, poor intra-partum care contributes to the high rate of injuries during childbirth.
Due to poor infrastructure, lack of access to healthcare in developing countries, and especially in rural communities, adversely affects an already complex situation. Research shows that less than 60% of women in sub-Saharan Africa deliver their children with the help of a qualified doctor or a midwife, and only 36% of women in Nigeria give birth under skilled medical care. Poverty and remoteness both play a central role in women’s inability to reach a hospital for obstetrics care.
These factors contribute to difficulties during child labor, where an underdeveloped pelvic girdle contributes to labor dystocia, or obstructed labor, increasing the risk of uterine rupture or infection. Often times, child labor lasts considerably longer than usual, resulting in tissue damage from pressure exerted by the child’s head, ultimately leading to vaginal fistula. Many of these women also experience stillbirth, which can cause postpartum depression.
Unlike in Western societies, where vaginal fistula is easily repaired immediately after childbirth, women in the developing world are often impacted for the rest of their lives. In Africa, in particular, husbands and immediate family tend to abandon the women who suffer from vaginal fistula. Due to an uncontrollable foul smelling discharge, society, in general, views these women as unclean, and often prevents them from partaking in day-to-day activities. These women, who already deal with the psychological impacts of stillbirth, are shamed to leave, and have to fend for themselves on the outskirts of society without access to traditional family support structures.
Poverty, lack of education regarding available medical treatments, and deeply-rooted religious beliefs prevent these women from seeking the help they need to heal. Oftentimes, vaginal fistula patients suffer for years without knowing that their condition is treatable with a simple surgery. In rural areas, there are simply no hospitals, and if these women seek care at a regular urban hospital, guards often turn them away due to their foul smell, and they leave without ever seeing a doctor. Unfortunately, in countries where this condition is most prevalent, specialized fistula hospitals are scarce, and not easily accessible for the majority of women from rural areas.
Ultimately, women suffering from vaginal fistula who are either unaware of, or unable to access treatment options, end up living alone, and often without their previous children. Their medical condition prevents them from leading productive lives, and contributing to the overall economy. Without the ability to advance their education and learn new work skills, these women are confined to a low social-economic status, which plays a significantly adverse role in their chance for recovery. This influences future generations of women, and perpetuates the current detrimental conditions.

Thursday, August 16, 2018

3 days left for a Giveaway

There are three days left to enter a drawing for a Goodreads Giveaway of 100 eBook copies of the Mad Days of Me, complete trilogy.

Winners are chosen by Goodreads, and copies are distributed directly by Amazon. 

Good luck to all participants. If you do not win, this edition is available exclusively on Kindle, and free to Prime members via KindleUnlimited.




Goodreads Book Giveaway


Mad Days of Me, the complete trilogy by Henry Martin

Mad Days of Me, the complete trilogy

by Henry Martin


Giveaway ends August 19, 2018.

See the giveaway details
at Goodreads.


Enter Giveaway

Tuesday, August 7, 2018

Image Prompt Poems June 2018

Here are a couple of recent poems written in response to image prompts put out by Realistic Poetry International on Twitter. Both were written live, on Twitter.


The artery of humanity 
branching in paths unknown 
thin veins traversing 
the fertile landscape of the world 

Through the capillaries 
though hardly perceptible 
runs a shared thread 
the collective subconscious 
which makes us whole 
despite our differences

Copyright Henry Martin July 06, 2018


Our pains and memories 
like tree branches 
spread from our cores 
through our existence 

Some see a tangled mess 
sore spots rubbed to inflammation 
where our experiences 
collide with a clash 

Yet I concentrate on our trunks 
deeply rooted in our past 
able to withstand 
any storm

Copyright Henry Martin June 26, 2018

Impossible Love, a Poem

This is a new piece I wrote on August 06, 2018 while sitting by the water. The scenery brought back some memories of long gone days - days spent on an island thousands of miles away.


Friday, August 3, 2018

Poems

Here are a few new poems from recent days.

Procrastinate

When the darkness seemed impenetrable
a drink from Lethe
was all I desired
hoping to start again

A tabula rasa
not yet stained
by horrid memories

I'm glad I procrastinated
for had I found it
I would have lost the moments with you
that made me who I am today

___

Dignity

Cracked lips gasping for air
as I curl up in pain
shaking with silent sobs
no one will ever hear

The wet pavement
soothes my agony
as tears mixed with blood
seep in between the stones

You have used my body
and threw it away
but my dignity
will never shatter
and I will live on.

___

Approval

Who knew
an act of kindness
could set our worlds ablaze

 Two hurt souls
finding in each other
what we needed most

Our unholy union
the thorn
in their side

In mad passion
we clashed
against tides of hatred

But when you sought their approval
we became lost again
to wander alone

All text Copyright 2018 by Henry Martin.

Poetry written live on Twitter via prompts from #dailywisdomwords


Saturday, July 21, 2018

Goodreads Giveaway of Mad Days of Me, trilogy




Goodreads Book Giveaway


Mad Days of Me, the complete trilogy by Henry Martin

Mad Days of Me, the complete trilogy

by Henry Martin


Giveaway ends August 19, 2018.

See the giveaway details
at Goodreads.


Enter Giveaway




Goodreads is currently running a Giveaway of 100 eBook copies of the entire Mad Days of Me trilogy. To enter, please visit Goodreads via the link below

Of course, the book is also available on Kindle Unlimited for free to Prime members and Amazon subscribers via this link: https://www.amazon.com/Mad-Days-Me-Complete-Trilogy-ebook/dp/B00ZAKVSG0