Culture, Medicine, and Psychiatry

, Volume 34, Issue 2, pp 353–379

Trauma and Humanitarian Translation in Liberia: The Tale of Open Mole

Original Paper

Abstract

The focus of this paper is the intercultural process through which Open Mole and trauma-related mental illnesses are brought together in the postconflict mental health encounter. In this paper, I explore the historical dimension of this process by reviewing the history of Open Mole, and the ways in which it has been interpreted, acted on, and objectified by external observers over the last half-century. Moving into Liberia’s recent war and postconflict period, I examine the process by which Open Mole is transformed from a culture-bound disorder into a local idiom of trauma, and how it has become a gateway diagnosis of PTSD-related mental illnesses, and consider how it is produced as an objectified experience of psychiatric disorder in clinical humanitarian contexts. By studying how Open Mole is transformed in the humanitarian encounter, I address the structure and teleology of the humanitarian encounter and challenge some of the foundational assumptions about cultural sensitivity and community-based mental health care in postconflict settings that are prevalent in scholarship and practice today.

Keywords

Liberia Trauma Open Mole Transcultural psychiatry Culture-bound syndromes Idiom of distress Community-based mental health Humanitarian intervention 

References

  1. Abramowitz, Sharon Alane 2009 Psychosocial Liberia: Managing Suffering in Post-conflict Life. Cambridge, MA: Harvard University.Google Scholar
  2. Abramowitz, Sharon Alane 2010 Moral Missionaries: ‘Being’ Traumatized and ‘Doing’ Psychosocial Work in Liberia’s Post-Conflict Reconstruction. In Legacies of Violence: Symptom, Memory, and Intervention in the Aftermath of Mass Trauma. A. Hinton and D. Hinton, eds.Google Scholar
  3. Baingana, F., I. Bannon, and R. Thomas 2005 Mental Health and Conflicts. Conceptual Framework and Approaches. Health, Nutrition and Population (HNP) Discussion Paper. Washington, DC: World Bank.Google Scholar
  4. Baingana, Florence, Ian Bannon 2004 Integrating Mental Health and Psychosocial Interventions into World Bank Lending for Conflict-Affected Populations: A Toolkit. Health Nutrition and Population, Conflict Prevention & Reconstruction. Washington, DC: World Bank.Google Scholar
  5. Bakhtin, M.M., and Michael Holquist 1981 The Dialogic Imagination: Four Essays. Austin: University of Texas Press.Google Scholar
  6. Banatvala, N., and A.B. Zwi 2000 Conflict and Health: Public Health and Humanitarian Interventions: Developing the Evidence Base. British Medical Journal 321(7253):101–105.CrossRefGoogle Scholar
  7. Bender, D.E., and D. Ewbank 2004 The Focus Group as a Tool for Health Research: Issues in Design and Analysis. Health Transition Review 4(1): 63–79.Google Scholar
  8. Bourdieu, Pierre 1977 Outline of a Theory of Practice. Cambridge: Cambridge University Press.Google Scholar
  9. Bracken, P.J., J.E. Giller, and D. Summerfield 1995 Psychological Responses to War and Atrocity: The Limitations of Current Concepts. Social Science & Medicine 40(8):1073–1082.CrossRefGoogle Scholar
  10. de Jong, J.T.V.M., and I.H. Komproe 2002 Closing the gap Between Psychiatric Epidemiology and Mental Health in Post- Conflict Situations. Lancet 359(9320):1793–1794.CrossRefGoogle Scholar
  11. de Jong, J. T. V. M., I. H. Komproe, and M. Van Ommeren 2003 Common Mental Disorders in Postconflict Settings. Lancet 361(9375):2128–2130.CrossRefGoogle Scholar
  12. Desjarlais, R., et al. 1995 World Mental Health: Problems and Priorities in Low-Income Countries. New York: Oxford University Press.Google Scholar
  13. Drewal, H. J. 1988 Performing the Other: Mami Wata Worship in Africa. TDR 32(2):160–185.Google Scholar
  14. Drewal, H. J. 2008 Mami Wata: Arts for Water Spirits in Africa and Its Diasporas: Exhibition Preview. African Arts 4(2):60–83.CrossRefGoogle Scholar
  15. Ellis, Stephen 1999 The Mask of Anarchy: The Destruction of Liberia and the Religious Dimension of an African Civil War. New York: New York University Press.Google Scholar
  16. Frank, B. 1995 Permitted and Prohibited Wealth: Commodity-Possessing Spirits, Economic Morals, and the Goddess Mami Wata in West Africa. Ethnology 34(4): 331–346.CrossRefGoogle Scholar
  17. Hales, Ann 1996 West African Beliefs about Mental Illness. Perspectives in Psychiatric Care 32(2):23–29.CrossRefGoogle Scholar
  18. Inter-Agency Standing Committee (IASC) 2007 IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Geneva: IASC.Google Scholar
  19. International Crisis Group 2004 Liberia and Sierra Leone: Rebuilding Failed States. In Crisis Group Africa Report. Washington, DC: International Crisis Group.Google Scholar
