Ameliorating Traumas Caused by International Crimes and Other Crises
Reviewing: Yael Danieli, Nigel S. Rodley, and Lars Weisaeth (eds.), International Responses to Traumatic Stress: Humanitarian, Human Rights, Justice, Peace and Development Contributions, Collaborative Actions and Future Initiatives. New York: Baywood, 1996, 473 pp.
International criminal law is an evolving process. The definition of international crimes remains incomplete, new ad hoc international criminal tribunals created in the wake of the Nuremberg and Tokyo war crimes courts of held a century ago have only circumscribed authority, and a permanent international criminal court with universal jurisdiction remains a hope on the distant horizon. In his foreword to the UN publication, Secretary-General Boutros Boutros-Ghali laments that the effects of traumatic stress caused by international crimes are too often neglected even by mental health professionals. The contributors seek to remedy the shortcoming – at least in part. How the international community is beginning to respond to the traumas endured by millions of innocent victims is a subject that should concern all those interested in the comprehensive development of international criminal law.
This book describes efforts by the international community to understand and curb the devastating psychological impact of horrendous human rights violations and natural disasters. The three editors are clinical psychologist Yael Danieli of New York, a recognized authority on traumatic stress in Holocaust survivors; Nigel S. Rodley, an international lawyer from England who has written extensively on human rights activities at the United Nations; and Lars Weisaeth, a professor of psychiatry from Norway who has studies the psychiatric effects of trauma arising in varied military and civilian settings. The book’s seventeen chapters are written by thirty contributors experienced in various UN and nongovernmental organizations (NGOs) concerned with ameliorating human suffering.
The scan of the book sweeps back and forth across the spectrum of activities that give rise to human pain and suffering enormous enough to disrupt the social order. The expert authors describe the dedicated efforts of many UN and nongovernmental agencies to diminish the social and psychological trauma generated by such crimes as mass rape, genocide, forced displacement, and other atrocities prevalent during armed conflicts. They portray the disabled condition of traumatized women and children – as well as the impact not only on victims but also on perpetrators and witnesses to human inhumanity. The magnitude of the problem compared with the relatively meager success of prevention or amelioration presents a frightening picture that the contributors hope will inspire greater determination and effort by the world community. Each chapter is followed by a list of references from which the reader can cull important writings on the subject.
Studies of Nazi Holocaust survivors reveal that integration of the traumatized victim cannot be accomplished by the individual alone. Feeling helplessly and hopelessly discarded, the survivor must be restored to a respected place in society. The stigmatization that occurred through separation can be relieved by public recognition of the historical truth regarding the persecution, apology from the perpetrators, real and symbolic restitution and compensation, rehabilitation, commemoration, and a perceived and determined effort to secure justice by publishing the wrongdoers and preventing recurrence of the crimes. Failure to implement these policies exacerbates the wounds and stimulates the desire for revenge, which frustrates conflict resolution and preventive interventions. 
A new term had to be invented to describe psychological so entrenched and severe that the damaging effects (as with nuclear explosions) can be seen in succeeding generations. “Post-Traumatic Stress Disorder,” or PTSD, gives a scientific ring and title to a condition that science does not yet fully understand. PTSD resembles what was called “shell shock” after World War I, but it is much more pervasive and elusive. The invisible internal stress caused by such violations of the human person as torture, mass rape, and genocide (now euphemistically called “ethnic cleansing”) is often so painful that the psychic trauma is denied by the victims – many of whom, after apparently reaching success, commit suicide.
There are limits to what the United Nations can do to offset psychic pain. Charged by its Charter to maintain peace and protect the human rights of all human beings, the United Nations can act only through its constituent sovereign states – when and if they share the political will to do so. Without authority to enact binding laws, without independent funds, and without enforcement powers, the United Nations is severely handicapped. Through exhortation, nonbinding General Assembly resolutions, and ambiguous conventions accepted by consensus, the United Nations encourages states to implement new standards of morality and humanitarian law. But when these desirable goals are flouted, as they often are, the consequences are paid for in cast amounts of human blood and misery while dedicated UN civil servants and NGOs are often obliged to look on in helpless frustration and despair.
