Central american survivors of political violence: An examination of contextual factors and practice issues

Despite compelling, well-documented findings on the levels of stress and trauma among Central American refugees, this group continues to be underserved. A host of issues contributes to this underservice, ranging from macro-level imposed obstacles, such as citizenship and health insurance as determining factors for accessing social and health services, to institutional factors that impede service utilization, such as an insufficient number of translators or a cumbersome and confusing bureaucracy. This chapter adopts a human rights framework as a strategy for working with groups of Central Americans who have experienced political violence. The ongoing effects of political violence on Central Americans, as they relate to mental and physical health problems, are reviewed and a case vignette is used to illustrate how political violence affects individuals and how macro-level forces and institutions create barriers to access and use of health care and social services. Treatment approaches for helping survivors of political violence in the context of a human rights framework are suggested.