acupuncture, Bahrain, Bangladesh, Burma, conflict resolution, Global Health, Haiti, HAS Haiti, Libya, PHR, Physicians for Human Rights, post-traumatic stress disorder, PTSD, Refugee Health, Refugees, Richard Sollum, Rwandan genocide, Schweitzer Fellow, Thailand, trauma, United Nations, war, Zimbabwe
As a Schweitzer Fellow in Boston in 2004-05, Richard Sollom—then an MPH student at Harvard—partnered with the International Institute of Boston (now the International Institute of New England) to establish an acupuncture clinic that successfully mitigated the effects of post-traumatic stress disorder (PTSD) on refugees who had experienced torture, kidnapping, and the horrors of war.
Seven years later, Sollom is Deputy Director for Physicians for Human Rights—where he oversees programs on emergency response, armed conflict, asylum, and U.N. advocacy initiatives (and leads human rights investigations in countries including Bahrain, Bangladesh, Burma, Libya, Thailand, and Zimbabwe).
Despite the atrocities he’s seen, Sollom remains awed by the human capacity to heal—and he says, “I believe more strongly than ever in Albert Schweitzer’s personal credo of ‘reverence for life.’”
Why did you decide to develop your particular Schweitzer project?
As a human rights monitor for the United Nations Mission in Haiti in 1993, I came across Hôpital Albert Schweitzer and began to learn about the eponymous man who inspired an American physician to build this medical oasis in the Western hemisphere’s poorest country.
The next year, during the Rwandan genocide, I worked as a protection officer in neighboring Burundi for the UN refugee agency. I interviewed hundreds of fleeing refugees who had experienced the worst horrors of war; many were undoubtedly suffering from post-traumatic stress disorder (PTSD). In other countries, too, I witnessed the physical ravages of war but also sensed a similar psychological toll among diverse populations such as Somalis, Bosnians, and Haitians—the vast majority of whom had no access to any health interventions to address their extreme traumatic stress.
The UN and humanitarian organizations were (and remain) stymied over how to bring psychosocial care to increasing populations of fleeing refugees sequestered in refugee camps across the globe. Prior to beginning an MPH program at Harvard, I wanted to test my hypothesis that traditional Chinese acupuncture could be used as a cost-effective and culturally appropriate health intervention to refugees suffering from PTSD-like symptoms.
The Albert Schweitzer Fellowship program allowed me to establish a pro bono acupuncture clinic to treat refugees with PTSD in the Boston area. At the time of the clinic establishment in 2004, Massachusetts ranked 7th in the United States as a destination for refugees. The International Institute of Boston—an established nonprofit organization that has provided refugees and asylum seekers with services for over 80 years—generously offered to host the acupuncture clinic.
What was the lasting impact of your project on the community it served?
Over the course of the project, 111 treatments were performed on 16 patients from 13 countries. A psychiatrist diagnosed all patients with PTSD as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The most common complaint was pain; secondary complaints were mental-emotional symptoms.
Although this clinic was not established with the intention of performing a clinical trial, based on clinical observation there was a considerable reduction in symptoms related to PTSD in 14 of the 16 patients. There were several additional indicators of the success of the clinic, such as the expansion of patient referral sources to include organizations other than the initial one, compliance of patients despite economic obstacles that often made commuting difficult, and extremely positive feedback from the caseworkers.
One representative case involved an African man who complained of chronic epigastric pain of unknown etiology and nightmares that occurred nearly every night for two years. The nightmares were vivid ﬂashbacks of the torture he endured. Over the course of three months and weekly acupuncture treatments, his nightmares reduced to twice weekly and his pain improved substantially. The last time that he was treated, he hadn’t experienced pain in 10 days. As his pain reduced and his sleep improved, he reported less frequent ﬂashbacks of his torture and presented as much more hopeful about his future in this country. When asked about the acupuncture treatments, he commented, “Acupuncture is like Wagesa [traditional medicine] in my country, not like hospital medicine.”
