Health Pluralism: A More Appropriate Alternative to Western Models of Therapy in the Context of the Civil Conflict and Natural Disaster in Sri Lanka?

This paper considers some dilemmas relating to developing effective assistance with and to people who have lived through extreme events in a civil war and post-conflict context within Sri Lanka. The recent tsunami which has devastated many coastal areas of the island of Sri Lanka and left many people with no homes or livelihood has further affected the country. It is hoped that some of the issues raised in this paper will have wider applicability and relevance to other countries. A major issue is how far the concepts and methods of western psychology are appropriate to radically different cultures and contexts. In particular how post-conflict and post disaster psycho-social rehabilitation may depend in complex ways on local specifics and interact or not with biomedical notions of PTSD diagnosis and individual therapy. The relationship between a culture and its healing rituals is a complex one, and cultural, personal, socio-political, existential and personal meanings, expressions and responses to civil war or traumatic events and their aftermath may be mediated by context. The recent tsunami which devastated the many coastal areas of the island of Sri Lanka has compounded the losses and difficulties many people have to face after 22 years of civil war. This paper details our findings and offers some suggestions for future practice.