Multicultural social work and national trauma: Lessons from South Africa

Introduction

South Africa’s history of apartheid from 1948 to 1994 as a crime against humanity is widely acknowledged and well-documented (Asmal et al., 1997; Cohen, 1993; Krog, 1998; Magubane, 1994; Sachs, 1991; Villa-Vicencio, 2000). Because of the circumstances during this time, the country endured prolonged national trauma that affected most of its citizens, but mainly black communities who were the primary targets of apartheid atrocities. In 1995, after the official end of apartheid, the Truth and Reconciliation Commission (TRC) was established to promote healing and reconciliation within and among South Africa’s traumatized and divided communities. Although it had a decisive impact in the short term, its eventual effect was limited and many communities did not benefit fully from the process. In the absence of further ongoing healing and reconciliation initiatives to address the remaining long-term needs of affected groups, past circumstances of national trauma continued unresolved and have since fused with broader social issues and disadvantage in the country.

Post-apartheid social work and welfare service delivery operate within this milieu of past national trauma, in combination with current intensified circumstances of poverty, unemployment, violence, social inequality, and persistent lack of effective service delivery to the majority of South Africans. They, as in the past, remain the main victims of oppression and disadvantage. These conditions have had a profound effect on the professional practice of social workers, posing critical challenges to them in achieving both the goals of social work and the democratic ideals of the country. To address these challenges, South Africa adopted a developmental social welfare approach guided by its White Paper for Social Welfare (RSA, 1997). Patel (2008: 73) contextualizes this approach as ‘a pro-poor strategy promoting participation of the socially excluded in development activities to achieve social and economic justice, human rights, social solidarity and active citizenship’. In the process, she explains that harmonization of socio-economic and human development is essential, but will require proactive collaboration between government, civil society, and relevant role-players.

This article analyzes the role of social work in the above context with specific reference to addressing past national trauma. It argues for multicultural social work as a particularly suitable response in engaging with the socio-psychological and human impact of the past. Within the unique history and circumstances of South African society and the developmental focus of social work, however, this response would need to move beyond the traditional emphasis of multicultural social work in direct practice with individuals and groups: it would in addition need to integrate communal dimensions that would draw communities as a whole into healing and transformation. In this respect, the work of the TRC provides material for such an alternative formulation of multicultural social work responses in South Africa. It provides information to extract community-specific assessment criteria that can be used in working with South Africa’s diverse communities in the process of long-term healing; and it alerts social workers to important principles of multicultural practice within the context of national trauma from which those different communities need to recover. Concomitantly, there emerges through this analysis preliminary intervention principles that may be applied to other countries facing national trauma as they assess and design appropriate multicultural social work services in their own circumstances.

Multicultural social work and the South African context

Integrating multicultural practice in service delivery is an essential part of social work (Mama, 2001; Sue, 2006; Weaver, 1999). As a specific form of practice, multicultural competence focuses on diverse communities and advances a shift away from applying predominantly Western-based knowledge and intervention systems in working with these communities (Johannes and Erwin, 2004). Factors such as culture, ethnicity, gender, race, religion, and traditional healing systems and their application in service provision are central to this approach (Abdullah, 2007; Moodley and West, 2005); social workers are encouraged therefore to reflect these issues when serving clients in multicultural settings (Dyeson, 2004). Sue (2006: 20) defines multicultural social work as:

both a helping role and a process that uses modalities and defines goals consistent with the life experiences and cultural values of clients; recognizes client identities to include, individual, group, and universal dimensions; advocates the use of universal and cultural specific strategies and roles in the healing process; and balances the importance of individualism and collectivism in the assessment, diagnosis, treatment and problem solving of clients and client systems.

Sue describes multicultural practice then in terms of balancing diversity in social service provision, adding that clients are assessed not only as individuals but in relation to their family, community, and cultural environments. Ow (1999) and Midgley (1990) affirm these views and emphasize further the importance of locating multicultural social work within a social development framework to advance efficient service delivery to clients. Debates on the indigenization of social work, in that social work is context specific and locally relevant in relation to the worldview, needs, and unique circumstances of clients (Gray and Coates, 2010; Weaver, 1999), reinforce the value of multicultural social work.