Another case concerned a woman from South America who presented with constant wrist pain secondary to a fracture many months before. She expressed frustration that doctors were unable to diagnose the cause of her pain. She also suffered from anxiety and depression, for which she was prescribed several medications. During our first meeting, she was tearful throughout the intake due to the kidnapping of her young daughter in Colombia. After only three acupuncture treatments, her pain had ceased. Over the course of the month, her affect brightened remarkably. Although the traumatic history from her past can never be changed, her quality of life in this country has improved dramatically. She reported, “I prefer acupuncture because it doesn’t make my body feel bad like my medicine does.”
Based on these (albeit limited) clinical observations, the use of acupuncture for the treatment of psychological trauma appears to be a viable treatment modality for refugees with PTSD. Of note, many of the treated refugees stated that acupuncture was similar to traditional medicine from their country of origin, and therefore they expressed a certain level of comfort with the treatments. None expressed any fears or doubts about acupuncture, and there were no observed cases of retraumatization. These observations support the value of further research evaluating the potential benefits of adding acupuncture to health services currently offered to refugees suffering from PTSD.
What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?
I’ve spent most of my career working in low-income countries, where the three leading risk-factor causes of death (childhood underweight, high blood pressure, and unsafe sex) lead to nearly 6 million annual deaths. From a public health perspective, one can easily argue this burden of disease represents the most pressing global health issue. Cost-effective and evidence-based interventions exist that address each of these issues; the primary challenge is securing requisite and sustained funding for such health initiatives.
Through chance and serendipity, I pursued a career in international human rights advocacy with a focus on war crimes and crimes against humanity. I’ve investigated human rights abuses in more than 20 countries over the past 20 years and have witnessed some of the worst atrocities man has inflicted on others, from the genocides of Rwanda and Sudan to Mugabe’s man-made disaster in Zimbabwe; from the world’s longest-running civil war in Burma to the recent violence in Libya.
Some 200,000 annual deaths are attributed to such collective violence, and its risk factors include the wide availability of small arms, political and socioeconomic inequalities, and human rights violations. I juxtapose these various health-related issues and attendant risk factors to demonstrate that although the number of deaths attributable to war is one-tenth that of deaths caused by childhood underweight, the “health intervention” for the former is far less clear than that of the latter.
As Deputy Director for Physicians for Human Rights, where we use medicine and science to stop human rights abuses, I consider collective violence and deaths related to torture at the hands of government authorities as some of the most pressing issues of our time—issues that health professionals have a unique skill set and ethical obligation to address.
What was the most surprising element of your experience as a Schweitzer Fellow?
Witnessing the extraordinary human capacity to heal, despite morose odds ratios and prognoses that evidence-based allopathic medicine may predict.
What does being a Schweitzer Fellow for Life (program alumnus) mean to you?
Being a Schweitzer Fellow for Life reminds me of the continued commitment I’ve had since formally ending my year-long fellowship in Boston in 2005. I believe more strongly than ever in Albert Schweitzer’s personal credo of “reverence for life”: the affirmation and respect for life, which he deemed the defining purpose of humanity. As an international human rights advocate, I am confronted with this mandate on a daily basis.
Richard Sollom is a Boston Schweitzer Fellow for Life. Click here to read more about The Albert Schweitzer Fellowship (ASF)’s Boston Schweitzer Fellows Program and the Fellows like Sollom it supports in creating and carrying out yearlong direct service projects that improve the health and well-being of vulnerable people and communities. To make a gift to support the Boston Schweitzer Fellows Program, click here.
Each week, Beyond Boulders delivers a new installment of “Five Questions for a Fellow” – an interview series with Schweitzer Fellows across the country and in Gabon, Africa who are leading the movement to eliminate health disparities. For an archive of previous “Five Questions for a Fellow” interviews, click here.