Searching for Normal in the Wake of the Liberian War 9780812246261, 0812246268

Table of contents :
Cover
Searching for Normal in the Wake of the Liberian War
Title
Copyright
Dedication
Contents
List of Abbreviations
1. Searching for Normal in the Wake of the Liberian War
2. Clusters, Coordination, and Health Sector Transitions
3. Trauma and the New Normal
4. Individual Interventions
5. The GBV Proxy
6. Ex-Combatant Rehabilitation
7. Redemption Time
8. The Healers
Notes
Bibliography
Index
Acknowledgments

Citation preview

Searching for Normal in the Wake of the Liberian War

PENNSYLVANIA STUDIES IN HUMAN RIGHTS Bert B. Lockwood, Jr., Series Editor

SEARCHING FOR NORMAL IN THE WAKE OF THE LIBERIAN WAR

Sharon Alane Abramowitz

U N I V E R S I T Y O F P E N N S Y LVA N I A P R E S S PHIL ADELPHIA

Copyright 䉷 2014 University of Pennsylvania Press All rights reserved. Except for brief quotations used for purposes of review or scholarly citation, none of this book may be reproduced in any form by any means without written permission from the publisher. Published by University of Pennsylvania Press Philadelphia, Pennsylvania 19104-4112 www.upenn.edu/pennpress Printed in the United States of America on acid-free paper 10 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Abramowitz, Sharon Alane. Searching for normal in the wake of the Liberian war / Sharon Alane Abramowitz. — 1st ed. p. cm. — (Pennsylvania studies in human rights) Includes bibliographical references and index. ISBN 978-0-8122-4626-1 (hardcover : alk. paper) 1. Social psychology—Liberia. 2. Postwar reconstruction—Liberia. 3. Mental health—Liberia—International relations. 4. Psychic trauma—Liberia. 5. Women—Violence against—Liberia. 6. Liberia—Social conditions—1980– 7. Liberia—History—Civil War, 1989–1996—Psychological aspects. 8. Liberia—History—Civil War, 1999–2003—Psychological aspects. I. Title. II. Series: Pennsylvania studies in human rights. HM1027.L7A27 2014 306.09666209⬘04—dc23 2014004863

For Judy and Jacob Abramowitz, Gertrude and Jerome Eisenbruck, and Myron Wolk

Contents

List of Abbreviations ix 1. Searching for Normal in the Wake of the Liberian War 1 2. Clusters, Coordination, and Health Sector Transitions 3. Trauma and the New Normal 61 4. Individual Interventions 91 5. The GBV Proxy 118 6. Ex-Combatant Rehabilitation 158 7. Redemption Time 183 8. The Healers 211 Notes 237 Bibliography 241 Index 255 Acknowledgments

267

32

Abbreviations

AFELL AFL CVT DDRR DSM ECOMOG ECOWAS GBV IASC ICD ICG ICRC IDP IRC JIU LCIP LNP LURD LWF/WS MDM MHPCC MHPSS MOHSW MSF NASW NCDDRR NEPI

Association of Female Lawyers of Liberia Armed Forces of Liberia Center for Victims of Torture Disarmament, Demobilization, Rehabilitation, Reintegration Diagnostic and Statistical Manual of Mental Disorders Economic Community Monitoring Group Economic Community of West African States gender-based violence Inter-Agency Standing Committee International Classification of Disorders International Crisis Group International Committee of the Red Cross internally displaced person International Rescue Committee Joint Implementation Unit Liberia Community Infrastructure Program Liberia National Police Liberians United for Reconciliation and Democracy Lutheran World Federation/World Service Me´decins du Monde [Liberian] Mental Health and Psychosocial Coordination Committee Mental Health and Psychosocial Support [Liberian] Ministry of Health and Social Welfare Me´decins Sans Frontie`res National Association of Social Workers of Liberia National Commission on DDRR National Ex-Combatant Peacebuilding Initiative

x Abbreviations

NPFL NTGL PSA PTSD SEA TOT TRC UNDP UNHCR UNICEF UNMIL UNOMIL USAID WHO

National Patriotic Front of Liberia National Transitional Government of Liberia psychosocial agent posttraumatic stress disorder sexual exploitation and abuse training of trainer Truth and Reconciliation Commission United Nations Development Program United Nations High Commission for Refugees United Nations Children’s Fund United Nations Mission in Liberia United Nations Observer Mission in Liberia United States Agency for International Development World Health Organization

Chapter 1

Searching for Normal in the Wake of the Liberian War

Agnes’s Lament On a hot dry day in the winter of 2006–2007, I accompanied a team of psychosocial workers to a village in the far north of Bong County to audit mental health interviews. Sitting in a dusty, narrow, blue examination room with a table, a few chairs, and an empty bookshelf, Agnes, the psychosocial counselor, looked down. Her typically tall and graceful frame was slumped, and her arms moved slowly and listlessly through her notebook and kit. She seemed far removed from her usual pert, optimistic professionalism— her eyes looked haunted and distressed. It was a slow day, and few clients were coming round to meet with her, so I asked her what was wrong. Agnes said she was ‘‘really discouraged, and upset about my country, my nation.’’ A very senior public official, Willis Knuckles, had been photographed having an affair with two women simultaneously, and in the photograph, the two women appeared to be engaged in sexual acts with each other.1 The photographs had been rapidly disseminated; they soon hung on walls, billboards, and doors in every large town throughout the country. Agnes began to sob. ‘‘What will become of our own nation? That’s a public figure. The immorality! I pray to God, and I know that God forgives, but what can this country be, what can this country become with the behavior of people like this? These are our leaders? And what will become of this man’s wife? What will become of this man’s children? What will become of his generation? I’m just sick. Where is the pride? Where is the dignity that

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you are supposed to have for yourself, for your family, for your country? We are totally ruined. The immorality is too deep, and it hurts us. It’s irreversible.’’ Agnes continued: ‘‘I tell you. It will take the grace of God. Sometimes I go home, and I just pray to God. And these women! These photographs! Women are supposed to respect themselves and be respected. I was just walking down [in town], and I saw a group, and I went over, and they were all looking at this photograph. This is the first thing I see. These are people who preach against prostitution, against corruption, against immorality, and they go and do the same!’’ Agnes’s eyes grew red, and she avoided my gaze. In an urgent low tone she moved into a steady patter of stories of shame and fear and horror. As she spoke, the circle of her condemnation grew larger and larger. She talked about ex-combatants, trauma, mental illness, and the local form of brain sickness called Open Mole. She talked about women who were trapped in domestic situations with men who had killed their family members and neighbors and about rumors of human sacrifice during the elections. She talked about community attitudes, noting that many of the Loma and Kpelle people she worked with believed that ‘‘Open Mole is a sign that you are a witch . . . that maybe you have done something . . . and it is playing on you.’’ With a great deal of shame, Agnes said, ‘‘Sometimes I feel so . . . African.’’ And then Agnes redirected her lament toward her community and her society. Agnes’s speech struck me powerfully. Unlike the other trauma counselors I had interviewed and watched during the previous weeks and months, she had never broken face. She had never indicated the slightest doubt about Liberia’s road to recovery, and she had never criticized the humanitarian NGOs that gave her an ID, a professional identity, and a stable salary. She believed in the psychosocial work they had done with ex-combatant rehabilitation, and as an example, she often cited the story of Princess. Princess was a young former child soldier whose life history had been written up for the NGO’s press kit. Her profile described her kidnaping from her village, her years spent as a soldier and as a bush wife with the rebels, and her reluctant participation in the Disarmament, Demobilization, Rehabilitation, Reintegration (DDRR) program. The narrative ended with a smiling photo of Princess in a DDRR T-shirt and a report that she had been successfully reintegrated into her village and her family. She was an iconic success story of ex-combatant rehabilitation.

Searching for Normal 3

Two years after her rehabilitation program had ended, Princess still came to the clinic to visit Agnes; her initially successful reintegration had faltered. She was lonely. Her boyfriend had promised he would come back and pay a dot (dowry) to her parents, but he had left and hadn’t called for more than six months. The people in the community didn’t like her very much, and it was hard for her to make friends with anyone who hadn’t previously been a fighter. Princess came often to visit with Agnes, and during her visits she sat humbly across the table from a psychosocial counselor who was no longer mandated by her NGO to work with her. For Agnes, her routine of peppering Princess with questions about work, dress, family, and drugs was a form of kindliness and support, but at the same time Princess was a living reminder to everyone that the immediate exuberance of postconflict interventions was wearing down into an extended period of uncertainty and ambivalence. Reviving her critique of the immorality of public leaders, Agnes told a story that I’d heard elsewhere in Monrovia, in the Bong County capital Gbarnga, and in some of the smaller trading towns between. Agnes, a Seventh-day Adventist, was a frequent churchgoer. In the years after the war, she attended Sunday services, as well as weekly Bible meetings and evening prayer sessions as often as she could. On a crowded weekend morning at her church, word had circulated that a nine-year-old girl—a church member—had recently been raped. The pastor brought the accused rapist onto the podium before hundreds of congregants and begged for their forgiveness for the rapist. Agnes’s voice swelled with rage and disgust as she recited his preaching: Everyone in this congregation must forgive this man and give him our protection, for this is a time of reconciliation! If we are to recover from this war, if we are to rebuild to assume the riches of Liberia and to become the blessed nation as we were born, we cannot harbor anger in our midst! This man needs our forgiveness, and we must forgive him, for this is the time when truth and reconciliation will set us free from the wickedness of our past! We must bring this man into our arms, into the arms of Jesus, and we must forget all the wickedness we have done against each other! For now is the time when we must forgive, when we must let the past remain in the past, and move on with our future!

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Agnes’s lament seamlessly transitioned into her own story of sadness and loss, her trauma, as she put it. Several years earlier during the war, Agnes, along with her sister and niece, were fleeing toward the Ivorian border in search of shelter. Agnes’s sister was pregnant, and their journey induced premature labor. Agnes had some training as a health worker prior to the war, and she guided her sister to a locked clinic in an evacuated village, where she managed to find an entrance. Inside the clinic there were no medications, no staff, and no supplies. Her sister and the baby died of a hemorrhage, and today Agnes is the guardian for her teenage niece. Agnes demanded, ‘‘Who is to blame for my sister’s death? Was it someone carrying a gun? No. Was it someone you can go to the TRC [Truth and Reconciliation Commission] and say this person did this thing? No. But it was the war that killed my sister. If it was not for this evil war, my sister would not have been left to die in that place, we would not have had to run away from the war, there would have been someone to help. And people talk about war trauma. Hmph! Can I ever be a mother to my niece? No! Can I give her what she has lost due to this wickedness? No!’’

The Sociality of Trauma As Agnes’s words demonstrate, the search for the new normal roamed beyond the tents and examination rooms in which trauma counseling took place. The purpose of this book is to examine the relationship between individual and collective trauma and the project of postwar social repair during a moment in which the Liberian state and its citizenry were in a state of traumatic transition, and to explore the architecture of the new normal through the lens of the massive global humanitarian project of trauma healing and psychosocial intervention in Liberia’s early postwar reconstruction, from 2003 to 2008. The story of postwar trauma has a life of its own that runs across humanitarian programs, through the the subjectivities of all those who provided or received psychosocial care or lived just beyond program eligibility, and in mental health and psychosocial programs, policy, implementation guidelines, and budgets. The context for this narrative is Liberia—a small West African country that struggled to rebuild under international peacekeeping forces, while receiving the support of a vast apparatus of humanitarian assistance that sustained the Liberian population until the Liberian state could re-assert its sovereignty.

Searching for Normal 5

Following other analyses of mental illness, politics, and violence that probe the ‘‘deep structure’’ of trauma and recovery in massive societal transitions (Pinto, Hyde, and DelVecchio Good 2008), I focus on the ‘‘superstructure’’ of trauma, especially the psychiatrically oriented pacification that has been present but made invisible in the history of military interventions in Africa and elsewhere (see Fanon and Philcox 2008; Elkins 2005, Pupavac 2004). In Africa, and particularly in Liberia, the interactions between international peacekeeping and psychiatry, mental health, and the psychosocial are not, and have never been, neutral, benign, therapeutic, or apolitical. Mental health and psychosocial interventions were directed towards the creation of a new postwar social order that would subordinate past habits of violence to a future of postwar political and social tolerance. The most curious feature of these efforts, however, was that they were uncoordinated, decentralized, ad hoc, and ambivalent. As such, they were indicative of some of the distinctive structural features of twenty-first-century humanitarian aid. Unlike other works on war and trauma, this book focuses on the sociality of trauma in Liberia, or the ways in which trauma was managed, displayed, communicated, and imagined at every level of society during the postwar period. A vast literature in anthropology, history, and the humanities explores the history of trauma as a social, medical, and legal fact (Fassin and Rechtman 2009; Young1995; Shephard 2000) and plumbs the densely interwoven theoretical substrates of how trauma functions in the interiority of the unconscious mind and produces effects in the subjective self (Leys 2000; Caruth 1995; Scarry 1985). But the sociality of trauma is also a crucial axis for analysis. The sociality of trauma can be thought of as the performance of trauma, as the habitus of trauma (Bourdieu 1990; Bourdieu and Accardo 1999), as manifestations of trauma, as symptoms of trauma, or as the externalization of trauma. But however one chooses to think about the sociality of trauma, the ontological presence of trauma in postconflict life often exceeded the limits of the explanatory frameworks, etiologies, and genealogies that we use to try to understand and contain it. In Liberia, trauma was a critical modality of the social experience of rupture and of repair, and we need to explore it thoroughly to understand how societies undertake the search for post-violence normalcy. (The psychiatric research literature on trauma, posttraumatic stress disorder (PTSD), and the neuroscience of trauma continues to grow exponentially, and lies beyond the scope of this work.)

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In the first five years of Liberia’s postconflict reconstruction, humanitarian agencies often used the language of trauma, healing, and recovery to describe the challenges confronted by the Liberian nation, but ‘‘mental health’’ was not the focus of humanitarian attention. Managing the trauma of the Liberian population was seen as a tactical necessity to prevent a backsliding into war, and consequently, trauma healing was regarded as a precondition for sustaining the new social order that the United Nations Mission in Liberia (UNMIL) was trying to solidify. To a population that had been shaken by the death of one-tenth of its citizenry, years of massive population displacement, and the inability to end a destructive thirteenyear long civil war, psychosocial interventions were introduced as a way to exercise a global mandate to restore social order, break the cycle of violence, and introduce pro-social, anti-violent behaviors and ethics. International NGOs like Save the Children, Me´decins du Monde (MDM), the Center for Victims of Torture, and the Lutheran World Federation/World Service (LWF/WS) were charged with implementing trauma healing and psychosocial interventions, and through them, instilling postconflict peace subjectivities (Charbonneau and Parent 2011), the individual and collective dispositions of nonviolent participation in postconflict life. In places like Bosnia (Locke 2009) and Sri Lanka (Argenti-Pillen 2002), and in the context of asylum courts and Truth and Reconciliation Commissions (Fassin and Rechtman 2009) anthropologists have explored how the international community has come to regard trauma as a problem of humanitarian management, and how those discourses have been localized. Through Liberians like Agnes, NGOs trained, counseled, and educated the Liberian population one-by-one and en masse, and attempted to mediate personal disputes and community conflicts as cheaply and as quickly as possible. Psychosocial techniques like group trauma counseling, play and sport therapies, and human rights trainings were designed to bring Liberian selves and subjectivities in line with new postconflict ideals of political, social, and economic participation. Although the stated objectives of these programs were psychological healing, peacebuilding, and community reintegration, in practice, the strategy was to socialize Liberians into pro-social, pro-peace, pro-liberal postconflict forms of sociality in order to achieve the primary ends of peace, military and economic stabilization, and national sovereignty. Rather than healing social, psychological, cultural, and political pathologies, mental health, trauma-healing, and psychosocial interventions were, at their foundation, efforts to manage and mitigate the social, psychological, and behavioral

Searching for Normal 7

sequelae of the Liberian war rather than cure the war’s social, psychological, cultural, and political pathologies. The implicit cure for wartime trauma was to be found in the construction of a new environment of postwar normalcy. How does trauma work as a social fact, a pervasive cultural force that is both constitutive of social life and functions as a substantial limiter of social possibilities? Like Agnes, many Liberians slipped seamlessly between a psychological understanding of trauma as a consequence of enduring exposure to violence, poverty, displacement, and corruption, a behavioral understanding of trauma as a social pathology, and a moral understanding of trauma as a sign of the moral and dispositional disorder that pervaded the national spirit. Her situated lament as a psychosocial worker employed by an NGO that promoted trauma healing, psychosocial rehabilitation, and mental health treatment identified trauma as an object of critique. But her experiences as a woman, a sister, an aunt, and a citizen gave rise to a keening that focuses our attention on the immediacy of her pain, the cleavage between her past life and her future potential, and the uncertainty of her own postconflict reconstruction. It also focuses our attention on the hope, doubt, and ambivalence about the new normal that were articulated in and out of therapeutic modalities across the recovering postwar world.

Scale Effects In addition to exploring the relationship between individual and collective trauma and Liberia’s search for the new normal, this book has two important objectives. First, it posits that the issue of scale is important for assessing humanitarian aid’s significance and impact; and second, it examines the promises made and results delivered in the domains of mental health, psychosocial rehabilitation, and trauma healing in postwar Liberia. Scale effects are important for showing how humanitarian organizations used trauma healing and psychosocial interventions not just for healing but also as a strategy for managing chaotic and restless postconflict populations. In the absence of data documenting the scale of psychosocial, trauma healing, and mental health programs introduced in Liberia and for Liberians, one can only conceptualize the problem of scale ethnographically, by studying the points of engagement between humanitarian programs and beneficiaries and engaging in quantitative conjecture about their number and size. In humanitarian crises across the world, how densely congregated

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are trauma-healing projects, and how far do their effects extend? Do psychosocial programs have primary effects upon laborers and participants? Do they have secondary effects upon the communities of program participants? Do they live into tertiary social strata, like the consciousness of the nation-state? How much counseling is needed, in what degree of dispersion, and with what frequency or continuity, for psychosocial interventions to yield measurable effects? Though it seems evident that social and psychological interventions implemented on a national scale are likely to have scale effects, neither researchers nor practitioners have registered those effects as scale effects or considered what those effects are. Solving the problem of scale is particularly problematic because no humanitarian officer, agency, or oversight mechanism had ever rigorously researched, analyzed, or even inventoried the mental health, trauma-healing, and psychosocial interventions carried out under the humanitarian umbrella. What follows is a set of indicative facts that reveal the scale of sporadic and unmonitored interventions, even though they cannot give a full accounting of the breadth of mental health, trauma-healing, and psychosocial action that took place in and around Liberia during and after the war. Trauma interventions were first introduced to the Liberian population in 1993, but by 2003 dozens of NGOs had arrived in Liberia to provide ‘‘trainings of trainers’’ (TOTs) for trauma healing and psychosocial rehabilitation. In 1996, the Lutheran World Federation/World Service (LWF/WS) Trauma Healing Program initiated trauma-healing activities that continued throughout the war. Famous for its longevity, reach, and effectiveness, and for having employed Nobel Peace Prize winner Leymah Gbowee as a psychosocial trainer and trauma healer, the LWF/WS Trauma Healing Program routinely visited communities of 2,000–5,000 people to offer traumahealing and psychosocial support, particularly in remote regions. One donor organization, Community Habitat Finance (CHF), noted in a 2007 report that during CHF’s few years of financial support to the LWF/WS Trauma Healing Program, it visited seventy communities in three districts on several occasions. In 1996, in a Liberian refugee camp in Nonah, Guinea, the Lutheran NGO Action for Churches Together (ACT) also reported that it provided trauma-healing services to 12,000 Liberian refugees. Subsequently, ACT requested an additional $450,000 to continue mental health, traumahealing, and psychiatric treatment in the N’Zerekore refugee camps from 2002 to 2005.

Searching for Normal 9

In 1997, thousands of ex-combatants participated in trauma-healing programs as part of the incomplete DDRR process to transition combatants from wartime to peacetime. In what might be called a secondary effect, several ‘‘graduates’’ of the DDRR ex-combatant rehabilitation program later created their own NGO, the National Ex-Combatant Peacebuilding Initiative (NEPI),2 which was actively involved in the psychosocial rehabilitation of thousands of ex-combatants during the post-2003 reconstruction period. Nearly ten years after the end of the war, in 2011, NEPI was still providing intensive psychosocial training to nearly one thousand at-risk youth (in partnership with a Yale University research initiative). By 2006, in Liberia, MDM, a French medical humanitarian NGO, had a stable patient load of more than 250 long-term outpatient psychiatric patients, with many more coming in for short-term psychiatric consultation or counseling. MDM also managed ‘‘traditional women’s groups’’ meant to provide counseling, peer support, and mental health education; the groups numbered 15–100 women per community, in ten communities. On a given day, MDM mental health workers could expect to be visited by approximately 200 people in Gbarnga, and in a given month, they could expect to interact with approximately 1,000 people across their service area in Bong County. Every NGO that provided trauma-healing, psychosocial, or mental health services claimed to have offered counseling, community education, and outreach to participants numbering in the hundreds or the thousands. Each of these NGOs also employed several dozen Liberian NGO employees to carry out these interventions in local languages and dialects, and their salaries and per diems supported families. As will be evidenced in Chapter 8, Some Liberian NGO employees adopted the trauma-healing framework as a personal calling, assumed the role of trauma counselor in their private lives, and circulated the language of trauma, reconciliation, and the new normal throughout their domestic and professional worlds. Perhaps hundreds of thousands of Liberian friends, family members, coworkers, and children came into secondary contact or were tertiary observers to the trauma-healing and psychosocial rehabilitation enterprise. As a result, though many trauma-healing and psychosocial programs have been lost to public recall, they’ve left an indelible social inscription upon Liberia’s social fabric.

Trauma Promises, Rehabilitation Effects In the thousands of trauma-healing and psychosocial interventions offered around the globe, trauma healing and psychosocial rehabilitation are offered

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as the promised ends of therapeutic initiatives. But much of what we know about trauma, and about mental illness more generally, indicates that under extraordinary conditions of loss, violence, and instability, trauma-healing programs offer a path to containment—to limiting the ways in which past and present traumas interfere with a person’s ability to function or a society’s ability to move on, recover, and rebuild. As this book will illustrate, many trauma-healing and psychosocial interventions managed the grossest manifestations of trauma on individual and societal scales. Unlike the shell shock therapies for World War I soldiers, in which sufferers were promised a full and complete recovery through self-confession, electroshock treatment, and moral beratement (Shephard 2000, Young 1995) today traumahealing programs in humanitarian settings often focus on the symptom—a woman’s social withdrawal, a man’s insomnia, a child’s fear of a knife or gun used in everyday life, a group of ex-combatants’ tendencies to become violent in arguments—rather than the root causes of suffering emerging from poverty, displacement, violence, and the insecurity of the postconflict moment. This begs the following questions: What range of social experience do trauma-healing projects purport to cover? How powerful are their effects? At what point of population saturation does the concept of trauma become localized or indigenized, and become an integral part of a postwar social fabric? Elsewhere in the world, the language and conduct of trauma healing and psychosocial intervention have had unmeasured and unanticipated social effects. In Sri Lanka, for example, a medicalized discourse of trauma created space for the apolitical discussion of horrific experiences, but it also justified the unwelcome imposition of intervention from expatriate professionals (Argenti-Pillen 2002). In India-administered Kashmir, more than a decade of nonbiological trauma treatment has served as a platform for local humanitarian workers to inscribe themselves into psychiatric modalities of clinical care (Varma 2012). In Sarajevo, after the Bosnian war, NGOs involved in trauma healing became symbols of hope, institutional sites for making legal and moral claims on the state, and a locus of ambivalent experiences of humanitarian abandonment (Locke 2009). Given the centrality of trauma discourses to the operation of humanitarian aid, and given the fact that at least half of all Liberians received some form of humanitarian aid at some point during the war, many Liberians living in Liberia today have little memory of a public discourse that does not include the word ‘‘trauma.’’ In everyday life, international NGO workers,

Searching for Normal 11

international donors, and many Liberians like Agnes moved easily between thinking about trauma psychologically, as a consequence of exposure to traumatic events and experiences, behaviorally, as an idiom for various social pathologies, and morally, as an expression of national disorder. As I elaborate in Chapter 3, in Liberia, trauma was a part of the vernacular. One is put in mind of Daniel’s assertion that ‘‘what defines language is not solely the use of words, or even that of conventional signs; it is the use of any sign whatsoever as involving the knowledge or awareness of the relation of signification’’ (Daniel 1996). The vernacularization of the concept of trauma in Liberia reflects more than just the arbitrary imposition of a meaningless category of medicalization on a population; it spoke to the fact that the concept resonated deeply, and meant something powerful and intimate to a nation of people. In contrast, expatriate managers in trauma-healing programs adhered to specific, Western understandings concerning the nature of trauma and the meaning of PTSD. They maintained that that the cause of trauma is an unconscious repression of memory derived from the incommunicable nature of suffering. This traumatic rupture could only be resolved through a process of symbolization of speech, or talk therapy, that reveals the traumatic experience or event and resynthesizes the traumatic event in a person’s life history. Adherents to cognitive approaches to trauma emphasized that the constant, routinized, conscious repetition of healthy practices and behaviors was necessary to create the context for the resolution of the traumatic response. Through careful instruction in correct behavior, substantial individual self-work by the trauma sufferer, constant vigilance and monitoring, and the provision of social support, specific behavioral modifications and conscious psychological adaptations could improve overall functioning, and resolve critical symptoms of impairment (i.e., autoarousal, social withdrawal, flashbacks, panic attacks, and aggressive impulses). In order to breach the divide between the vernacular usages of trama and expatriate models, Liberian NGO workers in psychosocial and trauma-healing programs often attempted to integrate moral exhortation, talk therapy, behavior change, and social critique, thereby engaging in a pidgin psychiatry that hybridized both approaches in the grounded locales of humanitarian projects (Abramowitz 2010). But what did trauma and, by extension, its healing or rehabilitation, mean in the world of humanitarian aid? What was promised, and what was delivered? (See Table 1.) Humanitarian practitioners became renowned in Liberia and internationally for overlooking key concepts, definitions, ethical

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Table 1. Modes of Psychosocial Intervention Psychiatric Treatment Individual and Group Trauma Counseling Ex-Combatant Rehabilitation and Reintegration Gender-Based-Violence Counseling Conflict Resolution and Peacebuilding Education Community Reconciliation Initiatives Case Management Strengthening Social Structures and Relationships Ethnopsychiatric Interventions with Local Healers Community-Based Human Rights Education Play, Drama, Music, and Art Therapies Drug and Alcohol Rehabilitation

frameworks, and cultural sensitivities in the rush to provide psychosocial intervention to war-affected populations. Consequently, around the end of the Liberian War, these very questions were attracting expert attention, and widespread critique. In an effort to develop minimum standards of response for mental health and psychosocial intervention in humanitarian contexts, leading humanitarian NGOs, UN agencies, and humanitarian funding institutions collaborated to establish a minimum set of guidelines for mental health and psychosocial interventions in humanitarian crises. The results of this multiyear endeavor, the Inter-Agency Standing Committee’s (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings, offered the following definition: The composite term mental health and psychosocial support is used in this document to describe any type of local or outside support that aims to protect or promote psychosocial well-being and/or prevent or treat mental disorder. Although the terms mental health and psychosocial support are closely related and overlap, for many aid workers they reflect different, yet complementary approaches. Aid agencies outside the health sector tend to speak of supporting psychosocial well-being. Health sector agencies tend to speak of mental health, yet historically have also used the terms psychosocial rehabilitation and psychosocial treatment to describe non-biological interventions for people with mental disorders. Exact definitions of these terms vary between and within aid organizations, disciplines,

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and countries. As the current document covers intersectoral, interagency guidelines, the composite term mental health and psychosocial support (MHPSS) serves to unite as broad a group of actors as possible and underscores the need for diverse, complementary approaches in providing appropriate supports. (IASC 2007) In this definition, the meanings of mental health, trauma healing, and psychosocial disorders, as well as the scope of their interventions, are obscure. Its vagaries are consistent with the humanitarian ‘‘gray literature’’ on trauma healing and psychosocial interventions. In these documents, the phrase ‘‘psychosocial interventions’’ refers to a set of rehabilitative practices that enable a process of healing by facilitating conditions for individuals to resume normal, everyday lives within their families and communities. It also, however, refers to individual, communal, and mass education campaigns to facilitate individual rehabilitation, community peacebuilding, and mass buy-in to the project of humanitarian transition. Some greater definitional specificity can be gleaned from the operational definitions for mental health, trauma, and psychosocial disorders offered by the World Bank. According to the World Bank, mental health is simply the state of health as defined by the World Health Organization (WHO) (see Table 2). Mental illness includes any disorders of cognition or emotion recognized by Western psychiatry’s diagnostic conventions, which poses a clear problem of validity in non-Western contexts (de Jong 2002; Desjarlais et al. 1995; Kleinman 1980). Psychosocial disorders include any problems resulting from the interaction between the self, social conditions, and society. Better understood as ‘‘social suffering’’ in anthropological analysis (Kleinman, Das, and Lock 1997), the term ‘‘psychosocial’’ embraces the social attenuation that results from chronic exposure to violence, displacement, poverty, and injustice, but it can also be understood as the simple absence of mental health. Trauma is recognized as the vernacular expression of PTSD, or the medicalized expression of posttraumatic psychopathology, which often co-occurs with other forms of mental illness, as well as with problems surrounding social performance and social reintegration. The concept of the ‘‘cycle of violence’’ has also gained traction among humanitarian experts, healthcare professionals, and mental health specialists. Many expatriates working in humanitarian intervention now believe that conflicts are caused by cyclical cultural and psychological forces that

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Table 2. World Bank Definitions of Postconflict Mental Health Mental Health

‘‘Mental health is more than the absence of disease or disorder. It is defined as a state of complete mental wellbeing including social, spiritual, cognitive and emotional aspects’’ (Baingana and Bannon 2004, 2).

Mental Illness

‘‘A mental illness is a disorder of the cognition (thinking) and/or the emotions (mood) as defined by standard diagnostic systems such as the International Classification of Disorders, 10th Edition (ICD 10) or the American Psychiatric Association’s Diagnostic and Statistical Manual, Revised 4th Edition (DSM IV-R)’’ (Baingana and Bannon 2004, 2).

Psychosocial Disorders

‘‘Psychosocial disorders relate to the interrelationship of psychological and social problems, which together constitute the disorder. The term psychosocial is used to underscore the close and dynamic connection between the psychological and the social realms of human experience. Psychological aspects are those that affect thoughts, emotions, behavior, memory, learning ability, perceptions and understanding. Social aspects refer to the effects on relationships, traditions, culture and values, family and community, also extending to the economic realm and its effects on status and social networks. The term is also intended to warn against focusing narrowly on mental health concepts (e.g., psychological trauma) at the risk of ignoring aspects of the social context that are vital to wellbeing’’ (Baingana and Bannon 2004, 2).

Needs

‘‘The term ‘needs’ is used to describe the need for humanitarian or development interventions to bridge the gap between identified deficits and the envisioned future (short-term post recovery) situation of a sector or country’’ (Kievelitz et al. 2004).

PTSD

A syndrome of symptoms meeting the criteria for posttraumatic stress disorder (PTSD) as specified by the American Psychiatric Association’s Diagnostic and Statistical Manual’s fourth edition (DSM-IV). Diagnostic criteria for PTSD include a history of exposure to a traumatic event and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyperarousal. The fifth criterion concerns duration of symptoms, and a sixth assesses functioning.

Trauma

The vernacular word used to describe the ongoing indicators of social pathology (criminality, avoidance, rage and aggression, inability to manage basic functions of everyday life, inability to participate in trusting, long-term social relations) resulting from enduring exposure to violence and vulnerability.

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compel individuals to reproduce relations of violence ad infinitum. According to the cycle-of-violence thesis, people who have been affected by violence are moved to reproduce violence in the role of perpetrators or victims; this leads to a dynamic of socialization in which relations of violence become normative and cyclical (Herman 2001, Steinmetz 1977). Thus, the presence of violence in everyday life is presumed to predispose people to a cyclical repetition of violence through time. When applied to mass violence, the cycle-of-violence theory proposes a metaphoric linkage between the cyclical violence involved in patterns of domestic abuse, and the recurrence of conflict among warring parties, giving long-standing conflicts a naturalized, intergenerational, and historically inscribed character (Lumsden 1997; Maxfield and Widom 1996). Scholars theorize that different factors contribute to the cycle of violence, including value commitments that valorize violence, psychodynamic tendencies toward violence emerging from the process of socialization, recent ethnic or regional rivalries, religious doctrine, land and resource rivalries, or ‘‘ancient ethnic hatreds.’’ Other theories posit that structural violence, or the prevalence of violence already in society, makes the continuity of violence a ‘‘tacit’’ strategy for survival. The cycle-of-violence theory also postulates that there can be a reversion to the cycle of violence—as when children of abusive parents are assumed to reproduce the roles of victim or abuser as they mature. Violence, which is, at its most basic level, a form of social action, is imagined across the humanitarian community as a crucial and determinative component of self, identity, and social values.3 It is important to note that the cycle of violence thesis, though widely circulated in therapeutic circles in the United States and elsewhere to this day, was researched intensively in the 1980’s, and was debunked. A series of case-control studies that examined violence among the adult survivors of child abuse found that participants were as likely to choose non-violence in their intimate relationships as they were likely to enter into abusive relationships. The appeal of the cycle of violence metaphor, however, has remained strong, and has persisted across therapeutic domains, and has entered into the international sphere of peacekeeping interventions. There, in ways reminiscent of the theories that emerged from Freud’s Civilization and Its Discontents (Freud and Strachey 1958), and classical anthropological studies of culture and personality (Benedict 1989), the idea of the deterministic nature of the cycle of violence has come to form a constitutive part of peacekeeping discourse.

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Psychological theories regarding the cycle of violence were mapped onto Liberia’s postconflict space in fascinating ways. Drawing on the cycle-ofviolence hypothesis, politicians, humanitarians, psychologists, and historians have argued that violence is inscribed into the cultural, ethnic, and tribal folkways of the Liberian population. Humanitarian workers and peacekeeping officials invoked cycle-of-violence arguments routinely; and merged their claims with arguments about resource scarcity and warlord politics had led to the social conditions contributing to civil war in Liberia (See Ellis 1999, Powers 2005, Reno 1999). But remarkably, these explanatory models extended to the U.S. and Liberian political classes, as well. Consider the statements of the following two key leaders involved in managing the early postconflict transition: Andrew Natsios, the United States Agency for International Development (USAID) representative to Liberia, and Charles Gyude Bryant, the unelected president of the National Transitional Government of Liberia (NTGL) from 2003 to 2005. At a 2004 donor conference regarding Liberia’s postconflict recovery, Natsios noted that ‘‘reintegrating and revitalizing Liberian communities, particularly in the countryside, through community-based economic, psychosocial, and political transition programs,’’ was one of the three key factors required to ensure postwar stability and democratic transition (Natsios 2004). Following his speech, Charles Gyude Bryant endorsed Natsios’s support for psychosocial intervention by arguing that it would be a crucial part of postconflict social engineering. He said, The reintegration and rehabilitation of ex-combatants into civil society, and the repatriation of more than 250,000 refugees and relocation of some 300,000 internally displaced people into communities which have been stripped of social amenities and governance structures by more than a decade of war, are daunting challenges that can only be addressed within a broader framework of national recovery. For us as a nation, this is definitely new ground. Relying on old formulas and old methods will not do. Success will require innovative approaches to problem solving and social engineering. (Bryant 2004) Advocates of the cycle-of-violence thesis believe that intervention is required to breach this pathological pattern of destruction, and a failure to

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intervene leads to ever-expanding, ever-renewing cycles of violence, retribution, dominance, and aggression that have one possible end: the permanent destabilization of social order. Because of the psychosocial ‘‘causes’’ implicit in the cycle of violence thesis, humanitarian aid workers have come to think of mental health and psychosocial interventions as having the ability to disrupt ‘‘cycles of violence,’’ and thereby end conflict. Ideas of postconflict reconstruction traced the project of transformation from the national to the individual through a process of social engineering that was located in the psychological and behavioral lenses of trauma and recovery. Humanitarians argued that the reconstruction of Liberia was a ‘‘hearts and minds’’ matter and that Liberians needed to be persuaded to abandon the past and live ‘‘normal lives.’’ Finding the ‘‘new normal’’ was the task of the day, and psychosocial interventions were a crucial site for the ‘‘normalization’’ of targeted populations: women who had been raped, men who had been combatants, children who had been separated from families, and victims of various other kinds of violence. Demobilization of armed factions, the political reconstruction of the Liberian state, and a militarized peacekeeping intervention were deemed to be unable to create a lasting peace in Liberia. Peacekeeping had to be wedded to societal rehabilitation for the cessation of war to occur. By transforming individual and collective behavior, cognition, emotion, and consciousness, humanitarians hoped they could socially engineer Liberians to be compliant with—or at least not resistant to—the project of nation-state building. Through the inconsistencies of the term ‘‘psychosocial’’ and its loose and ambiguous connection with the concept of mental health, humanitarian organizations had an unlimited mandate to intervene in people’s psychological and social lives.

