Developing a Response: learning from experience elsewhere.
Each country and community which has experienced prolonged and serious conflict, political violence
and torture has its own needs, cultural factors and particular contextual features which need to be
considered when healing and re-building are discussed and plannedxliv, and Zimbabwe is no different.
At national, community, family and individual levels, people will need to work out the ways forward
which are appropriate to them and to draw on their own traditions and ways of doing things. There is
also, useful experience and learning from elsewhere: Zimbabwe does not need to re-invent the wheel
when it comes to work for healing and re-building communities but can work towards its own
processes for dealing with what has happened, drawing on a wealth of experience from other postconflict societies.
During the last decades of the 20th century and the first decade of the 21st, peace-builders,
development workers, psychologists, psychiatrists and mental health practitioners have been involved
with communities and organisations in countries across the world, working with them to support
their efforts to heal the wounds of violent conflict and torture, and to move forward to transform their
lives. International work on healing and regeneration in post conflict societies is a prime example of
a movement away from narrow disciplinary modes of study and models of healing.
The
interdisciplinary work of social scientists (particularly in anthropology and psychology) is exemplified
in recent work.xlv Zimbabwe also needs such approaches and the structures required to help initiate
and sustain interdisciplinary work in these areas.
In the field of mental health, inevitably many international staff involved in such work brought with
them frameworks and ideas based in their own training and cultures and sought to use these in
planning interventions in post-conflict societies in Africa, Asia and South America, and after the
Balkans conflict. This led early on to the use of the trauma ―lense‖ by psychologists and psychiatrists
trying to understand how people had been affected by what had happened, with a resulting focus on
individual trauma, on the diagnosis of post-traumatic stress disorder (PTSD) and an interpretation of
symptoms and reactions based in Western mental health practice and thinking. There is no doubt that
the use of PTSD screening tools will reveal high levels of people in post-conflict situations suffering
from its specific symptomsxlvi, as well as high levels of depression and anxiety. As many practitioners
began to realise, however, symptoms do not have universal meaning xlvii and may well not have the
same significance and priority in people‘s lives as they would in more affluent societies. The focus
on PTSD and trauma led, in many cases, to the direction of efforts towards one-to-one counselling
and individual support, within a medical framework, as use of the trauma discourse somehow carries
with it the implication that there will be a medical/psychological cure which can be made available.
The focus on psychological treatment for people‘s distress can deflect attention away from the
social/political factors which are also likely to contribute to how people are feeling about their lives
and experiencing events.
This is not to say, however, that PTSD is a diagnosis which cannot usefully be used, when
appropriate, in non-western cultures; there is increasing neurological and clinical evidence for the
universal effect of serious and life-threatening events on the human brain and body, and
understanding of how PTSD symptoms are caused and can be treated. It would be a mistake to deny
treatment to those whose lives are likely to be seriously disrupted by PTSD type symptoms, or other
mental health problems, just as it is a mistake to foreground psychiatric diagnosis too much.
Although every culture has its own frameworks and understanding of mental health xlviii, these are not
static; the exchange and mutual learning which is taking place across countries and cultures has
blurred boundaries and opened the door to creative new thinking which blends ―traditional‖ and
western approaches. In addition, the use of PTSD diagnoses in conflict societies clearly has the
power to generate westyern sympathies and sources of financial and political aid.xlix
The word ―trauma‖ itself has acquired such wide usage as to make it almost meaningless, as it is now
used to cover the whole range of human suffering from bereavement, sadness, and distress through
to the experience of extreme violence, unexpected disaster and loss inflicted by others. Its
generalised usage masks the need for a wide range of different responses: the woman who has been
raped by a gang of youths from her own community has different needs to the young male activist
who was abducted and tortured by strangers; those who have suffered from ongoing divisions and
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