Inge Missmahl brings peace to the minds of Afghanistan

23,727 views ・ 2010-09-29

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Prevoditelj: Ivana Kordic Recezent: Tilen Pigac - EFZG
00:16
So I want to tell you a story -- an encouraging story --
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Želim vam, dakle, ispričati priču, jednu ohrabrujuću priču
00:19
about addressing
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o suočavanju s
00:21
desperation, depression and despair in Afghanistan,
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očajavanjem, depresijom i očajem u Afganistanu
00:24
and what we have learned from it,
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i o tome što smo iz njega naučili
00:26
and how to help people
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i kako pomoći ljudima
00:28
to overcome traumatic experiences
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da prevladaju traumatična iskustva
00:32
and how to help them to regain some confidence
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i kako im pomoći da povrate dio povjerenja
00:35
in the time ahead -- in the future --
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u vremenu koje dolazi -- u budućnosti --
00:37
and how to participate again in everyday life.
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i kako da iznova sudjeluju u svakodnevnom životu.
00:41
So, I am a Jungian psychoanalyst,
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Ja sam, dakle, Jungovska psihoanalitičarka
00:43
and I went to Afghanistan in January 2004, by chance,
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i u Afganistan sam otišla slučajno, u siječnju 2004. godine,
00:47
on an assignment for Medica Mondiale.
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na zadatku za Medicu Mondiale.
00:50
Jung in Afghanistan --
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Jung i Afganistan --
00:52
you get the picture.
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razumijete što hoću reći.
00:55
Afghanistan is one of the poorest countries in the world,
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Afganistan je jedna od najsiromašnijih zemalja u svijetu,
00:58
and 70 percent of the people are illiterate.
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i 70 posto stanovništva je nepismeno.
01:01
War and malnutrition kills people
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Rat i pothranjenost ubijaju ljude,
01:03
together with hope.
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ali ubijaju i nadu.
01:05
You may know this from the media,
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Ovo ste možda i doznali iz medija.
01:07
but what you may not know
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No ono što možda ne znate
01:09
is that the average age of the Afghan people is 17 years old,
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jest da je prosječna životna dob afganskog stanovništva 17 godina
01:12
which means they grow up in such an environment
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što znači da odrastaju u takvom okruženju
01:15
and -- I repeat myself --
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i -- kao što si ponavljam --
01:17
in 30 years of war.
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u ratu koji traje 30 godina.
01:19
So this translates
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Ovo se prevodi
01:21
into ongoing violence,
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u neprekidno nasilje,
01:23
foreign interests, bribery,
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strane interese, mito,
01:25
drugs, ethnic conflicts,
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drogu, etničke sukobe,
01:28
bad health, shame, fear
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loše zdravlje, sram, strah,
01:31
and cumulative traumatic experiences.
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i kumulativna traumatična iskustva.
01:34
Local and foreign military
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Lokalne i strane vojne snage
01:36
are supposed to build peace together with the donors
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trebale bi graditi mir u suradnji s donatorima
01:39
and the governmental and non-governmental organizations.
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te vladinim i nevladinim organizacijama.
01:42
And people had hope, yes,
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I ljudi su imali nadu, da,
01:44
but until they realized
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dok nisu shvatili
01:46
their situation worsens every day --
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da njihova situacija postaje sve gora iz dana u dan --
01:48
either because they are being killed
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bilo zato što ih se ubijalo,
01:50
or because, somehow,
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ili zato što su, nekako,
01:53
they are poorer than eight years ago.
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siromašniji nego što su bili prije osam godina.
01:56
One figure for that:
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Jedna brojka govori u prilog tome:
01:58
54 percent of the children under the age of five years
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54 posto djece mlađe od pet godina
02:01
suffer from malnutrition.
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pati od pothranjenosti.
02:03
Yet, there is hope.
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Ipak, ima nade.
02:06
One day a man told me,
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Jednoga dana jedan mi je čovjek rekao,
02:08
"My future does not look brilliant,
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''Moja budućnost ne izgleda sjajno,
02:10
but I want to have a brilliant future for my son."
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ali ono što želim jest sjajna budućnost za mog sina.''