The Postconflict Postcolony Although the historiography of the Liberian Civil War is important, the history of Liberia’s postconflict period requires its own telling, for the way the war transpired did not determine its aftermath. Over the next few pages, I want to relate a specific history of the postconflict period, one that pays particular attention to institutional authority, military presence, widespread population insecurity, and human experience. Most histories of Liberia end

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at the postconflict present where this book begins, so the end of the war is our point of departure.4 In 2003, when a coordinated effort by the United Nations, the United States, and the Economic Community of West African States (ECOWAS) led to Liberian president Charles Taylor’s exile in Nigeria, and internationally negotiated peace treaties established the NTGL, Liberia constituted a critical point of human vulnerability across the West African region. For years, Liberia was an unfettered source of weapons, young and cheap soldiers, epidemic diseases, illegal narcotics, and opportunities for military adventurism throughout the West African region. These activities were supported through the rapacious exploitation of diamonds and gold, virgin rain forest lumber, and latex plantations; through the provision of falsified financing and shipping documentation; and through the wholesale extraction of anything that could be sold, from copper wiring ripped out of schoolhouse walls to ceramic toilets hacked off of cement floors. In Monrovia, the capital, there was no electricity or clean water, and NGO workers were battling yet another cholera epidemic while journalists reported on the human devastation. The United Nations High Commission for Refugees (UNHCR) was gearing up to repatriate nearly a million people from neighboring Sierra Leone, Ghana, Guinea, and Coˆte d’Ivoire, and initial attempts at disarmament were failing. Vast UNHCR-administered camps for the internally displaced littered the landscape, and the task of relocating all those human lives seemed insurmountable. After more than twenty-five years of political turmoil and thirteen years of civil war and external military and humanitarian intervention, Taylor’s ‘‘help yourself’’ ethos had resulted in the stripping and sale for scrap of almost every piece of wire, metal, carved timber, and porcelain tile in the country for sale. Houses, schools, clinics, and factories had been shot up, bombed, looted, polluted, and defiled, and village after village had been burned to the ground or abandoned. Many farming communities had lain fallow for years, and a generation of peasant’s children lost the inheritance of their parents’ agricultural skills to military instability, resource degradation, and repeated displacements and raids. Though farmers returned periodically to check on their homes and holdings and maintained their fields, thousands of small-scale farms and fisheries had grown into tiny rain forests and swamps, and the mass agricultural production of commodities like rubber and palm oil had been substantially destroyed or derailed. What was left in their place were sophisticated wartime trade networks, nonsustainable

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systems for agricultural and mineral extraction, and an exploitative system of labor that revolved around wartime needs, powers, and opportunities. What was lost were the informal and formal educational mechanisms that generationally reproduced rural and urban economic, political, and social life. The total destruction of Liberia’s social, economic, political, and bureaucratic infrastructures resulted in the temporary abrogation of Liberia’s right to sovereignty. Under the Right to Protect (R2P) doctrine articulated by UN secretary-general Kofi Annan at the beginning of the decade, and concerns about further destabilization across the region, the international community had claimed the right to intercede through UN Security Council Resolution 1497, which established a peacekeeping mission, and UN Security Council Resolution 1509, which established the United Nations Mission in Liberia (UNMIL). Liberia was a fitting case for the application of the Right to Protect doctrine. The war had left behind a legacy of crisis, indeterminacy, and mistrust, a bankrupt treasury, and few leaders with the legitimate authority to rebuild a state. There was no possibility that the country would be able to emerge from the war without the substantial investment and protection of the international community. The imperative for success in postconflict reconstruction was felt by UN officials as well. After major missteps with peacekeeping missions in Bosnia, Somalia, Haiti, and the Democratic Republic of the Congo, the UN was uncertain about its own ability to effectively facilitate a postconflict transition. As one UNMIL official said during an interview with me, ‘‘We have to make this work in Liberia. After the last few years, and in such a small country—if we can’t prove that we can rebuild Liberia, then maybe we can’t do this anywhere.’’ In Liberia, as in other countries contemporaneously involved in postwar reconstruction, the postconflict moment had distinctive attributes that must be highlighted—specifically, the militaristic character of the peacekeeping intervention, the institutional distribution of the peacekeeping intervention, and the postconflict period’s temporality. In the beginning of the transition, the international community imposed new military, legal, and political forms of rule.5 UN Resolution 1509 authorized up to 15,000 military personnel, 1,115 police officers, civilian support staff, and humanitarian aid, while UNMIL and USAID worked directly with the NTGL to resurrect the state. Humanitarian intervention in Liberia was, therefore, first and foremost a militarized peacekeeping mission that was supported by ancillary administrative bodies coordinating population movements and

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population needs. An ambiguous mechanism of administration called the UN Cluster System was put into place to coordinate humanitarian aid in matters such as shelter, nutrition, health, and telecommunications. Simultaneously, UNHCR worked through the details of coordinating a massive repatriation effort of several hundred thousand Liberians from refugee and internally displaced person (IDP) camps across the region. Nearly one-third of the country’s 2.5 million citizens—particularly those with professional training and skills—lived outside its borders in Guinea, Sierra Leone, the United States, Ghana, Coˆte d’Ivoire, and Nigeria; and one million displaced persons and refugees (approximately one-third of the entire population of Liberia) were scheduled to return to overcrowded cities and to the burned, looted, and overgrown rural areas in the coming three years. Scholars like Giorgio Agamben (2005) have argued that the space of humanitarian intervention constitutes a ‘‘state of exception’’ in which, during a state of emergency, the rule of law is abrogated and the arbitrary rule of the sovereign is imposed, revealing the liminal character of the right to live and the right to let die. Without a doubt, Liberia’s sovereignty was abrogated and international authority was imposed in a state of emergency. Violent armed gangs resisted ‘‘peace’’ by installing roadblocks, turning plantations into fortresses, and engaging in violence, banditry, and theft across the cities and rural areas. While armed UNMIL peacekeeping forces from Pakistan, Bangladesh, Nigeria, and Ghana worked their way into Liberia’s interior, after the ceasefire, the international community attempted to pacify the population through threat, intimidation, containment, and moral force and persuasion. This was challenging; UNMIL peacekeepers were working with very little ethnographic or statistical information about the Liberian population. There were no Human Development Report Scores, economic indicators, governance indicators, or census data for Liberia because epidemiological monitoring mechanisms and all modes of governance had ceased to operate. Moreover, nearly all government records, but especially property ownership records, had been destroyed. No one was quite sure which iteration of the Liberian constitution still held legal force. As many people bemoaned, ‘‘It was all ruined. Everything was just to the ground. They took away everything.’’ Money flowed from international donors for peacekeeping support and humanitarian assistance, and hundreds of agencies flocked to the scene. Among the international agencies involved in Liberia’s postwar reconstruction were hundreds of globally recognized humanitarian charities like

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Me´decins Sans Frontie`res (MSF), the International Rescue Committee (IRC), and Save the Children, faith-based organizations like Action for Churches Together, autonomous institutions like the International Committee of the Red Cross (ICRC), and multilateral donor groups like the World Bank and ECHO (the European Commission Humanitarian Office). To bridge service gaps between military peacekeeping and humanitarian aid services, private corporations (such as Dyncorp) were contracted by governments to provide security services to humanitarian personnel, undertake engineering projects, and retrain Liberian private and public sector leaders. Moreover, in 2005 alone, more than a thousand national Liberian NGOs were registered with the United Nations Humanitarian Information Center. The priority for all of these agencies, from the outset, was to tread a quick and stabilizing path from humanitarianism to development. Humanitarian agencies were not allowed to linger, and most were subject to project reviews on three-month, six-month, and twelve-month cycles, during which projects were frequently initiated and terminated. Most NGOs operating in Liberia’s postconflict period were mandated to leave, or to shift to a development orientation, as soon as there was any indication that Liberia had the capacity for legitimate self-governance. NGOs that seemed intent to idle were confronted with externally imposed funding cuts or redirections of their institutional missions. Therefore, the battery of expatriate experts, technicians, and consultants traveling the roads in Land Rovers were in a race against the clock to get Liberia into ‘‘good-enough’’ shape to resume self-management, assume empirical sovereignty, and vindicate the efficacy of humanitarian operatives. As noted earlier, from the perspective of the international community, failure was not an option. The UN, the United States Government, and key NGOs like the Carter Center had been criticized for mishandling the protracted Liberian crisis, for having accepted Taylor’s 1997 election as ‘‘free and fair’’, and for ‘‘abandoning’’ the country to endemic internecine warfare that threatened to engulf surrounding countries. The International Crisis Group (ICG) wrote, ‘‘Expectations are high at UN headquarters in New York. As an UNMIL official said, ‘‘Everybody is talking about UNMIL as the start of a new style in UN peace missions, primarily because of its rapid civilian deployment and success in drawing existing UN personnel from UNAMSIL (Sierra Leone) to start up. Liberia is not large and has no more than 3.3 million people. There will be over 1,500 UN civilian personnel working on the peace

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process, and 1,115 civilian police to establish law and order, so how can it fail? (ICG 2004, 6).’’ After a long series of gaffes in Liberia and around the world, the UN was motivated to restore the legitimacy of humanitarian peacekeeping operations in Liberia. Mindful of the criticism that UN peacekeeping interventions had focused too much on elections as a benchmark of peacekeeping success, and had left too early, the UN regarded the success of the Liberian reconstruction as a critical test of the Right to Protect doctrine and as a moral test of the international community. The temporality of the postconflict moment also contributed to the sense that this period was a ‘‘state of exception,’’ or alternately, a liminal moment of ‘‘anti-structure’’ in a ritual of Liberian transformation from a communitas of war to a society of peace (Turner 1969). Following Paul Collier’s theory that the first five years of postconflict economic recovery would strongly determine the likelihood of ‘‘reversion to conflict,’’ humanitarians and policy experts on postwar recovery stressed the importance of intensive intervention during the first five years following the cessation of hostilities. (Some scholars, taking into account the destabilizing impact of economic and political fragility, believed the middle five years of Liberia’s postconflict decade to be the most important [Collier and Hoeffler 2004; Bigombe, Collier, and Sambanis 2000].) In word and deed, UNMIL officials exhorted the population to ‘‘Forget the past! The war is over! Now is the time for peace!’’ NGO workers and peacekeepers alike berated civilian and armed Liberians that ‘‘This is your only chance! When we leave, we will not come again! You must change, you must help to rebuild your country, or it will all be finished for all of you!’’ The massive influx of expatriates, white Land Rovers, helicopters, and money materially changed the landscape of Liberia and seemed to affirm the general sense that change was afoot. Therefore, the first five years after Liberia’s civil war, 2003–2008, were cordoned off in time and space from its social and historical connectedness to a known and reviled Liberian past and an unknown and unstable Liberian future. The adoption of Collier’s five-year (or ten-year) time frame into humanitarian policy created certain temporally bounded political economies of its own. Five-year and ten-year time horizons were used as benchmarks for humanitarian aid projections, and the retraining of the Liberian National Police, the Liberian army, and civilian government officials was timed against projected peacekeeper drawdowns and departures. The UNMIL peacekeeping mission was tasked with providing military security

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and governance for extremely limited periods of time, and budget and duration were subject to annual or biannual renewal. The Liberian Department of Defense underwent training from Dyncorp to learn how to manage a civilian-led defense force. Police forces were nonexistent after the 2003 negotiations over UNMIL’s presence denied the international peacekeeping force the right to act as local police on the grounds that this constituted an incursion against Liberia’s sovereignty. Plans to return responsibility to relevant government agencies were calculated in three-, five-, and ten-year time frames. At the same time, big business negotiations with international investors like the Chinese government, mining companies like BHP Billiton and Arcelor Mittal, and agribusinesses like Firestone Corporation were left to Liberian government officials to sort out. Furthermore, substantial social change was being advocated. Peacekeepers from Norway trained new Liberian police recruits to respect human rights, interview victims of rape or domestic violence appropriately, gather evidence, and go on patrols. Liberian politicians like Ellen Johnson Sirleaf urged expatriate Liberians to return to Liberia to invest in the economic redevelopment of the nation, to assume new leadership positions in government and politics, and to reshape core Liberian institutions. And humanitarian organizations stepped in to act as a shadow of the nonfunctioning state: providing education, potable water, food relief, trash collection, health care, and repatriation assistance, distributing home construction and farming materials, and reconstructing roads and bridges. And finally, as I discuss in Chapter 6, a massive demobilization process disarmed more than 120,000 ex-combatants within the first three years postconflict; five years postconflict, most ex-combatant rehabilitation initiatives could be declared completed.

Postconflict Experience Although there is a growing tendency in the postconflict literature to emphasize social, cultural, and psychological resilience, the facts from Liberia show that, prior to 2010, biological resilience often lost out to the postwar context. Most Liberians were not ‘‘getting by’’; in fact, population data indicated that Liberians were dying at the beginning and in the middle of their lives relative to the rest of the world’s populations. Amid the smog, humidity, and periodic cholera outbreaks, people were, in fact, failing to

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thrive. Liberian men, women, and children were getting too sick, dying too young, suffering too much injury and violence, and experiencing too much hunger and exhaustion, and few elderly people were left alive. Global health statistics show that in 2003, the average life expectancy at birth in Liberia hovered at 47 years (UNDP 2006) (but rose to 57 years by 2011 [UNDATA 2013]). In 2003, the child mortality rate was 194–198 per 1,000 children (UNDP 2006), with nearly twenty percent of all children dying of malaria, typhoid, water-borne diseases, from the physical traumas of accidents or abuse, or from neglected infections. Anecdotally, MSF representatives informed me that on a single visit to a private school for poor Liberian youth in Monrovia, they found a child victim of rape, three children suffering from severe ear infections; a child who had endured a bloody beating; and a student with an aggressive skin infection that had eroded most of the fingertips on one hand. The median age of the population was (and continues to be) about eighteen years of age, and only 3.6 percent of the Liberian population could look forward to living beyond the age of sixty (UNDP 2006). Random and unexplained death was an ever-present part of postwar life among Liberians, and it was always a tragedy. Many writers have illustrated the social disorder wrought by the Liberian Civil War to great effect. John Gay (2004), a scholar, teacher, and missionary in Liberia for nearly four decades, documented the social consequences of violence, modernization, endemic corruption, and social instability in his series of fictional novels. Rose George’s (2004) and William Powers’s (2005) personal memoirs and journalistic narratives brought to light the crisis of humanitarianism during the Liberian Civil War, as well as the impossible compromises shouldered by the international community in the face of unlivable circumstances within Liberia, for Liberians. Anthropologist Mats Utas (2003, 2005) and Danny Hoffman (2011) documented how Liberians built and rebuilt their lives while shuttling between camps, NGO jobs, cities, and armies and negotiated the possibilities of warbounded worlds. This is not to say that postwar Liberian life was unlivable, everywhere, all the time. People found opportunities for political, military, and social success. As Chris Coulter (2009) documented among ex-combatant women in Sierra Leone, after the war people reunited with families; some of those reunions were joyous, while some were painful. People learned who had lived and who had died, who had left for America and who had decided to stay behind in Guinea or Ghana or Coˆte d’Ivoire. Women and men found

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love and protection and created new families and communities. Mary Moran’s (2012) ongoing work on Liberian men who did not become combatants reveals how families remained strong and intact throughout the war, with family members often using any means necessary to keep their children from becoming fighters. Men and women found success in business, education, and NGOs, and many were promoted to national and international prominence through government, business, and NGO circuits. Schools operated, albeit intermittently, and people bought land and rebuilt homes. But it would be accurate to say that the onset of peace did not begin at the end of the Liberian Civil War. Tendrils of violence and destabilization protruded into postconflict realities for years after 2003, and Liberians today recall the years of 2004, 2005, and 2006 as particularly terrifying and insecure. In the war’s aftermath, 50 percent of the Liberian population temporarily resettled in Monrovia, and most of the remainder moved into a few large towns and cities in the interior. People were dispossessed from their lives and at a loss as to how to move forward. Many had passed through the various institutions of the war—refugee camps, IDP camps, militias, and the various incarnations of the Liberian government—and had come through with new identities: Pentecostal, psychosocial worker, excombatant, politician. Though some had reaped huge benefits from the wartime economies, most people ended the war poorer than before, and their personal connections to prewar communities, ethnicities, and identities were more abstract than many liked to admit. There was rampant banditry, armed robbery, and homelessness, and family units often could not keep up with the constant need for care, realignment, and reinvention that the postconflict moment had created. Moreover, certain habits of violence that had been instilled in youth over the long period of war took years to fade away. Boundaries needed to be re-created around physical, domestic, and privately controlled space, and the battles to reenact those boundaries were often public, heated, and intensely personal. In the relatively closed social, economic, and spatial boundaries of the postwar period, Liberians were transformed into beneficiaries of a massive, uncoordinated, and decentralized project of humanitarian social engineering. This included modernist practices of social persuasion like media campaigns, mass education initiatives, radio shows, theatrical presentations, and communal instruction in human rights, gender-based violence, and ‘‘peacebuilding.’’ In a parallel social universe, churches and mosques were

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used as vital locations for trauma healing, national forgiveness, and conflict resolution (Heaner 2010). People sought the Good News and instructions for living a good and moral life at church services, prayer meetings, and Bible groups, which also imposed elaborate social rules and behavioral restrictions on believers’ everyday lives. In addition, in such places of worship war criminals, war barons, prostitutes, and nearly everyone else sought, and gained, forgiveness and redemption for their wartime pasts. Because the median age of the population during the postwar period was eighteen and because the Liberian war lasted, on and off, for approximately thirteen years, by the time the war ended, more than half the Liberians left alive had almost no memory of life before the war, and the balance of the population had spent most of their adult lives as transients. In contrast to the situation in neighboring Sierra Leone, where many rural communities remained intact during the war, many Liberian youth had no adult relatives in the country who could tell them what life had been like before the onset of the political violence of the Samuel Doe era. The change promised by the postconflict transition wasn’t just ephemeral—it was epochal, and very strange and unknown. From the center of Monrovia, I watched the human environment of postwar subjectivity and tried to gauge social, cultural, and psychological resilience. From my perch, it seemed that the norms of West African life were turned inside out. On the International Day in Support of Victims of Torture, in 2005, I visited Mahtahdi, a suburban Monrovia neighborhood, for a community-based psychosocial training. There, I watched from the back of a truck as a surge of youth rioted around an NGO vehicle and started to throw rocks, while a dozen boys and girls trampled over old people in order to rip their sardine sandwiches and juice drinks out of their hands. On the main streets of Monrovia, and in the vicinities of the important markets, young men and women milled outside, seething with anger and loss, looking for what to do next with their lives. They pressed their bodies against doors and gates, and when they opened, they were forcefully shooed away by guards. Women hunched over squat cooking grills roasting bananas and raged over the cost and poor quality of commodities. The food vendors along the sides of streets had very little to sell, and it was of terrible quality. Impoverished youth, handicapped men and women, and street children climbed on top of NGO Land Rovers stuck in traffic and pelted NGO cars with rocks. Lebanese shopkeepers humiliatingly castigated Liberian employees. Even the nuns seemed angry.

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The economics of postconflict life are almost never quantified in humanitarian policy research, but they ought to be. With the end of the war, economies of housing, food, and transportation were inflated by the vast international presence and by the country’s total dependence on imported goods for every alimentary, construction, and transportation need. Food, clothing, and construction materials were scarce and prohibitively expensive as hundreds of thousands of Liberians sifted through the broadest reaches of the city trying to reclaim land and rebuild housing structures. In the meantime, they imposed on the uncertain hospitality of friends and relatives, squatted in abandoned buildings, or took rooms in dense and partially exposed housing arrangements at inflated rents. At the same time, the humanitarian industry was, without a doubt, the single biggest formal employer in Monrovia and it was the largest, most reliable, and most certain source of scarce capital in a cash-poor environment. The need and desire for jobs in the humanitarian economy led thousands of Liberians to make great personal sacrifices. Psychosocial workers I interviewed left their children alone, together, in cities halfway across the country so that they could take field-based positions for a global NGOs, and worried about their children’s welfare under the oversight of strangers. Men and women abandoned parents and marriages in order to relocate for NGO jobs, and from afar, fretted about their spouses’ fidelity, their parents’ health, and their siblings’ spending of salary remittances. People spent half of their salaries on complex transportation arrangments in order to retain the jobs that promised the distant possibility of promotion and capital accumulation. In contrast to the rapid restoration of normative social order that Coulter describes in Sierra Leone’s postconflict recovery, Liberian social life was filled with what James has called ‘‘routines of rupture,’’ or ‘‘multiple ongoing disruptions to daily life rather than single traumatic events after which there is a ‘post-’ ’’ (James 2010, 132). Rupture itself became a part of everyday discourse, as Liberians talked about their daily experiences of ruptures in the language of trauma. ‘‘All of Liberia is traumatized,’’ I heard time and time again. Borrowing NGO lingo, people said of each other, ‘‘There isn’t the human capacity. People are totally traumatized.’’ When Liberian government officials, expatriate NGO workers, repatriating Liberian refugees, and UN staffers used the word ‘‘traumatized,’’ the term indexed a social pathology of an inability to participate in the ‘‘normal.’’

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Cultural space was filled with radical questioning, uncertainty, doubt, and fear, which manifested themselves in humanitarian trainings, education programs, and occupational training initiatives. Within this artificial time frame, everyone present was intent on combating the latent potential for the reversion to violence. Veena Das wrote, ‘‘It is not only violence experienced on one’s body in these cases but also the sense that one’s access to context is lost that constitutes a sense of being violated. The fragility of the social becomes embedded in a temporality of anticipation since one ceases to trust that context is in place. The affect produced on the registers of the virtual and the potential, of fear that is real, but not necessarily actualized in events, comes to constitute the ecology of fear in everyday life’’ (Das 2007, 9). Change had its euphoric and dysphoric potentialities. Time seemed to drag endlessly, but there was a sense of panicky haste around emerging political and cultural possibilities. Women who sought greater political participation rallied behind the presidential candidacy of Ellen Johnson Sirleaf (‘‘Ma Ellen’’) and held billboards that read, ‘‘Now is the time for us to get on top.’’ Social roles were being redefined in people’s intimate relationships, norms and morality were being challenged, and histories underwent recodification. In postconflict time, there wasn’t just a possibility of transforming the self into a new form of social citizen; there was a moral imperative to do so. Politicians, pastors, and humanitarians called upon each and every Liberian citizen, saying, ‘‘Now is the time’’: to change, to search for their own culpability in perpetuating the war, and to take upon themselves the mantle of responsibility for change. Among humanitarian actors, state bureaucrats, and Liberian civilians, I found a vocal diversity of interests, intentions, and wills to govern, as well as an intense debate over the meaning and application of sovereignty in their daily lives. Across Liberia, people negotiated the pragmatic meaning of postconflict human rights, which promised autonomy and independence in their everyday lives, as well as the rights, goods, and services they were entitled to from the Liberian state (and its proxy, international NGOs). And across Liberia, UNMIL media campaigns issued a call for the restoration of law and order through advertising methods like peace concerts, billboards, posters, and radio jingles. Postconflict life in Liberia was life outside of the law, in search of law and order. In the early years after the war, when Liberian civilians assembled themselves into community watches to protect against murderous

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bands of armed burglars, international observers both hailed vigilantism as a sign of civil society and denounced it as a sign of lawlessness. The courts were in disarray, the police forces were effectively demobilized, and the legal system was in a state of suspension, while international consultants and local leaders sifted through twenty years of changes to the Liberian constitution and Liberian legislation in search of the letter of ‘‘the law’’ that was to be restored. In the meantime, the daily violence of postconflict life involved minute, nuanced, personal performances of terror. Even today Liberians recall the punchings, stabbings, and fistfights that transpired around day-to-day acts of hailing a taxi, buying a snack, or waiting in line for a phone card, and they remember how difficult it was to find work, food, and housing. Human life, for a time, was cheap, and rumor had it that young men could be hired to assassinate an enemy or nemesis for as little as $60. Without an effective police or justice system, fear and insecurity were widespread. The Asakaba gang, rumored to be a group of armed excombatants, continuously engaged in break-ins, carjackings, and rapes. Newspapers, radio, and gossip reported witchcraft ordeals, sacrificial child murders, and sorcery-driven dismemberment and cannibalism, in which police were sometimes implicated. Adult children directed gangs to rob their parents’ property, while family members stole from each other. Unpredictable and uncertain conditions were pervasive. One young social worker, Michael, was completing his associate’s degree in social work while working full-time. On the eve of his final tuition installment, he found that a family member had stolen his entire tuition and savings, leaving him penniless. It was impossible to demand compensation, as both formal and traditional justice systems were broken. Another young man, Sebastian, an ex-combatant, had started a small chicken coop of twenty chickens, which were stolen one night by local robbers. He had nothing left after three years of saved wages from the DDRR process. In DDRR he had studied carpentry, but the six-month skills training had been intermittent and incomplete, and all he could do was work as a manual laborer or gather firewood in the bush. Doing this work was excruciatingly painful; he had a war wound from his years as a National Patriotic Front of Liberia (NPFL) fighter that ran directly through his right buttock and groin, and he had lost a testicle and the full mobility of his hip joint. Travel at night was especially unsafe. Taxis are a crucial part of work life in Monrovia, and sharing taxis over long distances is often the only way

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to get from affordable homes in the urban periphery to low-salaried jobs in Monrovia’s downtown. Fatuma, an NGO worker, was kneecapped by a bandit while waiting for a taxi and then robbed. She also knew of another woman who had been pulled into a cab late at night, then kidnaped, raped, and robbed. Both women had thought there were other passengers in the taxi, but the other passengers were accomplices. Daniel’s meditation on the denaturing influence of violence speaks to Liberian experiences of the postconflict period: Where the present dominates, the future and the past, because they have to pass through the present, are shaken even as they partake of the present’s impermanence. Friends whom one considers to be unshakably like-minded change their opinions on vital matters. Today’s good cause turns out to be tomorrow’s evil. Yesterday’s liberators become today’s torturers. Last months’ confidants become next month’s informers. This week’s promise becomes next week’s betrayal. There are shifts in the other direction as well: from worse to better. Bigots turn into ardent nondiscriminators, murderers into penitent helpers, avengers into satyagrahis (nonviolent activists), hatemongers into compassionate human beings, raving extremists into rational mediators, chauvinists into humanists. . . . When the present looms large in this matter, both memory and hope become either emaciated or bloated. In either case, it is the present that dominates the past, making the past a mere simulacrum of the present. (1996, 107–108) The country became a time out of time, a time-bounded zone of social, political, and legal experimentation. Activists were able to advance unpopular legislation that supported women’s rights, democratic elections, and state governance. Numerous issues that were heretofore unacceptable for public debate, like Poro and Sande societies, Leopard societies, female genital cutting, and witchcraft ordeals, were being openly discussed. However, the newfound flexibility around the law challenged Liberians’ sense that the law was certain, that it had the legitimacy and the moral conviction that customary and formal legal systems required. In cafe´s, in newspapers, and on call-in radio shows, Liberians discussed the problems of the recent social, moral, and political order and questioned the legal, moral, and normative foundations of the new postwar society and government.

Searching for Normal 31

The Structure of the Book This book is divided into eight chapters, written with the intention that, ‘‘taken as a whole, they are juxtaposed in mutual discordance so as to echo the discordance of the phenomenon being studied—violence and its effects— albeit in a different register’’ (Daniel 1996, 6). The first chapter has framed the topic of trauma, psychosocial rehabilitation, the project of postconflict reconstruction, and the problem of humanitarian scale. The ethnographic core of the book begins in Chapter 2, which offers a ‘‘history of the present’’ (Moore 1987) of international health policy, Liberian national politics, and NGO coordination of psychosocial and mental health services in Liberia during the time period under investigation; much has changed in the last several years, and this is addressed at the conclusion of the chapter. Chapter 3 conveys the meaning of normality and trauma in postwar Liberia. Chapters 4, 5, 6, and 7 address major sites of mental health and psychosocial interventions: individual and group counseling, gender-based violence, and ex-combatant rehabilitation and DDRR. Chapter 8 focuses on the life stories of Liberian psychosocial workers and examines how they understand the nature of their own labor in the postconflict period. A note on privacy, pseudonyms, and sensitivity: My use of pseudonyms is inconsistently applied throughout. When referring to public leaders (such as prominent Liberians who appear widely in global media), I do not use pseudonyms unless I have been explicitly requested to do so by interviewees. In the case of private Liberian citizens or Liberian NGO workers carrying out their routine functions under my participant-observer gaze, pseudonyms are applied and identifying information has been changed to protect individuals’ privacy. I have chosen not to change the name of certain international NGOs, like the Carter Center, or Liberian institutions like the Mother Patern College of Nursing and Social Work, because the domain of mental health in Liberia is sufficiently narrow that it would constitute an awkward deception to try to mask institutional identities. However, at the request of several NGOs, I have changed the names of their organizations to reflect concerns regarding their global reputations. Lastly, I want to preemptively disclose to readers that much of the ethnography involves accounts of highly sensitive topics like forced displacement, rape, child abandonment, and murder. Those who may find this material too difficult to read may want to consider reading my other publications in lieu of this book.

Chapter 2

Clusters, Coordination, and Health Sector Transitions

Orientations In September 2006, I climbed up and down the back staircases of the World Health Organization (WHO) in Monrovia after receiving a referral from UNHCR. I was looking for the authorities responsible for managing the implementation of trauma-healing and mental health services in Liberia, but at the senior levels of the WHO’s country offices, the Ministry of Health and Social Welfare (MOHSW), and the few professional offices of psychiatry and psychology, no one wanted to talk to me. I was lost, embarrassed, and worried that someone was going to notice me and kick me out of the building. After hundreds of efforts to request audience with the various leaders reported to be involved in Liberia’s mental health coordination, I was at an impasse. Soon, two Indian GIS experts who worked for UNMIL helped me find my way to the appropriate office, and I noted the striking difference between the UNHCR’s offices and the WHO’s offices. During my interviews with UNHCR officers, I was seated in a spacious, clean, blue-carpeted and white-walled office with intense air-conditioning; while at the WHO, the office of the Liberian staffer responsible for mental health was dim, narrow, and covered with papers and news clippings, and it was stiflingly dank and humid. The spatial metaphor was apparent: in on-the-ground humanitarian action, how services were prioritized translated directly into space, manpower, technological sophistication, and public access. Mental health received far less attention than the tremendous movement of refugees and internally displaced persons in 2006, but oddly, UNHCR officials

Clusters, Coordination, and Transitions 33

argued that mental health interventions were key to the postconflict recovery, while WHO officers contended that it was ‘‘not a priority.’’ When I arrived in Liberia to conduct my research, I broadly wanted to understand the relationship between individual trauma and collective trauma in Liberia’s postconflict recovery. Just a few years before, I had spent two years (2000–2002) as a Peace Corps volunteer in the northern Korhogo region of neighboring Coˆte d’Ivoire, where I stood by as a witness to a republic in crisis while its populace talked itself into civil war. Prior to that, I had worked in domestic violence, rape crisis, and transitional residence programs for women and abused teenage girls in the United States. From these experiences, I became intellectually concerned with the empirical linkages between collective trauma and individual trauma, and with questions of survivorship, recovery, and reconstruction. With my newfound understanding of violence as a process of social change that took peaceful social spaces and opened possibilities for violent social action, I wondered how a country could reverse this process and, in effect, talk itself out of war and into a new form of social experience—postwar peace. More intimately, my interest in this research emerged from my own inheritance of intergenerational trauma from Jewish parents, grandparents, and great-grandparents who had fled from pogroms, hid from Hitler, struggled under postwar anti-Semitism, rejected Israeli citizenship, and built a life in America, the new world. I wanted to understand how it was possible to rebuild a life, a people, and a nation after undergoing some of the worst crimes against humanity modernity could offer. Liberia gave me a path to gain insight into the road my family had taken. Trauma, to me, meant more than suffering. It meant managing suffering while making choices, planning for the future, struggling with the present, and holding on to the redemptive possibilities of hard work, hope, and renewal. Thinking of my grandparents, I had the sense that recovery from trauma had little to do with healing or therapy; it happened after fifty years, at the end of a family dining room table covered with food, when the survivors looked out protectively over three generations of descendants. Recovery meant autobiography, and even at the end of survivors’ lives, it was never complete. My plan had been to act as a participant-observer of one humanitarian NGO’s mental health, trauma-healing, and psychosocial projects to study how Liberians understood their own experiences of war and reconstruction, and to examine how Liberian and humanitarian understandings worked themselves out in humanitarian practice. But soon after I arrived in Liberia,

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I learned that my contact, a Norwegian program officer, had left the country for six months. No one knew how to get in touch with her. The NGO was totally unprepared for my arrival, and it was utterly uninterested in hosting me. That plan was no longer an option. As an anthropologist, the political economy of life in Monrovia made the management of basic needs nearly impossible. Living on a fixed stipend from a research grant, I found that rents in Monrovia were as high as rents in London, Tokyo, and San Francisco. My mobility and housing options were severely constrained by my gender and my lack of affiliation with a humanitarian organization. Consequently, I relocated eight times during my year of fieldwork: I shared dim apartments behind barbed-wire-covered walls, hotel rooms, short-term local housing under the constant surveillance of bandits, and I was secretly offered couches in friends’ embassy compound apartments, UNMIL bases, and NGO guest houses. Leaving my various residences on foot, I was routinely physically assaulted, verbally abused, or threatened, like many of the Liberians around me.

Directions In order to get started, I called the only friend I had in the country, a consultant for UNMIL and the United Nations Children’s Fund (UNICEF), who set me up with a place to live and a general sense of the geography of the capital. With her help, I conducted an institutional inventory of international and local NGOs that reported having provided mental health and psychosocial interventions in their international media literature, marketing materials, and on their websites. Although NGOs often reported on the activities that they classified as psychosocial: ex-combatant education and retraining, GBV counseling, psychosocial curricula for elementary schools, civil society training, and human rights training, by 2006, most NGOs had ceased mental health and trauma-healing activities, and were intensely averse to providing financial, labor, or logistical support for mental health or psychiatric services. Few organizations were willing to claim any explicit involvement in mental health, and most took pains to separate themselves from those activities in situ, ‘‘on the ground.’’ Instead, in interviews, expatriate and Liberian NGO workers repeatedly used the phrase ‘‘destroyed human capacity’’ interchangeably with the word ‘‘trauma’’ in order to evoke a summary of the total human destruction wrought by the Liberian war.

Clusters, Coordination, and Transitions 35

To follow the meaning of psychosocial intervention in Liberia’s postconflict reconstruction, my research gradually expanded from interventions that could narrowly be defined as mental health and psychosocial to a consideration of any program or action that was classified, by anyone, as ‘‘mental health’’ or ‘‘psychosocial.’’ My emerging ambition was to study mental health and psychosocial intervention in a multiscalar and processual way, using a multisited ethnographic approach (Falzon 2009; Hannerz 2003). I first sought to examine the implementation and governance of mental health and psychosocial interventions vertically, from global and national decision makers, to Liberian and expatriate psychosocial and mental health workers, to Liberian program beneficiaries, and to Liberians who were excluded from psychosocial interventions (Marcus 1995). I also sought to examine mental health and psychosocial interventions cross-sectionally by looking at the experience of humanitarian/local interactions around psychosocial intervention at the point of their convergence in daily life. The goal of this chapter is to contextualize the mental health and psychosocial interventions described in the remainder of this book in the prewar, wartime, and postconflict histories of Liberian mental health, traumahealing, and psychosocial rehabilitation. Therefore, the primary task of this chapter is to write a ‘‘history of the present’’ for Liberian mental health in order to provide a framework for understanding the postconflict paradigm that emerged after 2003 by following the discontinuities, conflicts, and uncertain progress toward the creation of a Liberian national mental health policy, a WHO priority for national mental health systems. As the processes of humanitarian coordination, prioritization, and distribution of resources unfolded, they revealed the uncertainties and ambiguities of the postconflict moment. These processes were rooted in a dynamic of global-local engagement that was fractious, complicated, and bidirectional, and always filled with a sense of unknown ends (see Chapter 4). In the data collected for this chapter, nearly all of the historical material from the era before 2004 is the result of archival work, retrospective interviews, and publicly available NGO documentation (also known as the gray literature). In contrast, nearly all of the material post-2005 is based on participant observation, key informant interviews, and a careful process of cross-validating informants’ accounts with NGO, local informant, documentary, and international sources. This process of tracking down the ‘‘living history’’ of humanitarian implementation was a side pursuit to my multisited ethnographic fieldwork, in which I tracked mental health,

36 Chapter 2

psychosocial, and trauma-healing interventions in clinics, hospitals, NGO offices, government ministries, shantytowns, rural villages, and UN bases. My research transected four counties in Liberia (Montserrado, Bong, Lofa, and Nimba), and in them, I tracked patients with mental illness from clinics to hospitals; studied the financial and physical flows of aid from the capital to the country’s ‘‘most-affected areas’’ (Nimba, Bong, and Lofa counties); and followed the movement of mental health workers through their various assignments. I tracked the movement of policy documents through institutional hands, the gradual expansion of safe space, the availability of overthe-counter psychoactive medications from local markets to urban ghettos, and the usage of psychiatric medications inside and outside of mental health facilities. In my characterization of ‘‘the psychosocial’’ as a nonhuman actor that has agency, yields symbolic, interactional, and material effects, and creates logics of momentum, expertise, and resources in the decentralized, deinstitutionalized, and heterogeneous context of Liberia’s postwar humanitarian world, I owe a considerable debt to the work of Bruno Latour, and to actor-network theorists (Callon 1991; Callon and Law 1997; Latour 2005; Law 1992; Law and Hussard 1999). My movement through Liberian mental health, trauma-healing, and psychosocial work has been shaped by intuition, by access, and by my understanding of the concept of ‘‘the interventionscape’’ (Abramowitz and Benton 2005) as a nexus of complex, chaotic, deterritorialized humanitarian institutional interactions and global processes (see also Appadurai 1996) that constitute the culturally distinctive domain of ‘‘networked interaction’’ (Hall et al. 2001; see also Duffield 2001 on global governance) we have come to think of as humanitarian intervention. Across the interventionscape, flows of resources, personnel, bureaucratic protocols, administrative practices, financial mechanisms, and ethical guidelines shape the space of mental health, trauma-healing, and psychosocial intervention in the unique Liberian postconflict landscape and give it its meaning, form, and impact. I entered the theater of mental health intervention through interviews or fieldwork visits with prominent agencies in Liberian mental health like the Center for Victims of Torture ([CVT] a U.S.-based NGO), Cap Anamur (a German emergency medical NGO developed on the model of Me´decins Sans Frontie`res [MSF]), and Me´decins du Monde ([MDM] a French medical NGO), through Liberian institutions like the Ministry of Health and Social Welfare (MOHSW) and the Mother Patern College of Nursing and Social Work, through expatriate psychiatrists, consultants, and aid workers,

Clusters, Coordination, and Transitions 37

Figure 1. Katherine Mills Hospital. Photo by author.

and through Liberian psychiatrists, psychologists, mental health social workers, psychiatric nurses, gender-based violence advocates, trauma healers, and psychosocial workers.

1994–2003: Postconflict Mental Health During Liberia’s prewar existence, the country’s mental health infrastructure resembled that of many other sub-Saharan African countries. Formal mental health care in the nation’s capital often meant psychiatric hospitalization, while traditional mental health care in urban and rural areas often meant herbalists, witchcraft or sorcery trials, traditional medicine treatments, or fairly primitive methods of physical containment, using chains, ropes, or blocks of wood as anchors or foottraps. There was one center of modern psychiatric care in the national capital, the large, modern Katherine Mills Rehabilitation Institute in Monrovia, which was part of the Monroviabased John F. Kennedy (JFK) Hospital system.1 There was also a small, private, in-patient psychiatric hospital called Grant Hospital, owned and managed by Dr. Edward S. Grant. The hospital had a forty-bed capacity and was adequately furnished in a limited sense; it had dormitory rooms, a kitchen, outdoor and indoor recreational areas, and a medical dispensary. Between 1994 and 1997, as Liberia’s health infrastructure crumbled under the weight of civil war, the international community made its first foray into managing trauma in Liberia and into surrounding refugee sites in Sierra Leone, Coˆte d’Ivoire, Ghana, and Guinea. These early psychosocial

Figure 2. Entry, Katherine Mills Hospital. Photo by author.

Figure 3. Main gate, E. S. Grant Hospital. Photo by author.

Clusters, Coordination, and Transitions 39

interventions, then conceived of as trauma healing, ex-combatant demobilization, and psychosocial stabilization, were seen as novel, legitimate, and necessary. In Liberia, the WHO and the Lutheran World Federation/World Service (LWF/WS) were leaders in trauma management. The WHO provided short-term support for technical guidance, hired consultants to run trauma-healing training sessions, and oversaw pilot projects in excombatant rehabilitation. In contrast, the LWF/WS Trauma Healing Program built a large, community-based trauma-counseling program that operated continuously during the war, and developed a positive reputation across Liberia. Neither set of interventions were monitored or evaluated, and their efficacy remains unknown. Both the WHO and the LWF/WS oriented their psychosocial education to ‘‘scale,’’ targeting communities and groups rather than individual mental health counseling or treatment. Both also espoused a ‘‘training-of-trainers’’ (TOT) model meant to promote the sustainable dissemination of psychosocial knowledge. In the TOT model, short-term topical training sessions were offered to Liberian participants, who were then encouraged to go into their communities as local trainers, or health educators, and share their findings about trauma and mental health. But the LWF/WS’s long-term presence in Liberia and its rapid shift from an expatriate staff to a local Liberian staff seemed to have the effect of ‘‘indigenizing’’ the program, giving it a quality of local ownership that WHO initiatives seemed to lack. The LWF/WS program repeated training sessions in communities, had a long-term relationship with communities, and often spent the night in those communities. In the quiet night hours, after the official end of the training day, trainers would provide individual counseling to community residents. They also ran ‘‘after-hours’’ women’s encounter sessions where women recounted experiences of rape, or of sending family members to war. Eventually the LWF/WS shifted its training materials’ emphasis on PTSD theory and basic counseling skills to the meaning of trauma, to local problems like drug addiction and ‘‘human brokenness,’’ to the meaning of violence and the war, and to the meaning of the postconflict period. WHO materials never followed suit and instead upheld the priorities set by international consultants and elite Liberian psychiatrists and psychologists, such as HIV/AIDS and conflict management (see Table 3). But even with the local sensitivity exhibited by LWF/WS trauma-healing activities, by the end of the war, communities and trainers alike were growing tired of talking about violence, rape, traumatic memory, instability, and poverty, while nothing ever seemed to change.

