Post-war trauma, mistrust, fuel Ebola crisis

A posse of young boys armed with slingshots blockades a road to prevent a Red Cross vehicle from bringing medical supplies into a village wracked by Ebola. In another area, residents throw stones at an arriving health team. And in a another, villagers flee when a health worker in a white lab coat makes calls in the neighborhood.

Christian Zigbuo (right) works to distribute printed information to educate people in Liberia  about the Ebola virus.  Photo courtesy of Christian Zigbuo.

Christian Zigbuo (right) works to distribute printed information to educate people in Liberia about the Ebola virus. Photo courtesy of Christian Zigbuo.

Why?

These reports remind me of conversations I have had with survivors of horrific conflict. Having worked around the world, I have seen and heard the fear and mistrust that people have of government and others in official capacities in places such as Kampuchea, Ethiopia, Somalia, Mozambique, Sierra Leone, Liberia, and South Africa. In these places, the common historical theme is social conflict, and in some places outright war.

I recall a conversation I struck up with a young man sitting under a large umbrella by the roadside in Monrovia a few years ago. He was selling lottery tickets and gasoline in quart glass bottles. I learned he was a high school student when his education was interrupted by the civil war in Liberia. He wanted to study agronomy, but the post-war economy was making survival difficult and the dream of college unrealistic.

I asked him where he spent the war. His voice lowered and his expression changed.

“I moved about,” he said. “Sometimes to the bush, sometimes hiding in the city.”

Pointing to a now-empty swimming pool in an abandoned hotel across the street, he said, “See that pool? I was caught once by a gang of young guys who put a tire around me and threw me into that pool to drown. They were crazy.”

As if the war was not horrific enough, when peace came, gangs of young men armed with military weapons roved the city, robbing and intimidating the people until the U.N. established order and disarmed the former fighters. Without effective government, there was no security, and pronouncements by those who claimed leadership were unreliable. The nightmare of war does not end when the shooting stops.

Liberia and Sierra Leone are post-conflict societies. They are recovering, but strong civil institutions and governance are still evolving. Infrastructure such as sanitation, electricity, communication, health and education are weak. In both, a generation of children lost their childhood because they were born in a time of war. They didn’t attend school, and many were internal migrants or refugees in neighboring countries. And they’ve experienced trauma.

Health systems, never particularly strong, remain weak and fragile. For example, in the county most affected by Ebola in Liberia, according to a story in the New York Times, the health surveillance officer does not have a computer to track disease statistics. As a consequence, the health officer could not track the outbreak of Ebola in real time, and was relegated to an inadequate pen and paper record that was woefully behind the rapid spread of the virus.

Trust depends on the effectiveness of the government and its institutions to deliver adequate, impartial service to its citizens. Weak institutions cannot do this.

Hidden source of conflict

It’s true that people fear the Ebola virus and the toll it takes. But I think there is another, less obvious factor at work as well. It is the residual emotional state of people who are recovering from traumatic experiences in post-conflict societies. This trauma is often masked.

In daily survival it goes unnoticed, and in many places it does not figure into ongoing relationships. In others, of course, it remains a prickly source of conflict that has not been resolved. However, it’s been my anecdotal experience that in post-conflict societies, trauma is not far below the surface, and in times of crisis, when trust is on the line, it can rear its head.

Efforts to create reconciliation commissions have been tried with varying degrees of success. Sometimes they provide a platform for the abused to have a voice, sometimes they exacerbate unresolved divisions.

When I talk with people who have been through terrible experiences such as civil war, I often hear stories told in soft voices that surface pain and loss. Sometimes this pain is expressed with strong language that reveals unresolved feelings of injustice and indignity. Sometimes people are reticent to talk about their experiences at all. They fear retribution. Some don’t want to recall horrible memories. These unresolved conflicting emotions are carried silently. They reflect great personal loss. Spouses, children and whole families have been lost. Homes and sometimes entire communities have been wiped out.

Steps to rebuilding trust

Nurses listen intently during a panel discussion at The United Methodist Church's Mercy Hospital in Bo, Sierra Leone, to help prepare health care workers for dealing with the Ebola virus. Photo by Mike DuBose, UMNS.

Nurses listen intently during a panel discussion at The United Methodist Church’s Mercy Hospital in Bo, Sierra Leone, to help prepare health care workers for dealing with Ebola. Photo by Mike DuBose, UMNS.

This emotional reservoir, along with weak government, social structures and economies, creates a stew of uncertainty, unmet needs and struggle. In the case of Ebola, I think it points to a need for clear, trusted voices to interpret the reality of the virus, and to encourage people to get medical care and avoid traditional healing. It’s also important for the church to provide messages of hope, comfort, encouragement and concern. In this circumstance, it’s a form of public witness in addition to a vital community service.

This alone cannot heal the broken trust, but it is a step toward healing. Other actions must be taken as well. Improving the health system, physical infrastructure, education and governance are critical. Economic development is necessary to improve work opportunities.

The church has another important gift to offer people in these societies. While large group gatherings are being discouraged during the contagion, under better conditions local congregations are communities of support where spiritual comfort and assurance are given, and personal growth and development occur. In faith communities, people are assured that life is sacred. Life is a gift of God, and God’s intent is not for us to suffer, kill or be killed. God’s intent is for us to flourish, and to find purpose and meaning. In The United Methodist Church, we speak of God’s graciousness. In post-conflict societies, the community of faith can be a means of grace.

What the Ebola crisis has revealed is that residual trauma and weak civil society infrastructure have long-term effects. Untended, these can threaten global well-being in unexpected ways. But this is not the end of the story. It is only the beginning.


 

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