Timor Awakening 3: Qualitative Report Prepared by Veterans Care Association

Qualitative Report

Section 1: Overview of Timor Awakening 3 Program

Timor Awakening 3, an 11-day holistic health program immersion in Timor-Leste, was conducted from 18 February to 1 March 2017. The program included: 3 days in Dili, 6 days throughout remote communities, and the final 2 days in Dili. The program has intentional professional one-on-one guidance and periods of decompression at the start and conclusion of the immersion period. The backdrop of a developing and peaceful Timor-Leste is one that offers hope and healing for veterans of Timor-Leste and for all as Australians, given our significant contribution to peace in Timor-Leste. Timor Awakening is a program of awakening based on wellness rather than darkness and pain.

Each person with mental illness responds uniquely to different modalities of healing. Timor Awakening has a multitude of modalities and experiences for individuals, small groups and large groups including regular professional education and guidance, Peer2peer support, physical exercise, mindfulness, meditation, exposure and unique interaction with foreign communities and veterans.

Cultural experience

TA3 included daily immersion with Timorese culture, traveling through 5 of the 13 Districts and experiencing a wide range of cultural planned and unplanned activities in the cities and far reaches of the country. Extensive traditional welcome ceremonies were prepared for participants at Dili Airport, Aileu, Bazartete, Balibo and Cailaco. The warm, hospitable and forgiving nature of the Timorese, a culture rich in values and resilience, serves as an inspirational model for our participants. Many participants remarked they experienced a call to action in the service of others as a means of their rehabilitation.

NGOs and Volunteer Projects

On Timor Awakening 3 we visited some NGOs and volunteers throughout Timor-Leste to learn from their insights and projects, as well as to identify potential ways our veterans can support in the future (as volunteers back in Timor-Leste or to raise funds for other projects). We had lunch at the East Timor Development Agency (ETDA), a skills-based independent training institution that has received significant support from Australians, especially Australian veterans. Participants enjoyed the performances and trainee hospitality from the orphans who are receiving an education thanks to the Australian Commando’s orphan scholarship fund.  In addition, the TA3 group prepared and distributed 3000 basic writing kits for school children throughout the 6 days in many schools of rural communities. The resources were provided by Townsville Rotary/RSL in a program called Kits4Kids.

WW2 Perspectives

TA3 participants traveled through numerous locations of significance from WW2 learning of the survival story of Sparrow Force, a co-operation between Australian Commandos and Timorese ‘Criados’. Families of Criados welcomed participants and gave tours of areas that Australians were in combat and explaining accounts of what happened passed down from their fathers. Additionally, stories were narrated to the group from Australian testimonies that described the hardship and values of the soldiers, a source of inspiration for our generation of veterans.

Indonesian Occupation Perspectives

Through the personal testimonies of Timorese Veterans, we learned a personal perspective of the 24-year Timorese resistance struggle lead by FALINTIL. TA3 had 24 Timorese Veterans join the program throughout. Participants learned how the Timorese Veterans employed guerrilla tactics to defy unthinkable odds. Many of TA3 participants remarked that the resilience, reconciliation, forgiveness and continued service of the Timorese veterans was an inspiration for them.

Participants visited the sacred site of the 1991 Dili Massacre, the ‘Santa Cruz’ cemetery, learning of the trigger that led to the historic UN endorsed 1999 referendum. At the site, participants met members of the youth movement who rallied publicly in Timor throughout the resistance and were proud to have been wounded there despite being unarmed, in their country’s path to freedom

Peace Operations Perspectives

Participants visited the key sites of Australian military involvement from the time of INTERFET through to present day including Dili, Maubisse, Batugade, Gleno, Balibo, Maliana, Tonabibi, Memo, and Aidabeletan. Many of the participants related stories of their deployments and their feelings of contrast witnessing the changes that have taken place. Revisiting the site of previous destruction, stress and trauma was cathartic for all veterans who have previously served in Timor-Leste. Through the remarkable development that has taken place, the vibrant village life, active economy, and especially the thousands of children going to school with such vitality and happiness, all in well dressed uniforms, the Veterans felt proud of their contribution and felt healing of the suffering these places experienced in the past. Participants met many younger adults who were children during the suffering of 1999 to 2006 that are now attending university or tertiary qualified and positive about the future of their country.