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Table 3. LWF/WS and WHO Trauma-Training Manuals LCL-LWF/WS Trauma Healing and Reconciliation Program Peace Building Training Handbook Training Trainers Human Brokenness Understanding Liberian History: Highlights of the Various Periods The Meanings of Conflict and Violence The Meaning of Post-Conflict Dealing with Trauma Substance and Drug Abuse The World of Communication Psychosocial Skills Training Manual (WHO and UNESCO) Stress Management Handling of Drug and Alcohol Problems HIV/AIDS, STDs Trauma Counseling including: General Concepts of Counseling Confronting Sensitive Issues Learning about Stress and Trauma Conflicts and How to Manage Conflicts

The end of the postconflict demobilization process (DDRR) in 1997 did not lead to peace in Liberia, but it did serve to justify massive humanitarian withdrawal. Consequently, many trauma-healing and DDRR projects ‘‘on the ground’’ closed shop, while a few, like LWF/WS, continued to function. As the war gradually expanded again between 2000 and 2003, traumahealing and psychosocial assistance projects were provided to Liberians living in refugee camps in Guinea and Sierra Leone, while the interior of Liberia became a no-man’s-land for all but the most determined aid organizations. By 2003, for example, CVT had been operating a trauma-healing counseling program for four years in the Kissidougou, Guinea, refugee camp, which housed an estimated 81,000 refugees (most of whom were Liberians), and across Sierra Leone. In order to recruit participants into the screening process, approximately 20 Liberian CVT psychosocial agents (PSAs) and 120 volunteer peer counselors were individually responsible for recruiting

Clusters, Coordination, and Transitions 41

approximately 25 Liberians per month for six- to ten-week counseling sessions, which would have totaled approximately 18,000 screened participants. Many more thousands of friends, cohabitants, or bystanders witnessed the semi-public screening process, which included verbal training in how to recognize PTSD, depression, anxiety, and suicidal thoughts. These numbers give a sense of the density of trauma-healing interventions for Liberian populations outside of Liberia, and the paucity of services available inside of Liberia, at the war’s conclusion. The situation was indicative of the state of the entire health sector. When UNMIL assumed authority in Liberia at the end of 2003, all that remained of the MOHSW was the crumbling edifice of a building on Capital Bypass Road in Monrovia, a gutted national infrastructure of clinics and hospitals, thousands of emigrated or displaced medical professionals, and a backlog of salaries that had not been paid in years. The ministry’s main assets—its health clinics—had been stripped of their wiring, roofs, benches, doors, and sinks, as well as all medications, equipment, and supplies. Humanitarian medical organizations sent staff and supplies to JFK Hospital to keep it running, and health care across the country was administered by a patchwork quilt of medical humanitarian NGOs. Even after UNMIL’s quick restoration of the MOHSW with a fresh coat of white paint with blue trim, generators, vehicles, and a few computers, the MOHSW still confronted a significant labor crisis. Its ‘‘human assets,’’ medical professionals, had found employment as ‘‘volunteers,’’ social workers, counselors, translators, logisticians, or educators with humanitarian NGOs. There were legal and administrative barriers to hiring new medical staff, and many Liberian health workers preferred to work for NGOs, where materials, medicines, salaries, and physical security were somewhat assured. This would have implications for the debates around the professionalization of mental health services in just a few years’ time. Psychiatric care, like the rest of the medical sector, was in a state of collapse. The Katherine Mills Rehabilitation Institute had been completely destroyed during the war (see Figures 1–3) and transformed into a squatter settlement for 250 people. The WHO Mental Health Atlas noted in 2005 that Liberia lacked all of the following: epidemiological data, a mental health policy, a substance abuse policy, a national mental health program, mental health legislation, mental health financing, and mental health facilities. Serious mental illnesses were managed in alternative spheres like

42 Chapter 2

churches and mosques, among traditional healers, and within families and communities. Epilepsy and madness were explained with reference to witchcraft and sorcery by all of Liberia’s tribal and ethnic groups. By 2003, trauma-healing activities had been under way in Liberia for nearly a decade, and Liberian NGO workers told me that mental health and psychosocial interventions were being widely questioned. Phalanxes of international experts again descended upon Monrovia to conduct shortterm (four-day to two-week) trauma training sessions. Liberians noted that vast sums of money seemed to be spent on these trainings, and on the salaries of psychosocial workers who were purportedly trying to meet recruitment quotas. Intensive trauma counseling was giving way to more cost-effective ‘‘community-based ownership’’ models, or TOT approaches, which could shallowly capture a wide audience, and did not require longterm investments in treating serious mental illnesses or psychosocial disorders. Therefore, the flurry of activity around trauma-counseling TOT consultants and DDRR ex-combatant rehabilitation kept trauma-healing and psychosocial intervention locally relevant, while donors continued to share the sentiment that mental health was ‘‘not a priority.’’ The biggest site of expenditure on mental health was in the DDRR process, where for approximately eighteen to twenty-four months, monies flowed freely. From the outset, UNMIL, the U.S. government, and the NTGL had committed rhetoric and financing to psychiatric assessment and psychosocial interventions for demobilizing combatants in the cantonment sites, to education programs, and to job retraining projects that they sponsored from 2003 to 2006 (see Richards 2005). Despite the fact that international donors knew that the Liberian state could not possibly assume responsibility for mental health or psychiatric care, it left ambiguous the locus of authority for psychiatric interventions, trauma-healing programs, and psychosocial activities. Within the DDRR process, the WHO sought to have a supervisory role over the health—and the mental health—components of demobilization. It tried to recruit Dr. Grant, then known as ‘‘the Liberian Psychiatrist,’’ to participate in the WHO DDRR Project, and to lead mental illness diagnosis efforts among the more than one hundred thousand ex-combatants who were contained at the many dispersed cantonment sites for disarmament and demobilization. Although the WHO was quite keen to have a Liberian psychiatrist involved, Dr. Grant died just before DDRR, and his position was left empty. A WHO report commented,

Clusters, Coordination, and Transitions 43

In the initial agreement it was contemplated to have a total of six staffs, two national medical coordinators instead of one and a national psychiatrist specialist. For the first phase of the process we reviewed the question and agreed upon the need of just one national doctor, but for the mental health component it was a different situation. The director of the Monrovia Psychiatric Hospital was contacted by WHO to be in charge of the mental health part of the programme, but unfortunately passed away some days before the start of the DDRR process. It was impossible to find a reliable national candidate to do the work and finally, mid September, an international psychiatrist was engaged, but at that time the demobilization exercise was in a very advanced status and almost close to an end. This lack of a specialist could have biased our findings regarding mental diseases. (Larrauri 2004, 15) Despite the fact that there was no diagnostician present to identify serious mental illness among the ex-combatant population, the WHO reported, Regarding the group of ex-combatants suffering of mental disabilities, it was true that no psychotic diseases (schizophrenia, paranoia) were seen at the cantonment sites and just some minor signs of neurosis (anxiety, aggressiveness) were detected. The suspicion for these last ones was the lack of cannabis (marihuana) but due to the fact of not having an appropriate mental health specialist working with us we could not make any conclusion regarding the prevalence of traumatic reactions. Some few cases of epilepsy were identified. (Larrauri 2004, 42–43) Without any Liberian psychiatric expertise readily available, the two bureaucracies overseeing DDRR, UNMIL’s Joint Implementation Unit and USAID, redirected their attention away from psychiatry and back towards trauma-healing and psychosocial rehabilitation. They issued a rapid call for proposals from any Liberian organization that could do trauma-healing work with ex-combatants in the cantonment sites, and they promised full financing. Suddenly, thousands of Liberians living in Liberia in 2003 were transformed into local experts on trauma, ex-combatant demobilization, and psychosocial recovery. Within weeks, nearly everyone, everywhere, had posted a shingle advertising themselves as local Liberian NGOs providing

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mental health services, trauma healing, counseling, and psychosocial rehabilitation. Nearly one thousand Liberian NGOs registered themselves with UNMIL’s Humanitarian Information Center, with several hundred expressing an intent to provide psychosocial care, trauma healing, and rehabilitation, and several dozen having specifically listing the word ‘‘trauma’’ in their organization titles. After surviving the competitive bidding that drove the NGO selection process for DDRR contracts, many of these Liberian NGOs fell victim to financial mismanagement, ran afoul of Liberian government regulations, or were physically chased out of the cantonment sites by former soldiers who were enraged over demobilization payments or were in the throes of drug detoxification. How did the mental health component of DDRR come to be characterized by inefficiency, a lack of expertise and oversight, and ineptitude? Funding—specifically, the low prioritization of mental health needs—seems to have been an issue. NGO leaders and donors told me that they regarded psychiatric care as a secondary issue relative to urgent humanitarian concerns like securitization, water sanitation, primary health care, and rebuilding government capacity. Medical humanitarian organization directors presumed that treating serious mental illnesses like schizophrenia, drug addiction, post-traumatic stress disorder, and major depression was prohibitively expensive, would take too long, and demanded complex medication and patient surveillance protocols. Patients were unlikely to recover quickly, psychiatric consultants were expensive and difficult to recruit for humanitarian aid work, and long-term health care was largely seen as the responsibility of the state. Donor institutions reminded me that they wanted to avoid committing to forms of aid that could not be sustained beyond the postconflict transition. International NGO headquarters were reluctant to invest in Liberian mental health for unstated reasons—the recent critiques of trauma-healing interventions in postconflict settings (see Summerfield 1996, 1999; Bracken, Giller, and Summerfield 1997, Bracken, Petty, and Save the Children Fund 1998) may have cast doubt on the legitimacy of psychiatric interventions in postconflict African contexts. These critiques painted trauma-healing and psychosocial programs as having a prima facie intervention ready for the problem of PTSD without consideration for the character of the crisis, the experience of people within those crises, and the sources of authority and power that backed up PTSD diagnoses and interventions. Consequently, despite a strong climate of support

Clusters, Coordination, and Transitions 45

for mental health in other humanitarian settings (e.g., Palestinian Territories, Sri Lanka, Nepal, Uganda, and Rwanda), funding was not forthcoming for Liberia. As a result, the ‘‘continuum’’ of mental health and psychosocial support turned into a fragmented, partial landscape of services that created vast aporias of care. Trauma-healing and psychosocial programs were willing to see people with low-level, commonly occurring mental illnesses like moderate depression, anxiety, and PTSD, but refused to address more serious mental illnesses and symptoms like psychosis, severe depression, catatonia, or substance abuse. One NGO director of a trauma healing program told me that he explicitly directed his psychosocial workers to focus on highfunctioning clients who could participate in the NGO’s group therapy activities, and to turn away anyone with a serious mental illness, because managing their needs was ‘‘beyond our capacity.’’ Other NGOs that offered trauma-healing services screened out Liberians exhibiting symptoms of serious mental illness, and redirected them towards a dizzying web of fruitless referrals to medical humanitarian NGOs or regional hospitals. Medical humanitarian NGOs and regional hospitals, in turn, treated Liberian mental illnesses only when patients presented at their clinics for other medical problems, and solely in order to proceed with a physical examination. On those occasions, doctors or nurses administered sedatives or antipsychotic medications in order to proceed with their physical examination, and then released the patient without further psychiatric support or follow-up. Then, having focused exclusively on physical maladies or injuries, they referred mental illness cases back to trauma-healing or psychosocial NGOs. Nonmedical NGOs working in the domain of psychosocial rehabilitation avoided the issue of mental health altogether, and instead opted for costeffective public health ‘‘sensitization’’ projects that emphasized psychosocial counseling and education, and targeted ‘‘at-risk’’ populations for rehabilitation activities.

2004–2006: Struggle and Stasis From 2004 to 2006, medical humanitarian NGOs coordinated with each other through UNMIL’s Health Cluster. The Health Cluster, as part of the broader United Nations Cluster Coordination system for UNMIL, was an

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institutional mechanism for bringing together competing NGOs under a single umbrella for the purpose of metalevel coordination on issues like the geographic distribution of services, epidemic control, and policy discussions regarding international aid and the local conditions of health care provision. The Health Cluster system was also intended to provide an organizational framework that would allow humanitarian aid organizations to support, rather than supersede, the Liberian state in its effort to provide health services and set health policy agendas. As time passed and NGOs worked more closely with the MOHSW, the relevance of the Health Cluster system declined, but it had a constitutive role to play in the first five years of medical activity in postwar Liberia. Initially, the plan for managing the Liberian health sector’s transition from humanitarianism to development was presumed to be in place. In public statements, the Health Cluster asserted that it was working in partnership with the MOHSW and that it intended to transfer responsibility for national health care over to the MOHSW when the Liberian state had the capacity for self-management. The WHO served as a technical advisor to the Liberian state and provided guidance, policy recommendations, and ethics protocols. All parties agreed that, eventually, the MOHSW should assume full responsibility for health care in the country, and international NGOs should defer to its leadership in matters of nationally determined health priorities and legislative mandates. In the course of ‘‘handing off’’ health care responsibility, the international community was to work with the MOHSW to ‘‘build capacity’’ so that by the time of their departure, the MOHSW would be an effective state bureaucratic organization in practice and principle. The goal was to transition the Liberian state from postconflict dependency to development-appropriate autonomy. International and local health care leaders had a vague sense that mental health, trauma-healing, and psychosocial intervention fell within their domain of responsibility, but the scope of their responsibility was never defined. Mental health, trauma-healing, and psychosocial intervention did not fall within the purview of the UNMIL Health Cluster or within the scope of the Office of Coordination of Humanitarian Affairs (UN-OCHA), nor was it formalized under the WHO and MOHSW joint administrative agreements. It was, in effect, in an administrative vacuum. Periodically, bids would be made to move ‘‘psychosocial’’ over to the Ministry of Youth and

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Sports (in 2008) or to consolidate trauma healing under the social welfare division of the MOHSW, but external forces had prompted a plan of action that was being weakly advanced by the WHO and the MOHSW. In accordance with recently issued international ‘‘best practices,’’2 Liberia was to develop a national mental health policy, establish a national mental health budget, and facilitate the passage of national mental health legislation that would affirm mental health care as a legal right. In a world in which every humanitarian action was potentially an administrative placeholder for a government priority in ‘‘the transition from humanitarian aid to international development (H2D),’’ mental health did not have a home. Without an international or Liberian advocate for mental health who could build a constituency among aid organizations, motivate administrative attention, or inspire political or legislative movement, there was no engine for advancing mental health through postconflict institutions. Moreover, there was no authority ‘‘from the top,’’ within UNMIL or the MOHSW, who had an interest in the oversight and coordination of psychiatric, mental health, and psychosocial services and research. The advancement of postconflict mental health’s legislative, policy, and coordination agendas seemed to have stalled. For mental health in Liberia to be treated as a legal and procedural priority meriting the international commitment of resources, the country’s commitment to mental health needed to be stipulated in national law and in state health policy. But in order to stipulate the importance of mental health in Liberian policy, material evidence of donor interest needed to be forthcoming. In order to render Liberia commensurate with WHO recommendations, the MOHSW needed to take certain bureaucratic steps. It had to identify local experts—specifically, a Liberian psychiatrist—who could shoulder responsibility for the indigenization of the mental health policy process and ensure that mental health legislation would be nationally ‘‘owned,’’ culturally sensitive, and contextually relevant. The MOHSW had to establish ownership over the health sector by coordinating acting humanitarian aid organizations to ensure coherence, nonduplication, and full partnership and support. But its main responsibility was to commission the development of a national mental health plan by issuing a terms of reference to the Liberian Mental Health and Psychosocial Support Coordination Committee. The draft of this plan was to serve as a template for a national mental health policy, which would then be parlayed into national mental health legislation.

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Although international consultants needed to be brought in to advise the MOHSW on mental health policy, priorities, and the overall architecture of the mental health sector, donor representatives, humanitarian workers, and Liberian officials involved in managing the postconflict health sector transition were distrustful of handing over mental health to expatriate leadership. In interviews, aid workers and local officials repeatedly told me that ‘‘It wouldn’t be right to bring in a non-Liberian to build Liberian mental health’’ or that mental health policy in Liberia needed to be directed by a Liberian psychiatrist. Unfortunately, however, after Dr. Grant’s death, there was just one Liberian psychiatrist left in Liberia—Dr. Jarvis Brown, a contentious figure at the WHO and the MOHSW who will be introduced shortly. To provide guidance, Soeren Jensen,3 a Danish psychiatrist and psychotherapist (who had spent fifteen years working in the fields of trauma treatment, mental health coordination, and mental health policy in war zones and postconflict areas like Bosnia, Northern Uganda, Southern Sudan, and Sierra Leone), arrived in Monrovia in 2004 as a WHO consultant specialist postconflict mental health. His contract stipulated that he would work with local stakeholders to develop a mental health policy for Liberia over a sixmonth period. Jensen knew postconflict environments gave rise to an algaelike bloom of disparate international NGO projects bearing the labels of mental health, trauma-healing, and psychosocial, and that they were often implemented by poorly prepared local actors. But he hoped to ‘‘stay on for a while, to do what he could to help Liberia.’’ In a 2006 interview, Jensen told me that he drew on his experience in Sierra Leone to identify several priority tasks for his six-month tenure. These included: completing a population-based mental health needs assessment; establishing a mental health and psychosocial coordination committee; commissioning a study of local attitudes to mental health; strengthening psychiatric services; establishing a pilot project showcasing community-based mental health; and developing a draft national mental health policy for Liberia. In postconflict transitions, these kinds of activities are carried out in government agencies across the spectrum and are vitally important. The performance of these tasks and the allocation of resources to them served to act as a ‘‘bookmark’’ for the emerging postconflict state bureaucracy, and the failure to implement these activities meant that the domain of care they represented might be left out of postreconstruction state bureaucracies altogether.

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But problems arose. Having brought Jensen in, the WHO then refused to provide Jensen with a budget for mental health activities, transportation, any means of communication (like cellphones or short-wave radio), logistical support, or the permission to employ a research staff. His superiors made it clear that the WHO had no interest in financing or supporting mental health coordination at an operational level or for providing oversight for psychiatric care. According to expatriate officials from both organizations, no international aid funds had been allocated to support psychiatric care in Liberia. Thus, while the WHO engaged in supervising other aspects of the Liberian medical sector, like epidemic outbreaks, infectious disease programs, and vaccination campaigns, Jensen was unable to make substantial progress on mental health. To make matters worse, Jensen’s newly designated Liberian partner, the psychiatrist Dr. Jarvis Brown, was uninterested in moving the mental health agenda forward. Dr. Brown held prestigious pedigrees in psychiatry and global health. After his undergraduate medical training at the University of Liberia, he went to London to study at the Institute of Psychiatry and at Bethlehem Royal Hospital, where he specialized in alcohol addiction. In 1984, when many educated Liberians were fleeing Liberia to escape political violence, he returned to Liberia to work at Katherine Mills at the invitation of JFK Hospital. In one of two extended interviews with me, Brown recalled that working in Liberia was difficult before the war. Salaries came late, most medical professionals had fled the country, and by 1989 he claims that he was the only doctor left. When the war broke out in 1990, Dr. Brown left Liberia to join his family in the United States. During the war, Dr. Brown was recruited for a number of consultancies with the WHO and became a psychosocial counseling specialist for various UN HIV/AIDS programs. He was assigned to Malawi from 1990 to 1994, but from 1994 to 1996 Dr. Brown returned to Liberia at the request of the WHO and the United Nations Observer Mission in Liberia ([UNOMIL] the 1990s predecessor of UNMIL). As Liberia entered its first demobilization campaign (described earlier), the WHO intended to support a strong mental health and counseling component. Toward that end, the WHO supported the co-drafting of a guidance document for mental health in Liberia’s first DDRR process and sought the engagement of Dr. Brown, Dr. J. Oliver Duncan (a psychologist who died in 2006), and the aforementioned Dr. Grant in demobilization, substance abuse, and HIV/AIDS projects. Clashes erupted between Dr. Brown and Dr. Grant as each sought to

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be recognized as the Liberian psychiatrist. When war broke out again in 1996, Dr. Brown fled again to the United States, where he lived with his family while periodically consulting for the UNAIDS program over the next several years. Dr. Brown returned to Liberia in 1998 and continued his consulting work with UNAIDS, and opened several private businesses in Liberia, including (reportedly) a discothe`que, an ice cream shop, a stationery store, and a private psychiatric practice. He did not speak much of his role in Liberia under the Taylor administration, but when the war ended, the MOHSW repeatedly invited Dr. Brown to become its national mental health advisor. According to Brown, he repeatedly turned down this request because the position carried no salary. Others, including deputy ministers at the MOHSW, WHO officials, and local community leaders, disputed that claim. Dr. Brown had accepted this position and was drawing a salary but was failing to fulfill his responsibilities. Other participants in postconflict mental health policy activities reported to me that as of 2008, Dr. Brown was drawing a salary of approximately US$40,000 per annum to act as a consultant on mental health to the WHO. (I attempted several times to obtain confirmation on this from the WHO and from Dr. Brown but received no response.) Thus, from 2004 to 2008, Dr. Brown held the titular role as the ‘‘head of mental health in Liberia,’’ but his businesses competed for his attention. As late as 2012, a senior USAID official confirmed that Dr. Brown was receiving a salary from the WHO, while Dr. Brown continued to publicly protest that he provided mental health–related work for little or no compensation. Although the intricacies of Dr. Brown’s professional compensation and occupational history may seem to be a sideline, his stonewalling on matters of mental health led Jensen (and later the MOHSW, the WHO, the Mental Health and Psychosocial Coordination Committee [MHPCC], and humanitarian aid organizations) into an effective dead end for nearly five years. Without Dr. Brown’s engagement, Jensen’s work in Liberia was systemically discouraged and counteracted. In 2005 Jensen’s contract was not renewed, and he departed for Europe to await additional contracts and mandates from Liberia that never materialized. Four of Jensen’s goals were, however, achieved during his time in Liberia. First, he worked with UNMIL to close the Holy Ghost Mental Home, a sham operation run by ‘‘Sister Sarah,’’ a madwoman with impressive political connections who ran the only mental health institution in Liberia

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at the end of the war. Sister Sarah’s strategy was to find psychotic people on Broad Street (a busy shopping thoroughfare in downtown Monrovia), offer them charity, and then manacle them and remove them to her ‘‘hospital.’’ At her hospital/ministry, patients were chained in abusive and unsanitary conditions, but Sister Sarah used her hospital as a means to obtain international charitable donations (see Jensen 2004a, 2004b). Jensen explained that without a national mental health policy, it was nearly impossible to persuade either the UNMIL police forces or the NTGL to rescue mentally ill patients suffering severe human rights abuses from a woman with an extensive corruption network. When UNMIL police finally took action, Sister Sarah was tipped off by a contact in government and managed to escape with all but two of her wards, and her operation was driven underground, but continued to thrive. Second, Jensen and Immanuel Ballah, Grant Hospital’s chief psychiatric nurse, recruited the German medical NGO Cap Anamur to take over, repair, and reopen the E. S. Grant Mental Health Hospital in the national capital, which had fallen into decline after Dr. Grant’s death. Though Grant Hospital, like other emergency medical organizations, often had trouble maintaining consistent supplies of psychiatric medication,4 it was able to ensure the presence of an expatriate psychiatric nurse, and it worked hard to stock generic psychiatric medications, antibiotics, and malaria medications from the WHO’s essential medicines list. Thus Grant Hospital, under Cap Anamur, became the go-to resource for any NGO with a psychiatric case, anywhere in the country. Cap Anamur and MDM, a provider of outpatient psychiatric care, became the sole providers of psychiatric treatment in Liberia, and financially supported their psychiatric services through private charitable donations rather than waiting for nonexistent international humanitarian grants. Third, Jensen organized the MHPCC. Founded around the failed ‘‘Greenfields Project,’’ an attempt to create a dedicated space at JFK Hospital for outpatient psychiatric care and referral, the MHPCC soon assumed an important ‘‘ownership role’’ for mental health and psychosocial visibility in national health policy. In principle, the MHPCC was founded in an attempt to institutionalize mental health and psychosocial coordination in conformity with emerging standards (IASC 2007) and to compensate for the lack of mental health coordination within the UN cluster rubric and within the MOHSW. It was, in effect, a ‘‘shadow cluster,’’ voluntarily organized by constituent NGOs and UN partners, the MOHSW, and Liberian

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organizations like the newly founded Liberian Social Work Association. Under the auspices of the MHPCC, NGOs offering mental health and psychosocial services were to meet monthly to coordinate mental health and psychosocial activities, to lobby government and international organizations, and to establish standards for the licensing and professionalization of a new class of counselors, trauma healers, and psychosocial workers that had emerged during the years of the conflict. After Jensen’s departure, the MHPCC’s ownership transitioned into a joint chairmanship led by Sister Barbara Brilliant, dean of Mother Patern College, and Dr. Brown, which they held for the next five years. Finally, Jensen developed and circulated a draft mental health policy to include in Liberia’s national mental health plan, a crucial document for facilitating the health sector’s transition from humanitarianism to development, but without Dr. Brown’s authorship, the documents were viewed as invalid. After Jensen left, the document was lost, as were the completed needs assessments, mental health policy justifications, and network contacts for Liberians and expatriates working on mental health and psychosocial issues. While deputy ministers at MOHSW continued to assure me that mental health was important but ‘‘not a priority,’’ mental health continued to be excluded from coordination at the uppermost levels of the Liberian health sector.

2007–2009: Mental Health as a ‘‘Non-event’’ At the end of 2006, I sat in another air-conditioned, blue room in a quiet corner of JFK Hospital, in the new resource center for the MHPCC. Empty bookshelves and new office furniture, computers, and printers were shoved against a wall, waiting to be used. Behind me were plastic-wrapped printers and chairs, and to my left sat my friend Frank Joscheck, the German psychiatric nurse running Grant Hospital for Cap Anamur. Attendees also included delegates from USAID, the Mother Patern College of Nursing and Social Work, Cap Anamur, CVT, Dr. Brown, a delegate from the WHO, and representatives from Action Against Hunger and MDM. My presence there was unusual but ignored—Frank had insisted that I come as his guest and as a researcher, and no one else seemed to mind. Before the meeting opened, Dr. Brown turned to Frank to ask him if he could get him atypical antidepressants not readily available in Liberia. Frank muttered a diplomatic response but complained later to me that Dr.

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Brown wanted to use Frank’s NGO to gain access to ‘‘good drugs’’ for Brown’s private practice. Frank was particularly annoyed because his own hospital was barely able to obtain these drugs and because Dr. Brown had been invited many times to advise the hospital on matters of care but regularly refused—and then asked for favors. The meeting commenced with two items on the agenda: (1) the requirements for social work certification and (2) the drafting of the national mental health policy. The first issue soon became a quagmire of dissent. On the issue of certification, MHPCC members were reacting to the efflorescence across the country of thousands of Liberians who claimed to be ‘‘trauma counselors’’ after participating in one of the hundreds of ‘‘trauma-healing’’ training sessions that had taken place during and after the war. In the entrepreneurial environment of postwar Liberia, ‘‘trauma counselor’’ was a new professional category that could be potentially exploited, and many people carried TOT completion certificates as evidence of their professional credibility. The issues of ethics, qualifications, and professional competency were at stake. MHPCC members feared that ‘‘fake’’ Liberian trauma counselors waving worthless certificates of training completion were a threat to traumatized Liberians. They had good reason to worry. Several participants had heard reports of charlatans, acting as trauma healers, who engaged in Sister Sarah–like human rights abuses like ‘‘beating the demons’’ out of people experiencing posttraumatic stress. Under the guise of counseling, trauma healers in churches, in private practice, or as community members were also reported to be involved in recommending exorcisms, beatings, starvation, sexual violence, witchcraft ordeals, and religious shaming (see Heaner 2010). Although these reports were still just rumors, the MHPCC felt a strong need to consolidate professional authority around the title ‘‘counselor’’ to prevent the domain of mental health from becoming an object of ridicule. The debate, this day, was over the MHPCC’s recommendations on the length and types of training, formal or informal education, and professional experience that would merit the title ‘‘counselor.’’ Ultimately the goal was to bureaucratically mainstream thousands of Liberian counselors into a singular regulatory structure. The MHPCC’s efforts to develop national standards for counseling and accreditation soon devolved into a nasty case of infighting. One NGO, CVT, recommended that strict state regulations be bypassed or amended, given the institutional flux of the postconflict moment. As long as meaningful

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and effective efforts were being made to build human and institutional capacity, CVT—a trainer and employer of dozens of Liberian psychosocial workers—felt that on-the-job training and expatriate professional supervision should be recognized as the equivalent of a formal university degree. While trauma-healing NGOs wanted ‘‘their counselors’’ to be recognized as full-fledged professionals, colleges and social work organizations wanted counseling accreditation to fit within broader training and regulatory frameworks for nursing and social work. The Mother Patern College of Nursing and Social Work and the National Social Worker Association of Liberia asserted that the Liberian state had always existed, that it continued to exist during the war, and that ignoring formal processes of accreditation and credentialing was yet another attempt by the international community to undermine and deny recognition of the sovereignty of the Liberian state. They suggested that failing to recognize and engage with the state and to support formal educational institutions, certification processes, and oversight mechanisms might be an implicit attempt to keep the Liberian state dependent on humanitarian assistance and authority. The future of the state and the success of the postconflict reconstruction were entirely dependent on repositioning the state and local tertiary institutions at the center of regulation. This debate reflected a core ideological divide about the role of the state in postconflict reconstruction. While some humanitarian aid organizations attempted to bypass state structures in the training and management of their labor force or, as Sister Barbara said, ‘‘pretended there is no state,’’ other institutions sought to integrate their institutional protocols into the state structure, with the explicit goal of strengthening the legitimacy of the state. However, rival institutions argued—quite reasonably—that many Liberians who lacked access to institutions of higher education during the war had transformed their professional experiences in trauma counseling into highly skilled vocations. They noted that these psychosocial workers had been intensively trained ‘‘in the field,’’ had received substantial NGO guidance and supervision, and had a valuable and specific skill set. Consequently, they felt that in the new world of postconflict Liberia, there should be an occupational location for this new kind of counselor. With the MHPCC at an impasse on the issue of professionalization, Dr. Brown, the meeting cochair, introduced the question of drafting a national mental health policy for Liberia. For many months, the minister of health

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and social welfare had held the MHPCC responsible for drafting a policy document, which, in a sense, affirmed their status as a ‘‘shadow cluster.’’ But little progress had been made. At this meeting, Dr. Brown asked the group to list the domains of health care and social service provision that fell under mental health and psychosocial legislation. Attendees began to list areas that mostly reflected existing humanitarian funding priorities: psychiatric care, drug and alcohol abuse, mental health, trauma healing, psychosocial support, gender-based violence, ex-combatant rehabilitation, human rights, and so forth. The discussion turned to other departments and ministries that were also claiming the mantle of ‘‘rehabilitation’’—like the Ministry of Youth and Sports and the DDRR offices. Soon Dr. Brown reminded everyone in the room that he wasn’t getting paid to manage mental health in Liberia, and the meeting was adjourned with a few general action points identified but with no clear plans for finalizing a draft of the document. According to several meeting participants, by 2006 disputes like these had become routine and the MHPCC was deemed irrelevant—even by its members. Whereas initially most NGOs implementing psychosocial services felt compelled to participate in the MHPCC, by 2006, the committee had been reduced to a just a few international NGOs and local institutions. Important Liberian NGOs providing mental health and psychosocial care, like the LWF/WS and the National Ex-Combatant Peacebuilding Initiative (NEPI), were absent, were unaware of, or had long ignored the MHPCC. Under the joint leadership of Sister Barbara and Dr. Brown, the MHPCC’s monthly meetings failed to yield meaningful coordination, and in 2008 the MHPCC was defunct. Since 2004, the MHPCC’s sole achievement had been to obtain funding for the psychosocial resource center within JFK Hospital where the meeting took place. The purpose of the resource center was to manage, aggregate, and disseminate mental health and psychosocial research and to serve as a seminar room, a library, and a centralized location for training. The project was funded through USAID subcontractor Development Alternatives International (DAI) (part of the USAID-sponsored Liberia Community Infrastructure Program [LCIP]). It is important to note that the LCIP coordinator specified that the grant was solely for establishing a psychosocial resource center and that his organization wanted nothing to do with anything labeled ‘‘mental health.’’ Just prior to his departure, the director of

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the LCIP told me, ‘‘We are not interested in mental health. We are interested in psychosocial intervention. We don’t want to go anywhere near mental health.’’ Policy documents reflected the drift away from mental health and psychiatric care in coordination discussions. Mental health policy priorities now included: (1) ex-combatant psychosocial rehabilitation, (2) collective psycho-education (including peacebuilding, peace education, and conflict resolution interventions), and (3) civilian trauma healing, but notably did not include the provision of psychiatric care. Although the WHO had the institutional and technical leverage to press for mental health care, it lacked interest. Although the MOHSW had the political legitimacy to mainstream mental health and psychosocial interventions, it lacked the bureaucratic capacity. Although international NGOs like Save the Children, Christian Children’s Fund, and CVT, local NGOs, and Liberian training colleges were able to implement local programs, they lacked the institutional authority to change national policy or shift international funding priorities.

2010–2013: ‘‘Something Had to Be Done’’ In 2006, when medical humanitarian NGOs began to withdraw from Liberia, senior health officials, humanitarians, and donor countries were startled into action at the prospect of a national health care void. Officials from the MOHSW, the WHO, and the World Bank convened a meeting for expatriate Liberian medical experts to craft Liberia’s national health plan in time for the 2007 Liberia Partner’s Forum in Washington, D.C., and Dr. Brown was again approached to craft a national mental health plan. With the prospect of substantive international support, Dr. Brown finally fulfilled the request. A document was rapidly drawn up and submitted to the ministry, and it was gladly received by several of the Liberian expatriates who had fought for the inclusion of mental health in the national health plan. According to one participant at the meeting, everyone reviewed the document together. The World Bank official noted the mental health policy recommendations and said, ‘‘This makes the national health plan seem . . . unconventional.’’ With that statement, mental health was removed from the national health plan. At a later date, Minister of Health Dr. Walter Gwenigale reinserted a statement about mental health in the national health

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plan, saying, ‘‘It would be an embarrassment to Liberia to not have mental health in the national health plan.’’ Then mental health was removed again, this time by another unnamed policymaker. The pendulum on mental health’s fate seemed to swing with whoever was holding the document. In this manner, the development of a national mental health policy for Liberia continued to be a ‘‘non-event,’’ even as postconflict trauma-healing activities were defunded, psychosocial projects were streamlined into other domains, and psychiatric care remained limited to Grant Hospital in Monrovia and MDM’s outpatient services in Bong County. Nothing had led to the integration of basic mental health care into primary health care at the level of service provision or coordination. Expatriates observed that further progress could not be made on a national mental health policy due to a lack of Liberian ‘‘ownership.’’ Some senior Liberian officials felt a sense of helplessness against the tidal movements of humanitarian aid around mental health and psychosocial intervention. For example, in early 2007, Deputy Minister of Social Welfare Vivian Cherue told me, ‘‘Donors drove the Ministry of Health policy, and funding was driven by our partners. They didn’t bring in any experts on social welfare. . . . Donors drove the NCDDRR [National Commission on DDRR] process, but at the end of the day, it’s going to fall squarely back on us. We had a wave situation—people just wanted to help. We cannot provide the services as a government; we do not have the finances, or the human resources.’’ Finally, in 2008, a new set of international collaborators including the Carter Center, researchers from Harvard University, Massachusetts General Hospital, and Columbia University came to Liberia hoping to become involved in building Liberia’s mental health sector. By this time, collaboration within Liberia had completely come to a halt. A year had elapsed without an MHPCC meeting, and when the guests were brought to the resource center, they found that the room had been stripped of its furniture and computer equipment. The MHPCC reconvened itself as a welcoming committee, and Dr. Brown was quickly sidelined from the proceedings. New possibilities were floated to revitalize mental health and psychiatric care in Liberia, including the creation of a psychiatric hospital within JFK Hospital, the reconstruction of Katherine Mills, and the development of a psychiatric training program at the University of Liberia. International consultants were hired to produce a formal mental health policy, and in 2009, a national mental health policy was signed into law.

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The national mental health policy was hailed as a progressive achievement internationally for mainstreaming mental health care into basic health services, expanding psychiatric training to community-based healthcare providers, and committing to providing counseling to the entire population of Liberia. The national mental health policy has also attracted considerable attention from the international media. Its been lauded for its ambitions by global mental health activists and in profiles on NPR (2011) and in The Utne Reader (‘‘Liberia’s Model’’ 2010), but it has garnered criticism from PBS (2011), The Nation (Ololade 2012), and FrontPage Africa (Maximore 2011) for its insufficient reach. In 2010, the Carter Center launched a five-year initiative to help develop the mental health sector by supporting the MOHSW implementation of Liberia’s national mental health policy, creating anti-stigma campaigns, and financing and designing psychiatric nursing training for five hundred already licensed Liberian nurses and physician’s assistants employed by the MOHSW. The Carter Center resolved the ‘‘indigenization problem’’ in Liberia’s mental health policy by removing responsibility for mental health and psychiatry from a single Liberian psychiatrist and inserting psychiatric care into primary care. In addition, the Carter Center built alliances with donors and with international NGOs, who worked to revitalize the greater Liberian health sector, ensure bureaucratic efficacy, and sustain supplies of psychiatric medications from the WHO’s list of essential medicines. Cap Anamur left Liberia, and JFK Hospital assumed responsibility for Grant Hospital, which continues to operate as a psychiatric hospital with outpatient care, and has become a central training site for psychiatric residencies in the Carter Center training program. Most of the actors described here have participated in academic and epidemiological research initiatives to advance mental health in Liberia. Today, Liberia has earned some recognition as an innovator in African mental health services, and all signs seem to point toward an effective ‘‘scaling up,’’ or nationalization, of basic mental health services. With the support of the Carter Center and the Walter P. Annenberg Foundation, monthly coordination meetings are held at the MOHSW, and they include most of the institutions actively involved in providing clinical mental health care. The next step in Liberia’s postconflict recovery involves political and administrative decentralization, and as part of that process, efforts are under way to ensure that inpatient psychiatric care is available through the county medical system. Further localization, to the district level, is on the

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horizon over the next decade. Thanks to the mainstreaming of mental health services into the general health services basket, the problem of donor whims and dedicated funding lines should be diminished in the short-term foreseeable future, as long as international support continues to finance the remaining 80 percent of the Liberian health sector. In a groundbreaking move, psychiatric medications are now included on the essential medicines list for Liberia, and as the Liberian health system strengthens, each county health office must have a trained mental health specialist to oversee all local mental health activities implemented by subcontracted NGO basic health service providers. The MOHSW’s new headquarters, constructed as a gift from the Chinese government, now houses a full-time Mental Health Division that works with new health systems experts from USAID, but the afterlife of the early postconflict period remains. CVT departed in 2007, but it left behind several dozen psychosocial workers who insist upon their professional legitimacy as counselors. With the support of their previous employer, CVT, these psychosocial workers have founded a new national organization, the National Association of Psychosocial Workers, that is meant to rival the officially recognized National Association of Social Workers. In 2011, a Washington D.C.-based office of USAID awarded the new organization a US$5 million grant to engage in psychosocial activities without having consulted with the Liberia-based USAID office, which provides financial support to the Carter Center and the MOHSW through the Rebuilding Basic Healthcare Program, and is opposed to recognizing the new organization. At the same time, many former employees of CVT are trying to work within the MOHSW and other government agencies, while seeking donor support for independent counseling and research careers in Liberian mental health. Occasionally, Dr. Brown appears in the international media as an expert on Liberian mental health, but in national mental health coordination activities, a prominent Ugandan psychiatrist has effectively replaced him. Harvard University, Massachusetts General Hospital, and the University of Liberia are planning to establish a Center of Excellence for Mental Health, but this initiative seems to be connected with Dr. Brown and is evoking longstanding rivalries with the newly strengthened Mother Patern College and Grant Hospital, both of which work closely with the Carter Center. Although psychosocial support is no longer considered to be a part of Liberia’s mental health mandate, at the MOHSW, an office has been created for the coordination of psychosocial activities. As of 2011, that office had

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identified more than three hundred individuals or groups actively providing psychosocial care or trauma counseling throughout the Liberian countryside without training, coordination, or oversight. Government officials remain uncertain as to how deeply they should invest MOHSW resources in mental health. At a 2012 parliamentary hearing on the MOHSW’s budget, MOHSW minister Gwenigale came under attack from political leaders in Montserrado County for failing to allocate the MOHSW’s pooled funds to mental health services. One interviewee who witnessed the hearings recounted the following incident to me. As a Liberian senator reviewed minister Gwenigale’s plan for disbursing international pooled funds for the healthcare sector, he railed at Gwenigale, ‘‘After everything this country has gone through and everything our people have experienced—after all the trauma we have suffered—you mean to tell me that you are doing nothing for mental health?’’