  20. International Federation of Red Cross and Red Crescent Societies 2009 Psychosocial Interventions: A Handbook. Copenhagen, Denmark: IFRC.Google Scholar
  21. Kezala, W.S., C.K. Ampadu, and R.J. Macauley 1989 Study of the Knowledge, Attitudes, and Practices of Parents on Open Mole in Children. Monrovia, LR: Cuttington University College, International Development Research Centre.Google Scholar
  22. Kirmayer, L. J. 1984 Culture, Affect and Somatization. Transcultural Psychiatry 21(159):159–188.CrossRefGoogle Scholar
  23. Kirmayer, Laurence J. M. D., and Allan Young 1998 Culture and Somatization: Clinical, Epidemiological, and Ethnographic Perspectives. Psychosomatic Medicine July/August 60(4):420–430.Google Scholar
  24. Kirmayer, Laurence J., Robert Lemelson, and Mark Barad 2008 Understanding Trauma: Integrating Biological, Clinical, and Cultural Perspectives. Cambridge: Cambridge University Press.Google Scholar
  25. Krug, E. G., et al. 2002 The World Report on Violence and Health. Lancet 360(9339):1083–1088.CrossRefGoogle Scholar
  26. Makanjuola, R. O. A. 1987 Ode Oriî: A Culture-Bound Disorder with Prominent Somatic Features in Yoruba Nigerian Patients. Acta Psychiatr Scand 75(3):231–236.CrossRefGoogle Scholar
  27. Merry, Sally Engle 2006 Human Rights and Gender Violence: Translating International Law into Local Justice. Chicago: University of Chicago Press.Google Scholar
  28. Mollica, R. F., et al. 2004 Mental Health in Complex Emergencies. Lancet 364(9450):2058–2067.CrossRefGoogle Scholar
  29. Moran, Mary H., and M. Anne Pitcher 2004 The ‘basket Case’ and the ‘Poster Child’: Explaining the End of Civil Conflicts in liberia and Mozambique. Third World Quarterly 25(3):501–519.CrossRefGoogle Scholar
  30. Patel, V. 1995 Explanatory Models of Mental Illness in Sub-Saharan Africa. Social Science & Medicine 40(9):1291–1298.CrossRefGoogle Scholar
  31. Pedersen, D. 2002 Political Violence, Ethnic Conflict, and Contemporary Wars: Broad Implications for Health and Social Well-Being. Social Science & Medicine 55(2):175–190.CrossRefGoogle Scholar
  32. Poindexter, H.A. 1953a An Analytical Study of 45,000 Consecutive Admissions to a Clinic in Monrovia, Liberia, West Africa. Journal of the National Medical Association 45(5): 345–349.Google Scholar
  33. Poindexter, H.A. 1953b Epidemiological Survey among the Gola Tribe in Liberia. American Journal of Tropical Medicine and Hygiene 2(1): 30–38.Google Scholar
  34. Prince, R. 1960. The “Brain Fag” Syndrome in Nigerian Students. British Journal of Psychiatry 106(443): 559–570.CrossRefGoogle Scholar
  35. Psychosocial Working Group 2003 Psychosocial Intervention in Complex Emergencies: A Conceptual Framework. Oxford: Refugee Studies Center.Google Scholar
  36. Renner, Michael, Thomas Prugh and Worldwatch Institute. 2002 The Anatomy of Resource Wars. Washington, DC: Worldwatch Institute.Google Scholar
  37. Reno, William 2004 Reconstructing Peace in Liberia. Pp. 115–141 in Durable Peace: Challenges for Peacebuilding in Africa. T.M.A. Ali and R.O. Matthews, eds. Toronto: University of Toronto Press.Google Scholar
  38. Salama, P, et al. 2004 Lessons Learned from Complex Emergencies Over Past Decade. Lancet 364(9447):1801–1813.CrossRefGoogle Scholar
  39. Sawyer, Amos 2005 Beyond Plunder: Toward Democratic Governance in Liberia. Boulder, CO: Lynne Rienner.Google Scholar
  40. Silove, D., S. Ekblad, and R. Mollica 2000 The Rights of the Severely Mentally Ill in Post-Conflict Societies. Lancet 355(9214):1548–1549.CrossRefGoogle Scholar
  41. Summerfield, Derek 1995 Addressing Human Response to War and Atrocity. In Beyond Trauma: Cultural and Societal Dynamics. C. F. R. Kleber and B. Gersons, ed. New York: Plenum Books.Google Scholar
  42. Turner, V. W. 1967 The Forest of Symbols: Aspects of Ndembu Ritual. Ithaca, NY: Cornell University Press.Google Scholar
  43. UNMIL 2005 Status of Restoration of State Authority and Recovery in Liberia. United Nations Mission in Liberia. C.A. Section.Google Scholar
  44. Van Ommeren, M., S. Saxena, and B. Saraceno 2005 Mental and Social Health During and After Acute Emergencies: Emerging Consensus? Bulletin of the World Health Organization 83:71–75.Google Scholar
  45. Weiss, M. G., et al. 2003 Mental Health in the Aftermath of Disasters: Consensus and Controversy. Journal of Nervous and Mental Disease 191(9):611–615.CrossRefGoogle Scholar
  46. Wheeler, M 1975 Travel Notes: A Liberian Medical Experience. Yale Journal of Biology and Medicine 48(5):439.Google Scholar
  47. Wintrob, R. M. 1968 Sexual Guilt and Culturally Sanctioned Delusions in Liberia, West Africa. American Journal of Psychiatry 125(1):89.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of AnthropologyHarvard UniversityCambridgeUSA

Personalised recommendations