Conclusion

Through professional mentoring and guidance, together with the extensive Peer to Peer therapy, Timor Awakening offered an experience uniquely different to other programs available in the ESO world. The multitude of activities created a bonded group that will remain connected through each other’s journey of healing and growth. The overarching theme of hope and purpose was a feature of the dozens of activities. Even with the realities of a troubled and traumatic past, the Timorese experience is testament to veterans that there is hope and with purpose and support a positive future is possible.

Section 2: Participant Characteristics

Demographics

Fourteen participants were deployed on TA3, 13 males and 1 female. The average age of participants was 46 (M = 46.64 years, SD = 11.14 years). Of the 14 participants three reported being employed, nine reported being currently unemployed and two identified as retired. While three participants identified that they are still employed by the ADF in some capacity, 11 participants identified that they were no longer employed by the ADF. Of these 11 participants, seven reported that they were medically discharged.

Family Characteristics

Most participants identified that they were in a long-term relationship (de facto or married) with only three participants identifying as single. All bar one participant reported that they have children. Of the 13 participants who have children, 11 currently provide financial support to their offspring.

Health Status

Physical Health:

TA3 participants were administered the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12-item version to screen overall functioning and disability due to health conditions. The WHODAS 2.0 provides an overall summary score expressed as percentage of disability experienced in daily life over the past 30 days, with 100% representing full disability due to health condition. Participant disability scores on the WHODAS 2.0 are graphed below.

As the graph above demonstrates, there was variability in the overall functioning level of participants who engaged in TA3. The average summary score was 36.2% disability. Comparison with population data available from the World Health Organization (WHO) indicates that our participants’ average score ranks above the 90th percentile; namely, the level of disability reported due to health conditions reported on average by TA3 participants is above 90% of the population.

Mental Health

The 14 TA3 participants provided information about their current and previous treatment for mental health conditions. At deployment, over half of participants (57%) were taking medication for a psychiatric condition. Ten out of 14 participants reported that they were either currently, or had previously, received treatment by a psychiatrist and/or a psychologist for their mental health condition. The psychiatric condition most commonly reported by participants was Post-Traumatic Stress Disorder (PTSD), followed by depression.Secondary to this demographic information, participants completed the Quality of Life and Enjoyment Scale, Short Form (QLES) to provide information on their pre-deployment levels of life satisfaction. The QLES provides a summary score expressed as

Secondary to this demographic information, participants completed the Quality of Life and Enjoyment Scale, Short Form (QLES) to provide information on their pre-deployment levels of life satisfaction. The QLES provides a summary score expressed as percentage of life enjoyment over the past 14 days, with 100% representing full life satisfaction. Participant overall life enjoyment scores are graphed below.

Note: Participant 14 did not complete the QLES

As the graph above demonstrates, there was variability in the overall life enjoyment of participants who engaged in TA3. The average summary score was 49% life enjoyment (M = 48.98, SD = 22.74).

Section 3: TA3 Program Efficacy

Outcomes

Participants completed standardized self-report assessments at Pre- and Post-deployment. These included the Depression, Anxiety and Stress Scale 21-Item Version (DASS21), the Post-Traumatic Checklist – Civilian Version (PCL-C), and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). De-identified Pre- and Post-deployment results on each assessment area are demonstrated below.

Mental Health: Depression, Anxiety and Stress Results

Participants completed the Depression, Anxiety and Stress Scale 21-Item Version (DASS21) at Pre- and Post-deployment – herein referred to as Time 1 and Time 2, respectively. Each participant’s de-identified results on subscales at Time 1 and Time 2 are demonstrated below.