Chapter 3

Trauma and the New Normal

Finding the New Normal In the first nationwide, postconflict community-based study of mental health in Liberia (Johnson et al. 2008), researchers found that almost half of the population, and two-thirds of self-reported ex-combatants, reported significant levels of PTSD symptoms. The same study found that 40 percent of respondents reported symptoms of major depressive disorder, 11 percent reported suicidal ideation, and 6 percent reported at least one unsuccessful suicide attempt. Moreover, researchers found that 14 percent of excombatants, and approximately 7 percent of the total population, reported substantial substance abuse. As descriptive data, these pieces of information are helpful in gauging the breadth of psychiatric symptomatology across the Liberian population, but as many observers of global mental health will note, it does little more. How do the experiences of mental illness symptoms merge with everyday life? How do they interact with Liberians’ efforts to create a new condition of postconflict normality? What did it mean, from a psychological perspective, to be normal in postwar Liberia, when statistical normality meant high levels of mental health distress? In the social world of postwar Liberia, the question of ‘‘what’s normal’’ similarly permeated Liberian social life. What was normal in Liberian postconflict life? Who was to say what was normal? How were Liberians to recognize the new normal when it presented itself? What constituted social life in the absence of clarity about what ‘‘normal’’ meant? The battles over the meaning of ‘‘the normal’’ in Liberians’ private, most personal worlds

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and in public, debated social spaces were being negotiated with astonishing specificity and depth in the details of people’s everyday lives. There are at least three ways to define ‘‘normal.’’ The first conception of ‘‘the normal’’ refers to that which is socially approved, morally condoned, culturally valued, or socially accepted. A second understanding of ‘‘the normal’’ refers to the statistically normal, or how a given case trends toward measures of a population’s central tendencies. A third understanding refers to the quotidian, routine, or frequently recurring set of phenomena one encounters in day-to-day life. The three variations of the normal can be present simultaneously in lived experience, but they should not be confused as gesturing toward the same social phenomenon. People may, after all, have morals that are not reflected in the actions or social worlds of their daily lives; or they may follow social routines even if they do not believe in their moral or cultural value. Given the range of meanings available for ‘‘the normal,’’ it is important to draw a distinction between culture and habit, which often seemed to be at war with each other in postwar Liberian understandings of ‘‘the normal.’’ Consider the following example. On a sleepy Monrovia Saturday afternoon in 2006, two separate groups of young men and women lazed near the water and drank beer from a beach kiosk. After an hour or so, a man from each group started to talk to each other and then began to argue across the ten yards separating them. One man asked the other, ‘‘What is your tribe?’’ The second responded, ‘‘This country is in peace! This is a peacetime country! What do you need to know my ethnicity for? We are all Liberian!’’ The first replied, ‘‘Hey, man, it’s not normal. You can’t even tell a man your tribe.’’ Brawling ensued, and the fighters’ friends shouted, ‘‘Hey, peace and reconciliation, peace and reconciliation!’’ Beer bottles smashed, someone got hurt, and the fight soon stopped. The day at the beach regained its hazy drone. This example shows how ‘‘the normal’’ might be invoked as a referent for wartime habits that have become typical in everyday life, but it also might be invoked to gesture to postwar moral codes that were gaining (or regaining) cultural currency during the postwar transition. The first man’s invocation of the phrase ‘‘it’s not normal’’ echoed a phrase I heard many times a day in discussions, altercations, official pronouncements, and radio call-in shows. For the first man, ‘‘calling one’s tribe’’ was a ‘‘normal,’’

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frequently used line of affiliation and demarcation that had been used during the Liberian war. But although the Liberian Civil War was not a case of ‘‘ethnic or tribal conflict’’ per se, ethnic and tribal identities were layered onto regional, political, and military affiliations in ways that made ethnicity a site of protection or vulnerability. Consequently, for the second man, questions about his ethnicity transgressed the question of ‘‘what’s normal’’ in a postconflict life that was built around setting aside wartime lines of social distinction. In his invocation that ‘‘This country is in peace! This is a peacetime country!’’ the second man rejected the idea that ethnic affiliation, though commonly used during the war, continued to have moral salience and that it should be a habitual part of social communication. Instead, the principle that ‘‘We are all Liberian!’’ spoke to his concern that his peer was trying to invoke the moral and social norms of wartime Liberia. Both felt their points so strongly that they easily resorted to a violent fistfight, which was, in a very literal sense, an interactional struggle over the new norms of postwar Liberia. Ideas of the normal affected how people negotiated new moral commitments and revived old ones while debating the psychological, social, and institutional legacies of the war. In the years after the war ended, Liberians were constantly involved in tense, repetitive arguments over ‘‘what’s normal.’’ When a woman is being beaten by her boyfriend, ‘‘normal’’ might refer to her neighbor’s sentiment that she ‘‘deserved’’ what she got because she had been a former combatant; but ‘‘normal’’ might alternately speak to the neighbor’s observation of the frequency of domestic violence in shacks and shantytowns across Monrovia. The term ‘‘normal’’ might also indicate the neighbor’s irritable sucking of the teeth at the sounds heard next door and her private disapprobation of the beating—her sense that while beatings may happen all too often, it was the wrong way to live and was a sign of social depravity. Social life in postwar Liberia was in many ways ‘‘normal’’ and not ‘‘normal’’ at the same time. In widespread domestic disputes over core social structure principles like infant paternity, child custody, landownership, business contracts, responsibility for rent payments, and responsibility for food, clothing, and school fees, there was extraordinary uncertainty regarding family members’ rights and responsibilities to each other. Families fought because fathers, mothers, sons, and daughters, brothers, sisters, wives, and husbands were uncertain about the duties of any to all. Many agreed that the formal rules

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regarding female and male obligations, child deference, and elder authority no longer held fixed moral value for anyone. The uncertainty that remained created voids of social and cultural space in which conflict easily arose, and neither the government, international police forces, nor Liberian law had the capacity to offer helpful guidance. Consequently, in Liberian discourse, the word ‘‘normal’’ was often deployed to critique the past, challenge the present, and invoke new postwar ideals of civility, conduct, morality, decency, and appropriate behavior. Ideals of the ‘‘normal’’ juxtaposed the present and the future against Liberia’s recent history of normative rupture, in which violence had transgressed the most basic social values and the normal order of society had somehow become disordered. It also extended to the bedrock of social responsibility and social entitlements in everyday life. What was to come was yet to be determined. Therefore, the renormalization of social life was a paramount priority, and psychosocial interventions (along with economic and political reforms) were seen as a crucial tactic for achieving it. ‘‘Trauma’’ and ‘‘the normal’’ worked as interchangeable referents for problems of social order that extended across the personal and the political. One social worker’s account exemplified the perceived connection between the personal, the political, and the domain of trauma: ‘‘The politicians here are all traumatized! I know one man who went to go see a highup politician, a senior minister, a deputy minister, a big man! That man was so afraid to even talk to this person that he hid under his desk and pretended he was not there! Is that normal behavior? It’s not normal! That man is traumatized! The war—it has done something to him! What kind of a man would just go hide under a desk and pretend he is not there?’’ For years after the war ended, the psychological, social, and even bodily habits of wartime held firm, which created uncanny, dystopic experiences of familiarity and strangeness in social encounters. In the absence of predictable sources of food, shelter, income and safety, as well as the reliability of the normalcy of everyday life, Liberians’ faces and bodies were transformed by years of war. Saying ‘‘everyone is just traumatized,’’ respondents described changes in their family members that rendered them almost unrecognizable. Some said that they were like ‘‘zombies’’; one respondent reported that her friends’ and family’s personality changes were reflected in their faces and in the way they carried themselves. Suah, the Liberian director of an international NGO, reported that she could not recognize people

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she had known and cared for when she met them on the street because their faces, bodies, and carriage showed too much of their ‘‘trauma.’’ On the other hand, refugee returnees and Liberians who had lived outside Liberia during the war looked younger, healthier, happier, and fatter. In this way, they were physically marked as having escaped the worst. Liberian conceptions of ‘‘the normal’’ have relevance to contemporary discussions about the difference between ‘‘the normal’’ and ‘‘the pathological’’ (Canguilhem 1991), normality and insanity (Devereux 1965), and sociological considerations of normality, deviance, and criminality. Foucault took these discussions further by examining, in a manner germane to the subject of this book, how definitions of madness and ‘‘the pathological’’ influenced how societies impose, embed, and enforce social order and social control (Foucault 1980, 1988; Foucault, Marchetti, Salomoni, and Davidson 2003). Liberians’ concern with what was normal, what was pathological, and what was deviant was captured in speech about trauma, about the desire for a ‘‘normal’’ society and state, and in their concerns that the people around them were ‘‘not normal,’’ that they were ‘‘totally traumatized.’’ In these words, they communicated that a clearly understood and defined moral world did not exist. This chapter highlights the exteriority, or externalities, of trauma by focusing on ethnographic accounts that illustrate Liberian experiences of trauma as a social fact that saturated the postconflict moment (Kleinman, Das, and Lock 1997). In order to occupy new ‘‘normal’’ lives and find new places in society, many people had to learn to manage their memories, embody postconflict identities, and engage in an active process of forgetting. Forgetting involved more than just forgiveness, letting go, and leaving the past behind. It reflected the need to seek out and assume new habits of speech, behavior, and principles of interaction in their microsocial encounters (what Goffman [1982] called ‘‘interaction rituals’’). To reckon with this process of transformation, there is an ethnographic imperative to define what Liberians were meant to change from—a traumatized nation—and what Liberian society was meant to become—normal. Personal, societal, and national transformations were the political order of the day. Durkheim’s writings are a helpful point of departure for reflecting upon the meaning of postconflict suffering; his work is an early antecedent to the current literature on social suffering (Kleinman, Das, and Lock 1997). In the quote that follows, Durkheim reiterates his thesis that an effective moral community is necessary for human activity. But he also argues that once

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this community has been dismantled, the reconstruction of a common moral community and the reintegration of community members within it can be exceedingly difficult. Man’s characteristic privilege is that the bond he accepts is not physical but moral; that is, social. He is governed not by a material environment brutally imposed on him, but by a conscience superior to his own, the superiority of which he feels. Because the greater, better part of his existence transcends the body, he escapes the body’s yoke, but is subject to that of society. But when society is disturbed by some painful crisis or by beneficent but abrupt transitions, it is momentarily incapable of exercising this influence. All the advantages of social influence are lost so far as they are concerned; their moral education to be recommenced. But society cannot adjust them instantaneously to this new life and teach them to practice the increased self-repression to which they are unaccustomed. So they are not adjusted to the condition forced on them, and its very prospect is intolerable; hence the suffering which detaches them from a reduced existence even before they have made trial of it. (1951, 213) For the purposes of this chapter, I have provisionally defined trauma, using an anthropological perspective, as a rupture of the self (including behavior, ideas, practice, and social relations) from moral, social, and cultural life. I have also chosen to tentatively define the term ‘‘collective trauma’’ as the disarticulation of the subjective, embodied person from the collective norms, social mores, and moral conduct that constitutes social order. By highlighting the ways in which trauma has come to be understood throughout Liberia as a socially pathological norm, I do not attempt to articulate a theory of the collective mind, the collective unconscious, or collective psychiatric disorder (see Benedict 2003; Jung 1959; Freud and Strachey 1958, Freud and Rieff 1963). Nor do I believe that there is anything culturally intrinsic about the phenomenon. I do, however, hold that collective trauma was a salient fact in the unfolding of postconflict Liberian life.

Trauma and Self-Management: The Story of Valentine Valentine Gorpeh and I met at a thin-walled, open-fronted pharmacy stand in Gay Town, a middle-class neighborhood in Monrovia where strivers and

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stragglers bustled behind the backside of Old Road Market. Some of my former students from Mother Patern had arranged the meeting in response to my inquiries into the use and abuse of diazepam (Valium) among urban youth, which was illegally traded on the black market. While Valentine and I talked over a cracked glass countertop, we were able to observe one of the doors into the Gay Town ‘‘ghetto,’’ an enclosed space where people went to buy, sell, and use illegal drugs. Valentine was a lean, tall, sweet-faced youth dressed in jeans, a T-shirt, and a baseball hat. He was born in a village in Grand Bassa County, and when he was still very young he came to Monrovia with his parents, leaving behind one brother and one sister. Valentine remembered his childhood happily: ‘‘I liked going to school. I loved for me and my friends to be in class. I loved it so much. In school, I liked it when my teacher was teaching me on the board. I really liked that so much!’’ Valentine lived in Gardnersville, a suburb of Monrovia, from 1981 to 1990. During these years, Valentine’s parents tended gardens and grew vegetables to sell, and although they were poor, they were able to earn enough to be able to eat and to pay for Valentine’s school fees. His parents’ move to Monrovia was probably motivated by their desire to live in the city, to find better educational opportunities for their youngest son, and to try to take advantage of the favorable environment for Grand Bassa ethnic groups under the increasingly violent Doe regime. In 1990, the war came to Valentine’s home in Monrovia. His parents were killed almost immediately by either rebels or the army—Valentine wasn’t sure. With no family nearby, Valentine, now fourteen years old, was left to fend for himself in a city under siege that was repeatedly attacked by rebels, hosting international peacekeeping forces, and covered with deadly roadblocks and checkpoints. Not knowing what to do, he stayed in his parents’ home with a friend who had also been orphaned by the war. After a few months of struggling alone together, they parted ways: his friend ‘‘picked up gun,’’ but Valentine refused to do so and instead started to take drugs. Valentine explained his turn to drugs. ‘‘During the war, I was thinking so much. During the war, my mind was disturbed because my mother and father supported me, and they died during the war. And then, when I looked into myself, I was thinking so fast because my mother and father had left, and I never slept, and I was just thinking! And my mind was disturbed. My friends gave me drugs because I was thinking so much. The

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only way my mind would be set is to take drugs. Grass and diazepam. Drinking alcohol. Any kind of alcohol I could find—crazy horse, palm wine. . . . I put diazepam in the alcohol. I’m still taking drugs to this day.’’ Valentine and his friends had survived the war by doing basic manual labor—finding and selling scrap wood and portering loads. They lived together in the West Point ghetto of Monrovia, and every day he and his friends pooled their cash and were able to eat one or two meals. Valentine reflected, ‘‘I was supposed to be in college, but the war already carried me back. I had no financial support for schooling, and my parents, who had supported me, they died.’’ In 2007, four years after the end of the war, I asked Valentine what he was doing to survive. He answered that he was ‘‘still doing the same thing. Nothing had changed.’’ His life had no forward momentum, he seemed to have remained still in the passage of time. He kept the same habits, lived with the same friends and acquaintances in slum shanties, and worked at unskilled labor for low wages. He explained, ‘‘I am still doing that because I don’t want to get into the criminal behaviors—so I go around and do washing so that I can buy food to eat. And sometimes, after I eat a little food, I will take the change and buy drugs, and it will be the only way my mind can relax.’’ At this point, Valentine withdrew from his pocket a small plastic bag containing a pinch of marijuana and a half-dozen diazepam pills. Despite Valentine’s marginal existence on the periphery of postconflict life, his world was bounded by strict moral codes. These codes kept Valentine from becoming a militant during the war, and they have guided him away from the armed robbery and theft that are common in his community. He reflected, The struggle of the youth of Liberia—the poverty in this country—is the biggest problem this country can face. Our parents are poor. There is no financial support for us. Most of our friends held guns, were fighting, and taking people’s things; and now, after disarming, most of them are checking people on the street [mugging, burglarizing], checking their phones, taking from them. . . . Most of my friends are doing that. Stealing, going on the street and burglarizing. But me, only washing people’s clothes gives me money for drugs and for food to eat. But it’s character. My parents taught me that

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‘‘character is all,’’ and that’s why I don’t steal. [They told me] if I steal, they will catch you, and beat you, that’s what my parents said. In the present, I see people catching them, beating them, catching them with tires, and burning them. Valentine last saw his siblings six years earlier and receives no support from them. They don’t know about his drug problem, his friends, his marginal work, or his lifestyle. He is supporting an unemployed girlfriend who is also addicted to drugs and lives with her friends. He has no children. Valentine’s professional ambition is to become a plumber. He hopes that someone—an NGO, a mysterious benefactor, or a relative—will support him so that he can ‘‘go to school, dedicate his mind to a trade, and learn.’’ His dream upon acquiring a trade is to return to Grand Bassa and help rebuild his country. Valentine lived in a never-ending adolescence of peripheral employment, efforts to forget the past, and social exclusion from the emerging moral community of postconflict Liberia. Forcibly abandoned to his own fate by the death of his parents early in the war, he was surrounded by friends living on the violent margins of society. Living alongside them, he was increasingly under assault by the encroaching forces of postconflict social order like UNMIL police, mob violence against thieves, and neighborhood policing groups. The habits of his friends made his life tenuous and vulnerable, but without them he was alone in the world, without any social safety net, and truly isolated. His concern with character is telling. Despite the fact that his social mobility and maturation were cut short, Valentine was principally concerned with his moral character and with pursuing a life that exemplified ‘‘character.’’ Although Valentine had no opportunity for job training and depended upon his patchwork quilt of friends for daily food, housing, and care, he aspired to hold a respected trade, to be a part of a family, and to help rebuild his country. But without the help of parents, siblings, or patrons, he couldn’t manage the transition to the new normal—even with a postwar ‘‘peace subjectivity.’’ During DDRR, NGOs functioned as ‘‘fictive kin,’’ or surrogate families, to ex-combatants without social connections or families. Liberians who received services from NGOs or who worked for NGOs often perceived them as standing in the stead of lost, dead, or displaced family members. NGOs created paths to social mobility through their provision of cash and

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job training; and they reframed participants’ wartime identities through the administration of new configurations of benefits and privileges (e.g., former fighters were now declared to be ‘‘veterans,’’ regardless of what side they had fought for). In these ways, humanitarian aid organizations helped Liberians like Valentine negotiate their way through the process of transformation. But unfortunately for Valentine, he was excluded from DDRR educational, job retraining, and social rehabilitation opportunities. During the postwar period, there was no category of assistance for adult orphans, or nonviolent street youth, or nonviolent drug addicts who lived in violent ghettos, and so Valentine was ineligible for all reintegration services. He had refused to fight to sustain his moral connection to his parents, who had given him support, education, love, and ambitions, but it was his failure to fight that severed his chances of receiving aid from the international community. Valentine’s story shifts attention from narratives of trauma and resiliency to a consideration of trauma as a problem of biological, behavioral, and moral self-management. The biology of Valentine’s trauma—the insomnia, anxiety, and flashbacks—are temporarily resolved by selfmedicating with diazepam, marijuana, and cheap, high-proof alcohol. For many others, the widespread availability of harder drugs, like heroin, cocaine, and barbiturates, also made trauma management through selfmedication a viable option. Drug abuse was not seen by NGOs as a social pathology that they could intervene in but as a medical problem that was too difficult to become involved in. Drug abuse seemed to demand too many resources, too complex a system of surveillance and management, and too many potential risks to organizations’ global and local profiles. And so, afloat in an ocean of psychosocial programs, trauma-healing initiatives, and peacebuilding activities, Valentine had not overcome a lifetime of trauma-related drug dependency to find entre´e into the new postconflict ‘‘normal.’’

Trauma in Liberia Valentine’s symptoms, experiences, and efforts to manage trauma resemble the details of narratives of PTSD everywhere. It is not my intent to label Valentine’s experience as PTSD or call for improved diagnostic practices

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and PTSD interventions. Substantial research in global mental health is already being dedicated to studying the phenomenon of PTSD in humanitarian contexts, among impoverished populations, and in non-Western contexts. My goal, instead, is to focus on how trauma was vernacularized in everyday life and to study how Liberians transformed a global psychiatric diagnosis into an effort to manage their lived experiences of postconflict normalization. In short, trauma has meaning to Liberians, Liberians have trauma, and Liberians claim the experience of trauma as their own. Consider the following incident I observed in 2006 during a weeklong site visit with a protection unit engaging in psychosocial education. I traveled with three women and two men, all sophisticated, middle-class Monrovia professionals working for a prominent NGO, and our goal was to spend a week in a remote section of Bong County educating local inhabitants about trauma, genderbased violence, human rights, and HIV/AIDS. Our destination was Jorwah village, which lay on the Liberian border with Guinea, had been attacked repeatedly during the war, and had just been resettled in the previous six months. Most of Jorwah’s residents were old men, women, and children, and there were few adults who could engage in hard agricultural labor or infrastructure reconstruction. Given that Jorwah lay at the end of a pitted, axle-breaking path that took hours to transverse, the combination of demographic weakness and isolation gave the village a dilapidated, dirty, and desolate appearance. After long days of training, the staff and I would share dinner and watch a Nigerian, American, or South African gospel revival video on a VCR/TV set brought up from Monrovia. Then villagers came round, each bearing some ‘‘country bread’’ (local rice or grain), oranges, kola nuts, or small livestock (one man brought a chicken). In the privacy afforded by the dark, Jorwah residents sought advice from the Monrovia NGO workers about adolescent children abandoned in cities, cheating wives and husbands, family disputes, and village disagreements over land and labor distribution. The NGO workers gave council, and the complainants departed. Around midnight the visits would cease, and it was time to sleep. I shared the floor of a mud-brick room with Celeste, Ama, and Carolina. These three women were all tough, smart, and resilient, and they all had war stories, just like everyone else, and they shared them almost daily. The women were a delight to be around by day, but sleeping next to them at

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night was a nightmare. After everyone dropped off, they all snored loudly, and then the noise would begin. 12:30 pm: [Celeste screams in her sleep.] JESUS! I pray to you, keep those devils away from me, I beg you Jesus, I beg you I beg you, I worship you Lord I worship you Lord I worship you Lord, protect me from the Devil, protect me from the Devil. KEEP THAT DEVIL AWAY FROM ME! 2:00 am: [Ama, to my left, sobs into her mattress; her hands clutch her face.] God protect me God protect me God protect me God protect me God protect me Angels come and God protect me. Oh-oh-oh God, no-nono-no, save me God. 3:00 am: [Carolina sits up in bed, shakes over her small Bible, and starts reading psalms in a whisper until she falls back asleep again.] The wailing moans, silent prayers, and Bible clutching continued all night long, every night, as the women drifted in and out of sleep. No one ever sought to comfort each other at night or discussed it in the morning. I found it unusual that these bossy, nosy women never asked me if I noticed what was happening or sought to explain themselves. Every morning we would simply wake up, do our morning ablutions, and drink our coffee and eat our breakfast amid the usual rounds of jokes and laughter and then head over to Jorwah’s primary school to begin a new day of training. Were the nightmares, flashbacks, and terrors the women experienced symptoms of a pathological level of PTSD? Or were these women, who were otherwise happy, normal, and successful in every other aspect of their postconflict lives, individually managing their surfacing memories as best they could as they tried to build careers, relationships, and identities for themselves? All of these women had been trained as trauma counselors in the past or had received trauma education, counseling, or intervention in the course of their lives and careers. They were not naive to the meaning of their symptoms of trauma; they were simply managing them as well as they could, in the course of their everyday lives. A common Liberian response to the question ‘‘How are you?’’ was ‘‘We are trying.’’ These women were trying to manage their pasts while living their lives, as best they could. Liberian trauma is layered upon and intersects with local understandings of mental illness, but it also supersedes neat compartmentalization. The meaning of trauma in Liberia has come from almost two decades of talking to global humanitarian actors about the suffering caused by the war, the causes of the war, the need to end the war, and processes required to

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realize postwar reconstruction, normalization, and new structures of governance. In the dialogic relationship that has emerged over the meaning of trauma, trauma has entered local discourse as an appropriated and translated concept (Merry 2005; Abramowitz 2010). In the course of conducting research on trauma in Liberia, I interviewed several dozen Liberian NGO workers, professionals, and laypersons to sketch out the Liberian meaning of the term ‘‘trauma.’’ I soon learned that trauma is conceptually polysemic (it has multiple multimeanings, simultaneously), variable (those meanings change), and fluid (meanings can change at any time as well as revert to a previous meaning). Trauma is understood as having two polarities, global psychiatry and Liberian vernacularization, each of which carried specific cultural rules and frameworks. When interviewees chose to deploy a global psychiatric understanding of trauma, their narratives emphasized the individual manifestation of symptoms or specific narratives of mental illness and often concluded with the utterance, ‘‘These people need help!’’ When interviewees described Liberian vernacular understandings of trauma, their narratives focused on the collective experience of war and concluded with reflections on the nature of evil and the utterance, ‘‘We are trying.’’ Liberians can, and do, work with both understandings of trauma as part of everyday conversation. Does the Liberian adoption of the word ‘‘trauma’’ challenge critiques of PTSD interventions as inappropriate for non-Western, war-affected populations (Bracken, Petty, and Save the Children Fund 1998; Kleinman 1995; Pupavac 2001; Summerfield 1999), or does it express, instead, the historical reality of how societies exposed to global trauma discourses change after many years of exposure to humanitarian intervention? Alternately, can it continue to be said that this process of ‘‘appropriation and translation’’ is a form of cultural imperialism? Or might it be true that the global concept of trauma or PTSD has substantial linguistic usefulness in contexts well beyond its origin? One way of thinking about this might be to reflect upon how Liberians describe trauma as a pathology, as sufficiently abnormal and disruptive that it prevents people from living normal lives. Through interviews, home visits, and reviews of psychiatric records at Grant Hospital, I learned that local accounts of severe trauma had the capacity to situate trauma as a diagnosis of mental illness but postulated an alternative pathway of disease or disorder than the conventional course of mental illness for PTSD. For Liberians,

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severe trauma was not a disease that could be diagnosed, treated, and potentially resolved. Instead, trauma was a station on a continuum of mental illness. First, a person was normal. He or she might be psychologically healthy and function normally in society. Then he or she would become ‘‘traumatized.’’ This might happen as a result of a horrific event, like the death of a spouse or child, or as a result of sorcery, sacrifice, or ‘‘African medicine.’’ Then trauma led to total insanity, and concluded ultimately in death. It could be caused by exposure to a traumatic event, such as witnessing the killing of a parent, being forcibly recruited to fight, or being raped. But it might also be caused by having committed a horrific act, like killing another individual, or being involved in an act of sorcery. Liberians also understood that trauma could emerge as a result of the collapse of one’s social station in life, the loss of home and place, the loss of social status, or the loss of a career. Kumba, a psychosocial worker for an NGO, told me about her neighbor, whom she described as a traumatized old man with whom she occasionally shared rice. Before the war, he had been a village elder in his community. During the war, he, along with his family, had become displaced persons who had been forced to migrate from IDP camps to urban ghettos in Monrovia, where they now lived in a ramshackle hut in the Matahdi quarter. The old man, who had been a powerful figure in his community as a farmer, a Poro leader, and a respected subchief, no longer had any power to command labor, provide for his family, or control his destiny. According to Kumba, ‘‘He was just sitting down, doing nothing, not being able to do anything for his family, for his children, no job, no nothing.’’ When Kumba gave the man a cup of rice, he cried. For Kumba, the story of this man’s social humiliation was the quintessential story of war trauma. To her, the fact that he had been displaced, reduced to begging, and had lost his status were outcomes of the war. The man’s traumatization, however, was associated with the progressive decomposition of his self-worth, his integrity, his aspirations, and his authority. Trauma was perceived where the war broke lives and livelihoods or when people were unable to supersede brutal personal disappointments and letdowns. Trauma is what happens when pervasive violence and vulnerability lead to profound experiences of rupture. Thus, across ethnic groups, rural and urban dwellers, and social classes, trauma is a popular signpost of experience giving reference to somatic, biographical, psychological, or social rupture.

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During life history interviews with twenty Liberian social workers, I posed the question, ‘‘What does trauma mean to you?’’ Bendu, a long-term NGO employee, showed the range of responses typical of her peers. First, she reiterated her training about trauma: ‘‘Trauma . . . it’s something . . . it’s the shock people experienced when they saw, when they experienced something personally, or when they experienced someone talking to them about their suffering, of what they saw and experienced.’’ Almost immediately, however, Bendu amended her statement with a more fluid and expansive definition of trauma: You know, they are not going to recover. Some of them are not going to recover from that. They still feel that the war is coming tomorrow. That’s why, sometimes in the community, people sometimes say, ‘‘Let the war come back. Let’s see how long the war is going to be.’’ People think that being in a civil war is a good thing. . . . Some people feel that this way of normalizing public rules and regulations is normal. Because when you stay in that situation for a long time, you adapt to that situation, and you come to think it’s normal. That is what I think happens to people. I used to feel like that sometimes . . . that the only best position for Liberia would be under the rule of a militant. Yeah, because, if I am not seeing what it means to live, to respect my rights, my rights are always being abused, then for me it will be normal. I will already be abused. So if you try to tell me, or if you try to get me into a situation where people will respect my rights, it takes time to get accustomed to. ‘‘Oh, you know, so this is life.’’ So it is that issue that people struggle with. Bendu added, ‘‘Because some people still feel that they are in that state, they are unable to wake up from . . . being so dependent in one situation and moving to take initiative. People are paralyzed, many people are paralyzed. They just think that . . . well, the war came, and it killed my mother, it killed my father, what do I have? What can I do? I can’t do anything anymore. Even if I try to go to school I will achieve nothing, but I will get old, and so . . . there is no need for me to move forward. Let me stay where I am. Life will soon end, by the way, what do I need anymore? I’m saying this because this is suffered by a lot of people.’’

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Emic Epidemiologies The last part of Bendu’s quote recalls Valentine’s story, and it affirms the idea that in postconflict Liberia, a paradigm of ‘‘normalization’’ was deeply connected to abandoning the habits of violence and abuse tolerated during the war and embracing a new way of being in the world. But her statement also deflected the question of how violence came to be coupled with trauma in postconflict life. Others were not so circumspect. In a 2009 interview with The Lancet, Dr. Brown spoke more explicitly: ‘‘People used to say Liberians are slow to anger [but] now there are many maladaptive and dysfunctional behaviors and a markedly decreased anger threshold. A small incident can spark extreme violence: burning, stoning’’ (Cheng 2009). The concepts of ‘‘trauma’’ and ‘‘the normal’’ in Liberia’s postconflict society speak to the questions generated by George Devereux in conversation with psychological anthropology and cultural psychiatry (Devereux 1965). Devereux raised the point that midway between anthropology’s concern with culture and psychiatry’s concern with the normal and the abnormal lies a world of experience in which (1) mental illness may be suffered but socially adjusted or tolerated; (2) symptoms of mental illness may be normatively adjusted and thereby rendered socially acceptable; or (3) mental illness and the roles created to accommodate it may be socially rejected or found to be intolerable. Following from Devereaux, many scholars have studied the question of dissociation, especially in regard to shamanism and visions in nonWestern cultures. It has been well established that dissociation—a psychological mechanism that allows an individual to repress certain memories or experiences—is widely represented among most non-Western cultures, especially among individuals experiencing varying degrees of stress. Research, moreover, indicates that episodes of dissociation, like those that were perhaps evidenced in the psychosocial workers’ narrative, are not often regarded as seriously problematic. However, the psychiatric literature has also closely followed the relationship between trauma, drug abuse, and dissociation, like that described by Valentine (see Kirmayer 2011; Kirmayer, Lemelson, and Barad 2007), and the relationship between trauma, dissociation, and violence (see, e.g., De Jong et al. 2005). I found that many people I interviewed associated violence with trauma. Some observed the presence of trauma in the states

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of madness displayed by young men and women living in the Monrovia ghettos of West Point, Red Light, and elsewhere. Loupou, a child protection officer at the Liberian Red Cross, feared that an entire population of traumatized youth was being abandoned to drug abuse, armed robbery, and insanity. It is important to note that the status and meaning of violence, as a symptom, is a key point of localized disagreement between lay African and Western professional understandings of mental illness. For Liberians, violence and aggression are key features of both trauma and madness; for them violence was a likely indicator of madness. For non-African mental health experts, however, violence is not necessarily a symptom. Instead, violence is a value-neutral action that may reflect sanity or psychosis whose status requires the adjudication of expert analysts. It is worth noting that many kinds of violence were not interpreted as trauma and were regarded as within the framework of the normal. Certain patterns of violence between parents and children, for example, or between spouses and lovers were not necessarily socially condoned but were ‘‘normal,’’ in the sense that they were modal or widely prevalent. Common practices in Liberian child rearing in circulation for at least a century included peppering (rubbing hot pepper on a child’s body) and public and private beatings. On radio talk shows and in casual discussions, many Liberian women affirmed the idea that ‘‘beating is a sign of love’’ in romance and marriage. They argued (against substantial global discourse surrounding human rights and gender violence) that if husbands or boyfriends didn’t care enough to beat you to discipline your behavior, they were ‘‘loving to’’ someone else. It is important, however, to differentiate the phenomenon of traumarelated dissociation and the prospect of trauma-related psychoses. Dissociation is an event or episode in which an individual moves in and out of reality and may ‘‘check out,’’ repress, or hallucinate in response to a stressful stimulus and then recover a connection with ‘‘normality’’ soon after. Psychosis, on the other hand, is more typically associated with a global impairment of an individual’s ability to stay in contact with reality. It is often associated with hallucinations, delusions, violence, and impaired insight. Psychosis is often perceived as chronic and deteriorating, while dissociative episodes tend to be more episodic and are frequently associated with drug addiction. In the course of my fieldwork, Liberians routinely talked about the linkages between dissociation and trauma, and between trauma, psychosis, and

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death. From these discussions, a specific illness trajectory emerged. First, a person is exposed to a ‘‘trauma,’’ which is broadly understood as experiencing, performing, or witnessing something terrible in the human or spiritual domain. This might happen in a single incident, or it might result from continuous traumatic experiences over a long period of time. Then a person might show signs of functional deterioration, including social withdrawal, a lack of social functioning, difficulty modulating emotion in interpersonal engagements, poor self-care habits, inappropriate speech and interactions, and substance abuse. The person gradually deteriorates into suicidal ideation or gestures, extreme social isolation or homelessness, severe substance abuse, violence, or psychosis. Then he or she might die. One story, told by Dolo, a psychosocial worker, helps illustrate the trauma-psychosis continuum observed by Liberians. The story, told in an NGO transport in 2003, started as a funny piece of entertainment but then turned into a meditation on the violence and trauma of the war. At some point in the 1990s, Dolo’s uncle and aunt’s village came under attack. A series of events transpired as his uncle and aunt tried to escape, including some funny incidents of clashes and slipups, but finally, his aunt and uncle were caught by rebels. Then people were lined up. Dolo’s uncle was forced to watch as the rebels killed his [wife], cut her into pieces, and pushed her flesh around in a wheelbarrow demanding that everyone eat a piece. Dolo’s uncle was forced to eat a piece as well, and was then allowed to go free. Soon after, Dolo’s uncle became obsessed with the idea that he had spiders living inside him. He itched and scratched at his body continuously and kept rubbing his skin. Soon he stopped eating. All he could see in front of his eyes were spiders, and he was sure that spiders were coming out of his body. After a few months of this torture, he died. The madness of trauma was seen everywhere. People saw it in the behaviors of others—how people on the verge of madness gradually ‘‘let themselves go’’ and let their hygiene deteriorate or abruptly ‘‘lost their minds’’ and ran naked into the bush. Many of the insane men and women who lived in the street were seen as traumatized, and their characteristic symptoms included ‘‘just saying anything,’’ picking up garbage, pocketing

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garbage, becoming unmanageably violent, ‘‘letting people treat you anyhow,’’ or becoming mute and catatonic, ‘‘like a zombie.’’ In the rural areas of Bong County where I conducted research, frequent references were made to people who ‘‘just went off.’’ Their mental illness was highly disruptive to their communities. People had to make these individuals quiescent by retrieving them, sitting them down, and ‘‘talking nicely to them.’’ Even then, the man or woman might sharply withdraw from social interaction. Traumatic psychosis was an omnipresent, latent possibility in Liberia’s postwar world. Many of my respondents feared that their family members might slip into psychosis, and more than a few had personally witnessed the descent of friends and loved ones into chronic psychosis. This was much feared because it was often associated with dispossession from households and communities, suicidal acts, drug addiction, or death. The triangulation between trauma, drug addiction, and psychosis, in particular, was frequently made in dozens of interviews I conducted across the spectrum of Liberian life. However, the family members of people with trauma-induced psychosis rarely brought their loved ones in for treatment, so quantitative surveillance of this phenomenon was impossible. One reason, as pointed out in Chapter 2, was that mental illness treatment was scarce. But there were other reasons as well. Family members, friends, and neighbors assumed that people experiencing severe trauma or psychosis must have seen something or done something to have incurred this terrible fate. Psychosis was widely perceived to be a moral judgment, a condemnation of the person’s culpability for past deeds. Perhaps they had engaged in murder, rape, or cannibalism; taken bad medicine to protect themselves from harm during the war; witnessed violence or death; or otherwise engaged with sorcery, witchcraft, or genies and water spirits. Consequently, madness was often seen as a fitting punishment, and medical or therapeutic intervention were regarded as quite inappropriate for the condition of the individual, as well as potentially dangerous or unjust. Most people did not see it as within their provenance to interfere with God’s punishment, ancestors’ curses, or sorcery’s consequences. These attitudes are well known in the literature on religion and politics in West Africa. Scholars have documented the relationship between the political and spiritual realms in the Liberian and the Sierra Leonean conflicts, especially insofar as violence, cannibalism, and the consolidation of power are concerned (Ellis and ter Haar 2004; Ellis 1999; Richards 1996;

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Ferme 2001). Spiritual forces were neither intrinsically good nor intrinsically evil, but their power always exacted a cost, and that cost could be madness. During the postwar years, speculation abounded about the causes of others’ misfortunes and extended to people’s activities during the war and the use and abuse of the spiritual forces during and after the war. Liberian respondents were not content to simply report what trauma looked like, what its causes were, or how they understood the experience of trauma. Liberians were intent upon relating their own emic epidemiologies of trauma to Western observers. In dozens of accounts, Liberians sought to act as local experts, or as emic epidemiologists, who had the right and the responsibility to index the scale, severity, and scope of trauma in the Liberian population. Well aware that they lacked the capacity to quantitatively assess the impact of trauma on the overall Liberian population, Liberians still sought to communicate their quantitative perceptions of trauma’s scale, severity, and scope. Concerning matters of scale, Liberians contested that trauma was widespread, even pervasive, throughout the population. Although it was an object of pity for those at some remove, for those who lived near it, it created an environment of danger that made everyone vulnerable. Concerning matters of severity, respondents emphasized both the biological and social consequences of trauma to the sufferer and his family and the social burden of trauma to Liberia’s reconstruction. Concerning matters of scope, respondents tried to indicate that trauma’s symptoms functioned on a continuum and had varied outcomes. Moreover, Liberians had very clear sensibilities about which psychological and social phenomena constituted trauma and which did not. How much can we trust Liberian assessments of scale, severity, and scope? What scientific validity does the ‘‘local epidemiology’’ of the traumapsychosis continuum have? The challenge for anthropologists and for global mental health experts is to balance a view of African beliefs as exotic and esoteric against the empirical assessments of Liberian respondents. Addressing this problem has been the concern of cultural psychiatrists and psychiatric anthropologists like Mitchell Weiss (2001), who have advocated for recognizing ‘‘cultural epidemiologies’’ that integrate local forms of knowledge. Doing so has proven to be as methodologically challenging as it is conceptually promising. African psychiatrists have long argued that diagnostic knowledge and practice should emerge through a mutual exchange of experiences, insight, and epidemiological data between Africa and the West.

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Western psychiatric paradigms, such as those espoused in the Diagnostic and Statistical Manual (DSM) series and the International Classification of Disorders (ICD), have served as the source of psychiatric knowledge and expertise for all persons. African psychiatric and neurological events like Koro, Open Mole, and Brain Fag, on the other hand, were transformed into ‘‘cultural-bound disorders’’ that are regionally, linguistically, and culturally specific and require special attention and recognition in localized populations.1 The question of trauma complicates this process of psychiatric marginalization because trauma does exist in Western psychiatric nosologies. However, in Western psychiatry, there is no classificatory mechanism for the kinds of widespread traumatic psychosis reported by Liberians that affected Dolo’s uncle. In the previous edition of the DSM, the DSM-IV, psychosis was excluded as a symptom of PTSD and was classed as a distinct diagnostic entity. The DSM-IV noted that ‘‘Flashbacks in Post-traumatic Stress Disorder must be distinguished from illusions, hallucinations, and other perceptual disturbances that may occur in Schizophrenia, other Psychotic Disorders, Mood Disorder with Psychotic Features, a delirium, Substance-Induced Disorders, and Psychotic Disorders Due to a General Medical Condition’’ (APA 1997 467). As the field of psychiatry evolves, some researchers are challenging the imperative to distinguish between trauma-related dissociation and psychosis. Much of this literature finds validation in the history of PTSD itself, as when Abram Kardiner recognized in his work on war trauma that trauma is closely linked to psychosis (Kardiner and Spiegel 1947). But today, theoretical and empirical efforts to relink psychosis and trauma are under development (Garety et al. 2001; Morrison and Larkin 2006; Moskowitz, Schafer, Dorahy 2011). A growing battery of psychiatric research has shown that people who have been exposed to trauma, extreme stress, or violence from an early age show a higher predisposition toward adult-onset psychosis or severe mental illness. For these people, drug use, and specifically marijuana use, has a multiplier effect on the risk of psychosis. Research is also indicating that specific symptoms of psychosis, like hallucinations, closely correlate with early and frequent exposure to trauma, even among children. The implication of Liberian accounts of the links among trauma, dissociation, drug abuse, violence, and psychosis suggest potent possibilities for further psychiatric and epidemiological research. But although Liberian truths have yet to align with evolving psychiatric truths, one implication for global mental health practice is clear. The hard-line distinction drawn

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by humanitarian NGOs and donor agencies (see Chapter 2) between trauma healing and psychiatric care appears to lack clinical validity, empirical justification, and cultural sensitivity.

The Suffering of the Forsaken Taylorites The postconflict period is supposed to provide a framework for the reconstitution of social life, the reconfiguration of social relations, and the remoralization of society and the state. The following narratives of two men, Grant and Saa, demonstrate how the powerful, binding ties of the past made the uncertainty and instability of the present pale in comparison. Both men, each unknown to the other, had strong moral attachments and personal commitments to Charles Taylor, their former president, who was then being indicted for war crimes in Sierra Leone. In the aftermath of Taylor’s departure, both men experienced a loss of place in the world. Over time, both men became increasingly ‘‘traumatized,’’ according to observers. Their increasing inability to maintain personal hygiene, behave appropriately in social situations, and be politically aware led to social marginalization and an overall experience of debilitation. More than a decade after the end of the Liberian war, it can be easy to forget the influence that Taylor had over a vast network of Liberians. People within his network were well paid and relatively secure, and some, though not all, experienced Taylor’s world as one of loyalty, obedience, and love. Taylor’s departure resulted in the collapse of a vast structure of labor exploitation, patronage, and fealty that brought ruin upon many who had found identity, status, and stability within it. Thus, Saa and Grant’s stories also raise important questions about the nature of postconflict trauma. A primary task of postconflict social engineering is to sever loyalty and attachment to wartime leaders and redirect energy and affection to the postwar state. But people who continued to be loyal to Taylor and awaited his return engaged unevenly in this environment, and resulted in the undoing of some men. The story of Joseph Grant, a well-paid communications technician during Taylor’s presidency, offers one example of possible trauma-related psychosis in this context. When Taylor was forced into exile, Grant participated in mass protests opposing his exile. He also took to the streets to protest

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UNMIL’s arrival in Liberia and tried to resist UNMIL’s gradual steps toward the military securitization of Monrovia. Two years after Taylor’s departure, in 2005, Grant’s sister, an NGO worker, noticed a steady deterioration in his self-care regimen. First he stopped polishing his shoes; then he stopped wearing a belt. He started to leave his shirt untucked and unironed and gradually started to allow the top buttons to hang open, showing his chest. He stopped shaving, and his hair grew unkempt. After some initial, failed efforts to find work in Liberia’s impossible postconflict environment, where unemployment was estimated at 80 percent, Grant stopped trying to find a job. Then he stopped talking. When he did speak, he was angry, domineering, and aggressive. By 2007, Grant had become a shell of his former self. He barely spoke, moved, or ate. His sister was beside herself. She felt certain that he was on the road to madness and then to death. In Grant’s sister’s mind, the trauma that instigated his steady deterioration was Charles Taylor’s departure. Taylor gave Joseph Grant a place in the world and a sense of purpose, but it is difficult to tell from this story if the source of his suffering was his loss of unemployment or the disappearance of the head of his patronage network. Taylor had other meanings for other people, however. He gave James Saa a sense of political purpose. For Saa and many others, Taylor articulated a coherent ideology of ‘‘Liberia for Liberians’’ and a national commitment to Liberian autonomy and independence. Although by 2007, the image of Taylor was under attack, Saa and Grant had both found personal meaning in Taylor’s vision of loyalty, service, and citizenship and continued to hold dear a vision of the Liberian state with him at the helm.2 The process of postconflict remoralization was tearing apart some of their most cherished commitments. James Saa was the son of a powerful man with close ties to Charles Taylor. Educated at an Ivy League university, Saa had friends who spanned Liberia’s social and political youth elites and included the sons and daughters of the Tubman, Tolbert, Doe, and Taylor regimes, as well as powerful expatriate-raised Liberians and political appointees to ‘‘Ma Ellen’s’’ administration. He was also deeply involved with the younger leaders in UNMIL and the humanitarian worlds, as well as with emerging business leaders. President Sirleaf had appointed Saa to a prominent national commission in 2006, and his star was rising in Liberian politics. At an outdoor barbecue hosted by Emmanuel Jones, one of Saa’s political friends in the Sirleaf government, Saa and I chatted under a palaver hut.