It is not recognized that prosecuting the perpetrators of crimes against humanity and compensating the victims are critical pillars of justice.  But reducing the trauma of victimization requires more research, training and education. Eduardo Vetere and Irene Melup of the UN Crime Prevention and Criminal Justice Program, referring to the right of “humanitarian intervention,” sense a growing acceptance of collective responsibility for the fate of others as the world slowly moves toward greater cohesiveness, genuine solidarity, and social control under the rule of law. This hopeful view derives from the topics addressed by many UN crime conferences over the years: trafficking in women and children for sexual exploitation, violence against refugees and migrants, illicit drug trade, the killing of large numbers of children by land mines, terrorism, political repression, as well as fair treatment for offenders.
The emerging international law of human rights stems from more than eighty UN human rights treaties and declarations. But states are reluctant to subject themselves to international courts or controls and consensus declarations are usually laced with loopholes allowing varying interpretations. The United Nations Economic and Social Council, its new Department of Humanitarian Affairs, and many commissions and working groups valiantly try to improve the situation but have limited success. It is only under circumstances of extreme provocation and public outcry that the Security Council is prompted to act decisively by using its enforcement authority to maintain peace under Chapter VII of the UN Charter.
Mary Petevi describes the efforts of the UN High Commissioner for Refugees in trying to cope with the massive sadness and despair generated by the abuse and forced displacement of over twenty-three million persons in Africa, Southeast Asia, Europe, and elsewhere.  The difficulties of trying to treat the mental stresses of abandoned children, the elderly, and the mentally ill contribute to the burned-out feeling of relief workers, who themselves suffer traumatic effects from their experiences. The emotional stress on international humanitarian aid workers facing people dying by the thousands from thirst and dehydration in places like Zaire is also described in the book.  Survivors suffer from feelings of unearned guilt; helpers need help; witnesses to atrocities become emotionally devastated by feelings of rage, powerlessness, despair, and terror.  The challenge to NGOs, UN programs, and national agencies is often overwhelming.
A host of UN resolutions, treaties, conferences, guidelines, and declarations seek to protect women form discrimination, violence, and all forms of abuse. Christine Brautigam of the United Nations notes that the use of mass rape for “ethnic cleansing” in the former Yugoslavia is a war crime and that the creation of the ad hoc international criminal tribunal by the Security Council was a major step forward by specifically authorizing the tribunal to punish rape as a crime against humanity.  Rosalind Harris of International Social Service, a New York-based agency, deals with the contribution of many NGOs in handling traumas caused by violence against women. “It is requiring strenuous efforts,” she says, “to gain universal acceptance of the concept that human rights are women’s rights.”  John Orley of the World Health Organization describes the contribution made by that important UN agency as it recently took steps to incorporate PTSD into its diagnostic system. 
Armed conflicts are the greatest cause of traumatic stress, as can be seen from the report by Pascal Daudin and Hernan Reyes of the International Committee of the Red Cross.  Establishing contact with prisoners, deterring mistreatment, torture, or abuse – while maintaining neutrality and compliance with agreed standards – the ICRC, acting in conjunction with other organizations, helps to ensure better protection of basic human rights. UN peacekeepers, with limited mandates, are subjected to enemy fire, humiliations, and frustrations that generate stress syndromes that must be overcome. The UN Children’s Fund tries to heal the invisible wounds of children in war by tracing and reunification programs and training case workers to recognize and address symptoms of PTSD. Enabling young victims to mourn , reconnect, and rebuild their lives is part of the healing process fostered by UNICEF as it seeks to find causes and develop long-term holistic solutions to overwhelming psychological needs.
