'Don't think about it too much' - Psychological healing in Angola

September 12, 2002

A Health and Human Rights article in this week's issue of The Lancet highlights how displaced people cope with psychological trauma associated with death and displacement as a result of Angola's recent civil conflict.

A peace agreement in April this year ended four decades of civil war in Angola in which thousands of people were killed, tortured, and displaced from their homes. To assess how displaced people have understood their personal suffering, Carola Eyber and Alastair Ager from the Centre for International Studies, Queen Margaret College, Edinburgh, UK, did an ethnographic study in the province of Huila with displaced people living in the town of Lubango and in two government-run camps (Visaka and Chipopia) in surrounding rural areas, each housing around 8000 people.

The authors comment: 'Most people who experience distress, pain, and illness first turn to others around them for advice and suggestions, and this was the case for almost all the displaced people in Huila. Conselho, meaning advice or consolation, describes the general encouragement given to people to abandon the thoughts and memories of war events and losses. Conselho was given by family members, neighbours, church groups, and elders and had three main themes. First, death is natural and inevitable for all people: "We give them advice and we say don't think too much. As you see, our grandfathers are not here beside us, they are dead already. So there is no need to think about it." Daniel, 42 years, Lubango. Second, everyone suffers, and thus strength can be drawn from the fact that suffering is a shared experience: "It is not only you, it is all people. Stay calm and don't think anymore about it . . . Because tomorrow or the day after tomorrow you will also die and will accompany the child [who has died]. Because this doesn't only happen with you but it happens to everyone." Filomena, 35 years, Chipopia. Third, practical help must be given to people who are distressed: "So she [a widow] needs conselho first of all. This is not enough. This person needs a community of relatives or friends who will play the role of her husband. And then she will forget these kinds of thoughts. This is not an illness for which we can give medicines so that she can get better because she is destroying herself." Lucas, 29 years, Lubango.'

Alastair Ager comments: "Our findings raise questions about the appropriateness of western counselling approaches in a context where people have a different understanding of what a survivor needs to achieve and how they can be helped through a period of suffering and despair. We conclude that psychosocial programmes that attempt to use counselling are unlikely to be popular. We recommend that local perspectives, resources, and coping strategies be taken as a starting point, not only for assessing the existing strengths within a community, but also for rendering psychosocial interventions culturally appropriate and relevant."
Contact: Professor Alastair Ager, Director,
Centre for International Health Studies,
Queen Margaret University College,
Edinburgh EH12 8TS, Scotland, UK;
E) AAger@qmuc.ac.uk


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