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While he drank cocktails out of a plastic milk container, he told me that he knew that someone was going to try to poison him. Someone had already tried. In this crowd of twenty-something expats and young Liberian reformers with Ivy League degrees, I didn’t believe him. His paranoia seemed excessive, but there was contextual precedent. Over the next two hours, Saa shared with me his personal and political philosophy, which he called ‘‘African solutions for African problems.’’ He argued that African forms of democracy were fundamentally different than the type America was trying to impose on Iraq and Liberia. The problem with democracy, according to Saa, was the belief that everyone should have an equal opportunity to participate. In his view, some people were naturally superior to others, and they had a responsibility to lead the unseeing masses through their ignorance and into the future. Equal participation was an unfair imposition from imperialist forces. Saa went on to argue that the international community’s greatest error was its belief in the sacredness of life. He said that while he was a student in the United States, he came home during the summer to fight for Taylor and was proud of his service. He said, ‘‘I’ve killed many times, and I’m proud of it. I was fighting to protect my country from people who want to destroy it.’’ He contended that not all lives had equal value and that some lives should and must be eliminated to protect the African integrity of the Liberian republic. Saa’s worldview, despite his Ivy League education, was consonant with Taylor’s depiction of Liberian sovereignty as under threat from dangerous imperial forces. He mentioned that our host was a dangerous democratic reformer and that he was treasonous. He repeated his mantra that someday, UNMIL would have to leave, that UNMIL could not stay forever, and then Liberians would go back to ‘‘African solutions for African problems.’’ Then no one could prevent them from defending themselves with guns. For hours, Saa blocked me into a corner of Jones’s yard, talking rapidly, insistently, and loudly about the malevolent designs of the international community on the country of Liberia. It became dark, and still he talked, periodically filling up his milk bottle with more rum, juice, and vodka. Expatriates thought he was exaggerating, but one of his Liberian colleagues confirmed that Saa’s father had been involved in plots to kill Jones’s father, another reformer. After the party, I felt nauseous, clammy, and slightly histrionic. Even after having known and interviewed dozens of ex-combatants, I had never

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met anyone who expressed such a fervent willingness to murder friends and enemies in the name of his country. Although I had heard many critiques of human rights and learned many just and fair critiques against neoliberalism, I had not met a senior political official who regarded protecting life as a deliberate affront to his own freedom. More than at any point in my fieldwork in Liberia, I felt afraid. I understood that there was something going on in this country that I truly did not understand and that my casual assumption of global cosmopolitanism came attached to an assumption of shared values about pacifism and the sanctity of life. I ended my fieldwork shortly after. Saa’s speech hastened my departure, as I became newly afraid of people who had been friends and colleagues, newly suspicious of ‘‘Ma Ellen’s’’ political appointees, and newly aware of the varietals of violence in postconflict life. A year later, on a return visit, Jones, my host from the night of the party, explained to me what he perceived to be the fundamental truth of Liberian political and social life. Positioning himself as a cultural interlocutor, he told me that even though Saa and his family did want to kill him, they could be friends with each other. Jones felt that this fact proved the superior nature of Liberian democracy and its intrinsic, essential difference from Western democratic systems. Others, however, viewed this kind of treacherous amiability in Liberian social life as an indicator of a deeper, underlying form of social disorder. During this later visit, I learned that Saa was still working in the government and that he had been promoted to a new position in a different ministry. His wife and small child, whom he nicknamed ‘‘the next Charles Taylor,’’ had relocated to Liberia, but he lived with his expatriate girlfriend. She believed that Saa’s political philosophy was meant to toy with liberal expatriates and Liberian reformers. Saa’s neighbors said that Saa and his girlfriend spent most of their time doing drugs and having sex. They also said that one night, one of Saa’s houseguests awoke to loud sounds in the main area of the house. He found Saa sweating and shuddering, looking mad-eyed. Saa paced back and forth at the door, holding a semiautomatic gun, and was unable to rest, speak, sit, or sleep. After a long effort, the houseguest was able to induce Saa to sit down. He patted him on the back until Saa finally calmed down and fell asleep. Trauma-related mental illness in the postconflict period reveals a relationship between experiences of individual suffering, social disarticulation,

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and generalized societal disorder. As Grant’s and Saa’s stories suggest, grief, frustration, and loss all intermingled in the course of people’s daily lives to create durable conditions of hopelessness and a lack of faith in the future.

Trauma and Victimcy In recent years, there has emerged a robust critique contending that trauma and mental health interventions in humanitarian spaces are resulting from the global cultural production of victimcy (Utas 2005), a drive towards the pathologization of suffering, or the medicalization of normal human responses to conditions of extreme stress (Summerfield 1996, 1999; Kleinman 1995) in an effort to transform suffering populations into humanitarian ‘‘objects’’ of sympathy (Boltanski 1993). The concept of trauma also has been said to neglect how the experience of suffering is imbricated in complex webs of social and cultural meanings that give moral standing to the experience. Critics have argued that the category of trauma and the very notion of victimhood itself deny the political realities of impossible conditions of war, poverty, and atrocity and the political and economic relations that produce gross inequality and violence (Martin-Baro, Aron, and Corne 1994; Summerfield 1999). Moreover, critics have contended that the category of ‘‘trauma’’ creates a justificatory ideological framework for using military means to violate sovereignty in weak nation-states in the name of humanitarian ideals (Pupavac 2001; Pandolfi 2000, 2008). In a similar vein, in global mental health research, cultural psychiatrists, psychologists, and anthropologists are strenuously challenging the pervasiveness of PTSD diagnoses in non-European contexts (de Jong 2005; Watters 2001; Bracken, Giller, and Summerfield 1997; Silove 1999; Breslau 2004). Alongside this vast literature are careful, thoughtful treatises about the historical emergence of PTSD as a political, historical, and medical phenomenon (Leys 2000; Shephard 2000); of trauma as a cultural hermeneutic for memory (Caruth 1995, 1996); of trauma as a collapse of language and meaning (Scarry 1985); and of trauma as abjection (Kristeva 1982). Beyond the technical and academic literatures, trauma has been integrated into Western popular culture as a taken-for-granted form of illness experienced through books (Herman 2001), self-help workbooks (Bass and Davis 1988; Williams and Poijula 2002), hundreds of epidemiological studies, novels,

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and films.3 It is becoming apparent that PTSD is, at best, of only partial utility in understanding the pathological impacts of traumatic exposure. These critiques do not, however, override the utility of an anthropological concept of trauma once it has become vernacular for a population. In the ethnographic turn toward valorizing the resiliency of people living under extreme conditions, an emphasis on familial sharing, cooperation, and adaptation has often eclipsed the lived experiences of tremendous disappointments, abuse, abandonment, and despair. This turn is a necessary response to the dehumanizing representation of ‘‘victims’’ of war, disaster, or violence, and it is an attempt to correct the historical record. It is also meant to counterbalance humanitarian, journalistic, and political representations of local populations as ‘‘victims’’ and restore their humanity. My own challenge in ethnographic writing is to remain true to Liberians’ highly critical self-narratives, which often emphasize human weakness, moral compromises, and vulnerability while sustaining a sense of Liberians as more than caricatures, with strengths and weaknesses, virtues and deficits. Finding a balance between the imperatives of factual representation and the ethical imperative to challenge ideas of ‘‘victimcy’’ that denigrate Liberian agency and inventiveness was difficult, especially in light of recent ethnographic work from the region. For example, the premise that postconflict Liberia constituted an environment of extreme social rupture has been challenged by important recent work on African warscapes, most notably Stephen Lubkemann’s book Culture in Chaos: An Anthropology of War (2008). Lubkemann and other anthropologists, like Utas (2005), Coulter (2009), and Hoffman (2011), have argued that the individual agency and cultural force of preconflict social life persist in and through warscapes, even in contexts of forced migration, sexual violence, or militancy. But the anthropological search for agency and cultural continuity, contra an assumption of rupture, runs into problems of its own. Coulter addresses this issue most beautifully in the excerpt that follows. Although I do acknowledge that some of my informants may at times have chosen to become fighters or lovers to commanders, in my work I wanted to emphasize the structural constraints circumscribing those choices; sometimes the only choice was between becoming a fighter/lover or dying, which is not really much of a

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choice, more a matter of bare survival. Here, I find Aretxaga’s concept of ‘‘choiceless decisions’’ (Aretxaga 1997, 61) useful precisely in its subtle double critique: it at once questions women’s passivity and victimization while it also challenges the liberal belief of agents’ free choice. (2009, 150) As I hope to do in the remainder of this book, Coulter showed how efforts to sustain social order rarely had the effect of sustaining social structure and social reproduction in any familiar sense. Liberians, like Sierra Leoneans, have shown extraordinary agency in the struggle for survival. In the remittances from oversees families, in the resource sharing among people working for NGOs, and in the complex market networks created across vast and treacherous territories, people helped each other time and again. Sometimes they did so by providing shelter and food or by taking on a child. But fundamentally, the narratives of agency that scholars use to support arguments of agency and continuity come from the people who survived, whose efforts were effective in getting them through life-threatening conditions. But the people who survived have to live with what Marianne Ferme (2001) has called ‘‘the underneath of things,’’ the negative space or the void of people who are no longer present, lives that are no longer lived, and stations in life that have passed on to others. The social engineering of the postconflict period emphasized learning how to control and manage trauma in everyday behavior through memory, body, and moral work. In the international literature, a general consensus has emerged regarding the utility of PTSD as a specific diagnostic proxy for a deeper phenomenology of trauma. Over the last several decades, thousands of studies and monographs have described the neurobiological and psychological causes of trauma, as well as the psychological and behavioral signs and symptoms, course of disease progression, and interventions. Extreme stress, chronic stress, and early stress exposure experiences have been studied for their connection to mental health outcomes, biological changes, and therapeutic interventions. It is widely recognized that PTSD emerges from a core event of violence, risk, threat, or loss that stimulates the activation of physical ‘‘fight or flight’’ (parasympathetic) responses. The requisite severity and exposure to the fear stimulus continue to be debated,

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but in the newest iteration of the Diagnostic and Statistical Manual, the DSM-V, PTSD has its own category and has been separated from its former family of anxiety disorders. Pychological sequelae include emotional and somatic symptoms that last for more than one month, persistent reexperiencing of the event through flashbacks or nightmares, persistent avoidance of stimuli related to or reminiscent of the event, persistent symptoms of increased arousal (like hypervigilance, insomnia, and anger), are significant impairment of social functioning. Psychologists share the underlying assumption that PTSD is a disorder of the memory, in which the mind’s inability to integrate extremely stressful experiences leads to disordered and somatically expressed symptoms. (Within this construct, there is substantial room for theoretical variation [Leys 2000].) Some schools of psychology posit that traumatic memory is stored in the unconscious mind and is unavailable to the sufferer for recall and processing without significant psychoanalytic work to restore memory and integrate the experience into the survivor’s conscious self-narrative. Others posit that traumatic memory is essentially a problem of language. Memory is accessible to the sufferer’s conscious mind, but the experience of shock or terror has ruptured the traumatized person’s ability to articulate the memory through language or, more important, symbolism. This impedes the formation of declarative memory, making it impossible for the sufferer to experience the catharsis of social support and empathic relations. In this case, narrative therapies can lead the sufferer to psychic integration and social healing. The discipline of anthropology has historically grounded itself in an assumption that the biological and cultural bases of human sociality are interwoven. But in the study of trauma, the relationship between minds, brains, subjectivities, and praxis has been cautiously sidestepped. Despite the superficial holism of concepts like the ‘‘psychosocial,’’ an understandings of the relationship between individual and collective trauma remains siloed into divided research specializations, exclusive domains of humanitarian practice, and conventional paradigmatic boundaries. This prompts one to ask, how does the unlearning of fear work at the intersection of neurobiological, psychological, and cultural processes? What existing cognitive-behavioral and narrative therapies can we identify in the experience of postconflict trauma healing and rehabilitation in Liberia? Is the process of recovery from trauma intensified when interventions are

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multisited, multivalent, and collectively oriented and bring together many different therapeutic paradigms? How did postconflict peacekeeping transform the Liberian environment in ways that compelled Liberians to alter their behavioral responses? How did the postconflict mental health, psychosocial, and trauma-healing interventions, including the introduction of new modes of speech, narrative, and meaning, impel Liberians to reinterpret the meaning of the war, their experiences, and the new postconflict events and environments? Future interdisciplinary research needs to embrace the close alignment between the complexities of neuroscience, culture, language, and behavior. Interventions in postwar trauma need to recognize that overcoming trauma involves more than circumventing the neurobiology of trauma; it involves the resymbolization of one’s understanding of his or her relationship between the individual and the collectivity. It requires the acquisition of cognitive, behavioral, emotional, and moral dispositions that transcend the elements of traumatic memory that intersect with how we, as humans, together embody memory, meaning, and morality.

Chapter 4

Individual Interventions

A Genealogy of the Psychosocial In the well-documented history of Western psychiatry, the concepts of trauma, PTSD, and the psychosocial have been so widely used that they have generated vernacular lives. In the next few pages, I draw a brief genealogy of the term ‘‘psychosocial,’’ which provides context for deciphering the space of intervention that was enacted in Liberia during the postwar period. At the turn of the twentieth century, social scientists used the word ‘‘psychosocial’’ in two ways. First, it denoted processes of social functioning and psychological integration in social milieu (with all the attendant historical and evolutionary theories that might be anticipated from that period of scholarship). Second, it was used in American, British, and European psychoanalytic discourses as a descriptive technique for discussing the ‘‘black box’’ of social and psychological influences on criminal pathology and social deviance (Brasol 1927; Freedman 1939; Hoag et al. 1923). In the late 1950s, the term ‘‘psychosocial’’ underwent a significant transformation. James Lorimer Halliday used the term in the title of his groundbreaking work, Psychosocial Medicine: A Study of the Sick Society (1948), a critique of psychosomatic illness and social medicine. The term ‘‘psychosocial’’ was then increasingly applied to the psychological and social scientific analyses of new research questions involving psychology and disease. These included careful psychological and sociological profiles of selected ‘‘normal’’ subpopulations, such as the ‘‘college men’’ of Yale University’s The

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Psychosocial Problems of College Men (Wedge 1958), and profiles of other subpopulations presumed to have deviant traits, such as racial and ethnic minorities (see Abram Kardiner and Lionel Ovesey’s The Mark of Oppression: The Psychosocial Study of the American Negro [1951]). The term ‘‘psychosocial’’ was also increasingly deployed to do the work of unifying society, personality, and culture in social scientific studies of medicine and society. In anthropology specifically, luminaries from the school of culture and personality studies featured the concept of the psychosocial prominently, including Edward Sapir (1993), Abram Kardiner (Kardiner et al. 1963), Margaret Mead (2001), Ruth Benedict (2003), and Ralph Linton (1959). The term appeared also in the titles of monographs like David Alberle’s The Psychosocial Analysis of a Hopi Life Story (1951). In many of these studies, the term ‘‘psychosocial’’ delicately negotiated a dangerous balance between psychoanalysis, social behavior, and pathologizing culture. The term ‘‘psychosocial’’ broke through into mainstream usage in the late 1950s, when Erik H. Erikson articulated an ego psychology premised on a theory of psychosocial developmental stages. As individuals grew and passed through these psychosocial stages, their ability to successfully navigate the interplay between individual ego development, social conditions, and cultural norms determined their subsequent passage into becoming a normal, fully functional, socially acceptable human being (Erikson 1958, 1959). The failure to develop ‘‘normally’’ led to deviance, maladjustment, and a difficulty with coping under normal societal conditions. Halliday defined it best in a letter to Erikson: The crucial characteristic of this psychosocial theory of ego development, and of Hartmann’s adaptation theory (in contrast to the ‘‘culturalist’’ theories) is that they offer a conceptual explanation of the individual’s social development by tracing the unfolding of the genetically social character of the human individual in the course of his encounters with the social environment at each phase of his epigenesis. Thus it is not assumed that societal norms are grafted upon the genetically asocial individual by ‘‘disciplines’’ and ‘‘socialization,’’ but that the society into which the individual is born makes him its member by influencing the manner in which he solves the tasks posed by each phase of his epigenetic development. (Erikson 1959, 11)

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Throughout the 1960s, the term ‘‘psychosocial’’ gained prominence in the fields of social work and education in the United States. As an alternative to the Freudian id psychology of psychosexual development, social and psychological researchers and public policy makers found that the psychosocial approach was a useful, uncontroversial, and relatively conservative approach to understanding the ‘‘black box’’ relationship between individual psychology, social relations, and cultural norms. The concept of the psychosocial was picked up in mental health, education, social policy, and international development contexts, and it filled in a space for ‘‘soft interventions’’ meant to shape the substance of personhood to fit within the desired expectations of society. Today it is ubiquitous in discussions of social problems; a quick Library of Congress search reveals that in the last decade alone, approximately a thousand books have been published on the topic of the ‘‘psychosocial.’’ But what are the technologies of psychosocial intervention? From its original inception as a category of experience, ‘‘psychosocial’’ has expanded to index a vast domain of social action and professional, bureaucratized practice. The application of the term ‘‘psychosocial’’ extends NGO mandates into any and all ‘‘soft humanitarian interventions,’’ including nonbiological interventions (i.e., food and medical), nonsurvival interventions (i.e., security, shelter, and sanitation), and nongovernance interventions (i.e., democratic reform, elections). Psychosocial needs can also be read into social and economic activities like job training and education, which enables NGOs that provide such programs to claim that they are conducting ‘‘psychosocial interventions.’’ Furthermore, the term ‘‘psychosocial’’ extends into governance-related NGO activities regarding the rule of law, social order, and the assertion of human dignity, including civil society initiatives, human rights education, training on the UN Convention on the Rights of the Child, and GBV activism and education. Psychosocial interventions tend to be relatively low-cost and effective means of promoting transformations of selfhood and subjectivity toward specific desired ends. (Nguyen’s (2010) description of HIV/AIDS ‘‘confessional technologies’’ like therapy groups, encounter groups, individual talk therapies, and community education campaigns gives us some sense of their history and global operations.) Psychosocial interventions also tend to sprawl across confessional, didactic, and interactional domains. Perhaps because of the vaguaries and fluidity surrounding definitions of the ‘‘psychosocial,’’ the international humanitarian community can map the term

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onto numerous domains of action and encounter little critique or resistance. Paradoxically, ‘‘psychosocial’s’’ lack of specificity gives the term and its applications a great deal of semiotic authority when it is used as a frame (see Goffman 1986) for understanding humanitarian problems, strategies, solutions, and goals. Consequently, wherever psychosocially oriented humanitarian intervention took place in Liberia, a diverse array of projects were introduced, ranging from trauma counseling, to helping women psychologically recover from rape, to rehabilitation programs to help ex-combatants become resocialized to a still unstable ‘‘normal’’ Liberian social life, to prescribing psychiatric medications to help rural village women manage symptoms of depression, anxiety, and flashbacks and nightmares related to PTSD. All of these interventions were designed to bring human experience in line with new expectations about how Liberians should handle the postconflict transition and adjust to the new conditions of peacetime life. The trauma healing and psychosocial interventions offered by NGOs were geared toward managing the excesses of individual experiences of trauma through therapy and behavioral modification. The goal of these interventions, however, was to gradually build peace subjectivities, or individual and collective dispositions of nonviolent social action and social participation, in postconflict life and postwar politics (Charbonneau and Parent 2011). But where did ‘‘making peace people’’ end and treatment for mental illness begin? What was the empirical dividing line between ‘‘the normal’’ and ‘‘the pathological’’ in postwar Liberian life and humanitarian practice, and how far did interventions reach into the lives of ordinary Liberians? As I suggested in Chapter 1, time and density are important factors to consider when reflecting upon the saturation of trauma-healing and psychosocial interventions across Liberia. According to one study, less than 15 percent of Liberians had received mental health counseling since the war ended in 2003 and just 2–8 percent of Liberians felt that they had sufficient local mental health programs (Johnson et al. 2008). In another study of mental health services in Nimba County, researchers found that 12 percent of health clinics offered mental health care (Kruk et al. 2010) to a population reporting that 48 percent of its residents suffered from PTSD (Galea et al. 2010). Given the high rates of psychological distress reported in the Liberian population, these figures suggest that access to mental health care was limited, but they also allow an alternative reading—one of widespread

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NGO mental health and psychosocial presence. In a context in which there was almost no private or state-supported mental health infrastructure, the fact that Liberians reported rates of access to mental health care as high as 12 or 15 percent is quite striking. When Liberians reported access to mental health care, were they thinking of psychosocial, trauma healing, or psychiatric care programs offered by NGOs? When Liberians thought about mental health treatment, did they have in mind psychiatric care, or the therapies often found in the psychosocial interventions of postwar humanitarian projects? What were lay Liberian understandings of what constituted mental health treatment?

Making Peace People In May 2012, nine years after the end of the war, I sat in a large recreation room at the Monrovia Central Prison. I was there at the invitation of the NGO Second Chance, Liberia, which was founded by a Brazilian expatriate with psychological training and was remotely supervised by a psychologist in Massachusetts. Sumo Kupe, the organization’s director, led a fourperson team of counselors. Most of the counselors were refugees from Ghana’s Buduburum refugee camp and had repatriated to Liberia in 2008. Their total budget was about US$1,000 per month. The following narrative presents example of NGO efforts to produce peace subjectivities and prevent violence through the development of embodied habits for managing anger. Note that the emphasis of the intervention is on managing the stresses of the present, rather than resolving the traumas of the past. Sumo stood to speak to the audience of fifteen prisoners seated around us in a circle: ‘‘Thank you for coming here, and thank you for your time. We are all one family here together, because we are all humans together, and I really respect you and your time. So let me remind you that we will only be taking one hour here today. Let me also remind you that we will be following the ground rules that we have set together as a group. Now tell me, how are you sleeping?’’ My eyebrows popped up. How are you sleeping? In all my years of conducting ethnographic research on psychosocial programs, this was the first

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time I had heard this question posed at the beginning of a group. The prisoners remained silent. Sumo repeated his question, more insistently this time: ‘‘How are you sleeping?’’ The group nodded—fine. Sumo introduced me and explained the reason for my presence. I was there to observe the work of Second Chance, and I was not there to study their personal stories. The prisoners gave me permission to observe, but a skeptical participant left to find a prison monitor who could keep an eye on me and my notebook.1 Sumo led the group in a discussion of trauma and forgiveness, focusing on lessons learned and remembered from past sessions. Individually, the men stood up and spoke about what trauma meant, what forgiveness meant, and how difficult it could be to forgive. Soon, a verbal tussle broke out between two men over a reference to the New Testament during the discussion. One man, a Christian, wanted to talk about Matthew 18:21–22,2 while another, who didn’t read the Bible or believe in God, found his references offensive. William, another Second Chance employee, tried to shift the conversation to more secular topics, but Sumo, who was mindful of a recent UNICEF training that reminded NGOs to ‘‘respect everyone’s cultural differences and honor them,’’ overrode his intervention and gave space to the group to debate the meaning of the New Testament reference. A few moments later, the conversation grew heated again, and Sumo intervened. He reminded everyone to practice their breathing exercises. Breathing exercises? The group stood up, and under Sumo’s direction they took a deep breath in through their noses. They let a deep breath out through their mouths and held it. Sumo reminded them that when they were feeling angry, restless, or unforgiving, they needed to do their breathing exercises to calm their minds and rest their bodies. Sumo returned them to their seats to continue their discussion about forgiveness. The stories shared by the prisoners can be related without compromising their identities. One man was angry because his sister, who lived in America, had sent money to his uncle for his legal defense, but his uncle was misappropriating the funds. Another young man was filled with rage and jealousy because his overtaxed family rarely found the time to visit him. A former engineer reported that he was imprisoned for a crime he did not commit—a real possibility in the context of the broken Liberian justice

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system. A fourth man, who had been in prison for many years, wondered how he would return to his family and friends when he was released. Then a young man stood up and said, ‘‘I really have to thank Second Chance for the things they have taught me here. Sometimes it gets so HOT in the prison, I cannot sleep. And then I stand up, I stretch, and I do my breathing exercises, and I can sleep fine. People ask me how I can do it, and it’s because of my breathing. Also, when someone is trying to insult me and start a fight, I can breathe and turn it into a joke. Really, breathing is saving me here.’’ Sumo tapped one participant to stand up, linked a finger into his T-shirt, and walked in a circle around the room. He said, ‘‘This is a drama. It’s to remind you that when you cannot forgive someone, you have this person (unforgiveness) walking around with you, you are carrying them around all the time. It is too much of a burden for you to bear. All the time, you have this person sitting on your head, sitting on your neck, making your body heavy, worrying you all the time. Soon you cannot sleep, you are just thinking, thinking, thinking about this person. It becomes a trauma. Then you cannot eat. You start to feel sick. You start to think about hurting someone. And then this trauma, it can start to ruin you. Trauma could make you embarrass yourself in your life. You must forgive so that you don’t embarrass your life.’’ The group members agreed. They practiced breathing again, and Sumo emphasized the importance of sleeping well and not allowing ‘‘unforgiveness’’ to play upon their minds. We ended, as promised, after an hour and spent some time lingering and chatting before Second Chance and I exited the prison, leaving behind a group of men who were visibly physically relaxed and emotionally composed. The tenor of healing, relaxation, and cooperation that had been achieved over the course of the preceding hour disappeared as we walked through the door, back into the courtyard of Monrovia’s Central Prison.

Trauma Healing: The Center for Victims of Torture In contrast to the behavioral therapies described above, most efforts to help trauma survivors have emphasized narrative-driven methods like individual and group therapy, hypnosis, social support, case management, or ‘‘a stern, sympathetic chat, tea and a good night’s rest.’’ For a time, the Center for

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Victims of Torture (CVT) was one of the leading providers of individual and group therapy programs across Liberia, Guinea, and Sierra Leone. CVT is a nonprofit organization based in Minneapolis that provides medical, psychological, and social services to victims of torture, and engages in political advocacy against torture. Its model is similar to many of the trauma-healing projects that emerged across Bosnia, Rwanda, Afghanistan, and the Palestinian Territories in the 1990s and early 2000s, and in 2006, the journal American Psychologist lauded the organization for its focus on community-based mental health and its education campaigns to raise mental illness awareness in West Africa. It was also acclaimed for its use of Liberian paraprofessional counselors, called psychosocial agents (PSAs), to deliver basic group and individual counseling. American Psychologist reported, A psychosocial program was developed with three main goals: (a) to provide mental health care, (b) to train local refugee counselors, and (c) to raise community awareness about war trauma and mental health. Utilizing paraprofessional counselors under the close, on-site supervision of expatriate clinicians, the treatment model blended elements of Western and indigenous healing. The core component consisted of relationship-based supportive group counseling. Clinical interventions were guided by a three-stage model of trauma recovery (safety, mourning, reconnection), which was adapted to the realities of the refugee camp [and postconflict Liberian] setting. (Stepakoff et al. 2006) CVT’s foray into West Africa began as a USAID-sponsored experimental initiative to provide trauma counseling to survivors of political torture in West African conflicts. From its inception, CVT’s international trauma healing program was sustained through private donations and through grants from the U.S. Department of State’s Bureau of Population, Refugees, and Migration. After arriving on scene, CVT program officers learned that the profiles of violence in the Liberian and Sierra Leonean conflicts diverged from CVT’s institutional definition of politically motivated torture. They decided that such definitions were inappropriate for the local context and opted to define the concept of torture broadly so as to include as many Liberian refugees who had been exposed to traumatic incidents as possible. This decision created an ongoing tension between CVT in West

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Africa and CVT’s headquarters in the United States; CVT West Africa’s program officers complained to me that they never had the full institutional support of their home organization. CVT’s first project was in Guinea, where the NGO provided counseling to refugee Liberian and Sierra Leonean populations, and it soon expanded to Sierra Leonean refugee camps. As the Sierra Leone and Liberian wars came to their conclusions, CVT followed the NGO migration from camps to capitals in Liberia and Sierra Leone. CVT opened their Liberia headquarters in 2004 and soon expanded into Bong and Lofa, two of the counties deemed by international donors to be the most affected by the war. It built its offices and carried out local public education events, and CVT’s Liberian PSAs were well regarded. According to CVT’s PSAs, the CVT model was straightforward. During their training, PSAs underwent their own trauma counseling (see Chapter 8), learned about mental illness, and were taught how to identify mild to moderate symptoms of anxiety, depression, and PTSD. After training, they went out into camps or neighborhoods to educate Liberians about trauma and mental illness and recruit them for program assessment. Recruited participants then underwent an assessment of their symptoms of traumarelated mental illness, which included several symptom checklists and directed questions about their exposure to traumatic events. If those assessed were thought to be suitable for CVT’s eight- to ten-week group therapy sessions, they were invited to participate. Individual therapy was also available for some people with more severe symptoms of depression, anxiety, or PTSD, and this might last from as little as six months to as long as two years. Anyone identified as having a severe mental illness was turned away. No psychiatric medications were ever recommended or administered to participants or nonparticipants. As a research consultant3 with CVT, I did not observe their individual and group counseling activities, but I had close personal and professional relationships with Liberian PSA staffers, including recruiters, counselors, and managers. During group discussions, interviews, and private conversations from 2003 to 2008, PSAs related detailed accounts of trauma-healing groups. According to the PSAs, the structure of the CVT group therapy process was carefully formatted. Groups were closed to outsiders, attendance was mandatory, and group meetings were limited to eight to ten sessions. Members were carefully screened for gender, age, and similarity of experience.

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Rape victims and ex-combatants, for example, were unlikely to be placed in the same group, older men were not placed with younger women, and so forth. In the first few sessions, group members shared their immediate troubles and problems. When discussing their experiences as refugees or as newly resettled Liberian civilians, they related their difficulty finding food and shelter and their fear of crime. They complained about family sicknesses, their limited access to medical care, and their problems with transportation and transportation security. Each participant was invited to speak in turn. Then, the group brainstormed solutions to each speaker’s everyday problems, and recommended specific coping strategies for his or her daily struggles. A few sessions in, group meetings shifted into a discussion of the concept of trauma, emphasizing symptoms like social withdrawal, triggers that induced flashbacks, and emotions like sadness and anger. Each participant shared his or her story of trauma, taking as much time as needed, while group members offered support and encouragement. Speakers, in particular, were encouraged to offer a directed narrative that filled in all memory gaps and included all details. Group members and the group leader (usually a CVT expatriate) then helped the speaker reinterpret his or her narrative as one of survival, strength, and resilience. Members experienced this process as intensely cathartic. Then group members recommended to the speaker how he or she might better manage their symptoms of trauma, and the next person had his or her moment to speak. As each group meeting cycle came to an end, meetings were used to reorient participants away from the past and toward their present and future. Group members discussed how they might reinterpret their trauma narratives as stories that emphasized strength, resilience, and virtue, and talked about their hopes for themselves and their children. They finalized strategies for recognizing and isolating the most debilitating symptoms of trauma, and offered themselves to each other as social and moral supports in postgroup life. CVT’s leadership emphasized the psychological benefits of the program, but its PSAs, who had gone through the process, described the sociotherapeutic effects of the groups. PSAs often remarked that participants entered the therapeutic process feeling isolated and alone. As the groups moved forward, they came to recognize that other people, like them, experienced suffering similar to their own. The groups transformed personal experiences of

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isolation, recurring memory, and despair into normalized, taken-for-granted events that could be mined for lessons in managing everyday life. In doing so, the program transformed group members’ sense of social connection, attachment, and relatedness. This transformation was central to the reconstitution of postconflict life for individuals and for the participants as a group. The group created a model of mutual care through its intensely regulated environment of mutual support, sympathetic listening, practical solutions to practical problems, and a shared sense of common purpose. In the groups, men and women encouraged each other to have faith, to believe that there was a future, and to believe that there was life beyond war that was worth struggling for. Even though everything was ‘‘all messed up,’’ their survival meant that there was hope for a better future, and that future was shared. In their emerging sense of commonality, a new therapeutic communality was formed, giving them a hopeful set of dispositions with which to engage with postconflict life. To prove their point, Liberian PSAs often reported that group participants sustained supportive relationships with each other long after the group had ended. CVT’s trauma-healing groups followed the paradigmatic struggle that everyone was working through in postconflict life. Within the groups, as in the outside world, Liberians were innovating postwar modalities that would form the threads of the social fabric around which new forms of sociability, support, moral tolerance, and aspiration were emerging. With its strict focus on trauma, CVT was a visible focal point in the humanitarian community for trauma treatment, but the program constantly faced administrative and funding challenges. By 2008, PSAs in Lofa County were telling me that ‘‘CVT was a dying organization’’ because budget cuts had forced the elimination of most of its activities in Monrovia and the closure of all of the offices in the interior. Expatriate and local staffs were dramatically scaled back, and most of the CVT staff were seeking work elsewhere. By 2012 the Liberia program had closed, and CVT had opened a new trauma program in the Democratic Republic of the Congo.

Outpatient Clinics: Cultural Competency and Open Mole Since 2003, Sante´ Humanitaire, a medical humanitarian NGO, has operated clinics, hospitals, community health education initiatives, and pharmacies

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throughout Liberia’s Bong County. As of 2007, it regularly visited nearly a dozen rural villages for weekly clinics and vaccination campaigns, ran a short-term hospital and outpatient clinic in Gbarnga, one of Liberia’s largest cities, and managed health sensitization campaigns. Sante´ Humanitaire is philosophically rooted in tiers-mondisme, or ‘‘third-worldism’’ (Fox 1995; Redfield 2005, 2006), and claims a political commitment to social equality, human rights, the imperative to witness (te´moinage), and a belief in the moral right to interfere (le droit d’inge´rence). As a medical humanitarian NGO, its responsibilities are largely public health and medical in nature, but it sees its provision of medical care (including mental health care) as a form of activism intended to challenge global injustice. In 2004, as the international community implemented Liberia’s final DDRR campaign, Sante´ Humanitaire’s Paris-based board of directors decided to become involved in psychosocial activities to support trauma healing and demobilization. Sante´ Humanitaire deployed Jacqueline, a young French psychologist, to develop the Psych Team program at Liberia’s Sante´ Humanitaire branches and arranged for her to be supervised by a French psychiatrist with considerable experience in humanitarian emergencies and in West Africa. Jacqueline recruited four Liberian nurses, educators, and social workers to the Psych Team and provided rigorous training in basic counseling skills. According to Psych Team members, during training, Jacqueline stressed that their role was to provide high-quality psychological counseling but not psychosocial, social work, or education programs (see Medeiros 2005, 2007; Drogoul 2012). After training, members of the Psych Team were asked to do two things: conduct a mental health mapping project and provide psychological care to two hundred ex-combatant youth going through the DDRR process. During this time, the Psych Team also initiated ‘‘traditional women’s groups’’ in several communities, in which team members trained ‘‘traditional women,’’ usually older women in rural communities, to understand what mental illness was, to learn how to recognize it, and to participate in a trauma-healing group therapy process. Traditional women’s groups were seen as an important strategy for identifying people within rural communities who might be suffering from trauma and for providing them with culturally appropriate pathways to psychological treatment. It was in the course of these encounter groups that Jacqueline learned of Open Mole, which shall be discussed shortly.

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Jacqueline departed near the end of DDRR, in 2005, and the Liberian Psych Team was confronted with its first crisis of leadership. The allLiberian team needed training, supervision, and leadership, but the expatriate Sante´ Humanitaire doctors and supervisors did not feel that they had the authority to act in a supervisory capacity with the Psych Team. During Jacqueline’s tenure, Sante´ Humanitaire’s medical divisions had been structured so that the all-Liberian Psych Team was effectively autonomous from the rest of the NGO. Without an expatriate present who could work informally through social networks to obtain resources, build capacity, and facilitate collaboration between the Psych Team and the rest of the Sante´ Humanitaire program, the Psych Team struggled to remain independent. Until this time, the main responsibilities of the team had included excombatant rehabilitation and mental health outreach through traditional women’s groups, but with the end of DDRR on the horizon, the future of the Psych Team was uncertain, and their core responsibilities were in flux. When the DDRR program ended, Sante´ Humanitaire’s headquarters in Paris determined that Liberia’s lack of mental health services constituted a humanitarian crisis and that it was within the NGO’s mission to create a mental health program within their medical humanitarian program. In 2006 they sent a new supervisor, Marguerite, who had a background in psychiatric nursing, rather than psychology—signaling a shift in program priorities. (As noted earlier, Sante´ Humanitaire decided to support the program out of its pool of private financial contributions since international grant opportunities for mental health in Liberia were not available.) Under Marguerite’s direction, the Psych Team initiated outpatient psychiatric care, community-based psychiatric outreach, and psychopharmacological treatment for PTSD, depression, anxiety, epilepsy, and psychosis. With Marguerite at the helm, the Liberian Psych Team members were rapidly transformed into psychiatric nurses, in addition to their previous roles as psychologists and social workers. Traditional women’s groups in rural areas retained their functions, but recruiting mentally ill community members for outpatient psychiatric treatment became an increasingly important part of their socioeducation activities. Marguerite’s tenure lasted eight months. After her departure, the Psych Team, which had expanded to seven members, shared responsibility for twelve communities and participated in weekly phone supervision with a French psychiatrist. For nearly a year, Sante´ Humanitaire was unable to

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find a qualified expatriate to replace Marguerite. Among Sante´ Humanitaire’s in-country leadership, there was a sense that the Liberian Psych Team was working valiantly but that they were struggling with their expanding patient population and their lack of psychiatric training and experience. During this period, Marguerite was pressed into returning to Liberia for a short-term stint as supervisor. After she arrived, she invited me to observe Sante´ Humanitaire’s mental health activities in Bong County, which gave me the opportunity to see how Sante´ Humanitaire expatriate volunteers maneuvered through the postconflict humanitarian system in ways that the Psych Team could not. During a routine visit to a market town, Marguerite was led into a yard where a man with an undiagnosed mental illness was chained, naked, to a tree. Marguerite remarked that she was not a psychiatrist and was therefore unable to make a diagnosis, but she was able to offer the man’s family some antipsychotic medication and make plans for transporting the man in an NGO vehicle to Grant Hospital in Monrovia, where her relationship with Grant Hospital could ensure admission. Later that same day, Marguerite introduced me to a man suffering from severe alcoholism. His condition was exacerbated by his community’s willingness to compensate his manual labor with alcohol, creating a vicious cycle of ongoing dependency and worsening health problems. In order to break the cycle, Marguerite arranged for the man to be transported in Sante´ Humanitaire vehicles to Grant Hospital, for a short stay in order to support his detoxification. During his hospitalization, she sent the Psych Team to his community to educate residents about the man’s disease, and to ask his neighbors to refrain from trading alcohol for work. Although the all-Liberian Psych Team knew of both men’s problems, they were unable to leverage the same kinds of resources that Marguerite could, or achieve the same ends. Through MHPCC meetings in Monrovia, in casual conversations in expatriate lodgings, and in transports, Marguerite was embedded in webs of communication with people who could leverage resources in ways that the Liberian Psych Team members were not. Shortly after Marguerite’s final departure, I was invited by Sante´ Humanitaire’s country director to conduct ethnographic research into Open Mole (Abramowitz 2010). Sante´ Humanitaire regarded Open Mole as a bit of an ethnological discovery. While conventional medical anthropological thought would classify Open Mole as a culture-bound syndrome (a combination of psychiatric and somatic symptoms that are specific to a

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particular culture), Sante´ Humanitaire had come to regard Open Mole as an idiom of distress that communicated postwar Liberian trauma. Among Liberians, Open Mole was known to ethnic and linguistic groups ranging from the Gola to the Kpelle. Open Mole was regarded as a ‘‘folk’’ disease that occurred among rural or ‘‘traditional’’ urban Liberian women who had experienced a trauma, a sudden fright, or the death of a loved one. People who believed in Open Mole argued that its primary symptom was a sunken fontanel (a softening of the top of the skull) that resulted from problems in the brain or with blood circulation. According to the medical literature, sunken fontanel occurs only among children who are severely dehydrated; but among Liberians who believed in Open Mole, the sunken fontanel that characterized Open Mole was a widespread phenomenon that occurred in children and adults, and men and women. (At least a dozen informants swore that they had touched an adult’s sunken fontanel themselves and their finger had been able to press an inch deep into the skull.) It carried important symptoms of psychological distress like self-isolation, aural and visual hallucinations, depression, suicidal ideation, and anxiety. Beyond these details, however, its specific disease profile and cures were contested. Some thought that it was contagious and that it could be caused by sharing a hairbrush or head scarf, while others disagreed. Some felt that it happened when an individual tampered with dangerous spiritual forces; others regarded it as a typical medical misfortune, like any other disease. Although both men and women could contract Open Mole, its occurrence seemed to be gendered; according to Sante´ Humanitaire’s outpatient statistics, women accounted for 80 percent of complaints. Treatment for Open Mole was typically managed in the ‘‘country medicine’’ sector and was a widely distributed form of specialized knowledge. When an individual was feeling anxious or depressed, a friend or relative—perhaps a former sufferer of Open Mole—diagnosed the disorder by studying the sufferer’s head and listening to an account of symptoms. Then a healer, who might be a friend or a specialist in traditional medicine, prepared a paste of herbs and leaves. The paste was applied to a small shaved spot on the top of the sufferer’s head. The head was then bandaged tightly, and the remedy was reapplied for a recommended interval ranging from three days to three months. The contents of the paste varied by healer, and if treatment failed, it was recommended that the sufferer repeat the treatment until the symptoms were resolved, or seek a different healer who might have a superior

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Table 4. Open Mole Symptoms A soft spot in the center of the head Sunken fontanel Severe headache Neck pain Back pain Tiredness Weakness Sleeping problems Decline in appetite Bad dreams, nightmares ‘‘Worriness’’ Forgetfulness Loss of interest in usual activities Eyes swinging, swimming Fast heartbeat Headache General body pain Heat throughout the body Trembling Fear of death

medicine. Thus, some of Sante´ Humanitaire’s patients complaining of Open Mole had been seeking treatment in the traditional medicine sector for over a decade. In an effort to promote cultural sensitivity in Sante´ Humanitaire’s mental health activities, the Psych Team was encouraged to integrate the concept of Open Mole into their practice of psychiatric diagnosis. Jacqueline, the psychologist, interpreted this to mean that patients with Open Mole were really patients experiencing PTSD, who were describing PTSD symptoms within the framework of a more familiar culture-bound illness. But Marguerite, the psychiatric nurse, expanded upon this interpretation to require that Open Mole be used as a ‘‘diagnostic alter’’ for transposing indigenous reports of mental illness into an array of conventional psychiatric disorders. Thus, at Sante´ Humanitaire, Open Mole became a referent for a wide array of symptoms (see Table 4) that included dissociation, depression, anxiety, PTSD, symptoms of psychosis, and general somatized malaise.

