In a classic article in 1992, Derek Summerfield argued that "for the vast majority of survivors posttraumatic stress is a pseudocondition, a reframing of the understandable suffering of war as a technical problem to which short-term technical solutions like counseling are applicable. There is no evidence that waraffected populations are seeking these imported approaches, which appear to ignore their own traditions, meaning systems, and active priorities (p.1449). This paper describes a program of active collaboration between a Harvard Medical School team and the International Organization for Migration Indonesia in responding to the "remainders of violence" of villagers in rural Aceh, Indonesia, following the 2004 tsunami and the 2005 peace agreement between the Government of Indonesia and the Free Aceh Movement that ended a twenty year conflict. The paper provides data from a series of studies indicating high levels of traumatic experience and mental health problems in post-conflict Aceh. It describes an IOM mental health outreach project that used teams of GP physicians and nurses to respond to mental health problems, and an evaluation project that provides strong empirical evidence of the program’s effectiveness. It argues that PTSD is far from a "pseudocondition" and that programs of intervention can be extremely powerful in reducing symptoms and disability. It concludes that developing mental health programs as part of the public health efforts in post-conflict settings should be of high priority.
Keywords: PTSD, trauma, post-conflict mental health care