In South Africa, attention has been devoted in various disciplines to validating multicultural practice (Berg, 2003; Buhrmann and Nqaba Gqomfa, 1982; Crawford and Lipsedge, 2004; Kasiram and Oliphant, 2007; Swartz, 1998). In terms of service provision, emphasis has been placed on developing greater cultural sensitivity towards indigenous and black communities and marginalized groups whose worldviews and values were disregarded during apartheid times. In these analyses, multicultural practice is viewed as a means of breaking down past racial and cultural barriers between diverse communities, thus propelling a course towards greater understanding of one another. It is also seen as a means of delivering culturally relevant services to clients who were previously deprived of such services. Cultural diversity, therefore, is to be acknowledged and consciously assessed in providing services to clients and communities. Post-apartheid debates and policies in social work likewise reflect this perspective.

At policy level, the White Paper for Social Welfare (RSA, 1997) as well as the South African Council for Social Service Professions (SACSSP) Policy Guidelines for Course of Conduct, Code of Ethics and the Rules for Social Workers, although not directly referring to multicultural social work, support the principles of its practice. The White Paper in particular, includes the importance of diversity as fundamental to its developmental social welfare approach. Principles that inform this approach include ubuntu or humanness, appropriateness, and non-discrimination. Under ‘appropriateness’, the White Paper indicates that social welfare programmes should respond to the social, cultural, and economic conditions of communities, while under ‘non-discrimination’, it states that ‘Social welfare services and programmes will promote non-discrimination, tolerance, mutual respect, diversity, and the inclusion of all groups in society’ (RSA, 1997: 10).

Discussions more directly related to multicultural social work concentrate on direct services with individuals or groups. Ross (2008a), for example, argues in support of culturally relevant social work service delivery while simultaneously highlighting dilemmas that may evolve from its practice. She explores contentious issues pertaining to African medicine, ritual animal slaughter, organ donation, and virginity testing to illustrate the dilemmas that ensue when these practices are assessed within a framework of ethical social work and South Africa’s rights-based society. In a study of traditional healing in South African religious communities, including Muslim, Chinese, and Hindu groups, Ross (2008b) offers additional insights into these communities’ beliefs on health and well-being and their reliance on religio-cultural services in their specific environments, notwithstanding the availability of Western medicine.

In a related debate on supervision in social work, Engelbrecht (2006) calls for an approach of ‘cultural friendliness’ to challenge the racial and cultural inequalities of apartheid, which he believes can affect the supervisory relationship in inter-cultural and inter-racial supervision if not adequately addressed. The incorporation of ubuntu into community work (Mnyaka and Motlhabi, 2005) and advancing a culture of human rights – beyond narrow formulations of human rights rooted in Western society to instead address broader social injustices – as an integral part of social work (Noyoo, 2004) resonate similarly with multicultural social work in South Africa. A view linking broadly to the focus of this paper is from Sacco and Hoffmann (2004), who examine the role of social work in relation to the TRC. They list the failures of the profession in the education of social workers during the apartheid era and propose that social workers integrate the key theme of reconciliation into their work. Overall, however, multicultural social work in the context of the country’s broader social circumstances of national trauma and dealing with its long-term socio-psychological and human development implications at community levels is still indistinct. This article attempts to address this limitation by assessing the role of multicultural social work in national trauma and articulating preliminary principles for its practice.

The findings of South Africa’s TRC are central to this goal. Norval (1998) argues that the TRC remains an important ‘memory site’ that informs the present and will require constant engagement and change as part of the ongoing transformation in the country. As she says in evaluating notions of justice in relation to the TRC, ‘I would argue that public recognition and acknowledgement of injustices thus constitute the basis for the attainment of justice. That is why the public recognition of memories of the past in the reconstruction of the present and the future is crucial to the whole process’ (1998: 254). This article reflects on the TRC in this manner as a means to formulate principles for multicultural social work as it relates to national trauma and socio-psychological communal healing and transformation. It overviews selected findings of the TRC, which cohere with multicultural practice. These findings are relevant to multicultural social work; they merge concerns of culture, gender, healing, race, and religion, and provide a starting point for assessing clients and community needs in respect of multicultural services and the facilitation of interventions consistent with lived realities and circumstances.