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At the same time, Sante´ Humanitaire staff ignored the primary somatic symptom of Open Mole, the perceived sunken fontanel. When it was mentioned, it was ridiculed as an example of local ignorance. Other somatic complaints were disregarded as well. According to patient records and verbal reports, Open Mole also included range of somatic complaints from numb legs, to seeing shadows, to problems with vision, to feeling like there was a worm in one’s head. In clinical practice, the Sante´ Humanitaire Psych Team learned to ascribe Open Mole diagnoses to mental illness, and a shorthand diagnostic practice emerged in clinical records. Patients were routinely diagnosed with Open Mole—with Anxiety; Open Mole—with Depression; Open Mole—with Schizophrenia; Open Mole—with Psychosis, or some variation on these disorders. For these diagnoses, patients were treated with a limited range of conventional psychiatric medications, including gluoxetine (Prozac), amitriptyline (Elavil), alprazolam (Xanax), and haloperidol (Haldol). But in the case of a diagnosis of Open Mole— with PTSD, the recommended course of treatment was restricted to counseling. Consequently, many patients were initially given a diagnosis of Open Mole with PTSD and then had their diagnosis changed when their symptoms failed to respond to talk therapy. The Liberian Psych Team members were themselves divided over the validity of Open Mole and its usage in clinical practice. While they appreciated the NGO’s efforts to be culturally sensitive to the language and culture of the local Kpelle population, several members complained that educated Liberians did not believe in Open Mole and that it did not make sense to use it in a clinical context. Several other members suggested that if the Open Mole diagnosis effectively encouraged Liberians with mental illness to seek appropriate care, then it was a good thing. But the integration of Open Mole into Sante´ Humanitaire’s diagnostic practices also had some unintended consequences. As Liberians throughout Bong County learned that Sante´ Humanitaire was treating the symptoms of Open Mole, more and more first-time patients came to Sante´ Humanitaire clinics to seek psychiatric care. When they presented their troubles, many situated their presentation of symptoms in the language of Open Mole, and provided the narrative context of a trauma history. This suggests that between the humanitarian marketing of Open Mole, Sante´ Humanitaire’s psychoeducation efforts in traditional women’s groups, and word of mouth, Liberians had been trained to present their complaints in a manner that was most

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likely to yield their most preferred outcomes—the free provision of prescription medications. Case Study 1: Margaret

Margaret was a tiny, thin woman from a farming village with a broad smile, clear eyes, and a modest manner. While giving her informed consent, she sat easily at the consultation table in the Sante´ Humanitaire psych tent and waited for the clinical interview to begin. I learned from her records that she was a widow with three living children and that several more of her children had died. In the clinical interviews that I observed, Margaret reported that she was worried about the Open Mole and that she thought often about the deaths of her husband and son, which had instigated the onset of her Open Mole. Margaret first exhibited signs of Open Mole in 1991, when she lost her oldest son to the war. ‘‘Open Mole fell on me at that time,’’ and she ‘‘went off’’ and ran into the bush. She recovered, using country medicine, but in 1993 she lost her husband to illness (not war, she emphasized), and the Open Mole returned. Since then she had experienced headaches, heat throughout her body, and a fast heartbeat. She kept having flashbacks of her son’s death and had an ongoing fear of death. Like most other Sante´ Humanitaire patients complaining of Open Mole, Margaret used traditional medicine on numerous occasions, but after a first remission, the symptoms returned, and country medicine no longer worked. In initial clinic interviews, the Sante´ Humanitaire Psych Team diagnosed Margaret with Open Mole—PTSD. After a month of observation in regular clinic visits Margaret’s failure to progress in counseling (the sole intervention recommended for Open Mole—PTSD) concerned the Psych Team members. They changed her diagnosis to Open Mole—Anxiety Features and Depression and prescribed her a daily dosage of 1.25 milligrams of haloperidol. Since entering treatment, she had experienced some improvement in her symptoms but not much. At this visit, she complained of weariness, insomnia, her eyes swimming, recurrent headaches, flashbacks, and dreams of her late son and husband. In the United States, haloperidol is used to manage symptoms of psychosis, schizophrenia, hyperactivity, aggression, and delirium. It is widely recognized among psychiatrists as an outdated medical intervention for severe anxiety and organic brain syndrome (decreased mental function due to medical disease). In comparison to atypical antipsychotic medications

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like Zyprexa, haloperidol has fallen into disfavor because of its unpleasant side effects, including permanent dyskinesia (facial and body tics, tongue rolling), dystonia, and a possible causal role in depression. In my interviews with psychiatrists and public health officials, I learned that haloperidol is usually reserved to control severe aggression and agitation as a short-term measure and that almost any antidepressant is considered preferable for managing PTSD. Due to difficulties accessing psychiatric medications in Liberia, the Sante´ Humanitaire Psych Team was forced to prescribe it frequently, while expatriates understood that the treatment was less than ideal. At Margaret’s clinical interviews, John, the psychiatric nurse, was eager to demonstrate to me his counseling skills, as well as Sante´ Humanitaire’s Psych Team policy of prioritizing talk therapy over prescription drug treatment. I transcribed the following exchange in my fieldnotes. John asked, ‘‘Do you have the feeling that you are going to die?’’ ‘‘Yes,’’ Margaret replied. He replied, ‘‘Everyone is going to die.’’ Margaret sat silently, and tears welled up in her eyes. John, acting as a cultural interlocutor between Margaret and me, explained to me that Margaret, a Methodist, incorrectly feared that her son’s unnatural death meant that she would not see him after she died. He then counseled her to ‘‘just forget it’’ and tried to explain to her that she was wrong for being afraid about the death of her son. Margaret’s silent and querulous stare displayed confusion and continued distress, but John felt as though the counseling encounter was a success. He had deployed a therapeutic demeanor that was sympathetic, subdued, and attentive. Margaret, however, remained disappointed, which challenged John’s interpretation of the encounter and his legitimacy as a counselor. John grew slightly anxious and embarrassed. Noting the queue outside, he gave Margaret her biweekly supply of haloperidol and sent her away. Once she left the tent, John regained his sense of poise. He quickly moved on to the next client, and we both let the disjunctive moment pass. Margaret’s case was indicative of the challenges Liberian Psych Team workers faced in striking a healthy balance between community-based psychoeducation, talk therapy, and pharmaceutical treatment. Sante´ Humanitaire Psych Team members’ efforts to offer counseling were, at times, wandering and confused. Clinical interactions between patient and caregivers around Open Mole could be quite discordant, and efforts to empower Liberian Psych Team members were often in conflict with their ability to

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make diagnoses and prescribe medications accurately, and with the NGO’s ability to offer a first rate standard of treatment. Even so, Margaret indicated that she had found meaning in the interaction, and felt that she was being helped. She had been seen, she had been heard, she had been treated, and she intended to return. She wanted to be well, and she wanted the prescription medications that the doctors had prescribed to work. Despite the limitations of the encounter, she was satisfied. Case Study 2: Gorpu

My sole encounter with Gorpu occurred when she came to Sante´ Humanitaire’s psychiatric clinic in Gbarnga in November 2006 to renew her prescription for Open Mole. Gorpu was an older woman with a deep, quiet demeanor and a fearless, straightforward expression. She didn’t smile or chat and instead sat quietly, with a stern expression on her face, waiting for the Psych Team to ask her questions. Gorpu first experienced Open Mole in 1994, when she lost one of her twins during a difficult delivery. Soon after, in 1995, her mother and sister were killed in the war, and she was left with eight living children. Her Open Mole worsened. She began to experience sadness and a fast heartbeat, but it was her constant crying that led to severe headaches, difficulty sleeping, and poor concentration. She lost weight, grew weak, and heard voices no one else could hear, which made her afraid. Then Gorpu began to isolate herself. She stopped talking to friends, family, and neighbors and spent long hours sitting alone in crowded areas. She worried constantly. Prior to her Sante´ Humanitaire diagnosis of Open Mole—Severe Depression Type, Gorpu had sought help from herbalists and traditional healers, all of whom applied the typical paste of roots and leaves to the top of her head. After twelve years of experimentation, Gorpu reported that traditional medicine was sometimes able to ease the pain, but ‘‘it could not finish the Open Mole.’’ Having given up hope in traditional medicine, she sought help from Sante´ Humanitaire. Under the Psych Team’s care, Gorpu was on a daily regimen of 20 milligrams of the antidepressant paroxetine. In her brief clinical interview, she was asked if the paroxetine was giving her any relief. She reported that it helped her sleep better. The Psych Team spent less than five minutes trying to draw her out in conversation, and asked her about the troubles in her life. They emphasized to her that her problems could be resolved through talking, rather than pills, and they encouraged her to share. She skillfully evaded their questions with a fixed

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gaze and solemn silence, and indicated through her posture and demeanor that she wished to leave as quickly as possible. The Psych Team workers gave her the pills, and she left. On the day I observed Gorpu’s interview, the Sante´ Humanitaire Psych Team was inundated with over two hundred patients seeking mental health treatment, of whom many were first-time patients, and complained of Open Mole. The Psych Team recognized the limitations of their roles as clinical care providers, cultural interpreters, and Liberian staff in an expatriate organization. With limited time and an ever-growing patient load, the team changed diagnoses and issued psychiatric treatments on an ad hoc basis in an effort to ‘‘do something’’ to help the sufferer as rapidly as possible. Liberian mental health workers, like their expatriate managers, were often swayed by the ‘‘tyranny of the urgent,’’ or a perception that their work was conducted in an environment of crisis or emergency. This perception often defused their latent critiques of their own work practices, and they often affirmed that ‘‘good enough’’ interventions were necessary and sufficient. During the early postwar period, Sante´ Humanitaire’s Open Mole patients learned strategies for gaming the treatment system in order to access potent psychiatric medications, in search of a permanent cure for their various forms of distress. With persistence, patients like Gorpu were able to compel the Psych Team to set aside their aspirations for counselingbased mental health care, to modify diagnoses to address patients’ medication goals, and to adhere to a transactional relationship in which prescribed narratives were given and medications were received. As a result, the Open Mole treatment paradigm succeeded in achieving a certain degree of cultural competency by playing upon locally significant culture-bound syndromes but failed to recognize the local value of Western pharmaceuticals as a highly desirable commodity that local residents would pursue through an array of more or less legitimate means. Case Study 3: Hawa

In a rural village with a Sante´ Humanitaire health clinic, Hawa, a petite, elderly woman, entered the Psych Team consultation office for her first visit. Once she was seated, she started to cry. Speaking in rapid Kpelle, with tears streaming down her cheeks, she told us that she first experienced Open Mole during the 1994 war, when she lived in a village just outside Ganta. Her village was one of Taylor’s National Patriotic Front of Liberia

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(NPFL) strongholds, and as a result, it was a constant target for peacekeepers from the Economic Community Monitoring Group (ECOMOG). In those years, jets flew over her village and strafed the area below with bombs and bullets. Hawa said that every time the jets flew overhead, she became afraid. She started to develop Open Mole and couldn’t sleep. Under the perpetual air raids, her Open Mole grew worse. Since 1994, Hawa reported to the Psych Team nurse that she had tried many, many (her emphasis) kinds of herbalist treatments, none of which proved effective. When she took her problems to clinics and hospitals, they diagnosed her symptoms of weakness, heat in the body, headache, and insomnia as typhoid. She was treated for typhoid, but it did not cure her Open Mole. The Psych Team nurse listened patiently and then told her that they would not give her any medication this day or during her next two visits because these visits were for talking (and observation). She also told Hawa that if she continued to return, she would likely receive a diagnosis (their records suggested Open Mole—PTSD) and some medicine if they thought it was appropriate. Again, they emphasized the importance of counseling. Hawa was disappointed that she had come all this way, and had failed to obtain medicine that would cure her ills. She did not know that if she was persistent, she was likely to be placed on a medication regimen within the next few visits, and that counseling would largely disappear from the clinical encounters. As noted earlier, Psych Team members privately acknowledged that as the number of Open Mole cases continued to rise, their ability to provide counseling was limited by demands upon their time, and clinical visits were growing shorter and shorter. Like Hawa, hundreds of Liberians sought effective resolution of their symptoms of suffering, and were far less concerned with clinicians’ priorities for the therapeutic process. Through Open Mole, dozens of men and women found medical entre´e into postconflict trauma healing and psychosocial transformation. Before Sante´ Humanitaire integrated Open Mole into its recruitment and diagnostic strategies, many Open Mole sufferers did not consider the clinic a site for resolving mental health issues. But after the introduction of Open Mole and the expansion of Sante´ Humanitaire’s widespread mental health education efforts, the clinic became the next stop in long careers of medication-seeking behaviors that ranged from ‘‘country herbs or country medicine’’ to Chinese and Indian medicines sold in markets, to psychiatric drugs, to narcotics, marijuana, and alcohol.

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A common observation among Liberians is that Liberians will take any pill so long as they believe it is curative, because all pills heal. Medical NGOs in humanitarian crises have tended to avoid analysing cultures of medicine, while attending to the more exotic and esoteric. As a result, NGOs paid close attention to local reports of Open Mole syndromes, but ignored local attitudes regarding the uncritical desirability of Western medicines. Furthermore, it would have served the NGO well to note that the members of the Psych Team were Liberians as well and, to a certain degree, shared their patients’ beliefs in the curative powers and in the magical properties of Western medications. They also shared the sentiment that ‘‘doing something’’ with whatever medication was on hand was superior to taking no action whatsoever. In the words of one Psych Team member, the team hoped that the psychiatric medications might ‘‘at least do something for these poor people.’’ Both sufferers and healers were committed to ‘‘getting help’’ and ‘‘giving help’’ and were engaged in a mutually reinforcing, interlocked relationship of claim, appeal, and assistance. At the heart of the encounter was a plea for help and for medication to ease suffering in the liminal moment of postconflict transition. In this sense, psychiatric medication was a communicative pathway through which the ‘‘will to be normal’’ was expressed.

Psychosocialization Goes on a Road Trip Across Liberia, the postwar message that ‘‘the war is over, help is here, and you have to forgive and forget’’ echoed throughout psychiatric care, trauma healing, and psychosocial interventions. These messaging efforts regularly spilled out of clinics and humanitarian projects, into Liberian psychosocial workers’ routine interactions in everyday life. In these engagements, Liberian NGO workers expressed a sense of personal responsibility for the transformation of the nation. In their daily encounters with family members, neighbors, and strangers, they often presented themselves as moral missionaries pursuing the production of peace. As the narrative below demonstrates, psychosocial workers seized informal opportunities to exhort Liberian youth to ‘‘correct themselves’’ so that the country would not return to violence or war and to expel war and evil from within their hearts. Outside of the counseling encounters offered inside NGO projects, they

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were zealous about producing peace and rejecting war, and they sought to enforce their postwar ideals through person-to-person encounters, in the hopes that the sum total of their efforts would have a societal impact. They also felt responsible for rooting out individuals’ tendencies to revert to violence, and they fought hard, in direct communication, to establish postwar norms that would enabled an environment of social order. Notably, the dialogues that ensued from their efforts were often tense, intrusive, strongly biased, and unwelcome. Unlike expatriates, who tended to focus on trauma narratives and postwar recovery ambitions, Liberian psychosocial workers assessed personal disorder by studying one’s integration into society, including his economic productivity, her personal presentation and comportment, his management of self-identity and self-promotion, or her ability to care for herself and others. While NGO officers focused on the language of healing, confession, and forgiveness, Liberian NGO workers repeated the mantra that Liberians needed to ‘‘engage in the peace process’’ by correcting their social and behavioral dispositions. NGO workers were self-empowered to preach their ministries of postwar transformation, and they wielded sharp moral axes against the visible roots of the remnants of dispositions violence. On a hot afternoon in 2006, I stepped down from a beat-up white Land Rover somewhere between Bong and Lofa counties. The team and I were returning to Monrovia after a week of human rights and gender-based violence (GBV) training sessions, and we were all weary, dusty, and eager for a shower. Our tire had blown out, and the red laterite road ran on as far as the eye could see, marking a long road home. We stopped in front of a tiny shack with a torn black rubber tire hanging from a nail on a post to get the car repaired. I was traveling with the LWF/WS protection unit mentioned earlier, which carried out GBV, human rights, and child protection training in communities across Liberia. Koli and his brother emerged from the shack, and my Liberian peers talked with Koli while his brother, the tire repairman, worked on our car. We ate oranges under a majestically tall cottonwood tree, and he told us his life story, starting with the promise he made on his grandmother’s deathbed to never cut down the cottonwood tree. His grandmother, knowing of her neighbor’s distrust of all cottonwood trees (commonly thought to be a late-night gathering place for witches), made Koli swear on her deathbed that he would never cut down the tree, no matter how much he was pressured by his neighbors. Koli promised, and

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he noted with pride that he had kept his promise to his grandmother. The tree was special and important, and it had somehow, miraculously, survived the war despite its proximity to ongoing battles. Koli was small, thin, and young, and was wrapped in a ski jacket and ski cap in 90⬚F heat. After the team and he had exchanged introductions, pleasantries were set aside, and he submitted himself to the psychosocial workers’ rapid fire questioning. They asked about the farm, his wife and children, his brother, and the cottonwood tree, and they asked him about his involvement with witches. Then the questioning accelerated, as though the psychosocial workers were in pursuit of something, with the usually reserved Ama taking the lead. ‘‘Where were you during the war? Don’t lie, because we will know. What were you doing during the war? You were fighting for LURD [Liberians United for Reconciliation and Democracy], weren’t you?’’ Koli replied, ‘‘Sister, I cannot tell a lie. They came here and killed my brother, and he was like a father to me. I saw the bullet go right through him, and then he just fell down. I was so angry, I just wanted to GET those people. The only thing I could think about was going to hold gun. So, I cannot tell a lie to you my sister, because I can see you are fine people. I was a fighter.’’ Ama answered, ‘‘You are still with those people. We can see, you still want to go back and fight. What will you do if Charles Taylor comes round here and offers you money, offers you this and that, to take you back to hold gun? You will go.’’ Koli, in a contrite voice, said, ‘‘Sister, I swear to you that I will not. I am done with all that. You would not believe the things I have seen. But I swear to God, I am done with holding gun.’’ Ama, disbelieving, pressed him. ‘‘You will go. Why do you say you won’t go?’’ Koli replied, ‘‘Sister, I went through the program [DDRR], and I knew it was all done when they cut my dreadlocks. Before that, I did not believe it was over. I thought we would give in our guns and get money, and then they would leave and we would fight again. But when they came and cut my dreadlocks off, I knew that the war was over. Now, I cannot go back to doing such things. I have two children [ten months old and two years old] and I will not go back and fight again. I am done with all that.’’ Paul, a tall, young engineer and former Armed Forces of Liberia (AFL) soldier volunteering for the week on the LWF/WS team, chimed in, ‘‘You

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saw many things as a fighter. You took medicine [war medicine, including antibullet inoculations, totems, and taboos (Ellis 1999)], you held a gun, and you raped women.’’ Koli turned to Ama and appealed, ‘‘Sister, I swear to you, I never raped a woman. I killed plenty of people, but I never raped anyone. It was the law of my country medicine—if I was loving to a woman, it would not work. Like for some, if they ate pumpkin, their medicine would not work. So I could never rape a woman. Never.’’ Ama and Paul, appeased by the logic of country medicine, moved on to the next phase of their interrogation: Koli’s present and future. They asked him how he was making a living and how he was supporting his family. In effect, they were saying, ‘‘You are stealing, you are in a gang, you are doing drugs.’’ Koli swore, ‘‘No, sister. I am farming. I am here with my wife, my brother, and my children. I am a good man now.’’ Paul and Ama, looking around, asked what crops he farmed. Koli replied, ‘‘Cassava, potato greens, and some fruit. But I beg you, my brother, it isn’t going well. No money for pesticides. Please. Can you give some assistance?’’ Paul challenged him, asking, ‘‘Why aren’t you farming orange trees? You don’t need to go buy that pesticide in the market! That costs plenty of money! Didn’t they teach you to make pesticide with ash and soap in the classes? You were sleeping, you weren’t paying attention.’’ Koli sheepishly replied, ‘‘Ah, yes. I think I remember. They did teach us something like that.’’ They ganged up again. ‘‘Go learn how to do that. You have beautiful land, and you can be rich, if you are not bad and lazy. You are still doing drugs. It’s clear. You still have bad left in you. You have to stop smoking marijuana. You will stop.’’ Koli, embarrassed, admitted that he still smoked marijuana, but he insisted that he was not a bad man. Paul and Ama, both briefly employed as psychosocial workers during the DDRR process, would not be persuaded or appeased. Holding onto marijuana meant that Koli was holding onto antisocial and potentially violent attributes of the combatant persona. They insisted that he would never come to anything if he continued to smoke, that he would be driven back into a life of violence and crime and would abandon his family, ultimately losing his soul.

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Koli was hounded into solemnity and seemed to absorb their counsel while he retreated into himself for a moment. The entire encounter had required an extraordinary degree of frankness and honesty on his part and had been conducted under terms of assaultive interrogation, fundamentally contrary to nearly all conventions about acceptance and compassion in counseling practice. Then Koli, hanging his head, whispered in Ama’s direction. ‘‘Sister, I am talking to you today because Jesus cannot come down from heaven to talk to me, but he can send people like you to talk to me. Jesus cannot come himself, but he can send you to give me his words. I will think about what you have said, my brother and sister. Tonight, before I go to bed, and tomorrow night, I will think about what you have said, and I will pray, and I will seriously consider it.’’ At that moment, I understood that interactions like these were being replicated thousands of times a day across the country, between social strata, and in every part of public and private life. It seemed quite clear to me that Paul and Ama were battling the human legacies of war as much as CVT and Sante´ Humanitaire were. Drawing on cues that I couldn’t recognize, they knew that Koli had some past issues lingering beneath the surface, and they sought a complete renouncement of violent war subjectivities and a full-throated adoption of postconflict peace subjectivity. In urging his psychosocial transformation, Koli, for his part, was already sensitized to this form of interaction through the exhortations of DDRR personnel, family, friends, and strangers and knew how to submit himself to the moral evaluation of others for consideration, appraisal, and correction.

Chapter 5

The GBV Proxy

Rape is Wrong (that’s right)! Rape is a Crime! . . . Raping anybody is wrong! If it happens, take it to the police! If you rape, you will go to jail. If you rape, you will go to jail. Don’t send your child out when it’s late. Don’t force your child to tutu party for them. Don’t send your child out where people do the bad things, so nobody can rape them. If you force anybody and rape them, that’s straight to jail. You will go to jail. And when a person tries to not make you to rape them, that’s straight to jail. You will go to jail. You will stay plenty years of time. So y’all who like to do the plenty bad bad things, Stop rape. Stop rape now! —Popular UNMIL radio jingle, 2003–present

In many ways, GBV projects in Liberia were unlike the programs described in the last chapter, which explicitly targeted mental health, trauma healing, or psychosocial rehabilitation. Although both classes of humanitarian aid activities shared ‘‘technologies of the self’’ like individual counseling, support groups, and community-based education initiatives, GBV interventions contrasted sharply with the disorganized polymorphism of psychosocial intervention. First, GBV interventions were highly efficient, coordinated, and well funded. They tended to support large, highly trained Liberian national staffs who were carefully monitored by experienced

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expatriate managers. Second, GBV operations were effective: they were active, mobile, well documented, and bureaucratically transparent. Third, GBV programs worked in coordination with each other under the authority of the Ministry of Gender. Under its auspices, a multi-agency advocacy effort emerged that was able to effectively advocate clear, discursively coherent political, legal, and social messages about GBV and its prevention, legislation, and criminal enforcement. As a result, GBV was a politically powerful force in postconflict life. As noted earlier, during my research in Liberia I conducted an institutional inventory of mental health, trauma-healing, and psychosocial interventions in Liberia’s humanitarian space. Time and again, my efforts to do so were frustrated by an inability to match NGO public reports of psychosocial work with those NGOs’ real-time activities. When I conducted interviews with the leadership of several dozen NGOs, I was frequently referred to their organizations’ GBV interventions. Soon I came to think of these efforts to redirect attention to GBV and away from mental health and psychosocial interventions as the ‘‘GBV Proxy,’’ which I came to recognize as a meaningful ethnographic fact. When other psychosocial programs had disappeared because of funding shortfalls or shifting priorities, GBV services continued to hold a prominent place in humanitarian assistance. Although mental health legislation stalled at the drafting stages, important GBV legislation was passed almost immediately. While trauma-healing programs experienced internal battles over transportation, housing, and salaries, GBV programs were able to visit and build relationships with dozens of communities across the interior of Liberia and sustain those connections through visits every few weeks or months. At a time when there were almost no effective police or judicial systems in place to contain armed violence, international monitors made weekly visits to local police stations to educate officers on the ethics and practice of confidential interviewing and referral in reported rape and domestic violence cases. In this book, GBV interventions function as a humanitarian foil to mental health, trauma-healing, and psychosocial interventions. By looking at the strength of GBV programs, in contrast to the weakness of mental health, trauma-healing, and psychosocial programs, it is possible to sketch out a diagnostic of power in postconflict humanitarian aid (Abu-Lughod 1990). This gives rise to a new range of ethnographic questions. What were GBV interventions? What was the relationship between humanitarian understandings of GBV and the interventions they delivered? How did GBV

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Figure 4. ‘‘Raped?!’’ Monrovia billboard. Photo by author.

interventions resonate with the postconflict experience of Liberian men, women, and children, and how were they received at the community level? What was the context for the postwar naturalization of GBV as a category of humanitarian meaning?

The Gendering of Violence The violence against women that took place during the Liberian Civil War emerged because of the social destabilization and culture of impunity that surrounded the conflict. During and after the war, Liberian girls and women reported being more vulnerable to sexual harassment, assault, and murder by armed militants, as well as by household members, neighbors, and community leaders. Families often put out daughters for sex work in order to access food, money, or favors; women who had been displaced from families or whose families had been killed subordinated themselves to ‘‘loving’’ relationships and servitude arrangements to stay alive. Statistics lend some insight into the pervasiveness of gender-based violence during the war. One of the first studies on GBV in the Liberian conflict found that 50 percent of respondents reported having been raped (Swiss et al. 1998; Jennings and Swiss 2000). Several years later, in 2004, a study conducted by the WHO found that 78 percent of female respondents reported having been raped and that 50 percent of male and female respondents said they had been forced to watch someone else get raped. In addition, 30 percent of female respondents reported that they had been compelled to have sex in order to obtain items necessary for survival (Omanyondo and WHO 2004). A 2008 study found that approximately 42

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percent of female ex-combatants reported at least one incidence of rape in their lifetime; among noncombatant women, this figure was 9 percent (Johnson et al. 2008). Although the integrity of statistical reports on rape emerging from postconflict African contexts can be challenged (see Palermo and Peterman 2011), these rates were indicative of an environment of profound physical insecurity for men and women. Given the highly public character of GBV in Liberia, sexual violence could not remain secret. During the war, the prevalence of rape, ‘‘girlfriending,’’ bush wives, cooks, and sexual enslavement was as well-known (Coulter 2009) as the individuals involved in the acts. In life history interviews, women from every social stratum of Liberian society shared with me unsolicited narratives of rape and abuse by parents, boyfriends, and husbands; and they did so much more openly than I had anticipated. Evidently, the issue of wartime rape is much less a collective secret than researchers often assume is the case. Instead, GBV is, at times, presented as a shared, though painful, site of experience—albeit one that continues to be socially stigmatized (see Boehm 2006). However, to Liberian men and women, the concept of ‘‘gendered violence’’ meant more than wartime rape, domestic violence, or sexual and physical enslavement. Liberians were concerned with the ways that wartime experiences of loss were gendered (as when Agnes lost her sister in childbirth while running away from the war) and with how men and women were tortured or killed in gendered ways (as when men were forced to rape family members or watch their mothers, wives, or daughters being raped and murdered). One story, repeated so often it had the status of a parable, described how soldiers or rebels at roadblocks forced pregnant women to lie down across the road at gunpoint. The combatants, who were usually described as high on drugs, took bets on the sex of the fetus and then cut open the woman’s belly and pulled the baby out. The child was killed, and the mother was either killed or left to die. This, for Liberians, was a paradigmatic example of ‘‘gender-based violence,’’ and in postwar telling, it assumed mythic proportions. Everyone reported knowing that it had happened, having seen it happen, or knowing someone who had seen it happen, and the story was often among the first told by Liberians in describing the horrors of war. After the war ended, some of the most egregious forms of gender-based violence came to a halt, but other kinds of violence took their place. Liberian women revived local romantic ideals that ‘‘beating is a sign of love,’’

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which suggested that men who didn’t beat, threaten, or order around their girlfriends or wives were sleeping around. Ex-combatant women endured domestic violence and ritual humiliation by boyfriends, neighbors, and family and were subjected to extreme social censure. Prostitution was widespread; money and goods were exchanged for sex with such frequency that it was simply considered an integral part of meeting, dating, and keeping a woman.1 What the international community calls ‘‘harmful traditional practices’’—witchcraft ordeals and female circumcision—resurged across the country as communities attempted to revive secret Poro and Sande traditional societies. Moreover, for reasons that have been little understood or explored, postwar sexual violence against children became rampant. One nurse for a prominent medical NGO reported that each day at least ten children under the age of twelve came in to her central Monrovia hospital with signs of severe physical trauma resulting from rape. Feminist scholars who have studied this issue believe that during wars, violence helps to dismantle women’s economic, social, and political capital, which diminishes political resistance. After conflicts, however, violence against women may increase, rather than decrease, but assume different forms, as men seek to reinsert themselves into domestic economies and politics (Meintjes, Pillay, and Turshen 2001). This trend can be observed in Liberia. During the war, women fought as soldiers, participated in politics, held key government posts, and led social movements. Women held families together by deciding whether sons could enter the war, controlling the labor of sons and relatives they kept out of the war, and sustaining families in refugee and IDP camps (Moran 2012). Women were the economic lifeblood of ordinary Liberian families excluded from wartime economies who helped keep their families alive by working for NGOs, running trade routes, or working in other countries. They also sustained cultural continuity by passing on tradition, by assuming the roles of traditional healers, doctors, and midwives, and by keeping churches alive and thriving. They shared food and housing; and they often shared a sense of wartime camaraderie. Other scholars like Cynthia Enloe (2000) believe that men, habituated to hypermasculine gender roles in militant contexts, bring home their cultures of hypermasculinity after they leave the battlefield. My own research suggests that both arguments have merit. The gendered violence of the postconflict moment was an artifact of war culture, but it was not

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identical to the kinds of gendered violence found during the war. Gendered habits of violence persisted into the routinized patterns of daily life when the war ended, but they changed form. Therefore, combatting postwar forms of gendered violence involved a process of psychosocial renormalization that was consistent with the renegotiation of postwar identities. As Coulter (2009) has described for Sierra Leone, some Liberian women continued to live with the ‘‘captains’’ who abducted them during the conflict and even formally married them. This was not necessarily a case of continued victimization or Stockholm syndrome, as some GBV activists have suggested. Instead, it indicated that men and women were passing through a process of renormalization in which wartime relationships of violence took on new postwar meanings and interpretations. In order to understand how violence played into this dynamic of renormalization, violence needs to be dethroned from the status of culture and reconsidered as an expression of habit. In the last two decades, anthropologists (see Scheper-Hughes and Bourgois 2004; Hinton 2002) have tended to interpret violence as an agentic force rather than as an action. Violence has been ascribed powerful cultural properties, and it has also been characterized as a mode of ‘‘anti-culture’’ (Daniel 1996), as anti-language (Scarry 1985), and as a destroyer of worlds of meaning. While these reinterpretations of violence have helped to reconceptualize the relationship between culture and violence, it is important to recall that at its foundation, violence is still fundamentally a social action, and not a social actor. Violence does not ‘‘do’’ things. People engage in violent acts to create effects. Violence works to create spaces of disrecognition, but it cannot do so in the absence of human agency. By recalling that violence is a social action, it is possible to reinterpret violence as a cultural phenomenon or as patterns of habits with little historical and semiotic depth. Certain kinds of violence can have deep cultural foundations, such as religiously sanctioned warfare (jihad), bodily selfsacrifice (kamikaze), ritual scarification, and even institutionally sanctioned corporal punishment in education systems. But recurring forms of social action do not in themselves constitute cultures of violence. Culture connotes the circulation of moral, social, and symbolic goods through recurring practices. The presence of recurring forms of violence within cultures does not mean that those forms of violence are sanctioned or carry moral, social, or symbolic goods.

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This distinction is important because it has implications for how we understand the legal and societal contexts of gender-based violence in postwar contexts. The gender-based violence of the postwar period cannot easily be ascribed to cultural frames like patriarchy and militarism or to historical processes like socioeconomic and political transitions. Instead, GBV seems to be occurring because of changes that have taken place in Liberian cultural space that have resulted in the disappearance or destruction of spaces of gendered social protections; and the creation of spaces of impunity for the commission of gendered violent actions, against prevailing norms. When habit and culture are discordant, even in matters like the use of violence, we confront the norm/norm paradox discussed earlier in the book, a situation in which habit has come to trump the link that binds together moral experience and social practice.

The Status of Law Postwar humanitarian intervention was shaped, in part, by a revolution in global feminist activism on issues of gender violence, gendered political representation, and gender equity. At high-profile events like the 1993 UN Declaration on the Elimination of Violence Against Women, the 1993 UN World Conference on Human Rights in Vienna, and the 1995 Beijing Fourth World Conference on Women, gender justice was elevated to a global priority in international humanitarian and development assistance. After years of fighting, third-world feminists had succeeded in shifting global feminism’s concern away from the culturally exotic (female circumcision, polygamy) and toward everyday, routinized forms of violence, including economic vulnerability, limited access to education, and rape and domestic violence. Gender violence was now clearly understood to be a critical global health issue, a major impediment to economic development, and a needed focus for democratic reform. When, in 1997, the International Criminal Court recognized rape as a weapon of war in Bosnia (and later in Rwanda), the decision created an international precedent for funding medical and mental health treatment and economic assistance programs to rape victims in postwar humanitarian contexts. Soon GBV programming and gender-focused human rights activities could be found in peacekeeping interventions in Bosnia, Kosovo, and

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Haiti and in development interventions from Bangladesh to Brazil. In the United States, donor institutions like USAID, research agencies like the Center for Disease Control, and a host of human rights NGOs identified GBV as a priority while internationally, donor institutions like the UK’s Department for International Development (DFID), the European Community Humanitarian Office (ECHO), Germany’s Deutsche Gesellschaft fu¨r Internationale Zusammenarbeit (GTZ), and the Norwegian and Dutch governments allocated funds to combat GBV in postwar contexts. In 2001, the UN Security Council approved Resolution 1325, which created a global mandate for intervention in gender-based violence during peacekeeping operations and postconflict reconstruction. Mazurana et al. summarized Resolution 1325: Security Council Resolution 1325 reiterates the importance of bringing gender perspectives to the center of attention in all United Nations conflict prevention and resolution, peace-building, peacekeeping, rehabilitation, and reconstruction efforts. It calls for increased representation of women, particularly at decision-making levels, increased consultation with women, and attention to the special needs of women and girls. . . . It emphasizes the respect for the human rights of women and girls, the need to draw attention to violence against women and girls, and calls for an end to impunity and the prosecution of those responsible for crimes related to sexual and other violence against women and girls. The resolution furthermore requests that the United Nations incorporate gender perspectives in negotiation and implementation of peace agreements, in peacekeeping operations, in refugee camps, and in disarmament, demobilization, and rehabilitation initiatives. It asks the Security Council itself to ensure that Security Council missions take gender considerations into account, including through consultation with women’s organizations. It specifically calls upon member states to increase voluntary financial, technical, and logistical support to gender-sensitive training efforts and to incorporate gender perspectives in national training programs. The resolution requests that the secretary-general include progress in gender mainstreaming in reporting on peacekeeping missions. It also requests that he provide member states with training guidelines and materials on the protection, rights, and needs of women and girls and invite member states

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to make use of these materials, as well as HIV/AIDS awareness training. It asks the secretary-general to ensure that civilian personnel of peacekeeping operations receive similar training. Finally, the resolution asks the secretary-general to prepare a study and report on the impact of armed conflict on women and girls, the role of women in peace building, and the gender dimensions of peace processes and conflict resolution. (Mazurana 2005, 16) Resolution 1325 provided the legal justification for the integration of GBV concerns into military peacekeeping activities in Liberia, as well as a mission for internationally sponsored GBV humanitarian assistance programs. The scope of humanitarian aid activities was further framed by an emerging consensus around the definition of gender-based violence (see Abramowitz and Moran 2012; IASC 2005). Gender-based Violence is an umbrella term for any harmful act that is perpetrated against a person’s will, and that is based on socially ascribed (gender) differences between males and females. Acts of GBV violate a number of universal human rights protected by international instruments and conventions. Many—but not all— forms of GBV are illegal and criminal acts in national laws and policies. Around the world, GBV has a greater impact on women and girls than on men and boys. The term ‘‘gender-based violence’’ is often used interchangeably with the term ‘‘violence against women.’’ The term ‘‘gender-based violence’’ highlights the gender dimension of these types of acts; in other words, the relationship between females’ subordinate status in society and their increased vulnerability to violence. It is important to note, however, that men and boys may also be victims of gender-based violence, especially sexual violence. The nature and extent of specific types of GBV vary across cultures, countries, and regions. Examples include: 1. Sexual violence, including sexual exploitation/abuse and forced prostitution 2. Domestic violence 3. Trafficking 4. Forced/early marriage 5. Harmful traditional practices such as female genital mutilation, honor killings, widow inheritance, and others. (IASC 2005, 7)

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In addition, in Liberia, a perfect storm of factors collided to facilitate the emergence of the gender issue as a privileged area of concern. In 2003, the UN High Commission for Refugees (UNHCR) came under international criticism after the NGO Save the Children published a report revealing the widespread sexual exploitation of Liberian and Sierra Leonean women and children in Guinean refugee camps, where sex was parlayed for food and supplies (Ni Chonghaile 2002). Concurrently, peacekeepers in the Congo, Haiti, and Bosnia had come under attack for raping, pimping, and sexually enslaving local women. The international community was under pressure to show that they could do peacekeeping right in Liberia and to show that they could do it in a gender-sensitive way. At the same time, the international community aligned itself with an increasingly powerful Liberian women’s peace movement to demand that the National Transitional Government of Liberia (NTGL) enact gendersensitive legal reforms. In October 2003, the Liberian legislature was pressured into passing an inheritance law, titled An Act to Govern the Devolution of Estates and Establish Rights of Inheritance for Spouses of Both Statutory and Customary Marriages, to extend property and child custody rights for women. The inheritance law changed legal codes regarding the customary rights of women to inherited properties and lands and restored legal protections involved in the transmission of properties to women. The goal of the inheritance law was to interrupt a cycle in which Liberian women were regarded as familial property. It was meant to strengthen women’s economic position within their families, codify economic equality between men and women, and enable women to act as strategic economic actors and as the heads of families. However, the inheritance law has been rendered ineffective by ignorance of the law as well as ongoing confusion about which legal codes are legitimate in the postconflict moment. Contra expectations, Liberian women experienced an expansion of political and economic roles once the war ended (Fuest 2008). In 2005 Ellen Johnson Sirleaf, a Harvard-trained economist and former World Bank official, was elected to the Liberian presidency, becoming the first female president in Africa’s history. Sirleaf’s election was treated as a historic watershed for women in Liberia. During her campaign, Sirleaf presented herself as the candidate best able to garner international support for Liberia’s fragile reconstruction, to sustain support for a prolonged international peacekeeping force, and to shepherd the country through its multitude of fiscal, infrastructural, and development crises.

