The mental state of people affected by war and other disasters has been a subject of special interest to academic researchers and practitioners in humanitarian assistance and public health for over two decades. The last decade in particular has seen a rise in the number of papers published in scholarly journals around the Post-Traumatic Stress Disorder (PTSD) debate. Anthropologists have rarely engaged in this debate. Nevertheless, some of the most illuminating contributions have come from socio-medical anthropology (Last, 2000).

This paper describes a pilot study assessing the psychosocial impact of political violence in the Peruvian Andes, utilizing a collaborative approach with local professionals and communities. The study team prioritized dialogue and information exchange with the local professional community and villagers participating in the assessment in order to raise awareness of psychosocial issues and provide education and support. Participation in the pilot study had positive therapeutic effects for villagers, and inspired ongoing discussion groups to address psychosocial problems in communities. This paper also describes a psychosocial assessment strategy utilizing qualitative methods and an adaptation of the Harvard Trauma Questionnaire in collaboration with Andean villagers. Usefulness and limitations of the data will be reviewed, in terms of cultural and context relevance, usefulness for informing interventions, and comparisons with ethnographic methodologies and other survey instruments.

Within seven years after the end of the Nicaraguan civil war in 1990, forced migrants, whose lives had been most disrupted by the conflict, were self-settled in a squatter community in the capital city of Managua and lived in extreme poverty with minimal health, education, security and social service supports. Compared with voluntary migrant neighbours, whose lives had been less affected by the conflict, forced migrants exhibited equal clinically significant symptoms of physical and mental health and psychosocial maladaptation. These findings run counter to generally held theory and assumptions about the negative long-lasting effects of the trauma and stress of war, forced migration and resettlement. Explanations are offered to explain the discrepancies between theory and the study findings as well as the dominance of poverty and socioeconomic status. Implications are also drawn for increasing social support and other durable forms of assistance that emerge from the study as important to meeting the needs of equally poor and unhealthy forced and voluntary migrants in proliferating squatter communities throughout the Third World.

The paper looks at the limitations and strengths of using the A-cope questionnaire for measuring strategies for coping with prolonged conflict by Palestinian young people in Gaza. The scale was administered to young people between the ages of 8 and 17. The results show some gender differences in coping strategies. However, some items on the subscales are not relevant for Muslim societies or societies in situations of prolonged conflict. The authors suggest that combining an anthropological contextual perspective and qualitative data with psychological instruments is an effective way of addressing the limitations of using a single quantitative method of assessment in non-Western complex social and cultural settings.

This paper focuses on the clinical and social diagnostics of stroke-like symptoms in Limpopo Province, South Africa. The research questions addressed here are: what are the lay understandings of strokelike symptoms and what are the health-seeking behaviours of Tsongan Mozambican refugees and South Africans in this area? The study site is ten villages in the Agincourt sub-district of Limpopo Province which are within the health surveillance area of the Agincourt Health and Population Unit (AHPU) of the University of Witwatersrand. The population are Tsongan who speak Shangaan and comprise self-settled Mozambican refugees who fled to this area during the 1980s across the nearby border and displaced South African citizens. The latter were forcibly displaced from their villages to make way for game reserves or agricultural development and moved to this area when it was the former ‘homeland’ of Gazankulu. The team collected data using rapid ethnographic assessment and household interviews as part of the Southern Africa Stroke Prevention Initiative (SASPI). The main findings are that stroke-like symptoms are considered to be both a physical and social condition, and in consequence plural healing using clinical and social diagnostics is sought to address both these dimensions. People with stroke-like symptoms maintain their physical, mental and social well-being and deal with this affliction and misfortune by visiting doctors, healers, prophets and churches.

The effects of war-induced anxiety and mental distress on individuals and groups can either be mitigated or exacerbated by ‘humanitarian action’. This paper focuses on two key factors that protect the mental well-being of war-affected populations: organized displacement or assisted relocation; and coordinated humanitarian aid operations that are responsive to local needs. Qualitative data from two internally displaced person (IDP) camps in Eritrea are presented. Analysis of these data serves to substantiate and refine a working hypothesis: that social support of the right type, provided at the right time and level, can mitigate the worst effects of war and displacement on victims/survivors. An integrated model of psychosocial transition is suggested. The implications of this approach for humanitarian policy and practice are discussed in the wider context of current debates and lamentations of the ‘humanitarian idea’.

The latter part of the twentieth century has seen an increased concern for the implications of war for civilian populations, and more attention has been given to psychosocial impacts of uprooting and displacement. ‘Loss of place’, acute and chronic trauma, family disruption and problems of family reunification have become issues of concern. The war in Bosnia was characterized by massive displacement, disruption and loss of life, relatives and property. Health and psychosocial well-being were affected in a number of ways. There was an overwhelming loss of perceived power and self-esteem. Over 25% of displaced people, for example, said they no longer felt they were able to play a useful role; even in non-displaced populations approximately 11% of those interviewed said that they had lost a sense of worth. Widespread depression and feelings of fatigue and listlessness were common and may have prevented people from taking steps to improve their situation. Almost a quarter of internally displaced people had a high startle capacity and said they were constantly nervous. Most adverse psychosocial responses increased with age and in a population that includes many elderly people this poses serious problems. The findings point to major challenges with respect to repatriation and reconstruction. They highlight the importance of family reunification and the facilitating of decision-making by affected people themselves. The findings also shed light on potential problems associated with over-dependence on external assistance and hence the need for people to be given the means of using their skills and knowledge to control their day-to-day lives.

NYC RECOVERS, an alliance of organizations concerned with New York City’s social and emotional recovery post-9/11, was formed to meet the need to rebuild social bonds strained or ruptured by the trauma to the regional system caused by the destruction of the Twin Towers. NYC RECOVERS, with minimal funding, was able to create a network of 1000 organizations spanning the five boroughs, carrying out recovery events throughout the ‘Year of Recovery’, September 2001 to December 2002. This paper describes the concepts, techniques and accomplishments of NYC RECOVERS, and discusses potentials of the model, as well as obstacles to its implementation.

This paper critically analyses from a political sociology standpoint the international conceptualization of war-affected populations as traumatized and in need of therapeutic interventions. It argues for the importance of looking beyond the epidemiological literature to understand trauma responses globally. The paper explores how the imperative for international psychosocial programmes lies in developments within donor countries and debates in their humanitarian sectors over the efficacy of traditional aid responses. The aim of the paper is threefold. First, it discusses the emotional norms of donor states, highlighting the psychologizing of social issues and the cultural expectations of individual vulnerability. Second it examines the demoralization of humanitarianism in the 1990s and how this facilitated the rise of international psychosocial work and the psychologizing of war. Third, it draws attention to the limitations of a mental health model in Croatia, a country which has been receptive to international psychosocial programmes. Finally it concludes that the prevalent trauma approaches may inhibit recovery and argues for the need to re-moralize resilience.