02:14
This is a picture I took in 2005,
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Ovo je slika koju sam snimila 2005. godine
02:16
walking on Fridays over the hills in Kabul,
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u svojim šetnjama petkom preko kabulskih brda.
02:19
and for me it's a symbolic picture
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I za mene ona predstavlja simboličnu sliku
02:21
of an open future for a young generation.
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otvorene budućnosti koja čeka mlađu generaciju.
02:27
So, doctors prescribe medication.
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Dakle, doktori propisuju lijekove.
02:31
And donors
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I donatori
02:33
are supposed to bring peace
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bi trebali donijeti mir
02:35
by building schools and roads.
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gradeći škole i ceste.
02:40
Military collect weapons,
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Vojska prikuplja oružje,
02:42
and depression stays intact.
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i depresija ostaje netaknuta.
02:45
Why?
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Zašto?
02:47
Because people don't have tools
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Zato što ljudi nemaju vještine koje bi im omogućile
02:49
to cope with it, to get over it.
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da se nose s time, da to prevladaju.
02:54
So, soon after my arrival,
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Tako sam, ubrzo nakon svojega dolaska,
02:56
I had confirmed something which I had already known;
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bila potvrdila nešto što sam otprije znala
02:59
that my instruments come from the heart of modern Europe, yes.
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da moj instrumentarij dolazi iz srca moderne Europe, da.
03:02
However, what can wound us
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No, ono što nas ranjava,
03:04
and our reaction to those wounds --
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i naša reakcija na te rane --
03:06
they are universal.
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one su univerzalne.
03:08
And the big challenge
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I veliki izazov bio je u tome
03:10
was how to understand the meaning of the symptom
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kako razumijeti značenje simptoma
03:13
in this specific cultural context.
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u specifičnom kulturološkom kontekstu.
03:16
After a counseling session, a woman said to me,
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Nakon terapijskog sastanka, jedna mi je žena rekla,
03:19
"Because you have felt me, I can feel myself again,
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''Stoga što ste vi osjetili mene, ja mogu iznova osjetiti samu sebe,
03:22
and I want to participate again
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i želim iznova sudjelovati
03:24
in my family life."
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u mojem obiteljskom životu.''
03:27
This was very important,
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Ovo je od iznimne važnosti,
03:29
because the family is central
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jer obitelj je u središtu
03:31
in Afghans' social system.
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afganistanskog društvenog sustava.
03:34
No one can survive alone.
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Nitko ne može preživjeti sam.
03:37
And if people feel used, worthless and ashamed,
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I ako se ljudi osjećaju iskorišteni, bezvrijedni i posramljeni,
03:40
because something horrible has happened to them,
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stoga što im se dogodilo nešto užasno,
03:43
then they retreat, and they fall into social isolation,
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povuku se, i potom padnu u društvenu izolaciju
03:46
and they do not dare to tell this evil
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i ne usude se pričati o tom zlu
03:49
to other people or to their loved ones,
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drugim ljudima ili svojim najbližima,
03:52
because they do not want to burden them.
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jer ih ne žele opterećivati.
03:54
And very often violence is a way to cope with it.
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I nasilje je vrlo često način na koji se s time nose.
03:58
Traumatized people also easily lose control --
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Isto tako, traumatizirani ljudi lako izgube kontrolu --
04:01
symptoms are hyper-arousal and memory flashbacks --
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povišena nadraženost i bljeskovi sjećanja simptomi su toga --
04:03
so people are in a constant fear
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tako da su ljudi u stalnome strahu
04:05
that those horrible feelings of that traumatic event
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od toga da bi se užasni osjećaji vezani uz traumatični doživljaj
04:08
might come back unexpectedly,
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mogli vratiti neočekivano,
04:10
suddenly,
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iznenada,
04:12
and they cannot control it.
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i da ih neće moći staviti pod kontrolu.
04:15
To compensate this loss of inner control,
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Kako bi nadomjestili gubitak unutrašnje kontrole
04:18
they try to control the outside,
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pokušavaju kontrolirati izvanjski svijet,
04:21
very understandably -- mostly the family --
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razumije se -- uglavnom unutar obitelji --
04:23
and unfortunately,
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i nažalost,
04:25
this fits very well
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to se vrlo dobro uklapa
04:27
into the traditional side,
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u tradicionalnu stranu,
04:30
regressive side, repressive side,
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regresivnu stranu, represivnu stranu,
04:32
restrictive side of the cultural context.