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But Sirleaf also ran a campaign based on gender. In the months preceding her election, Liberian women supporting Sirleaf argued, ‘‘We have seen what men can do to ruin this country, now let us give it to a woman to see if she can do something different.’’ During her campaign she promised to pass legislation that would criminalize rape and to take action on female genital mutilation and other violence against women. Rumors circulated that Sirleaf herself had been a victim of gender violence during the war and that she had survived imprisonment at Bella Yella, one of the most feared fortified prisons in Liberia. Her nickname was ‘‘The Iron Lady,’’ and people joked that ‘‘Ellen was so tough, she wore iron underpants.’’ ‘‘Ellen’s’’ powerful presence was felt throughout the postconflict scene after her election in 2005. Just months after taking office, she oversaw the passage of the ‘‘rape law,’’ officially titled An Act to Amend the New Penal Code Chapter 14 Sections 14.70 and 14.71 and to Provide for Gang Rape, which fulfilled her campaign promise to reform Liberia’s existing legal code to criminalize rape. In a radical shift from earlier practices, she nominated women to some of the highest positions in government. She supported international efforts to integrate women into security sector reform and appointed women to leadership positions in the Liberia National Police (LNP) and in the Armed Forces of Liberia (AFL), which were being reorganized, reengineered, and retrained by UNMIL. In doing so, Sirleaf’s administration, with UNMIL, set Liberia’s postconflict recovery apart from the gender trajectories of other postwar countries. In addition, the international community adored her and gladly helped her discursively adopt many global gender innovations as her own. Although Liberia’s rape law has been criticized for its failure to criminalize marital rape, for confusing legal and criminal processes, and for lacking enforcement capabilities, its enactment created an important symbolic and discursive break with the past. Culturally, Liberians sensed a shift in the limits of tolerance for pervasive everyday violence. Consider the following incident, drawn from my field notes: Late one night in 2005, I smoked a cigarette with two guards on the porch of an NGO guesthouse in Monrovia and kept company with them while they teased each other. As one guard, Abdullai, continued his joking, his coworker Paul grew quiet, angry, and embarrassed. Paul had gotten in trouble with

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their boss because he hadn’t come to work the previous night. Abdullai knew why, and I did not. At Abdullai’s prompting, I asked Paul why he had been unable to come to work. Paul, still embarrassed, reported that he and his girlfriend had quarreled the previous night and he had hit her. Immediately his girlfriend ‘‘called GBV on me.’’ His girlfriend had run to the UNMIL police, told them that her boyfriend was beating her, and he had spent the night in jail. Abduallai howled with laughter. Then he scolded Paul. ‘‘You can’t do this beating women business anymore, man. It’s a new world now. These women, if you beat them, they will just go call GBV on you.’’ Paul responded that it was his right as a man to beat his woman if she got out of line. He asked Abdullai to tell him how he was supposed to maintain control over his two wives if he couldn’t beat them every once in a while. Abdullai lectured Paul. He argued that Paul, a poor nineteenyear-old, had no business having two ‘‘wives,’’ several children, and no education and that he would no longer be able to beat everyone to keep them in line. He emphasized to Paul, ‘‘You better get serious and change your thinking because these women, they can just call gender on anybody now.’’ This incident, while humorous in some respects, reveals a fundamental shift in attitudes toward the legal and cultural acceptability of domestic violence during the postwar transition. Men complained when the new ‘‘rape law’’ was passed because they couldn’t beat their girlfriends anymore or they would ‘‘call gender.’’ Men were also afraid that women were going to abuse their new legal rights by falsely reporting paternity, or ‘‘calling their names’’ to the police, which they feared would result in forced payroll deductions and in the forfeiture of their properties. These fears persisted: over drinks in 2012, an ambassador from Liberia insisted to me that men’s rights needed to be protected through DNA-based paternity testing. Women, too, were skeptical about the rape law, but their focus was on the failed justice system. Their concerns were justified. In November 2007, a UNMIL Situation Report identified the failure to try cases of genderbased violence in court as ‘‘a challenge to the rule of law and the protection

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of fundamental human rights’’ in postwar Liberia. It stated, ‘‘The failure of the state to prosecute impacted negatively on the rights of women and girls to equal protection afforded by the law (IRIN 2008).’’ These critiques led gender advocates like the Ministry of Gender, the Association of Female Lawyers of Liberia (AFELL), UNICEF, and various NGOs to advocate for the establishment of a court to prosecute rape crimes in Liberia. The new rape court was meant to expedite GBV prosecutions and to bypass the dysfunctional justice system, but it was ultimately unable to successfully prosecute more than a handful of cases over several years. Even so, Liberian women regarded the inheritance law and the rape law as important achievements that recalibrated gender norms and made them safer. One woman who worked for an embassy household told me that she was confident she was safe from any man who might try to rape her: ‘‘Ellen wouldn’t allow it. There is a law, and if anyone does anything to you, you go right to the police, and they will go to jail!’’ This was particularly significant to her in light of the repeated rape, social stigma, domestic violence, and abandonment she had experienced before and during the war.

Cultures of Intervention In local and international discourse, GBV was characterized as a public health epidemic requiring population-based research and large-scale interventions (Heise et al. 1994; Heise 1994), as a barrier to economic development, as a global security challenge, and as the source of a host of other societal ills with pathological implications for the body politic. In Liberia the convergence of changing local norms with an ascendant global interest in gender-based violence interventions created a climate conducive to the creation of global-local partnerships. International NGOs saw the new situation as a chance to effect long-term gender reforms that had been beyond their reach in other postconflict environments, and they were able to draw on financing dedicated to other programs, as well as funding earmarked for GBV, and to assemble large GBV prevention and treatment initiatives, staffed by hundreds of Liberians. These programs sought to provide community education about rape and domestic violence, to offer counseling services, and to provide advocacy in legal and medical contexts. But unlike psychosocial interventions, GBV programs also sought to change the medical sector by providing material support (clinic reconstruction, rape kits)

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and by training Liberian medical professionals to deal ethically and discretely with victims of gender-based violence. They also sought to transform the legal and criminal justice systems by promoting new legislation, instigating new judicial institutions to prosecute rape, and conducting procedural trainings within Liberian courts, the LNP, and the AFL. At the highest levels, collaboration was particularly intense between humanitarian donors and the Ministry of Gender, and power, agendas, and resources were matters of intense negotiation. The international community had an important stake in creating a GBV agenda in Liberia, and as one humanitarian worker commented, ‘‘There’s a real conflict-related sexual violence obsession’’ in the international community. Donors provided a huge amount of international financing to GBV initiatives, but in order for their efforts to have credibility, donors had to ‘‘indigenize’’ GBV efforts by localizing them within Liberian institutions, like the Liberian Ministry of Gender, NGOs like AFELL, and Liberian NGOs involved with the Liberia Gender-Based Violence Task Force. These domestic institutions were, in turn, particularly adept at transforming GBV into an international branding instrument that helped them accrue concrete material, financial, and human resource assets, like restored buildings, office furniture, functioning computer equipment, Internet access, and trained policy advocates and epidemiologists. The Ministry of Gender, in particular, benefited from this arrangement. Unlike many other government ministries and NGOs operating in Liberia at the time, the bureaucratic operations at the Ministry of Gender functioned well and wielded considerable domestic and international political capital. It was, moreover, one of the best-operated and bestequipped government bodies in the early postconflict period. An exchange of human capital was an important attribute of this collaboration—international expatriates were paid to work within Ministry of Gender, and senior Liberian staff traveled abroad regularly for high-profile international meetings. But in my interviews with foreign expatriates, it was clear that expatriates’ gender influenced their perceptions of the need for GBV interventions, the causes of the GBV epidemic, and the scope of the problem. Expatriate men tended to characterize GBV as a problem that happened in the past, during the war, and described GBV interventions as means for addressing the legacies of wartime rape, sexual enslavement, and imprisonment. In contrast, expatriate women tended to describe GBV as a problem that had worsened in the aftermath of the conflict, especially in the domains of rape

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and domestic violence. When one looked beyond global humanitarian discourse, or local expatriate platitudes about causes and solutions, ‘‘the sexual violence obsession’’ of Liberia’s expatriate humanitarian community could be traced to a deep, lurking fear among female expatriate staff about their own vulnerability to sexual violence from Liberian men. In the first few years after the war ended, female expatriate NGO workers were terrified of being raped or killed by Liberian men. During the first five years of the recovery, expatriate women told me of incidents that created a shared collective experience of imminent threat that fueled the GBV initiatives they worked to implement. For example, female UNMIL peacekeepers and NGO workers reported to me that from 2003 to 2004, soldiers going through DDRR used a combination of physical aggression and sexual innuendo to intimidate them. Female UN political officers described working with Liberian legislators who also used sexual innuendo and sexual harassment to create climates of fear and intimidation in their working relationships. Women often expressed frustration over their lack of authority with Liberian men in negotiations, trainings, and project implementation efforts; and they described moments when the conflicts that resulted from their exchanges turned uncomfortable or compromised their professional goals. Lastly, female expatriates were conscious of the history of sexual violence and aggression against expatriate women in the local environment, and they quietly communicated local histories of rape and murder to each other. These stories included the 2006 case of a female NGO worker who was attacked and gang-raped at knife point on one of the busiest throughways in Monrovia, after spending a Sunday morning at the beach. She was the third NGO worker to be raped in Monrovia during a two-week period. Two years later, in 2008, a young female NGO worker was stabbed to death when she returned to her house during an armed robbery. Her story and the stories of other sexual assaults, break-ins, and stalkings became cautionary tales about the vulnerability of expatriate women in Liberian society, and they created the emotional backdrop to a local expatriate narrative of Liberian apathy to gender-based violence. This emotional narrative helped to validate an explanatory ideology of ‘‘GBV primordialism,’’ which was repeated in expatriate personal communications, NGO gray papers, and GBV research frameworks. This ideology amalgamated a racist framing of Liberian (or African) culture as intrinsically and irreversibly patriarchal, oppressive, and violent with global

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feminist and human rights principles and politics. In my interviews with leading NGO and UN officials, the ‘‘cultural/primordial origin’’ of GBV and the violence of the war often collapsed in a semantic slippage of blame for gender-based violence. Commonly heard explanations for GBV included the following: ‘‘These people only know how to use women like slaves’’; ‘‘Women were treated like possessions’’; ‘‘Tribal culture was designed to subjugate women and keep elite men in power.’’ Centuries of cultural, tribal, and religious traditions were reduced to ‘‘savagery,’’ and female circumcision was a prime example of ‘‘barbarity.’’2 The ‘‘politics of primordialism’’ (Snajdr 2007) came to light through rants and raves about male promiscuity and polygamy. Some who had read background histories of the Liberian conflict contended, ‘‘The chiefs had vested interests in sustaining the system of patriarchal gerontocracy.’’ Consequently, ‘‘they [the chiefs] had no interest in helping women’’ because ‘‘women were free labor who did their cleaning and their work and took care of the children.’’ These analyses merged with expatriate women’s experiences of fear, humiliation, and degradation and their awareness of lethal violence to entrench a justificatory ideology for most GBV activities. Although the justificatory ideology of GBV primordialism was intensely compelling, it was grounded in prejudice rather than fact. Elsewhere, Mary Moran and I have drawn upon the ethnographic and historical record to review the cultural norms across Liberian ethnic groups that have historically protected women from physical violence, sexual violence, and other forms of abuse (Abramowitz and Moran 2012). We found that historically, Liberian cultural traditions shaped local definitions of GBV and offered a robust set of gendered protections within those definitional limits. However, we also found that the social destabilization caused by the war weakened those cultural systems and traditions and have proven to be an insufficient foundation gendered protections in the postwar period. The following case, which describes the collapse of gendered protections in a northern Liberian community, helps to illustrate this argument.

Suah’s Story, or the Collapse of Gender Protections At the outset of my research into Open Mole, I expected my days to be filled with fairly rough travel to remote villages and long hours of participant

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observation in clinics, but my mornings and evenings promised quiet companionship in a UN residential compound with my friend Elizabeth. Elizabeth was often out of town, so I spent most of my time with her Liberian ‘‘family’’: her washerwoman, Marie, Marie’s eight-year-old daughter, Suah, and the night watchman (all identifying details have been altered). Suah was bright, loving, and funny, and she bounced her way through the house when she visited. Most of the time, however, Suah lived in a nearby city with caretakers while her mother worked for Elizabeth. Elizabeth had invited Marie to bring Suah to live with them several times, but Marie declined. Shortly after I arrived, Elizabeth learned that Suah’s seventeen-year-old neighbor had been caught raping Suah. During a medical examination of Suah, her mother learned that Suah had been raped repeatedly over a long period of time. Marie brought Suah to stay with us until she recovered and until an alternative arrangement could be made. Because Elizabeth traveled a good deal, she asked me to take care of Suah, but there was little I knew to do other than treat her like the little girl she was. She played with my things and stayed close to her mother, but she seemed to heal and recover and quickly regained her normal, playful demeanor. Soon the situation escalated. Elizabeth had known Suah since her arrival in Liberia, and she took a passionate interest in Suah’s rape case. She accompanied Suah to the hospital for her examination and then threatened the hospital administration with investigation by the UN human rights division when it became apparent that the hospital was trying to conceal the results of their initial examination. Suah’s mother, Marie, had tried to obtain Suah’s medical records, but she had been told that the records needed to be sent directly to the courthouse. The medical staff admonished Marie that she wasn’t allowed to know the results, and they ordered her to leave. Elizabeth then used all of the authority she carried in her position at UNMIL to force the local police to arrest the nineteen-year-old man, who was living comfortably in his neighborhood and socializing with his friends. She used her position to insist to the LNP that the boy be detained inside the jail rather than released back into the community, and she threatened to make trouble for anyone who set him free. The boy’s father, however, was a prominent Liberian employee in a large NGO, and he was eager to pay to silence the public reporting of his son’s violence. He approached Marie and attempted to pay her damages.

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He offered the sum of US$5, or Liberian $300, and requested a pardon on behalf of his son. Marie was eager to avoid a conflict with the rapist’s father and wanted to resolve the issue as quickly as possible. She was willing to accept his offer, which would have given her a bit of cash and a powerful connection within the community. The NGO worker’s son would have been freed from jail and welcomed back home. Suah would still have been at risk, but that seemed to be of little concern to almost everyone except Elizabeth. As a UN employee, a humanitarian, and a vigorous defender of human rights, she thoroughly agreed with GBV discourse that the best outcome for Suah and for the community was the prosecution and imprisonment of the perpetrator. Between the payoff, the medical records debacle, and local residents’ refusal to act as witnesses to any rapes, past or present, Elizabeth detected a cover-up. She forbade Marie from accepting the deal, referred the case to UNMIL’s Human Rights Division, and hired a well-known Liberian attorney to prosecute the case in the Liberian court system. Elizabeth went to the community where the rape had taken place to notify neighbors that a child rapist lived in the area and to seek support and evidence for the case against him. Their responses resonated with Agnes’s lament in Chapter 1. According to Elizabeth, no one denied the rape, but many people said to her, ‘‘What can we do? We have to learn how to forgive people. So forgive him.’’ Only one woman expressed concern for the child, but even she claimed that she was powerless in the situation. Suah continued to live with us, and she bounced, sang, and played with other children in the area. She helped her mother with cooking, cleaning, and drawing water, and she recited her letters and numbers under a shady mango tree, inside the bamboo fence. It was a rare treat for her to get to spend so much time with her mother. As time went on, Marie became frustrated with Suah and felt that she was becoming proud and disobedient. She became sleepless with worry about the girl’s education, and she wondered what the future held for her and Suah once Elizabeth completed her mission. While the rape case stalled in the Liberian court system, Elizabeth decided that she couldn’t live with any uncertainty regarding the little girl’s welfare, and she committed to sponsor Suah’s education at a private international school for the rest of her childhood. She moved Suah to Monrovia, where she lived with a Liberian family affiliated with the school. Elizabeth also promised Marie that

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she would find her a job in Monrovia so that she could live with Suah and meet her needs. Soon after Suah and Marie moved to Monrovia, Elizabeth received reports from Suah’s Liberian host family that Marie resented the fact that Suah was receiving an education. She complained to all who would listen that Elizabeth cared solely for Suah and not at all for Marie, and she worked poorly at her new job. When Elizabeth confronted her, Marie demanded a large cash settlement to leave Monrovia so that she could start her own business and return home to her boyfriend. Marie also began to withhold food from Suah and refused to take her to school. Suah, in turn, began to refer to Elizabeth, a foreign expatriate, as her mother, even though she had left Liberia. Finally, after several months, Marie attempted to withdraw Suah from her school, but Suah looked at her mother and swore that she would never leave. Marie and Suah’s parent-child relationship was effectively severed, and Suah now lives with a custodial family in Monrovia. Suah still visits Marie during her long summer vacations, and Marie lives with her boyfriend, while Elizabeth continues to provide for Suah’s education. The rape trial was ultimately a debacle, and the rapist went free. A particular low point of the trial involved Suah’s own attorney putting her on the stand in order to cross-examine her about her virginity and demanded to know whether or not she was promiscuous. Suah’s story reveals the collapse of social protections for women and children that would have been unthinkable just a few decades earlier. Had Suah not been ‘‘adopted’’ by a foreign expatriate, she would likely have continued to be at risk of sexual violence. But because she was ‘‘adopted’’ by an expatriate, the already thin ties that bind families together were compromised by expatriate resources and moral priorities. The violence that she experienced was the specific consequence of the permissive environment in which she lived; of apertures that had emerged in the ‘‘social fabric,’’ the cultural matrix of protection and vulnerability that constitutes regimes of basic social protections. Suah’s story reveals that violence is a consequence of a social context in which local abilities to assess guilt, balance responsibility, and enforce justice are compromised, and the social expectations surrounding fundamental social relationships— mother-daughter, law enforcement–criminal, stranger-local, community leader-community member—are in a process of contestation.

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Loupou For many Liberians, the inhumanity of their wartime experiences, their trauma, lies in experiences of abandonment, or the moments in which their families, broadly conceived, abandoned them to their fates. The specific incidences of desperate actions or violence that people passed through mattered greatly to them, but in their stories of suffering, many of my interviewees focused on the moment when their partners in survival said ‘‘Sorry’’ and left. The following narrative relates the story of Loupou, a young woman who was captured and held as a bush wife during her teenage years. She also was a refugee and later, a soldier and bodyguard for Charles Taylor, before she became a psychosocial worker for an NGO after the war. Her narrative introduces many elements of wartime and postwar gendered violence, but her points of inflection are around the collapse of social protections that created the conditions of vulnerability that made the violences possible. I interviewed Loupou in her NEPI office above Camp Johnson Road on a hot, clammy May morning, just before the onset of the rainy season. She was thirty years old, tall and graceful, dressed comfortably in a lappa and T-shirt, with her hair braided and piled high. Because of the nature of her work, she had given her life history many times. She quietly steadied herself to tell her story and gazed at me while I prepared my notebook and recorder. Loupou was born in Monrovia to an elite family, and her father was a banker. At the age of twelve, she lived at a missionary-run boarding school, but her parents were closely involved in her education and upbringing. When the war found her, she was away at school, and all of the students were sent home when word arrived that the NPFL had taken a nearby school and raped all the children. For a short time Loupou lived with her father’s family, and then the war found her again. When the rebels came to town, they hunted for her father, who, as bank manager, had the keys to the bank’s safe. In just a few weeks he fled, leaving Loupou and her family behind with no knowledge of his whereabouts. Then one day, after playing basketball with some friends, someone who knew her father informed on her to the rebels. She was kidnaped, put into the trunk of a car, carried to Nimba County, and held as a hostage.

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The NPFL soon realized that Loupou, who was about fourteen years old, was worthless to them as a hostage. She had no idea where her father was and no way to contact him, and it was evident that he wasn’t going to return for her. For more than a year she was a bush wife to a rebel commander. He took her everywhere with him—into battles, onto warplanes, and even into jail when he was imprisoned for betraying Charles Taylor. While she sat in jail with him, Loupou ‘‘was thinking, and thinking, and thinking,’’ and she felt that something had to change. Her mind and body couldn’t take life lived this way any longer. Loupou was eventually released from prison. She packed some possessions, fled the NPFL commander, and headed east toward the Coˆte d’Ivoire border. En route, she was stopped and arrested at a roadblock in Sanniquellie. During the routine checkpoint search, NPFL fighters rummaged through her belongings and found a two-way radio. She didn’t have any travel papers, letters of authorization or support, or credentials because she had fled from an NPFL commander and was terrified of being returned to him. He had already sent people to look for her, and she knew that she was being hunted. She also knew that the NPFL guards were all his friends, and if they learned her identity, she would be sent back. But the two-way radio created a problem for her. The NPFL accused her of conducting reconnaissance for another armed group. They imprisoned her in Sanniquellie prison and brutally tortured her for three months. The commander in charge of the prison personally tortured and interrogated her to uncover her identity and her mission. She had no answers and thus said nothing. She gained a reputation among the NPFL as ‘‘the recon girl,’’ and after some time Charles Taylor asked to meet her. The commander of the prison initially demurred, and Taylor gave him more time. Finally, the commander asked, ‘‘You really aren’t a recon girl, are you?’’ She said, ‘‘No, I swear I am not.’’ He said, ‘‘Listen, if I take you out of here and bring you to my house to work for me, will you run away?’’ She said, ‘‘No, I swear I won’t.’’ He brought her back to his house and within two weeks began to rape her regularly. ‘‘Oh, God,’’ thought Loupou. ‘‘What have I gotten myself into now? I thought that this man was going to help me, and now I am even worse than before.’’

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She ran away again and first headed back home. Her presence in town put her family’s lives in danger, so she fled to Coˆte d’Ivoire through the forests, in the middle of the rainy season, when mud made the roads impassable and travel was dangerous. Loupou spent several hard years in Coˆte d’Ivoire, where she had a female family member who promised to take care of her. Because she knew little French, she had trouble finding work. Her years in Coˆte d’Ivoire were tragic because several people—all women—promised to step in and act like family to give her aid and support but never followed through. Then her family member—perhaps a cousin or an aunt—left her to go to Guinea with some other people. She promised Loupou for three years that she would come back for her, but she never returned. Loupou became pregnant and survived a difficult delivery, and another cousin joined her in Coˆte d’Ivoire. This woman was running away from Guinea to escape the family who had helped her flee Liberia, and she swore to Loupou that she would never leave. Months later, her friend said that life in Coˆte d’Ivoire was too hard, and she returned to Guinea. Loupou remembers this woman’s abandonment as being one of the worst experiences she endured during the war. In 1997, peace seemed to be returning to Liberia, and Loupou was twenty years old. Charles Taylor was elected president, and Loupou couldn’t stand the loneliness and the struggle of life without support as a refugee in Coˆte d’Ivoire. She decided to return to Liberia to ‘‘find what she could find there’’ and went to Ganta, where she was ‘‘adopted’’ by another man. He forced her to be his wife, but he also fed her and paid for her to finish her elementary education, and so she remembers him with gratitude. In 2000, she told him that she wanted to find a job, and he arranged for her to work as a laborer on Taylor’s plantation near Gbarnga. She worked there fairly happily until she was caught in a group arrest, carried down to Gbatala, and forced into military training camp. The sweep marked another new chapter in Loupou’s life. She was forcibly conscripted into Taylor’s elite Anti-Terrorist Unit (ATU). Training included thirty days of torture (called a trial), the threat of death during training exercises using live ammunition, treacherous drills atop muddy mountainsides, and constant beatings. Loupou survived the thirty-day trial and then went through training for the ATU. When she completed her training, she was assigned to be a member of Taylor’s all-female Presidential Guard at the Executive Mansion in Monrovia from 2000 to 2003. Then, she said, ‘‘Things were fine.’’

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Loupou’s last memory of Charles Taylor was just before his departure for Nigeria in 2003. Taylor came to her and her bosses and told them that the international community was making him leave but that he would make sure that they continued to be paid until the end of his term as president. She and the other members of the Presidential Guard stayed at the Executive Mansion after his departure and waited and waited. They didn’t know what would happen next. Then one day international peacekeepers broke into the mansion with guns and kicked them all out. Loupou was alone again, on the street, not knowing what to do or where to go, when she was approached by the director of NEPI. He was looking for female ex-combatants to do peacebuilding work, he said. Would she like a job? She said yes. Loupou’s life changed a great deal between 2003 and 2012. In 2008 she worked for NEPI on a ‘‘voluntary’’ (short-term contract) basis, earning about US$100 per month. She lived in Paynesville with her two children, one of whom is the child of the first commander who kidnaped her in the early 1990s. She told me in 2008 that since the end of the war, her experiences with friendships and romantic relationships have been fraught with pain, abandonment, and abuse. She had a ‘‘husband,’’ but he beat her routinely for having been an ex-combatant and abused her, spat on her, shamed her, and yelled at her. The residents of her local courtyard refused to come to her defense, saying, ‘‘Oh, she’s jus’ an ex-com. You know how those people be. Jus’ leave it alone.’’ Her man ultimately left her and abandoned her first child and their common child to her care, and refused to make any financial contributions to the children’s schooling or upkeep. She felt herself to be very much alone. Her own father had not, and would not, return from Guinea. According to her, he was still being hunted, even in the postconflict ‘‘peace,’’ five years after the conclusion of the war. She didn’t know what to do next or what would become of her and her family. Much changed in the subsequent four years. By 2012, Loupou was a highly sought-after Liberian NGO worker receiving US$400–500 a month. She was no longer in an abusive relationship; her children were healthy and in school; and she had moved to a neighborhood that was friendlier. She was happy, confident, and successful, and her future looked bright. Loupou’s story reveals the constant assault on her body and soul throughout the duration of the war. For women like Loupou, persistent

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experiences of exposure, vulnerability, and abandonment over more than half her life had moral and social consequences that continued through the postwar years. Not only was her body battered and treated as a fungible commodity during the war; after the war, she was abused, scorned, and denied recognition from the people in her life as a human that deserved basic social protections. Her father abandoned her, a commander that promised to protect her instead imprisoned and raped her, her cousin abandoned her—even Charles Taylor abandoned her. Then for years after the war, the neighbors who shared a courtyard with her abandoned her to ongoing marital rape and beatings, thus stripping her of the informal social protections that come with living in courtyard-style collective households. For Loupou, social censures against violence and verbal abuse didn’t pertain. She, like other ex-combatant women, experienced a kind of a gender loss, ‘‘a loss located in significant ways within the domain of gender constructs and, in particular, the forms of female sexuality and reproduction that are valued within it’’ (De Mel 2001, 204). War-affected women experienced the negation of their entitlement as women to ‘‘normal’’ protections from their neighbors, families, employers, and communities, leading to the persistence of social abandonment that took Loupou nearly a decade to overcome.

GBV Trainings: Form and Function My Husband doesn’t care for me, I suffer. I’m Somebody. My wife is not good to me. I’m Somebody. I have no food and no money. I’m Somebody. —Call-and-response exercise, GBV training

We now turn our attention to the twin operations of culture— humanitarian culture and Liberian culture—that paralleled and frequently entered into dialogue with each other in postwar GBV interventions. While millions of dollars poured into programs to fight rape, attempted rape, forced marriage, female circumcision, and sexual exploitation and abuse by aid workers, Liberia’s humanitarian community created a cultural space of discourse for engaging with GBV in Liberia, questioning GBV program implementation efforts, challenging established habits of gender and violence, and renegotiating the gendered meanings of the rule of law. This

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section explores GBV interventions at the site of their occurrence, in community-based trainings carried out by Liberian representatives of international NGOs. In community-based trainings, the tensions surrounding gender roles, local habits of violence, and the ongoing uncertainty around the rule of law were articulated in exchanges between Liberian NGO workers and Liberians from all walks of life. An important but often unrecognized feature of these engagements was the ways in which all actors treated these trainings as a public forum for negotiating the emerging social norms surrounding gender, violence, and domestic and civil conduct. Across Liberia, men and women recognized that substantial legal change was taking place in Monrovia that could affect the domestic sphere, but in Monrovia, there was a gross informational vacuum that Liberian NGO workers were often required to fill. Through the conversations that took place in and around GBV trainings, global ideals of gender justice were communicated to local populations, and local populations critiqued those global ideals, and grounded their critiques in the lived economic, legal, social, and sexual realities of postwar reconstruction. For the Liberian employees of humanitarian institutions, GBV trainings involved hard work. In GBV trainings, as well as in the ex-combatant rehabilitation and human rights trainings that are discussed in the next two chapters, Liberian NGO workers were placed in the awkward position of acting as cultural interlocutors between the transitional world of Monrovia’s changing governance institutions and the shifting patterns of culture and social relations that loosely structured people’s postwar lives. In the course of their NGO careers, the Liberian staff of GBV programs challenged thousands of people, in groups of several dozen at a time, to reconsider the terms of their social lives, their intimate relationships, and their habits, Liberian NGO teams were forced to translate their own perceptions of new legal and ethical paradigms into local intimate domains. As teachers of global discourses about GBV, they often worked as interlocutors between global GBV ethics and local Liberian gendered realities, which they know to be more complex. As trainers, and as Liberians with access to cosmopolitan social and professional networks, GBV workers shouldered the responsibility for adjudicating local conflicts that touched on GBV but truly spoke to more basic social structure dilemmas that confronted the Liberian population in the aftermath of the war—like child custody, marriage formation and dissolution, land tenure, inheritance, courtship, and sex. While they were trained to understand the structural forces that contributed to GBV

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(like sexism and historical patriarchy), in their daily work they were confronted with essentially new problems that were emerging from the war, and from the context of postwar transition. Consequently, trainers often had to innovate solutions for local problems on the spot, and reshape their training agendas to speak to local needs and priorities, rather than adhering to international norms regarding GBV interventions. In a typical GBV intervention, a team of GBV trainers—mostly Liberian, but sometimes led by expatriates—arrived in a village or an urban neighborhood in an NGO vehicle. Having scheduled their visit in advance, NGO teams descended from their vehicles, set up a few flip charts, and convened a meeting of community leaders, which usually included women’s leaders, village heads, heads of youth organizations, teachers, nurses, and civil administrators. Sometimes NGOs arranged gender- and occupation-specific meetings (like female market vendors, sex workers, or male religious and community leaders) to organize subgroups around GBV issues, or to mobilize men to support the elimination of violence against their wives, mothers, sisters, and daughters. Most meetings took place in a public space—a newly constructed school, a circular palaver hut, a clinic, or an unoccupied house—and were opened with a Christian or Muslim prayer. As training began, GBV trainers (some of whom were NGO employees and some of whom were volunteering time away from their other occupations in hope of securing future NGO employment) used ‘‘ice breaker’’ exercises to warm up the community—stretches, saying silly words, short dances, and so forth. Trainers used brainstorming activities, presentations, role plays, video shows, slogans, and ‘‘session energizers’’ typical of participatory development approaches.3 GBV interventions required trainers to use consensus-building strategies to educate local communities about the NGOs’ training messages and translate them into local patterns of normative behavior and decision making (build awareness). They asserted that the international community had arrived at a consensus around GBV that was grounded in the framework of human rights and that local Liberian populations were failing to adhere to international norms. Trainers routinely presented on the following themes: the difference between gender (a social role) and sex (a biological role); specific forms of gender-based violence (which conformed closely to international standards); patriarchy and gender oppression; and strategies for minimizing and resolving gender-based violence in the community. Then trainers would ask the audience to share

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their own concerns about gender-based violence. Throughout, they insisted that local communities needed to change in order to catch up with the times, and then built upon this assertion by trying to persuade local populations to incorporate GBV prevention tactics and principles into local forms of practice. Predictably, local communities often pushed back. People’s lives were hard. Personal relationships were often vastly more complicated than trainers or GBV counselors anticipated. GBV cases came to the fore that were totally unlike the narratives presented in training modules. The cultural and historical origins of gender relations in rural Liberian communities were unclear and subject to debate. Consequently, trainers’ invitations to their audiences to share their GBV concerns often resulted in palavers. Participants raised important questions about social problems that extended well beyond the formal scope of GBV but were locally regarded as gendered forms of abuse (Abramowitz and Moran 2012). These included problems of ‘‘friskiness’’ (infidelity), wifely disobedience and laziness, disputes between co-wives, fights over land or health care costs, child support, and violence by women against men. Liberian audiences could, and did, argue that in many cases women had far too much power, and used the public forum to censure each other for recent infractions, like parents’ forcing daughters to marry men they didn’t love or men’s abandoning their children. Despite the inclusive nature of public GBV debates, NGOs considered two topics to be off-limits in GBV trainings: female circumcision and witchcraft ordeals. Female circumcision was often excluded because it was widely perceived as a third rail of humanitarian intervention in West African contexts, due to the subject’s political and social sensitivity (see Abusharaf 2007). Witchcraft ordeals, which were of paramount local concern, lay just beyond the pale of NGO awareness, despite the fact that their occurrence (along with the persistence of kidnapping and human sacrifices) perpetuated a climate of terror and intimidation in rural Liberian populations. Witchcraft ordeals, in which individuals who had been accused of practicing witchcraft or sorcery were subjected to poisoning, torture, confinement, or beatings to prove their innocence or guilt, were a matter of significant concern to UNMIL’s human rights offices, and were routinely reported in newspapers, but they were poorly integrated into NGO theories of genderbased violence and tactics of intervention. In 2005, for example, the director of one Liberian NGO reported that in an isolated corner of Nimba County, local leaders, police, and businessmen were using witchcraft accusations, rape, and imprisonment to steal

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land from repatriating families. The orchestrators of the plan had built a camp to imprison people accused of witchcraft. There, they forced people to drink poison or undergo torture in order to exonerate themselves of witchcraft accusations. When the victims died, organizers used the opportunity to seize their land and properties. UNMIL’s efforts to prosecute the organizers were disregarded by Liberian national officials, who were believed to be complicit in the witchcraft ordeals as members of Poro and Sande societies, and the more secretive Leopard societies. That same year, a UNMIL human rights officer in Grand Cape Mount and Bomi counties shared with me that the bodies of women and children, and occasionally men, were routinely dumped at the doorsteps of hospitals and police stations in Grand Cape Mount and Bomi counties after being subjected to witchcraft ordeals. The officer was unable to follow up on these cases because, according to UNMIL’s legal framework, witch-related violence did not constitute a violation of human rights, nor did it constitute an incident of GBV, although women seemed to be disproportionately targeted. Finally, it was widely reported in the run-up to the 2005 national elections that there was a spate of human sacrifices taking place, in which body parts were harvested for the purpose of engaging in sorcery to accrue political power. These incidences of violence were the subject of considerable legal and political discussion, but were not examined as a dimension of the climate of violence that pervaded the early post-conflict period, nor was it studied from a gendered perspective. As noted earlier, NGO workers were asked to adjudicate thorny legal issues involving inheritance law, parental responsibility for children’s education, spousal access to one’s husband’s or wives’ earnings, and the community distribution of land. Many of these issues were legally, technically, and normatively unresolvable because the Liberian state was in the midst of a fundamental revision of its entire legal code and legal structure, particularly with regard to land use, inheritance, parental responsibility, and spousal roles. Customary law had lost much of its authority since past modes of legal regulation, like The Rules and Regulations Governing the Hinterland of Liberia, had fallen into disuse. Moreover, the habits developed during urban and life during the war, or under humanitarian administration, led many to challenge the legitimacy of prewar customary and formal legal conventions. One incident, reported by a participant in GBV training, illustrates the state of flux that surrounded legal and customary law. One evening, after the end of a training day, community members paid evening visits to the

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GBV team in their allocated hut, and lay their problems before them. The first visitor, a village elder, requested legal counsel on an inheritance issue. During the war, his daughter had done everything to take care of him and his wife. His sons were somewhere else—he didn’t know where. They may have been involved in the violence, or they may have been refugees themselves, but what mattered was that they did not support him and his wife through their years as refugees. Now he was back home, he was old, and he didn’t want his sons to inherit his land and property. He wanted to leave everything to his daughter, but to his knowledge, Kpelle tradition forbade it. No one knew if Kpelle tradition was good—that is, legal—anymore. The GBV team listened carefully and then pronounced, ‘‘Now, there is human rights!’’ They informed him that he didn’t have to leave anything to his sons; he could leave everything to his daughter. All he had to do was go to the police station in the nearest regional capital (a twelve-hour bush taxi ride away) and ‘‘get paper’’ before he died, and everything would be solved. Unfortunately, the team had some knowledge of Kpelle inheritance law but almost no understanding of the new Liberian inheritance laws. They believed that because the police station was the nearest site of state power, it had the authority to execute a will. It did not. Later they assured me that while reality might differ from their ideal world, the information they gave the man reflected how things ought to be, and so it was their best possible counsel. GBV teams were also called upon to informally adjudicate thorny issues of familial and social adjustment (see Williams 2012). During the war, many Liberians had come to believe that family members were dead and had created new families. After the war, the process of reconciling prewar families with wartime families created microcrises in households across the country. Consider the following example, presented to a GBV team during a late-night counseling session during a week of GBV training. A man in his mid-forties squatted at the door of the trainers’ hut and set forth his problems. He and his wife were separated from each other when the rebels came through the village and burned it to the ground. He fled to Guinea and remained there for many years. During this time, he assumed his wife was dead and married another woman, with whom he had several children. When he returned to the village, he learned that his wife and children were still alive. He brought them to live with his new family, but there was considerable infighting. He swore that he wouldn’t have married again if he had known that his wife and children were alive, but now that they were

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all together, he didn’t have enough land and money to support both families. He said his heart hurt over the situation. The GBV team listened compassionately and then, while he listened, speculated about his family life. They concluded that his second wife and children felt bad because his former family had returned and were worried that they were going to take everything away. They recommended that he be very kind to his second family and advised him to talk to his children and tell them that they had to get along. They also reminded him that he was the man in the house, and it was his responsibility to keep everyone in order. He seemed pleased with their advice and said that he would do what they advised right away. He then thanked them and departed. GBV teams presented themselves as credible experts who could offer information and prescriptions for action. Liberians had great uncertainty about existing norms and laws, and NGO workers tried to fill the void with sympathy, advice, and directives. GBV team members worked with local chiefs and community elders to persuade them to act as GBV enforcement officers or mediators within their communities. They encouraged local leaders to issue protections and render decisions that supported women who were being beaten, who had been raped, or who wished to refuse an arranged marriage. Local community leaders did, in fact, want to follow the current laws of the state (doing so would enhance their own standing), and so many tried their hand at enforcement. GBV teams also advised many women to go to local chiefs or to the police for support; many did go but met with little success. GBV trainers tried to persuade communities that county-level police and courts had the will, the mandate, and the capacity to legally enforce GBV violations, even in the face of copious evidence to the contrary. Despite these glaring inconsistencies, foreign NGO teams and the Liberian personnel who worked for them were seen as reliable interlocutors between the village and the capital and between tradition and global human rights discourses. In the normative and legal confusion of the postconflict aftermath, Liberians listened responsively and projected an air of trustworthiness. By the end of the meeting, when T-shirts, hats, and a healthy lunch were distributed, village chiefs and women’s groups asserted their enthusiastic support for GBV education and women’s equality and pledged to implement GBV awareness efforts. They hoped that the NGO would ‘‘remember them’’ when food, farming tool, seed, or roofing material distributions took place (Fuest 2007). After a closing

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prayer and benediction, the training ended and the NGO workers departed. Heading out of town, NGO workers processed their training experiences. They laughed, hung their heads, and discussed the events that had transpired at this training and at others they had successfully completed in the past. They recounted instances in which when women went to their local leaders, the chief advised them to go back to their husband and to stop complaining, misbehaving, or displeasing him. Village leaders wanted women to stay subordinated, they explained, and urban leaders blamed women for inciting domestic disputes. One trainer, who had a long history of psychosocial training, complained about country people’s ignorance and stupidity because they continually raised issues that weren’t ‘‘GBV.’’ Her colleague, Christian, laughingly retold exotic narratives of cult practices involving rape and forced marriage throughout the country. Then, in their own critique of global GBV discourse, Liberian NGO workers told tales of women tricking men into poverty or death, of women using African Sign (juju, country medicine) to steal men from their families, and of people who used magic to turn a local leader blind to the right course of action. They discussed the rapes, beatings, and murders they had witnessed and mocked the claims of the formal and customary justice systems. Then GBV educators shared with each other detailed procedural stories of police and court ineptitude. They recounted disturbing tales of miscarriages of justice in new rape cases, problems with rape kits in the clinics, and the corruption and incompetence of lawyers and judges. In these ‘‘off-stage’’ discussions, Liberian NGO workers expressed their profound ambivalence about the GBV messages they carried and the ability of their countrymen to receive them.