The TRC’s record on national trauma as a guide for multicultural social work

South Africa’s TRC Report provides a national record of trauma and suffering at personal and community levels specific to the country. It serves as an analytical reference point for social disintegration and national trauma as well as for the problems that communities face and towards whose resolution social workers attempt to assist. Social workers can use this record as a starting point to gauge the types of experiences that have caused national trauma as well as its socio-psychological and human development impact, and to plan appropriate multicultural intervention services to communities.

The TRC was established in 1995 after the country’s first democratic election in 1994 and, as mandated by legislation, appointed by former President Nelson Mandela. To enhance and sustain a peaceful transition in the country, the TRC was advanced as a bridge-building exercise to move South Africans from a divided past to a society based on human rights and democracy (TRC Report, 1998). Drawn mainly from the religious and legal fraternities, it was tasked with providing a comprehensive account of the nature and scale of apartheid atrocities. This it did by charting gross human rights violations committed by all parties of the apartheid state as well as the liberation movement over the period of 33 years of apartheid rule commencing with the Sharpeville massacre. The designated period for the enquiry was March 1960 to May 1994. Guiding legislation for this overall was the Promotion of National Unity and Reconciliation Act (No. 34 of 1995).

According to its legislative mandate, the Commission had to identify and assess the fate of victims of apartheid human rights violations. For those who survived, it had attempted to restore their civil and human dignity by giving them an opportunity to relate their experiences and recommending appropriate reparation. The Commission also had to decide on the contentious issue of granting or denying amnesty to perpetrators of human rights violations based on the full disclosure of their actions. Information on the commission’s activities and findings, including recommendations to prevent any recurrence of human rights violations in South Africa, was then be compiled in a detailed report (TRC Report, 1998).

The work of the TRC covered many dimensions of South African life under the apartheid regime. A range of submissions came from political parties, apartheid state structures, and various sectors of society including business and labor, faith communities, the legal community, the health sector, children and youth, and women (TRC Report, 1998). An estimated 21,000 people (of whom 12% appeared at public hearings) made submissions, while approximately 7500 perpetrators sought amnesty (Green-Thompson and O’Leary, 1998).

On completion of its work, the TRC documented its findings. These findings provide a record of trauma and suffering relevant to multicultural social work, with violence, social disintegration, and a lack of appropriate multicultural services as critical indicators. The TRC located apartheid in a historical and socio-political context. It noted that its mandate period, in relation to the African continent, was the last stage of the struggle for African decolonization, a process which Fanon (1967), in an analysis of the relationship between the colonizer and colonized, observed as intrinsically violent. Fanon (1967: 27) stated: ‘National liberation, national renaissance, the restoration of nationhood to the people, commonwealth: Whatever may be the headings used or the new formulas introduced, decolonization is always a violent phenomenon.’

For South Africa, as the TRC Report observes, its mandate period was the culmination of conflict initiated in the early 17th-century European colonial settlement of the continent. Slavery, wars of dispossession, the hunting and elimination of indigenous peoples, concentration camp deaths, genocidal wars and, later, apartheid human rights atrocities, defined this colonial presence (TRC Report, 1998). White people were identified as victims during this time as in the concentration camp deaths of Afrikaner women and children by British forces in the early 20th century. A number of individuals from white communities also joined the liberation struggle or resisted apartheid policies and became targets of the state. However, black communities bore the brunt of these atrocities. The report concluded therefore that apartheid, rather than a distinct and separately instituted system of violence, was in reality an extension of an entrenched tradition of excessive force and violence against opposition, resulting ultimately in a society in which a culture of physical and institutional violence was ingrained.