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restriktivnu stranu kulturološkog konteksta.
04:36
So, husbands start beating wives,
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Tako supruzi počinju tući supruge,
04:39
mothers and fathers beat their children,
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majke i očevi tuku svoju djecu,
04:41
and afterward, they feel awful.
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i nakon toga se osjećaju grozno.
04:43
They did not want to do this, it just happened --
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Nisu željeli to napraviti. Jednostavno se dogodilo.
04:45
they lost control.
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Izgubili su kontrolu.
04:48
The desperate try
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Očajnički pokušaj
04:50
to restore order and normality,
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da vrate red i normalnost,
04:53
and if we are not able to cut this circle of violence,
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i ako nismo sposobni prekinuti taj krug nasilja,
04:57
it will be transferred to the next generation without a doubt.
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on će se, bez sumnje, prenijeti na iduću generaciju.
05:00
And partly this is already happening.
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To se dijelom već i događa.
05:03
So everybody needs a sense for the future,
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Tako da je svima potreban osjećaj za budućnost.
05:06
and the Afghan sense of the future
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A afganistanski osjećaj za budućnost
05:08
is shattered.
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je slomljen.
05:12
But let me repeat the words of the woman.
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Ali, dopustite mi da ponovim riječi te žene.
05:15
"Because you have felt me,
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''Stoga što se vi osjetili mene,
05:17
I can feel myself again."
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ja mogu iznova osjetiti samu sebe.''
05:20
So the key here is empathy.
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Znači ključna stvar ovdje je empatija.
05:22
Somebody has to be a witness
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Netko mora biti svjedok
05:24
to what has happened to you.
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onoga što vam se dogodilo.
05:26
Somebody has to feel how you felt.
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Netko treba osjetiti vas, ono što ste vi osjetili.
05:29
And somebody has to see you and listen to you.
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I netko vas mora vidjeti, mora vas poslušati.
05:34
Everybody must be able
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Svatko mora biti sposoban
05:36
to know what he or she has experienced is true,
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pojmiti da je ono što je on ili ona iskusila istinito.
05:40
and this only goes with another person.
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A to je jedino moguće uz drugu osobu.
05:43
So everybody must be able to say,
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Stoga svatko mora biti sposoban reći,
05:45
"This happened to me, and it did this with me,
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''Ovo se dogodilo meni, i učinilo mi je to,
05:48
but I'm able to live with it, to cope with it,
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ali sposoban sam živjeti s time,
05:50
and to learn from it.
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nositi se s time i učiti iz toga.''
05:52
And I want to engage myself
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I želim se uključiti
05:54
in the bright future for my children
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u svijetlu budućnost za moju djecu
05:56
and the children of my children,
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i djecu moje djece,
05:58
and I will not marry-off my 13 year-old daughter," --
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i neću udati svoju 13-godišnju kćerku'' --
06:01
what happens too often in Afghanistan.
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što se i prečesto događa u Afganistanu.
06:04
So something can be done,
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Znači da je moguće nešto napraviti,
06:06
even in such extreme environments as Afghanistan.
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čak i u takvim ekstremnim okruženjima kakav je Afganistan.
06:09
And I started thinking about a counseling program.
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I počela sam razmišljati o terapeutskom programu.
06:12
But, of course, I needed help and funds.
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Ali trebala sam, dakako, pomoć i sredstva.
06:14
And one evening,
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Jedne sam večeri
06:16
I was sitting next to a very nice gentleman in Kabul,
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sjedila pored jednog vrlog gospodina u Kabulu,
06:18
and he asked what I thought would be good in Afghanistan.
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i on me pitao što bi bilo dobro za Afganistan.
06:21
And I explained to him quickly,
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I objasnila sam mu brzo
06:23
I would train psycho-social counselors,
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kako bih obučila psihosocijalne terapeute,
06:26
I would open centers, and I explained to him why.
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otvorila centre, i objasnila sam mu zašto.