The worldwide contribution of NGOs to helping young victims of violence is described by Nancy Dubrow of the International Society for Traumatic Stress Studies (Chicago), Norbetto Liwski of Defence for Children International (Argentina), Carlos Palacios of Childhope International (Guatemala), and Meg Gardinier of the International Catholic Bureau (New York).  The contributions of NGOs offering victim assistance and support are outlined in many of the chapters. Victims of torture and “disappearances” harbor fears for the safety of their families. Agencies such as Amnesty International can publicize such illegal acts but much more is needed before these crimes can be brought to a halt. Agencies like the Lawyers Committee for Human Rights and the International Commission of Jurists have fought valiantly to enforce human rights through the courts. The activities of such legal NGOs slowly advance the rule of law despite great political obstacles.
In the final chapter, Professor Roger Clark of Rutgers University and Professor Daniel Nsereko of the University of Botswana deal with the vital issues of implementation and coordination of international organizations and mechanisms to curb traumatic stress.  They call for more detailed standards at both the national and the international level, international supervision and reporting, individual complaint procedures, and greater public awareness of the work being done in the field and what still needs to be done to protect human rights by coordinated and coherent policies on all levels.
Despite efforts to end on an optimistic note, the perceptive editors must conclude that “traumatic stress is one of humanity’s growing plagues.”  They are to be applauded for this systematic attempt to describe international responses to great human tragedies that almost go unnoticed by the general public. As nationalist and ethnic tensions continue to explode into conflict all over the world, the virus of unchecked hatred destroys millions of victims – physically, morally, and mentally – in an endless cycle of recurring crime and violence. If, as the editors conclude, “[g]enuine peace cannot exist without the resolution of trauma,”  the traumas herein described cannot be curbed without the existence of peace. Everything is linked. We must have clearer laws, courts with binding civil and criminal authority, and an effective system of international law enforcement built around a stronger United Nations supported by the many nongovernmental organizations and an informed public from all nations. The editors here challenge all human beings to behave like human beings in order to save humanity. International Responses to Traumatic Stress is a book worth reading and pondering.
The writer was a Nuremberg war crimes prosecutor.
 Editors’ Introduction to International Responses to Traumatic Stress 1, 4 (Yael Danieli et al. eds, 1996)..
 Eduardo Vetere & Irene Melup, Criminal Activity – Victims of Crime: The Contribution of the United Nations Crime Prevention and Criminal Justice Program, in International Responses to Traumatic Stress, supra note 1, at 15, 48-49.
 Mary Petevi, Forced Displacement – Refugee Trauma, Protection, and Assistance: The Contribution of the United Nations High Commissioner for Refugees, in International Responses to Traumatic Stress, supra note 1, at 161.
 Barbara Smith et al., Health Activities across Traumatized Populations – Emotional Responses of International Humanitarian Aid Workers: The Contribution of Non-governmental Organizations, in International Responses to Traumatic Stress, supra note 1, at 397.
 Id. at 406.
 Christine Ainetter Barutigam, Traumatized Women – Dealing with Violence against Women: The Contribution of the United nations Commission on the Status of Women, in International Responses to Traumatic Stress, supra note 1, at 347, 361.
 Rosalind W. Harris, Traumatized Women – Dealing with Violence against Women: The Contribution of Non-governmental Organizations, in International Responses to Traumatic Stress, supra note 1, at 383.
 John Orley, Health Activities across Traumatized Populations – WHO’s Role Regarding Traumatic Stress: The Contribution of the World Health Organization (WHO), in International Responses to Traumatic Stress, supra note 1, at 383.
 Pascal Daudin & Hernan Reyes, Armed Conflicts and Analogous Disturbances – How Visits by the ICRC Help Prisoners Cope with the Effects of Traumatic Stress: The Contribution of the International Committee of the Red Cross, in International Responses to Traumatic Stress, supra note 1, at 219.
 Nancy Dubrow et al., Traumatized Children – Helping Child Victims of Violence: The Contribution of Non-governmental Organizations, in International Responses to Traumatic Stress, supra note 1, at 327.
 Roger Clark & Daniel Nsereko, Issues of Implementation and Coordination, in International Responses to Traumatic Stress, supra note 1, at 425.
 Yael Danieli & Lars Weisaeth, Conclusion to International Responses to Traumatic Stress, supra note 1, at 439, 440.
 Id. at 440.