Disasters like wars, earthquakes, floods, cyclones, landslides, technological accidents and urban fires occur in all parts of the world. Armed conflicts alone have produced about 12 million refugees and 25 million internally displaced people. Many of these refugees, internally displaced people and other victims of conflict have suffered, and continue to suffer, the effects of traumatic stress. The ratio of disaster victims in developing countries to disaster victims in developed countries is 166:1. The ratio of morbidity and mortality following disasters in developing countries to developed countries is 10:1. Psychological problems tend to affect some 30-40% of the disaster population within the first year. According to the World Bank and the WHO, almost half of the estimated total burden of disease worldwide can be attributed to mental and behavioural problems. This paper focuses upon three aspects of providing mental health and psychosocial care in (post-)conflict emergency situations, as well as during the subsequent phases of rehabilitation and reconstruction. First, it explains why it is important to go beyond a dyadic helper-patient relation in contexts in which few mental health professionals are available. Next, it considers the selection of priorities for intervention and training in situations of massive traumatic stress. Finally, it presents a preventative and curative intervention model that can be used in an eclectic way in post-conflict or disaster situations and that can be tailored to specific local socio-cultural contexts.
This paper explores the problem of the moral recognition of human suffering after mass violence. In post-conflict societies, truth commissions and trials have been used to address the legacy of violence and to form the basis for national reconstruction through truth-seeking, justice and reconciliation. However, in those countries that held trials and truth commissions more than 15 years ago, these rituals of political transition have not closed the door upon past atrocities. In South America and elsewhere, movements for the ‘disappeared’ continue to motivate human rights movements and individual victims to know the truth—even if justice itself must be suspended—producing transnational human rights alliances and prosecutions designed to challenge the impunity of perpetrators. This paper looks at the way in which truth commissions and trials have shaped post-transition politics of identity and national reconciliation by drawing upon material from Uruguay, Argentina, Bosnia, Rwanda and South Africa. It further considers the social and political consequences of the official framing of conflict through human rights hearings and legal cases—for example, in the International Criminal Tribunal for the Former Yugoslavia (ICTY) construction of the Bosnian wars as an ethnic conflict—for broader movements for justice. Of particular interest is the role of the legal and healing professions, which seek to translate individual suffering as a legacy of violence into claims of the right to challenge impunity. The paper argues that these ongoing movements for the moral recovery of victims are essential for anchoring justice and reconciliation in a more reflective public morality about the past and the present. Moreover, they point to fundamental cultural processes at the core of law-making: the role of the suffering victim as a primary source for institutionalization.