“ “Psychosocial and legal assistance to former prisoners of war, military and civilian “ Prim dr Fehma Kovač Psychiatric Hospital of Canton Sarajevo 21st EUMASS Congress of Insurance Medicine and Social Security and the 4th International Congress of Medical Assessors,Ljubljana, Slovenia, June 2016

Disclosures   I have no potential conflict of interes to report

 “If you want to fly on the sky, you need to leave the earth. If you want to move forward, you need to let go the past that drags you down.” ― Amit Ray, World Peace: The Voice of a Mountain Bird Amit RayWorld Peace: The Voice of a Mountain BirdAmit RayWorld Peace: The Voice of a Mountain Bird

What happened in the past?  During the war in BiH were registered 657 detention sites - prisons and camps  The camps were captured over civilians,  30,000 camp prisoners were killed or are missing

blue circle-one camp yellow triangle -5 camp red square - 10 camp

Definition of torture „ Torture is any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity..“ UN CONVENTION AGAINST TORTURE and Other Cruel, Inhuman or Degrading Treatment or Punishment

Stress and Physical and Mental Health External demands placed on an organism Organism’s internal biological and psychological responses to such demands

Potencial responses to trauma (O’Leary & Ickovics, 1994)

What happens to these people 20 years later?

The Association of former camp Prisoners in Bosnia and Herzegovina   Association of Camp Prisoners of Bosnia and Herzegovina, established in year, is a non- governmental, and multi-national associations of camp survivors   It has a 30,000 members  

 Association has recognized the need to evaluate the quality of life of their members, and identification of unmet needs

Project goals  Raising the level of psychosocial health and functioning of Torture Victims  Examine quality of life  Providing legal, administrative, psychotherapy and social support for the camp prisoners 21st EUMASS Congress of Insurance Medicine and Social Security and the 4th International Congress of Medical Assessors,Ljubljana, Slovenia, June 2016

Participants in the project  The Association of Concentration Camp Prisoners in BiH ( Center for providing legal, psychosocial and other forms of assistance )  OHCHR provided financial support

Legal assistance   The staff of the Center together with a team of lawyers experts in the field of civil, criminal and international humanitarian law supporting ex - camp prisoners in proceedings on claims for compensation of consequential damage - reparation.

Psychosocial suport  Selection of the sample  Entry test (MANSA)  Group and individual activities  Individual psychotherapy work with users depending on the needs and clinical features that were detected during the workshops

Group activities  Psychoeducation  Relaxation  Separation of mental suffering (GROUNDING)

Results  Manchester Short assessment of Quality of Life (MANSA), as a self -report scale (Priebe et al. 1999). The questionnaire contains 16 items. It has 10 questions with responses in Likert format, ranging from 1 to 7. Lower scores indicate a lower level of subjective perception of the Quality of Life.

MANSA Table 1.Sociodemographic characteristics

Satisfaction with specific areas of life Table 2. Mansa responses

What do these data suggest  T here is dissatisfaction with physical health, and dissatisfaction with mental health.  The most of satisfaction is related to social functioning (family and friends)

Conclusions  To get more relevant information we must to do  -A more comprehensive study, with a large number of subjects  - Detect potential risk of cardiovascular disease and other somatic condition in relation to the population that did not have the experience of camp torture  -In the study include instruments that talk about posttraumatic growth

Thank you for your attention! Thank you for your attention!