THE POSITIVE ROLE OF TRADITIONAL APPROACHES AND BELIEFS

PHOTO: Miles Hankin/IMC Burundi Traditions can be a comfort those affected by conflict and disaster, providing a reassuring sense of continuity and stability.

The way traumatic events are socially viewed can dramatically impact how they are dealt with emotionally. For example, family members of Albanian Kosovars who died in the 1999 war viewed their loved ones as martyrs, which helped ease the grieving process (De Jong 2002). Similarly, cultures with a strong belief in an afterlife or reincarnation may experience a lower level of trauma when accepting the deaths of loved ones. Two recent studies conducted in Afghanistan demonstrate the substantial role values and beliefs play in coping with loss and facing the future. Lopes Cardozo and his colleagues (2004) found that ‘reading the Koran or praying’ was among the top two coping strategies employed by disabled and non-disabled Afghans. Likewise, Scholte et al. (2004) reported that religion and family were the most frequently cited sources of emotional support for Afghans. A study by Punamaki (1996) on the mental health of Palestinians found that ideological and religious commitment, social connectedness, and local political involvement were all contributing factors to improved mental health among women and their children.

The majority of people suffering from mental health disorders in developing countries do not seek treatment in health facilities at any level. Instead, those who do seek help often resort to traditional healers and rituals. As a consequence of their easy accessibility and cultural acceptability, traditional healers have the potential to become important resources for mental health care. As Mollica points out, despite the devastation caused by conflict or other traumatic emergencies “…the local healing system is still there, no matter how damaged…” acting, in effect, as “psychological first aid” (Gewertz 2005, p. 3). However, incorporating traditional healers and rituals in the healing process must be approached cautiously since the same high social regard that can make them effective can easily be abused.

Communities’ own rituals and traditional practices can often help people affected by trauma reintegrate into normal life. Many of these rituals take the form of symbolic cleansing, of washing away the blood or the traumatic memories, of driving away bad spirits and of calling ancestors for assistance. These rituals contrast with Western (and more intrusive) modes of dealing with trauma, which emphasize psychotherapeutic recounting and remembering experiences. Instead, traditional rituals aim to create a rupture with the past (McKay and Mazurana, p. 48). For example, while in some societies raped women are blamed for bringing dishonor to their families and are ostracized or murdered, in Uganda, a “collective purification ritual” conducted by elders has been shown to help survivors of group rape deal with their traumatic experience (De Jong 2002). Communities in Angola and Mozambique practice special rituals and ceremonies to help soldiers make the transition to peace and reintegration (Honwana 1997, Wessels and Monteiro 2000). Efforts should be made to determine existing practices that facilitate trauma recovery, and to compile evidence as to whether or not they positively impact mental and psychosocial conditions, and strengthen those practices that work.

While rituals and cleansing ceremonies can be very helpful in dealing with milder forms of psychosocial stress, and in assisting communities in coping with returnees from conflict, they should be approached with caution. McKay and Mazurana note the need for caution from a gender perspective, since “some rituals violate the human rights of women and girls, reinforce patriarchy and oppressive gender roles…” (McKay and Mazurana 2004, p. 50). In some instances, rituals may be clearly damaging, as for example when they involve female genital mutilation performed by members of secret societies (Bouta, Frerks and Bannon 2004). Just as useful approaches should be encouraged, efforts must be made to discourage customs detrimental to mental and psychosocial wellbeing.

SOURCE: HNP DISCUSSION PAPER Mental Health and Conflicts: Conceptual Framework and Approaches
Florence Baingana, Ian Bannon and Rachel Thomas 2005 (PDF)