06:30
This man gave me his contact details at the end of the evening
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Taj mi je čovjek dao svoje podatke na kraju te večeri
06:33
and said, "If you want to do this, call me."
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i rekao, ''Ako želite to sprovesti, nazovite me.''
06:36
At that time, it was the head of Caritas Germany.
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U to je vrijeme on bio na čelu Njemačkog Caritasa.
06:41
So, I was able to launch a three-year project with Caritas Germany,
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Tako sam dobila mogućnost pokrenuti trogodišnji projekt s Njemačkim Caritasom,
06:44
and we trained 30 Afghan women and men,
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i obučili smo 30 afganistanskih žena i muškaraca
06:46
and we opened 15 counseling centers in Kabul.
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te otvorili 15 savjetovališta u Kabulu.
06:49
This was our sign -- it's hand-painted,
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Ovo je bio naš znak. Nacrtan je rukom.
06:52
and we had 45 all over Kabul.
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Imali smo ih 45 diljem Kabula.
06:55
Eleven thousand people came -- more than that.
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Došlo je 11.000 ljudi -- više od toga.
06:57
And 70 percent regained their lives.
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I 70 posto iznova je vratilo svoje živote.
07:00
This was a very exciting time,
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Bilo je to vrlo uzbudljivo vrijeme,
07:02
developing this with my wonderful Afghan team.
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dok sam razvijala ovo sa svojim divnim afganistanskim timom.
07:05
And they are working with me up to today.
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I oni sve do danas rade sa mnom.
07:07
We developed a culturally-sensitive
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Razvili smo kulturološki osjetljiv
07:09
psycho-social counseling approach.
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psihosocijalan pristup terapiji.
07:12
So, from 2008 up until today,
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Tako da se od 2008. godine do danas
07:15
a substantial change and step forward
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događa jedna suštinska promjena
07:17
has been taking place.
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i korak naprijed.
07:19
The European Union delegation in Kabul
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Delegacija Europske Unije u Kabulu
07:22
came into this and hired me to work
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ušla je u ovo te su me zaposlili
07:24
inside the Ministry of Public Health,
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u Ministarstvu javnog zdravstva
07:26
to lobby this approach --
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kako bi zagovarala ovaj pristup.
07:28
we succeeded.
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Uspjeli smo.
07:30
We revised the mental health component
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Promijenili smo segment mentalnog zdravlja
07:33
of the primary health care services
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u primarnoj zdravstvenoj zaštiti
07:35
by adding psycho-social care
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pridodajući psihosocijalnu skrb
07:37
and psycho-social counselors to the system.
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i psihosocijalne terapeute u taj sustav.
07:40
This means, certainly, to retrain all health staff.
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To dakako uključuje ponovno obučavanje cjelokupnog zdravstvenog osoblja.
07:43
But for that, we already have the training manuals,
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No za to već imamo priručnike
07:46
which are approved by the Ministry
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odobrene od strane Ministarstva,
07:49
and moreover, this approach is now part
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i, štoviše, ovaj je pristup sada dio
07:51
of the mental health strategy in Afghanistan.
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strategije mentalnog zdravlja u Afganistanu.
07:55
So we also have implemented it already
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Tako da smo ga već uveli
07:57
in some selected clinics in three provinces,
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u odabrane klinike u tri provincije
08:00
and you are the first to see the results.
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i vi ste prvi koji će vidjeti njegove rezultate.
08:03
We wanted to know if what is being done is effective.
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Željeli smo doznati je li ono što se obavlja učinkovito.
08:06
And here you can see
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Iz ovog možete vidjeti
08:08
the patients all had symptoms of depression,
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kako su svi pacijenti imali simptome depresije,
08:11
moderate and severe.
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umjerene i ozbiljne.
08:14
And the red line is the treatment as usual --
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Crvena linija označava uobičajeni tretman -
08:16
medication with a medical doctor.
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lijekove propisane od strane liječnika.
08:18
And all the symptoms
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Svi su simptomi
08:20
stayed the same or even got worse.
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ostali nepromijenjeni ili se čak pogoršali.
08:23
And the green line is treatment with psycho-social counseling only,
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Zelena linija označava liječenje koje obuhvaća samo psihosocijalnu terapiju,
08:25
without medication.