In assessing the socio-psychological and human impact of this relentless violence, the report notes that apartheid led to wide-scale loss of life, pervasive poverty, and the lack of resources in spheres of life such as housing, education, and health. Citizens suffered sustained psychological stress, deprivation, dire socio-economic conditions and the cumulative trauma of violent state repression and community conflict. In addition, forced removals of black people through the Group Areas Act (No. 41 of 1950) and other punitive legislation affected families, communities, and social systems, which disintegrated along with family functioning. Family members were removed from each other for long periods and many parents were not available to care for their children due to harsh living conditions and working far from home to ensure economic survival. The disintegration of family networks affected children and youth in particular, who were also the main targets of apartheid state atrocities including murder, torture, and displacement (TRC Report, 1998). Sachs (1990) confirms that it was the explicit intent of apartheid laws to split up black families by means of the migrant labor system and associated taxes and pass laws. He observes that the home was the centre of political and economic life, and separating as well as dispossessing people from their land became the focus of the ideological, legal, and economic attack that struck at African customs and family life.

The report established further that police invasions of homes, arrests, harassment and the killing of relatives of political activists and in certain instances of whole family units, together with enforced separation of the family through detention, exile and imprisonment, intensified social and family disintegration. These factors undermined family cohesion vital to ensuring stability and development in communities and society at large. Physical ailments in victims due to torture as well as post-traumatic stress disorder (PTSD) and other mental health problems from sustained trauma added to the disruption of interpersonal, family, social and community relations. Societal violence was reflected down the line in the high levels of family violence directed primarily at women and children who were subjected to violence and abuse in the home (TRC Report, 1998).

Gender-based violence was one of the serious damaging features of apartheid South Africa. In their submission, Goldblatt and Meintjies (1996) emphasize the severity of apartheid on women. They highlight the oppression of women in respect of race, class, and patriarchy under apartheid, noting that civil and political participation by women in society was curtailed; women were tortured physically and psychologically, sexually assaulted and abused, and banished when not in possession of a pass that all black people were expected to carry as part of regulating their movement in the country. Reflecting on the social and cultural climate of oppression, the submission noted that prevailing societal norms encouraged an environment that treated women as objects and empowered men to disrespect them, while customary law relegated women to the status of minors and excluded them from resources such as property. Further, single women, heads of households, and widows suffered abuse not only by the state, but also often within their communities at the hands of extended family from whom they faced the risk of eviction and homelessness in the absence or loss of a spouse. Losing a spouse increased discrimination based on cultural norms, which added to women’s difficulties.

Given these circumstances, the TRC Report concluded that apartheid affected the collective socio-psychological well-being of the majority of South Africans. It observed the lasting negative effects of that political system as well as the TRC’s own limitations in addressing them, stating:

The extent of trauma experienced by victims of the policies of the former State is incalculable reaching far beyond those who approached the Commission. This trauma is part of the legacy of apartheid and it will be many years before its effects are eradicated from society. (. . .) However, because of the extreme paucity of mental health services in South Africa, the mental health of the many victims of apartheid – and indeed of all South Africans – will depend on the ability of the new government to work towards the provision of adequate services. (TRC Report, Vol. 1, 1998: 371)

Factors that aggravated this situation and which continue in the present, as the report indicates, included historical neglect in areas of mental health service provision as well as a lack of trained practitioners, including social workers, to address the specific problems related to trauma associated with apartheid atrocities. South Africa’s past circumstances were not conducive to dealing with social and psychological traumas and implementing successful therapeutic interventions; resource allocation was limited in black communities and clients lived in impoverished and dysfunctional environments that undermined the outcomes of available services. Critically, appropriate intervention services were lacking especially those culturally relevant to South Africans (TRC Report, 1998).

In considering these circumstances, the TRC attempted to direct a way forward in achieving change, even though many of its suggestions did not materialize in the long term. From a socio-psychological and human development perspective, the Commission identified principles that could facilitate communal change including forgiveness, reconciliation, restorative justice, ubuntu, utilizing traditional healing systems, reparation, and advancing social redress through adequate resource allocation and service provision. It emphasized the value of religion and culture, which are important components of multicultural practice in this process, noting:

We are also required to look again at the restorative dimensions of various traditions in South Africa, such as the Judeo-Christian tradition and African traditional values. Neither is monolithic in its approach; both contain strong sources of communal healing and restoration. (. . .). As far as traditional African values are concerned, the fundamental importance of ubuntu must be highlighted. Ubuntu, generally translated as ‘humaneness’, expresses itself metaphorically in umuntu ngumuntu ngabantu – ‘people are people through other people’ (TRC Report, Vol. 1, 1998: 127)

The above findings identify the historical and social environment that defines South African society. They point to areas of need that intersect with multicultural practice, especially human development outcomes as envisaged by the developmental social work approach. In introducing a communal focus for multicultural social work, this vast archive of information collectively provides a basis on which to formulate principles of practice for multicultural services in the South African context of national trauma.

