March 13, 2002
A hundred years ago, wars were fought between armies and the overwhelming majority of casualties were soldiers. But most modern wars are civil conflicts that target civilians.
"You're seeing something very different than you have in the past--rebel groups targeting civilians, or governments targeting civilians. People are tortured, they suffer all kinds of atrocities, and they're displaced from their homes," said Leslie Snider, director of mental health and medical anthropology in the School of Public Health's Department of International Health and Development. She's something of a pioneer in the emerging field of psychosocial intervention in emergency settings.
"I work in post-war places," she explained. She leads her own project in Peru, working with victims of the militant Maoist group Shining Path, and also does extensive work with Christian Children's Fund. She's worked with CCF in South Africa, Colombia, West Africa and Kosovo, and this summer will travel to Afghanistan for the organization. And with the assistance of graduate students Tonya Thurman and Andrea Becklund, she's writing a manual for CCF that will guide workers through the process of setting up children's programs in the field.
"People are used to digging latrines, setting up shelter, distributing food and doing immunizations. It's really just been in the last 10 years that we've begun to think about the psychological consequences of what's going on," Snider said. "You can't ignore the psychological condition that people are in. They're so traumatized that they're not able to get to the food distribution tent and get food for their children. "That kind of dislocation and disruption is really bad for kids' development," added Snider. "But if you can get some programs started that normalize their lives a little bit, they usually do better."
Western-style one-on-one therapy can be more stigmatizing than it is helpful, according to Snider. What is needed is a return to order. "These are communities that functioned before. They went through hardships and they had ways of dealing with that. They need to get their support system back. If you get the adults functioning again, usually the children can get themselves back together," Snider said.
CCF has been named the non-governmental organization for education and child protection in Northern Afghanistan. It quickly opened 12 "child-centered spaces" in a refugee camp in Kunduz in one week in January. It plans a total of 85 child centers in Northern Afghanistan, staffed by local women who were not allowed to work under the Taliban.
"You can set up a child-centered space in a day. You just get the community interested. You teach a few people how to do it, and the community takes it up and does it. It's amazing to watch that," Snider said.
Programs are directed not only at children, but also at helping children's caregivers take care of themselves. CCF has long been involved in developing countries, but has only recently begun to work in emergency settings. It has learned quickly how difficult it can be to start a program in the midst of post-war chaos.
"As much as we want to have this great manual that tells people exactly what to do, you don't know what you're up against until you get there," Snider said. She tells stories of colleagues stuck in Tajikistan with endless visa problems, and others held up at gunpoint in Afghanistan. Even finding food and a place to stay can be a problem.
But even if aid workers can't foresee every challenge they will face, certain issues--like security--are universal. Snider's manual aims to help workers get the information they need before they get to the site and to assess the situation when they arrive.
Much of what Snider knows about the subject was learned the hard way--by what went wrong in places like Kosovo, where she found herself without security or communication equipment. And while part of the manual was finished in time for workers in Afghanistan to use, it's also being shaped by their experiences there. "This is a field that's learning as it goes along," she said.
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