ABSTRACT
Western psychosocial experts such as psychologists, social workers, or psychiatrists are trained to assess a person presenting with stress-related complaints, followed by a diagnosis, treatment plan, and therapy. They mostly provide psychotherapy or pharmacotherapy within the culture of an existing mental health care system that has already been built up and that they will rarely question. This reality is quite different from the “crisis zones” in the world. Complex humanitarian emergencies, natural or human-made disasters, affect large and often displaced civilian populations. Complex emergencies involve a combination of factors such as interstate or intrastate violence, terrorism, recurring food shortages, or co-occurring natural disasters. These factors result in high levels of physical and mental morbidity or mortality. This chapter
examines the consequences of complex humanitarian emergencies as a challenge to the mental health profession. The chapter will also examine one of the major challenges for mental health practitioners — understanding the role of culture in disasters. Culture permeates the whole process of traumatization and recovery from traumatic stress. The context of crisis zones interacts with culturally mediated systems of meaning such as religion or causative attribution, and with practices such as cults, rituals, and social support systems. I will illustrate the importance of cultural factors by focusing on local variations in the construction of the self, in the interpretation of traumatic stressors, the ways the events are appraised, in variations in coping strategies, and in the expression of people’s plight in terms of idioms of distress or psychopathology.