Multicultural social work and national trauma

The TRC record highlights possible sites for community assessment and intervention for multicultural social work within the framework of the profession’s responsibility in South Africa to respond to national trauma and to attain redress for the majority of the county’s citizens. This is especially necessary given the limitations of the TRC. The Commission was criticized at various levels for, among other things, its public emphasis on Christian principles of redemption and forgiveness and for providing limited reparation to victims through minimal financial compensation, but more importantly, for failing to attain in the long term its own goals of socio-psychological and communal healing and reconciliation (Adam, 1998; Bhargava, 2000; Chapman, 2007; Gutmann and Thompson, 2000; Mamdani, 1997; Vora and Vora, 2004). A respondent at the Commission captured the sentiment of the times when she said:

I know, Chairperson, the Truth Commission has got a programme of therapy, but I hope it can be sustained, because my own experience in the few months has been that some of the women whose wounds you opened – we did not pay enough time or give them enough opportunity to heal once they left these halls. (. . .) but those wounds, they need to be addressed, Chairperson. You cannot open them in this hall and leave them gaping. Somebody has got to take responsibility. (TRC Report, Vol. 5, 1998: 355–6)

Today, close to two decades after the TRC, the circumstances of South African black communities remain marked by violence, inequality, and poor service delivery rooted in the long-term impact of the past. The number of people living in poverty is estimated to be at 40 percent of the population (Landman et al., 2003), and the latest unemployment figures remain high at 23.9 percent (Statistics South Africa, 2011). In a recent survey on social trust as an indicator of social well-being, including health, welfare and community participation, South Africa scored low on trust amongst its citizens and was classified as a ‘low-trust society’ (Mmotlane et al., 2010: 5). In healthcare, a lack of relevant multicultural services continues to present major concerns in mental health service provision (Kohn et al., 2004; Swartz and Drennan, 2000). National healing remains a critical challenge.

Social work can play an important role in improving the circumstances of communities who continue to bear the long-term implications of apartheid, by offering multicultural services at community levels. This intervention should target the larger context of South Africa’s experience of national trauma and assess its communal impact. Practitioners should then further respond to meet the needs of clients and communities by articulating criteria and principles of intervention applicable to their specific situation.

A preliminary set of intervention principles to facilitate this outcome may include the following assessment criteria:

In their assessment and subsequent interventions, practitioners could draw on techniques relevant to dealing with post-conflict healing. Feminist and narrative interventions that allow articulation of experiences of oppression and healing as survivors, the genogram as a multi-generational tool to illuminate multicultural family concerns, and merging Western and African traditional healing, are options to build on this process. There are indications of success of these methods in African and South African settings (Crawford and Lipsedge, 2004; Marchetti-Mercer and Cleaver, 2000; White and Dotson, 2010). New emerging methods like multimodal therapies that deal specifically with the collective trauma of discrimination, oppression, and poverty (Kira, 2010) also need to be considered. Grassroots initiatives, which are consistent with community development in social work, could further mobilize diverse groups within defined communities and localities to explore past circumstances of privilege and disadvantage based on multicultural divides like class, culture, ethnicity, gender, and race; ideally, a new consciousness of the past and commitment to work together towards change could develop.

Social workers would have to discern for themselves the most appropriate interventions, but depending on the makeup of a community, such therapeutic techniques together with community-specific multicultural principles and underpinned by values of ubuntu, social justice, redress, and reconciliation, could form part of a repertoire of principles to guide the worker towards attaining social transformation. Essentially, communal experiences in relation to the larger social trauma would be holistically assessed. Such experiences would be further assessed in relation to multicultural criteria relevant to the community to which clients are bonded personally, culturally, and socially, and appropriate interventions planned.