Note: TA03P14 did not provide responses at Time 2

Note: TA03P14 did not provide responses at Time 2

Note: TA03P14 did not provide responses at Time 2

In addition to the graphic representation of participants’ reduction in scores on the subscales of the DASS21, analysis was conducted to examine if the difference between Pre- and Post-deployment scores were of clinical significance. Two tailed t-test demonstrated that on average, there was a significant reduction in participants’ overall scores on the Depression subscale of the DASS21 from Time 1 (M = 10.46, SD = 6.02) to Time 2 (M = 5.38, SD = 3.94), t(12) = 5.23, p = .001. There was also a significant reduction in participants’ overall scores on the Anxiety subscale of the DASS21 from Time 1 (M = 8.92, SD = 5.89) to Time 2 (M = 5.31, SD = 3.92), t(12) = 3.13, p < .01 and a significant reduction in participants’ overall scores on the Stress subscale of the DASS21 from Time 1 (M = 11.42, SD = 4.24) to Time 2 (M = 6.53, SD = 4.07), t(12) = 4.88, p < .001.

Post-Traumatic Stress Symptomatology

Participants completed the Post-Traumatic Checklist – Civilian Version (PCL-C) at Pre- and Post-deployment. Each participant’s de-identified results at Time 1 and Time 2 are demonstrated below.

Note: TA03P14 did not provide responses at Time 2

In addition to the graphic representation of participants’ reduction in scores on the PCL-C, analysis was conducted to examine if the difference between Pre- and Post-deployment scores were of clinical significance. Two tailed t-test demonstrated that on average, there was a significant reduction in participants’ overall scores on the PCL-C from Time 1 (M = 54.03, SD = 18.71) to Time 2 (M = 40.15, SD = 13.84), t(12) = 4.21, p = .001.

Mental Wellbeing

Participants completed the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) at Pre- and Post-deployment. Each participant’s de-identified results on the WEMBWS at Time 1 and Time 2 is demonstrated below.

Note: TA03P14 did not provide responses at Time 2

In addition to the graphic representation of participants’ increase in scores on the WEMWBS, analysis was conducted to examine if the difference between Pre- and Post-deployment scores were of clinical significance. Two tailed t-test demonstrated that on average, there was a significant improvement in participants’ overall scores on the WEBWBS from Time 1 (M = 36.31, SD = 13.58) to Time 2 (M = 49.54, SD = 9.96), t(12) = -5.19, p < .001.

Post TA3 Participant Contact

TA3 participants have been engaged via several different modes with VCA staff since returning to Australia with both clinical and pastoral staff members. Contact with each participant is as follows:

  • Two phone calls to each TA3 participant within 2 weeks with clinical and pastoral staff.
  • Closed group forum made available via Facebook for peer-peer support. VCA staff monitoring content published by participants.
  • Offer of one-one counseling (in person if living locally or via telephone if living remotely) made to all participants with VCA psychologist who attended TA3.
  • Offer of availability to attend 2 Victoria Park Road Drop-In Centre for peer-peer support, already utilized by several participants.
  • Upcoming formalized TA3 catch-up with participants facilitated by VCA staff with special guest speaker presentation on Surviving PTSD on April 1, 2017.

Section 4: Participant Testimonials

The following written feedback was provided by participants at the Post-deployment assessment time-point:

  • “It was good to see what the Timorese had gone through.”
  • “I got to see that what we did made a difference “
  • “It was an unbelievable experience that I am grateful for “
  • “I had trepidation beforehand but now I feel absolutely enriched by the experience”
  • “I loved the whole experience – it was fantastic”
  • “The Timorese veterans have helped my journey in ways no one can understand.”
  • “Very helpful to see the locals and seeing their growth.”
  • “Reflection time is invaluable.”
  • “Culturally enriching.”
  • “Very supportive and knowledgeable staff.”
  • “Very full on program however I have taken in some stuff.”
  • “After seeing the locals, my life seems less hard.”
  • “Seeing what we have done here in the military and how that has helped the people.”
  • “I have learned a lot about myself.”
  • “TA3 reminded me of the importance of the relationships with my friends and family.”
  • “I was not a Timor Vet but this trip has reminded me of the importance of our neighbours.”
  • “I was able to find an ease that I haven’t had in a long time.”
  • “It was very humbling. I got to see that we did make a difference.”
  • “It is an unbelievable experience that I am so grateful for.”

 

 

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