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bez lijekova.
08:27
And you can see the symptoms almost completely go away,
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Kako možete vidjeti simptomi su gotovo u potpunosti nestali,
08:30
and the psycho-social stress has dropped significantly,
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i psihosocijalni je stres značajno opao,
08:33
which is explicable,
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što je objašnjivo
08:35
because you cannot take away the psycho-social stresses,
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jer nije moguće u potpunosti ukloniti psihosocijalni stres,
08:37
but you can learn how to cope with them.
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ali je moguće naučiti kako se s njime nositi.
08:40
So this makes us very happy,
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Ovo nas čini vrlo sretnima
08:42
because now we also have some evidence
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jer sada imamo i neke dokaze
08:44
that this is working.
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da naš pristup djeluje.
08:47
So here you see,
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Ovdje možete vidjeti,
08:49
this is a health facility in Northern Afghanistan,
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ovo je zdravstvena ustanova u Sjevernom Afganistanu
08:51
and every morning it looks like this all over.
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i svakoga jutra iznova izgleda ovako.
08:54
And doctors usually have three to six minutes for the patients,
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Doktori obično imaju od tri do šest minuta koje mogu dati pacijentu.
08:57
but now this will change.
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No sada će se to promijeniti.
08:59
They go to the clinics,
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Ljudi odlaze u klinike
09:01
because they want to cure their immediate symptoms,
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jer žele izliječiti neposredne simptome,
09:03
and they will find somebody to talk to
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i tamo će pronaći nekoga s kime mogu pričati
09:05
and discuss these issues
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i raspraviti stvari s kojima se suočavaju
09:07
and talk about what is burdening them
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i razgovarati o onom što ih opterećuje
09:09
and find solutions, develop their resources,
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i pronaći rješenja, razviti vlastite sposobnosti,
09:12
learn tools to solve their family conflicts
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naučiti vještine koje će im pomoći da razriješe obiteljske sukobe
09:16
and gain some confidence in the future.
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i dobiju pouzdanje u budućnost.
09:19
And I would like to share one short vignette.
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Htjela bih još podijeliti s vama jednu kratku vinjetu.
09:23
One Hazara said to his Pashtun counselor,
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Jedan Hazar rekao je svojem paštunskom terapeutu,
09:27
"If we were to have met some years ago,
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''Da smo se sreli prije koju godinu,
09:30
then we would have killed each other.
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ubili bismo jedan drugoga.
09:32
And now you are helping me
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A sada mi ti pomažeš
09:34
to regain some confidence in the future."
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da povratim povjerenje u budućnost.''
09:37
And another counselor said to me after the training,
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Jedan mi je drugi terapeut nakon obuke rekao,
09:40
"You know, I never knew why I survived the killings in my village,
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''Znaš, nikada nisam znao zašto sam preživio pokolj u svom selu,
09:44
but now I know,
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ali sada znam,
09:46
because I am part of a nucleus
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zato što sam dijelom jezgre
09:48
of a new peaceful society in Afghanistan."
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novog miroljubivog društva u Afganistanu.''
09:51
So I believe this kept me running.
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Vjerujem da me to nastavilo pokretati.
09:54
And this is a really emancipatory and political contribution
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I ovo je uistinu emancipirajući i politički doprinos
09:57
to peace and reconciliation.
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miru i pomirbi.
10:00
And also -- I think --
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Mislim, isto tako, da
10:02
without psycho-social therapy,
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bez psihosocijalne terapije,
10:04
and without considering this
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i bez da ovo uzmemo u obzir
10:06
in all humanitarian projects,
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u svim humanitarnim projektima,
10:08
we cannot build-up civil societies.
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ne možemo izgraditi građanska društva.
10:11
I thought it was an idea worth spreading,
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Smatrala sam da je ovo ideja koju vrijedi proširiti
10:14
and I think it must be,
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i mislim da mora biti,
10:16
can be, could be replicated elsewhere.
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može biti, ponovljena drugdje.
10:19
I thank you for your attention.
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Zahvaljujem vam na pozornosti.
10:21
(Applause)
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(Pljesak)
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