As noted by Patel (2008) earlier, in addition to clinical interventions effective developmental social welfare requires collaboration between government, civil society, and relevant stakeholders. As a component of this process, social workers could link with role-players engaged in similar projects in their multicultural practice. South African non-governmental organizations like The Centre for the Study of Violence and Reconciliation (B. Kekana, personal communication, 13 July 2011) and The Trauma Centre (Z. Joseph, personal communication, 14 July 2011) offer examples of practice that resonate with multicultural social work as proposed by this article. They provide trauma services to ex-combatants and victims of apartheid torture as well as client-specific interventions that include multicultural foci. Social workers could collaborate with these groups in the broader communal assessment of national trauma and design holistic programs to advance the transformation goals of their targeted communities. This will allow for greater synergy in service delivery.

These criteria are only preliminary indicators however; they need to drive the formulation of more systematic evidence-based guidelines specific to multicultural social work in the South African context of national trauma. In social work, practice guidelines are the foundation for improved services and client outcomes, providing a sounder base for social and professional advocacy (Jackson, 1999; Kirk, 1999). It is a professional endeavor that has to be formulated by groups or organizations with expertise relevant to specific practice areas (Howard and Jenson, 1999) and be guided by systematic research (Williams and Lanigan, 1999) as well as consensus building (Steketee, 1999). Howard and Jenson (1999: 297) indicate that guidelines in social work have been developed mainly for clinical settings, but their formulation for macro-level intervention is likewise important, stating ‘it is of utmost importance that social work guidelines address contextual factors and person-by-situation interactions as they impact on the selection, application, and effectiveness of interventions’. They conclude that properly formulated guidelines can promote empirical practice without limiting professional autonomy.

In this respect, in the South African environment, social work that assesses and profiles communal experiences of national trauma and translates it into evidence-based guidelines for multicultural practice would be essential. Expert, professional, and State welfare role-players can facilitate this process with policy development and education, integral macro processes. Policies for multicultural practice can emanate, for example, from efforts of task teams and professional bodies like the Association of South African Social Work Education Institutions (ASASWEI), and the National Association of Social Workers – South Africa (NASW-SA).

In education, social work programs at both undergraduate and postgraduate levels could assess the cultural appropriateness and relevance of their curricula, policies, and practices and incorporate culture-specific training into their programmes. Training to develop capacity amongst both educators and students to address challenges of diversity and cultural competence in fieldwork and service provision would be crucial. Research to promote best practice would be a necessary part of the process. Such changes are particularly needed as guidelines for multicultural practice in welfare legislation and the code of conduct for professional practice is seriously limited. Above all, South Africans have suffered from collective sustained national trauma whose features remain part of the country’s functioning. Because of past racial divides, different race groups as either survivors or perpetrators of apartheid atrocities view and experience this trauma differently. Without a national strategy to address these circumstances, it remains an ongoing source of social division and dissent. Social work engaging macro-level and professional efforts to provide appropriate multicultural services in these circumstances will go a long way in advancing human and socio-psychological healing in South Africa as envisaged by the ideals of the TRC and the goodwill of the majority of South Africans.

Conclusion

South Africa’s transition to democracy signified a time of liberation and significant improvement in the life of black communities in respect of political freedom. The implications of apartheid in entrenching long-term national trauma and a culture of violence and disadvantage, however, continue to pose a major challenge in the new democratic order. The TRC’s record of the socio-psychological impact of these conditions on South African communities provides an ideal starting point to reflect holistically on prospects for multicultural service delivery in the country’s ongoing healing and transformation process. In addition, refinements should be proposed to assist social workers in directing their efforts effectively and creatively.

The TRC record is directly relevant to multicultural social work and provides a context for its practice at community level. Social workers in South Africa can therefore locate their intervention within the broader parameters of this record when seeking to assist clients from a multicultural perspective. This principle would encourage practitioners to consider broader emerging social problems in the light of their rootedness in the past, and to redefine the developmental framework of social work to take into account the experience of earlier national trauma. In essence, multicultural social work can play a significant role as a healing and transformation initiative, serving the needs of diverse communities as they emerge in their different ways from the long-term damage caused by the national trauma of apartheid.