GBV Training: Case Study During a dry season week in the winter of 2007, I attended a four-day NGO training session on gender-based violence and sexual exploitation and abuse (SEA) in a village in northern Liberia, a six-hour drive from the nearest town. The training was intensive, and each day was dedicated to one topic. My traveling companions were five Liberian NGO workers. The audience included a local border agent, the village chief, religious leaders,

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teachers, and adult men and women in the community. Everyone received breakfast, lunch, and T-shirts in exchange for their participation. When we entered the village, murmurs of disapproval arose from the urbane Liberian NGO team. ‘‘Don’t these people have any self-pride, any self-respect?’’ they asked. ‘‘Look at these goats in the road, and not behind the fence. These people say that they can’t plant crops because the goats eat them. Hnh! Let them build a fence! Something is wrong with these people.’’ After an early breakfast of doughnuts and coffee, the day’s training began. Charlene, tidy in a white T-shirt and blue jeans, stood before the audience and opened her lecture on GBV with a discourse about the evils of polygamy. She began, ‘‘A man wants a woman because of her children. He has three wives, and though he will never love the three women equally, the coffee is growing fine, the cocoa is growing fine [cash crops], he has some small money, and he takes a woman. But he can’t give all his love to her. That woman will just be suffering for her children. There will be no love for her. She goes back to her family, and they tell her, ‘Go back. You already have children.’ Traditional practices say, ‘I saw my ma do this, I saw my pa do this.’ The question is—What can you do for yourself? Polygamy is dangerous!’’ She then addressed the men in the room: ‘‘With two or three wives, you don’t know their hearts. They can drug you and kill you! This kind of thing is known to be happening everywhere!’’ She then began a call-and-response chant: ‘‘Be Somebody.’’ ‘‘I’m Somebody!’’ The audience thundered. Charlene then recited a series of tragic incidents, to which all participants were expected to respond, ‘‘I’m Somebody.’’ Even though this man is laying his hands on my chest . . . I’m Somebody! My husband die . . . I’m Somebody! My wife die . . . I’m Somebody! I don’t have nothing . . . I’m Somebody! The Government put me down . . . I’m Somebody! Charlene liked this participatory technique. She had used it in excombatant rehabilitation sessions to good effect. With Christian zeal, she hoped that a focus on self-pride, self-love, and self-value might turn her

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audience away from the past and harmful traditional practices and toward new forms of habits and behavior. Charlene used the interlude to offer a definition of rape on a flip chart and then returned to her previous theme: love. She said, ‘‘This thing called love, it’s hard to understand. Your money is finished, the love is finished, and all the things it got are finished.’’ Charlene led the group in a quiz based on GBV case studies. The first case examined the problem of rape: ‘‘A man and a woman were in a couple, in love, and everything was fine. The girl was raped. What does one do when someone is raped?’’ The group hesitated to respond, so eventually one of the NGO facilitators stepped in to give the correct answer. He explained, ‘‘When someone is raped, that person should go straight to the hospital so that the hospital can give them proof of rape, which can be used by the police to prosecute the rapist. Instead of saying, ‘Oh, my sister is lying,’ you take her straight to the hospital. If there is no hospital, take her to the local midwife, who has been trained in such things.’’ Charlene changed topics to address another nonsanctioned but crucial GBV issue: confidentiality in relationships. Asking the audience to identify whether it was true or false, she made the following statement: ‘‘When a man and woman are involved, but there is no law to say it is so, and the love comes to an end, you must tell one or two persons your problems.’’ The group, again, sat silently. The facilitators again offered the correct answer: ‘‘Do not keep your problems with your husband or boyfriend silent, to yourself. They will be your witnesses.’’ Charlene shifted to the topic of infidelity, a popular theme at GBV training sessions. She posed the following case and asked the group to come up with a resolution: ‘‘Two men in Boma fell in love with each other’s wives, but no one acted on their feelings. After some time, one of the wives left to find some work. Suleyman, the security man, stole into the house of Botiman, the policeman. He heard someone coming. Botiman brought Suleyman’s wife with him, and they had fun while her husband hid under the bed. The other wife then came to the door.’’ According to the facilitators, the lesson from this story was, ‘‘If you say you love me, you pay my dowry, and I become your wife, I give you children, and then things become hard and you don’t love me anymore, God will judge you. God helps those who help themselves.’’ The quiz session concluded with a case about kidnaping. Charlene posed the following problem: ‘‘A man and a woman have three children, but the man’s mother said, ‘Drop that woman.’ The husband doesn’t want

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to do so, but instead he beats on the woman until she has a miscarriage. He takes the children away to live with him and doesn’t tell their mother where he has gone.’’ The correct answer to this problem was, ‘‘Go to Save the Children [NGO] with the pictures of the children and the husband and their names. Save the Children can find them. IRC [International Rescue Committee] will check for children, too, but some NGOs cannot help you.’’ The training was then supposed to move to a discussion of women’s positions of societal weakness, with particular reference to single heads of households, widows, girls looking for jobs, students having sex with teachers to get higher grades, girls living with foster parents, girls who worked as housemaids, and unaccompanied minors. The trainers skipped these pages. Charlene reintroduced the question of child custody: ‘‘Who is the rightful owner of the child, the woman or the man?’’ The group was unsure but offered several tentative responses. Some young women believed that if they had children, their parents had to adopt the children and pay for their school fees. Young men believed that they had no responsibility for the care of children if they couldn’t afford them. Men and women were locked in battles over competing claims of responsibility from parents, children, current partners, and former lovers. The trainers told the group that according to Liberian law, children should be with their mothers until the age of seven. They also told the villagers that if a mother could not retrieve the children from their foster family or caretakers, if she beat the children, or if she could not feed the children, according to the law the children could be removed from the mother’s custody. This response prompted some concern from the village residents. The Liberian state could come to take a mother’s children? (I learned later from the Ministry of Health and Social Welfare that the Liberian government lacked the legal mandate and the capacity to regulate parental custody and oversee child welfare. Their only mandate was to monitor orphanages, the elderly, juvenile delinquents, and—curiously— psychosocial interventions in trauma. In practice, state-sponsored social workers were largely restricted to monitoring a few elderly recipients of international charity, reporting on abuses in orphanages, and managing international adoptions.) Confusion ensued, and the trainers changed the subject. Charlene presented a fight between a wife and her brother-in-law over her dead husband’s property. Stepping away from the uncertain terrain of legal counsel, the trainers moved into their psychosocial counseling mode and reminded

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the audience that feelings of insecurity, depression, and psychological trauma could result from a woman’s disempowerment. Charlene said, ‘‘If you are abused, you will not be yourself. Every time you are sitting down, you are feeling bad. You are just traumatized about your whole life! If you have low self-esteem, you don’t want to be around your friends, you are just feeling sorry for yourself. Maybe you will have an unwanted pregnancy. You can then have abortion complications caused by ‘Nigerian seed,’ leaves, or a hospital DNC. Perhaps you will encounter a marital separation or marital strain. You and your husband live apart, even if you are living in the same house. Some people, when they are weak-minded, they commit suicide. Or perhaps you will turn to sorcery, poisoning, or witchcraft! It happens here!’’ She broke into another call-and-response chant, ‘‘If you don’t learn it . . . You Lose It!’’ ‘‘If you don’t learn it . . . You Lose It!’’ Massa, Charlene’s colleague, moved into a complex discussion of the inheritance law. The psychosocial team advised the men in their audience, ‘‘Before you die, make a paper [a will] with the government of Liberia. If your brother takes the property, he will not think of your wife and children; he will think of his wife and children first, and your wife and children will suffer.’’ Lunchtime came, and I was exhausted. We were midway through a long, hot, emotionally intense day of GBV training, and the team was worried that the villagers would steal food. Together, the group had a lunch of rice and sauce. After the break, the team showed Nigerian soap operas to drive home key points. Reminding the audience to ‘‘Be careful who you marry,’’ they first showed a clip on rivalry between co-wives in polygamous families, in which two wives attacked each other over their mutual claims to yams on their husband’s farm. After the film was over, Charlene decided to focus on the problem of ‘‘materialistic’’ women and their social exclusion: ‘‘There is a woman who loves material things too much, and she used all her money to buy lappas. Every time you saw her, she’s wearing new lappa. We talk about trauma . . . the girl was traumatized inside. The girl was traumatized from the abuses she suffered. The mama may be dressed up, but she was

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still the same person inside. Don’t overlook anyone because of their clothes. Don’t overlook anyone because of money. Like during the period of the war, the people who pulled out people’s intestines, now they are nicely dressed and riding around in big jeeps. Don’t overlook people because of money or clothes.’’ Then we watched another Nigerian video about a wicked, vain, and selfish young girl named Alice who disobeyed her stepmother and sought gifts and moral support from her distant father. She adopted Christianity and refused traditional religious practices through the shocking act of revealing the humans behind African masks during traditional ceremonies. She also tried to poison her husband, whom she had been forced to marry. In the group discussion that followed, the audience agreed that Alice was someone they would avoid at all costs. Her future was dire. When she was old and had grown children, her children were going to abandon her to the care of strangers, who in turn would wait for her to die rather than care for her. Alice had no respect for the hierarchy of authority within the family. She circumvented her stepmother by going to her father, and she tried to kill her husband. The trainers challenged the group’s criticism of Alice, noting that Alice had embraced Christianity and rejected traditional ‘‘devils.’’ By revealing the human behind the mask, Alice revealed the truth about traditional religion, but she was to be condemned for failing to respect tradition and for showing a lack of respect to her husband. Noting the scene in which Alice burned a traditional mask, Charlene abruptly warned, ‘‘Devils get out of control. The Bible says that I must not shed blood. Civilization is improving.’’ In other contexts, under the careful watch of expatriate supervisors, the training team held much more closely to the scripted discussions of rape, domestic violence, human rights, and women’s empowerment. Throughout the course of the training, both villagers and Liberian NGO workers struggled to stay ‘‘on task.’’ Village residents sought to use the training to address the issues they confronted in their own lives, while trainers tried to adhere to their predetermined script. Even so, no matter how hard the trainers tried to keep the focus on their standardized flip charts, they could not refrain from improvising and deviating far from their NGO program. As a result, much of the training was comprised of counsel, cautionary tales, warnings, legal directives, and threats rather than NGO workbook lessons.

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The guidance they gave and the moral lessons they shared resonated much more closely with a specifically Liberian version of postconflict social change than an internationally designed human rights curriculum. In this far corner of Liberia, away from the careful eyes of expatriate management, the NGO team freestyled their interpretations of gendered violence and integrated their understanding of the community into the messages they delivered. During the morning session, for example, the trainers emphasized that rape victims should seek professional clinical care in the aftermath of a rape and report it to the police, despite the sparsely available medical care and the total lack of access to police in the area. They encouraged people involved in abusive or neglectful relationships to build a public social history of maltreatment by reporting details about the relationship to their friends and family. They framed infidelity as a gendered form of abuse that merited God’s punishment. They asserted that a husband’s removal of children without their mother’s consent could be redressed with the assistance of international NGOs known to work in postconflict child tracing and family reunification. The trainers then referred local populations to international NGOs—sometimes erroneously—to fulfill advertised social protection and social welfare needs. On the final day of the training, the GBV team turned their attention to SEA education. As mentioned earlier, the humanitarian community was battling a recent legacy of having used humanitarian resources to extract sexual favors from young girls and women in Liberian refugee camps. To combat the humanitarian exploitation of local women, UNMIL had allocated funds to GBV programs that were focused on prevention. Charlene and her team had received international funds to integrate SEA prevention trainings into their GBV education program, and they used stories of NGO coercion as a way to emphasize some of their points about gender-based violence. After talking about factors that caused SEA, like poverty, refugee status, social vulnerability, and the pressure of elders, the trainers described the problem of SEA as an issue of national respect. Massa, a trainer, assumed the role of a young girl in a role-play. She announced that an NGO worker had offered her a sack of rice and some money in exchange for sex but that she intended to say no. Modeling her rejection of the NGO worker, she announced to the audience, ‘‘Things are hard now, but they will be better someday, so I will not disgrace myself for some small U.S. money. The women who will [disgrace themselves will] do

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so for some small beers. They are disgraceful to Liberia, to you, and to me. So tell your children to be careful!’’ The training team then divided the men and women in the audience into two groups and charged them with identifying possible causes of SEA. Both groups agreed that women could be drawn into a sexually exploitative relationship if she was poor and had a lot of debts, dressed promiscuously, or was unable to access NGO assistance any other way. They also agreed that a girl might turn to an NGO worker if her husband failed to support her economically, if she had low morals or character, or if she were lonely. Both groups ticked off their matching responses and soon came to the end of their lists. The last items, however, prompted a brawl. The women’s group wrote that a woman might be drawn to having an affair with an NGO worker if her husband refused to ‘‘play with her.’’ The men’s group, on the other hand, felt that a woman would be drawn into a sexually exploitative relationship if she was ‘‘too frisky.’’ Clearly Liberian women’s sexuality was a site of contention within the community. Shouts, insults, and personal accusations were hurled across the room between the men’s and women’s groups, as men mocked women and women shouted at men. To save the training, the GBV trainers ended the day by preaching about marriage and relationships. Massa, siding with the women, announced, ‘‘Women are human beings, and they have feelings.’’ Charlene concluded the GBV training on a conciliatory note: ‘‘That’s why we’re having this workshop. It’s not to say that it doesn’t happen, but to say. . . . Stop this behavior! This workshop is for reconciliation and forgiveness! We are Liberians. We are here to come together and make peace! We need to thank God for giving us this beautiful country. We have all had fourteen years of war. We need to forgive each other, we need to forgive ourselves, and we need to think about what we can do to rebuild our beautiful country. Now let us close our eyes and forgive ourselves, and forgive each other.’’

Coda In the examples presented in this chapter, two facts about GBV interventions stand out. In individual case profiles and life history interviews like Suah’s and Loupou’s, specific examples of rape, violence, and abandonment

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stand out strongly, as does a sense of the ‘‘choiceless choices’’ available to women during and after the war. But in the sections on community-based GBV interventions directed by Liberian NGO workers, which were intended to focus on issues of physical and sexual assault, an entire world of gender contention erupted, turning GBV interventions into a site for social and legal contestation. Under expatriate supervision, GBV interventions tended to be more tame but also less ethnographically productive. An American woman who directed a large GBV program often became frustrated when she supervised her team’s trainings in communities and attempted to facilitate local women’s empowerment around GBV issues. In one conversation, she told me that the culture of Liberian patriarchy made it almost impossible for women to stand up for themselves because Liberian men had longstanding, institutionalized, culturally enforced material interests in keeping women subordinated through violence. As the previous examples suggest, this was hardly the case—but it did capture the stochastic state of global GBV paradigms in interaction with local Liberian social worlds. Despite all the aggravation that the expatriate experienced in her work, she occasionally experienced moments of hope. Two stood out in her mind. The first came from a GBV training in which NGO trainers sought to empower local women to talk about gendered violence in their communities. One middle-aged market woman wearing an elaborate lappa and a bright silky scarf sat on an oil drum in the corner of the stagnant room. She bellowed, ‘‘It’s very simple. If any of these men beat these women, we will all go to his house and beat him with sticks!’’ The GBV trainers, torn between their GBV agenda and the immediate need to discourage postwar vigilantism, felt privately gratified. These women ‘‘got it,’’ they decided. Their intervention was a success! The second example came from a border village in northeast Liberia, a ‘‘most-affected’’ area. Almost entirely without the ‘‘professional expertise’’ of the NGO, the women of the village had become empowered to fight back against gender-based violence. They had independently constituted a women’s cooperative, established a local mechanism for community policing, and developed other initiatives recommended elsewhere by the NGO’s GBV program. Finally, the women approached a visiting NGO worker and asked for some assistance. They wanted to start a small soup and rice restaurant to generate some petty cash for their local GBV organization. In recognition for their work, the NGO worker assured them

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that she would provide them with the construction materials they requested. She then said to the women’s group members, ‘‘You are all so wonderful. How is it that you can do all of this, that you understand GBV so well?’’ She reported to me that they looked at her pityingly and said, ‘‘You don’t understand, do you? We just love each other.’’

Chapter 6

Ex-Combatant Rehabilitation

‘‘Security-Mindedness’’ One late night in Foya Town, near the Sierra Leonean border, I was laughing with two young Liberians, Joseph and Sumo, in the front room of our hotel. For over an hour, they had been mimicking the costumes, behaviors, and rollicking prayers of Monrovia church ladies, and each outdid the other as they took on church after church. Then an older, unkempt, sullen man came in to the main area buy some sweets from the small canteen and bar. He did not greet us, kept his head down, and projected a silent attitude of lethal predation. I noticed that Joseph, an ex-combatant NGO worker who had been demobilized for three years, changed his demeanor completely. Although he kept smiling and talking, he dropped his voice and his chin, furrowed his brow, and subtly repositioned his feet to ready for attack. The conversation lost its drift, and he became palpably watchful and attentive. In an instant, Joseph had gone from being a sweet thirty-year-old university student to a very scary guy. Our other friend, Sumo, seemed to disappear into the wall. Joseph held his stance until the man left; he told me later that he believed that the man was scoping the hotel for a possible armed attack. He seemed a little shaken, and soon afterward we turned in for the night. Our lighthearted evening was over. In the years after the war, whenever I entered spaces filled with poor youth or ex-combatants, the same embodied show of aggressive protection emerged and posed a discernible but invisible physical barrier to entry. It took little to provoke a violent outburst—the perception of disrespect, of

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being cheated, of being slighted, or that someone was withholding information was often sufficient. Some ascribed the human geography of embodied aggression, intimidation, and predation to ex-combatants’ military training, which made them ‘‘security-minded.’’ Others called it ‘‘their trauma.’’ Regardless of its title or its origins, expatriates and Liberians alike knew the stance, feared it, and found it to be a significant barrier to communication. In conflicts, a level of ‘‘right’’ was often accorded to the terrorizer, and no intervention was made to assist the victims of an outburst. The display of violence was not just a sophisticated form of posturing. It also signified a person’s actual capacity for beating, killing, or taking revenge. Rebels, soldiers, thugs, prostitutes, and armed robbers all wore it as a studied form of behavioral self-protection, a learned habitus that was solidified through the actual deployment of physical or implied violence on a regular basis. This chapter shows how the task of deconstructing ‘‘security-mindedness’’ and replacing it with peace subjectivities fell to Liberian psychosocial counselors working with ex-combatant populations. Like the mental health and GBV workers observed in previous chapters, psychosocial counselors were expected to work within a trauma-counseling framework to help bring ex-combatants and violent youth ‘‘back to their selves’’ and to assist them in revalorizing memory, empathy, and civilian social morality. In reality, however, intervention took on the form of a highly moralized discourse that focused on public behavior, comportment, sociality, and economic reintegration. The lesson, then, was that postwar rehabilitation needed to be enacted through the repeated transformation of social and physical characteristics and through changed patterns of thought and cognition. In order to study this process, I offer a brief history of the psychosocial rehabilitation component of Liberia’s DDRR process in order to institutionally situate the field of ex-combatant rehabilitation as it transpired in Liberia, insofar as I was able to reconstruct it in the immediate years after DDRR had ended. I also offer an ethnographic narrative that documents the content and character of psychosocial rehabilitation courses in a DDRR initiative that took place in 2008, which provides insight into how both the participants and the counselors understood their respective roles and expectations. After discussing the work of one ex-combatant-run NGO, NEPI, I conclude the chapter with a consideration of how ex-combatant rehabilitation and what Liberians have come to call ‘‘the crisis of the youth’’ align with Liberia’s distinctive challenges surrounding social, economic,

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and political reproduction following the war’s longue dure´e. This chapter does not recount the many trauma-healing and psychosocial initiatives that took place at agricultural and industrial job-training sites or educational campuses, but it is worth noting that these initiatives continued to be carried on as late as 2012 and hosted tens of thousands of ex-combatants.

DDRR In late December 2003, UNMIL initiated a process of Disarmament, Demobilization, Rehabilitation, and Reintegration (DDRR) to disarm and demobilize over 120,000 fighters in the Liberian conflict. DDRR was, first and foremost, a military-led postconflict stabilization process that was intended to separate fighters from each other and from their weapons and remove weapons from circulation. Former fighters were identified for compensation through DDRR identification cards that were issued at cantonment sites, where fighters were to receive medical care, psychosocial support, lodging, and transitional guidance into postconflict education or vocations. During and after the DDRR process, ex-combatants were also entitled to cash payments. A 2004 International Crisis Group report on Liberia’s DDRR noted, Entering a DDR process, with or without a weapon, is in effect a statement by the individual that ‘‘I am tired of fighting, and I am willing to give this a try. Show me what you have to offer.’’ So far, the answer has been very little. Demobilization, such as it is, has consisted of three days of completing questionnaires, sleeping in large tents on a mat on the damp earth, and waiting for an initial $150 payment. Originally envisioned as a three-week process addressing ex-combatants’ psychological, social, and health needs, it has become little more than a pro forma waiting period between turn in of weapons or ammunition and turn over of money. (ICG 2004) Liberia’s DDRR process has been widely documented in gray papers and policy documents, so I will forego a systemic discussion here and instead direct attention to the psychosocial dimension of DDRR, or the process of rehabilitation and reintegration that was widely advocated in the immediate aftermath of the war. My understanding of this history limited,

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as my fieldwork in Liberia did not begin until 2005, by which time DDRR activities had largely ceased. The information provided here is drawn from retrospective interviews with twenty Liberian NGOs subcontracted for psychosocial work in DDRR activities, from interviews with ex-combatants across Liberia, and from focus groups and participant observation at the Guthrie Plantation’s demobilization camp in 2008, which I will address shortly. In the buildup to Liberia’s DDRR process, the international community argued that peace in Liberia could not be achieved without a substantial psychosocial transformation component. Institutions like Human Rights Watch (2005) and UNICEF and numerous NGOs produced qualitatively researched, dense, and complex analyses of the life conditions, aspirations, and frustrations of Liberian ex-combatants. All agreed that war trauma would prove to be a significant factor in demobilization. DDRR planners proposed to conduct psychiatric assessments and to integrate a strong psychological counseling component, occupational and educational rehabilitation initiatives, and long-term community follow-up into the cantonment process. Unfortunately their goals were not consistently implemented. As previous examples have demonstrated, rehabilitation initiatives were undertaken by subcontracted NGOs. Charlene, for example, conducted psychosocial trainings at cantonment sites, where she developed her call-and-response chant ‘‘Be Somebody . . . I’m Somebody!’’ The Sante´ Humanitaire Psych Team provided intensive psychological counseling and individual followup to some two hundred ex-combatants. Someone, somewhere, at a cantonment site in northern Liberia forced Koli to cut his dreadlocks off. But for the most part, the psychosocial component of DDRR remained an intention rather than a plan, and psychiatric assessments of demobilizing ex-combatants were never implemented, nor were meaningful drug and alcohol addiction services provided to a population notorious for substance abuse throughout the war. Funding problems, bureaucratic disagreements, and internal administrative divisions within DDRR seemed to have been the primary roadblocks to the realization of mental health and psychosocial goals. The DDRR process was supposed to have been coordinated under a single bureaucratic institution called the Joint Implementation Unit (JIU), which was divided at the outset between disarmament and demobilization initiatives coordinated by and through UNMIL and those coordinated and implemented

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by USAID’s subcontractor, the Liberia Community Infrastructure Program (LCIP). Without clear leadership for the rehabilitation component of the DDRR process, international funding institutions failed to make sufficient financial and human resource commitments. For example, LCIP subcontracted psychosocial care to fifty-five Liberian NGOs, including Liberian educational, cultural, and religious institutions. In LCIP’s call for proposals, the competitive bidding process considered only cost. Criteria for selection were minimal, and no demonstration of training, certification, or experience was required. Selected agencies included historic Liberian institutions with educational missions, like the Booker T. Washington Institute and the African Methodist Episcopal Church; Liberian traumahealing NGOs that emerged during the war, like NEPI, the LWF/WS Trauma Healing Program, and the Center for Justice and Peace Studies; and several dozen Liberian NGOs that were invented for the purpose of responding to LCIP’s call for proposals, like Smile, International. Most of these newly invented NGOs admitted to me in interviews that they knew they were in over their heads after the initial riots at Camp Schiefflin—UNMIL’s first attempt at demobilization. To the apparent surprise of DDRR’s administrators, the psychosocial rehabilitation of thousands of violent, drug-dependent, demobilizing ex-combatants required skill. Organizations with experience working with ex-combatant populations, like NEPI and LWF/WS, had little trouble managing their responsibilities, but other, newer NGOs were simply unprepared. With just a handful of untrained staff, many Liberian NGOs that had little more than an entrepreneurial spirit were placed in charge of several hundred demobilizing ex-combatants. In addition to Liberian NGOs, LCIP and JIU made funds available to international humanitarian assistance NGOs for the provision of psychosocial rehabilitation projects that offered limited enrollment, treatment, and follow-up. International donors, however, could not decide whether Liberia’s DDRR should have a maximalist, all-inclusive approach or a minimalist, basic needs approach. Comprehensive rehabilitation programs tended to fit within the scope of the former rather than the latter. Consequently, LCIP and JIU tried to do rehabilitation and reintegration inexpensively. They farmed out ex-combatant rehabilitation to proxy projects like traditional healing and cleansing ceremonies, GBV education programs, and peace and conflict resolution trainings. As ‘‘events’’ rather than ‘‘processes,’’ these psychosocial components of humanitarian workshop culture were cheaper to implement, easier to complete, and required only a limited knowledge

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of local culture and local experience to reach their processual ends. Consequently, psychosocial counseling was thinly delivered to the majority of the 120,000 men and women who passed through the DDRR process. When I started to investigate DDRR in 2006, the most striking feature of its psychosocial offerings was how they had simply disappeared, or had been absorbed into other DDRR activities like job retraining programs. While projects continued to offer vocational training to ex-combatants, the humanitarian memory of DDRR’s psychosocial activities was so limited that I couldn’t even find out what the budget had been for rehabilitation and reintegration activities. Program officers were gone. Local NGOs had dissipated. Larger Liberian institutions had moved on to new initiatives and had dismissed or reassigned employees. No monitoring or evaluation activities had ever been conducted. A report written by Nancy Baron, the sole consultant brought to Liberia to train ex-combatant psychosocial counselors, had disappeared. UNMIL, JIU, UNHCR, and USAID had no records or reports of successes or failures. In 2007 I interviewed twenty Liberian NGOs that were founded to conduct psychosocial work during DDRR. Most were defunct. Directors described being chased out of cantonment sites by their charges within their first weeks there and feeling utterly stunned by the drug abuse, detoxification, and violence they encountered in the camps. Other NGOs, like the Center for Justice and Peace Studies, felt that they had made the best of a difficult situation by inserting themselves into facilitated group discussions around mealtimes and work camp breaks. Several said that once they realized they were insufficiently trained to manage ex-combatant populations, they sought technical support and guidance from UNMIL, but none was forthcoming. Others recounted stories of nonpayment from LCIP and JIU, which made it impossible for them to hire enough people to implement counseling or support programs at assigned scales. One man, who hadn’t received his balance of payments from JIU, never even made it to the cantonment sites. He had spent the previous four years trapped in court battles with a former employee who complained about his wages during DDRR, and he was on the verge of losing his home. Every failed NGO director admitted that they had tried to jump on the DDRR funding bandwagon, but they emphasized that their intent was neither venal nor corrupt—they were simply entrepreneurial and unprepared. One of the most famous descriptions of an ex-combatant rehabilitation project can be found in Ishmael Beah’s A Long Way Gone: Memoirs of a Boy

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Soldier (2007). In Beah’s account of his youth as a child soldier in Sierra Leone, one of the most moving moments occurs when he is brought into a camp for demobilizing child soldiers from different military factions. He is drug-addled, violent, and so far separated from his own sense of self and his moral center that he is, in effect, gone. Beah’s recovery of self is facilitated in the rehabilitation center. After an initial period of detoxification, brawling, and containment, he is gradually restored to a pro-social sense of self through counseling, attending classes, and the solicitous care and attention of a skilled nurse/counselor. Beah’s account describes a gold standard, or maximalist, approach to ex-combatant psychosocial rehabilitation, one that is rarely seen in the melee of typical postconflict DDRR processes. He is transformed in the care of strangers who act in loco parentis and then transition him back to the care of his parents (extended family). His subjectivity undergoes a fundamental change from the ruthless, apathetic, violent boy soldier who lived outside of norms and outside of the law into a caring, loving, and morally connected young man who has been subjectively restored to ‘‘human,’’ prosocial sociality. This transformation happens under the gentle care and attention of experts who watch him closely, grant him time and space for anger, sadness, and memory, and parent him back into normal life. Previous longitudinal studies of demobilized child soldiers in Sierra Leone suggest that local psychosocial interventions conducted by NGOs were effective at facilitating child soldier reintegration into postwar life. When NGOs were present and involved, youths demonstrated less anxiety, depression, and mental illness, lower levels of hostility, and greater prosocial attitudes (i.e., attending follow-up visits over a long-term period). Similarly, their caretakers reported that the youths displayed better attitudes toward them and experienced greater family and community acceptance and lower levels of discrimination (Betancourt, Pochan, and de la Soudie´re 2005). In Sierra Leone, NGOs effectively functioned as neutral, highly legitimate mediators of postconflict passions around social issues of guilt and forgiveness. Beah’s narrative is important for this story because the services he received in Sierra Leone were largely made available to child soldiers and were different from the cantonment rehabilitation services available to adults. In Liberia, too, for years after the war, humanitarians arrived in Monrovia seeking child soldiers for whom they could provide counseling, nursing, and trauma healing. Unfortunately for both the humanitarians

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and the ex-combatants, the problem with child soldiers in a long war is that if they survived, they grew up. Consequently, by the time DDRR arrived in 2003 and in the ensuing years, most child soldiers had already become adults and were therefore ineligible for many ‘‘gold standard’’ rehabilitation programs.

The Guthrie Plantation In 2003, as the war approached its conclusion, approximately one thousand LURD fighters seized control of a fifteen-kilometer stretch of the Guthrie Rubber Plantation to the northwest of Monrovia, on an important transit road that led to Sierra Leone. For four years they had supported themselves through illegal rubber tapping, which they sold to brokers in fifty-kilogram bags of latex, earning approximately US$6.50 per bag. Commanders earned as much as US$60–150 per week (several times greater than the typical Liberian civil servant salary), while low-rank rebel rubber tappers earned approximately US$5 a week. I observed the Guthrie Plantation fighters’ psychosocial rehabilitation project in 2008 and learned something of the dialogic process of resocialization. Challenging the idea that soldiering is a space of ‘‘anticulture,’’ anthropological research and personal memoirs have shown that child soldiers experience a process of resocialization rather than asocialization or desocialization in conflict (Beah 2007; Honwana 2006; Utas 2003; Rosen 2007). Coulter (2009) and Hoffman (2011), in particular, have drawn careful lines of cultural continuity between combatants’ prewar, wartime, and postwar identities, attachments, and relationships. In contrast, humanitarian practice has embraced the principle that the human material of child soldiers requires fundamental refashioning. New cultural, educational, and social attachments need to be created, children need to be relocated into community environments, and ‘‘psychosocial approaches’’ that emphasize cultural, economic, and political reintegration are prioritized. Through a psychosocial approach, ex-combatant cognition, behaviors, and relationships will be transformed, and psychological trauma will at least be managed, if not healed. In a context of social, normative, and legal destabilization, the principle of resocialization is much more complex. What type of community were ex-combatants being resocialized into? On what foundation could people

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establish postwar identities? Into what ‘‘culture’’ was cultural rehabilitation taking place? These questions were largely left to Liberian psychosocial trainers to answer. In their training and individual and group counseling sessions, they interpreted the future to ex-combatants going through postconflict transition, promised them of their potential for change, and warned them of the social consequences if they did not submit to a more peaceful subjectivity. By the end of 2007, the Guthrie Plantation ‘‘Boys’’ (and girls) still had not demobilized and were a constant irritant to UNMIL. The Guthrie Plantation was the last stand of the rebels, and in order for UNMIL to have full territorial control over the Republic of Liberia, the plantation had to be demobilized. The continued occupation of the plantation was impeding progress on high-level negotiations over Liberia’s rubber sector reforms. The rebels also posed a continuing security concern because they occasionally attacked local Liberians, UN observers, or private security firms who ventured onto the plantation to monitor their activities. Their continued occupation was a threat to NGOs, blocked plans for economic development, and was stalling discussions on timetables for UNMIL drawdowns. Although their continued occupation of a small corner of the plantation was described as a major security threat, the real threat came from the brazenly open existence of functioning military structures, warlord economies, and rebel lifestyles in the emerging postconflict state. The first threat was sociological: the Guthrie Boys modeled a ‘‘way-of-being-in-the world’’ that fundamentally subverted the new moral order that UNMIL and the government of Liberia were trying to create. The economic threat was more powerful: their ongoing presence impeded the process of reforming and reallocating the rubber plantation economy then under way, a process in which many Liberian legislators and business elites sought ownership stakes. In the course of prolonged negotiations, the Guthrie Plantation Boys obtained terms for disarmament that were much better than those in the original DDRR process. They negotiated for a substantial cash payment, intensive vocational training, and a robust ex-combatant psychosocial rehabilitation program. (All parties involved were concerned about the rebels’ ability to reintegrate into the postwar social world, which had changed considerably in five years.) The Guthrie Plantation fighters also claimed that they had been promised farms after completing DDRR, but Landmine

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Action, the NGO managing their demobilization process, denied that this was so. Therefore, in 2008, Landmine Action contracted NEPI to provide fulltime psychosocial support, integrated psychosocial training, and rehabilitation classes to four hundred participants at the Tumutu Plantation, where the ex-combatants were spending their six-month transition. At NEPI’s invitation, I joined them midway through the training. During my stay, I observed psychosocial training sessions, interviewed ex-combatant trainee participants in group and individual settings, and talked to the NEPI staff. Driving into Tumutu, I was struck by the tranquility of the environment. A long, smooth, carefully maintained road ran past thickets of rubber trees waving silvery and birch-like, sloping overhead. There were welltended fields of rice and corn, a few oblong mud-thatch homes, and a few lightly guarded roadblocks manned by Landmine Action. At the top of a gradual hill stood the training center, a government depot that Landmine Action had recently renovated. On its left were several tall, long, rectangular buildings painted in fresh coats of red, white, and beige, a dormitory, and the mess hall. To the right were recently rebuilt or repaired low-slung buildings, and beyond stood a small canteen. From anywhere in the camp, one had a cool, breezy view of the valley, filled with local farms and temporary agricultural projects being carried out by trainees. With the exception of the occasional brawl or heated argument, the training camp had the calm and somnolent feeling of a summer camp or a college campus in summertime. It was a contemplative place for reflection. When I first arrived, I was greeted with the scowls, stares, and leers of about fifty men and women in bright yellow Landmine Action T-shirts. My hosts were concerned about the possibility of violence; in the first few months of training, the ex-combatants had frequently rioted to protest training measures, disciplinary actions, and wage schedules. Several hours later, a casual, post-focus group chat with me about DDRR turned into a fifty-person mob when a Landmine Action employee tried to end the conversation. Accusing him of being in on the plot to defraud them, they moved, en masse, threateningly toward him, increasingly shouting and pounding their fists, until NEPI staff arrived and defused tensions. In less than a moment, a jovial atmosphere could become filled with tension and threat; in the same amount of time, a tense and terrifying atmosphere could relax with a joke or a song.

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The account that follows describes a class session on careers run by NEPI. It illustrates the pedagogical strategies of the NEPI trainers in nearly ideal conditions and shows how the Guthrie Boys in class that day interpreted their lessons. Through lecture, discussion, and example, NEPI trainers, all of whom were former combatants, attempted to instill a sense of what peace subjectivities look and feel like. They presented themselves as models of successful, achievable, subjective postconflict transformation, saying, ‘‘If I can do it, you can do it, too!’’ This rapid shift from violent hostility to amiability recurred at the debut of the careers class. As I walked toward the class escorted by NEPI staff, the men and women formed a close corridor around me. On entering, the trainees—mostly men, with four women—seated themselves at neat, new desks and chairs, and the atmosphere calmed down. After briefly introducing me and asking their permission for me to attend, the NEPI staff (two men and a woman) presented a few statistics on careers and unemployment in the United States and launched into their training. Sam, the NEPI trainer, asked, ‘‘Why is having a career important?’’ The trainees responded with a list of answers: ‘‘After you get work, your life will have changed. Your life will improve if you go from having no skills to having skills. From no money, you will have money. Then from having money, you can go to putting your kids in school and to having a good phone. Acquiring a career is very important for our lives and for being a real citizen of this country.’’ Sam agreed. ‘‘You must always say that ex-combatants can develop, that as ex-combatants you can improve your life. Aren’t there ex-combatants in leadership positions in government?’’ The trainees nodded and listed them: ‘‘Adolphus Dolo and Prince Johnson.’’ Sam bellowed at the trainees, ‘‘Aren’t they holding a large place in society? And where are you? Plenty of people are watching Dolo and using him as an example. Let people use you as an example, too!’’ The trainees were docile. They meekly agreed with NEPI’s lecturers that their lives were, at present, useless and that they would have to earn their way to public respect by having reputable careers. When asked to list some of the careers that were available to them, they mentioned careers for which training had been made available to ex-combatants in the past: carpenter, mason, plumber, driver, tailor, tie-dyer, farmer, and pastry chef.

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After a brief break, in which the NEPI trainers led the group in calland-response games called ‘‘the stand up and dance drill’’ and ‘‘Do! Do! Do, I say do! Just do it!’’ the training continued. Sam demanded, ‘‘Why don’t the youth today prepare for tomorrow’s achievement? People say that the youth is the tomorrow of our country!’’ The trainees knew the answer and responded immediately. ‘‘If you don’t know nothing, you get nothing in this society. But if you live in a community, you can’t get no training. You don’t know nothing. And then, as soon as something happens, they [the broader community] will call you a criminal in the community, because when they leave their homes to go to work or to their farms, you remain behind among the empty houses.’’ Sam and Mabel, one of the founders of NEPI, made a show of agreeing on this point, and Sam continued. ‘‘Careers are important for your life. For women, careers are important because with no career, a man can just treat you no-how because he can see that you don’t know how to have anything for yourself. The importance of a career is to make you be respected. If you are an ex-combatant, people just know that you know how to pull a gun. [The trainer perfectly mimicked pulling and cocking a machine gun, and the participants laughed.] It’s important to have a skill to be able to take care of yourself, to leave something after you. Otherwise, after fourteen years of war, you are just an armed robber.’’ The trainees absorbed this lesson, while Sam and Mabel took turns speaking. Mabel stepped forward in a bleached white T-shirt, camouflage green pants, a gold medallion, and a tight ponytail. She barked at the trainees in a husky voice, ‘‘With no career, no one wants to speak to you. People will only want to speak to you if you have a career. But you don’t know what to do. You don’t know your talents. It’s better to have an interest in your career.’’ She then moved into a component of the training that was deeply challenging to the participants: reality checking. ‘‘You always wanted to be a doctor, but you can’t be a doctor. Are you going to just sit down? NO! If you learn today what you need to learn, tomorrow, people will work for you! Any time you are afraid, you should accept it. But if you are not interested, you will not be the best at it. A career, without discipline, is just a wish.’’ Mabel soothed. ‘‘It takes a lot of courage, and a lot of care, to permanently change yourself and your station in life, from the you you know to

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a changed person. If you want to be like someone [in a professional career], you’ve got to see what that person is doing and learn it! You can’t run after that person to have that person’s life, but you can choose a role model to become a better man.’’ Sam and Mabel opened the training to questions. The first question came from a young man who wanted to know about being a man working in women’s jobs. Sam, the primary trainer, responded, ‘‘Perhaps a woman doesn’t have the commitment to be fulfilling that job. You can take the job and seek instruction, guidance, and support in your home, school, and community.’’ Questions continued and were followed by another active game break—a ‘‘Simon Says’’ routine with the trainers barking, ‘‘Moses says stand! Moses says come! Go! Come! Go! Stop!’’ as the trainees kicked up a storm of dust in stationary runs and stops. As they returned to their seats, one trainee pointed across the room at two young men sitting on either side of the youngest trainee. They swatted a few flies off his head and gave him an affectionate punch as the training recommenced. Mabel took the stage again to talk about the difference between ‘‘positive’’ and ‘‘negative’’ careers—between making money and having a career. The audience responded warmly. ‘‘If you end up in jail, kill someone, have to stay up all night, or can end up dead or in prison, this is a negative career.’’ Mabel pushed back to try to get them to think about the honor and dignity that come from having an honest, socially accepted, nonviolent job. She asked, ‘‘Does a positive career need to be something you can boast of? Why do people pursue a negative career?’’ The trainees reflected on their subjective struggles in the six months since the Guthrie demobilization. They answered, ‘‘Some people want to earn money they don’t want to work for. Every day, I want to be cleaner than you; I don’t want to work hard, like you. Because you’re used to getting easy money.’’ Nelson, another NEPI trainer, rotated in: ‘‘People who are always failures will always try to be a part of a negative thing. Friends who see themselves failing in the [DDRR] program will try to pull you down so that they will not be alone.’’ Some trainees were moved to speak by Nelson’s speech. One young man encouraged the others, ‘‘We have to provide that what they say about us is NOT TRUE in society!’’ A young woman drew an imaginary line across her face and worried aloud, ‘‘People would assume that your scars mean that you continue to have a bad character and will behave rudely to

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you. So we have to avoid friends with bad behavior; avoid bad friends and avoid bad associations.’’ There was a collective outburst as trainees yelled to each other concerns about establishing themselves in the rest of the world. The NEPI staff then acknowledged change was hard, and that real barriers existed: ‘‘Some people cannot change. But you can do it.’’ NEPI trainers offered practical alternatives to negative ‘‘careers’’: ‘‘Avoid negative thoughts like ‘I think if I kill that person, I can have that money.’ Your thoughts should be good thoughts, not bad, bad things running negative in your mind. No ‘I just want to hurt that person.’ Anything in your thoughts should be about progress, things that should improve your life.’’ The trainees were stirred by the lecture. The expressions on their faces changed from hopeful, to afraid, to bored, to already weary with the enormity of personal change the trainers demanded. Mabel reiterated, ‘‘With no discipline, you will have no career. You can want it, but you will not get it. In order to have a career, you have to be obedient. You have to be humble, you cannot just go off if someone tells you what to do, or beat them, or say no. You have to be honest—you cannot just lie and steal. You must be straight and correct!’’ The trainees might have to make compromises to have a career. Sometimes they might have to eat the same food day after day or wear the same shirt. They shouldn’t look to material things to get respect. Mabel emphasized that to earn respect in postwar Liberia, ‘‘People are looking to your behavior. You have to get respect by being respectful, by being humble, and by being hardworking.’’ The training concluded with Nelson morally exhorting the audience in a way that was seldom heard in other psychosocial projects. In a low and threatening voice, he said, ‘‘We’ve got rich soil here. We’ve got money in the soil. We just have to look for it.’’ He continued: People will laugh at you and laugh at your wives and children if you go back and you have learned nothing at this training. You are being given a chance to really learn something. After Tumutu, there may not be any other opportunity for you. You can’t go back to Guthrie. Guthrie is closed. It has been taken by the government for use by a private company, and now it has security, so there will be no more illicit tapping.

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Your families are sacrificing for you, for you to get your training, and if you go back without any knowledge, you will make problems in your family. They are suffering, straining for your training [in the absence of their incomes]. When you become an armed robber, you will end up either burned or robbed. Some people here are still playing fun. You need to reflect here and in your own time on what you will do to go back to where you come from. When you were the man from Guthrie, you just did whatever they told you without thinking good or bad. But now you must think, ‘‘Is this good or is this bad?’’ The question you should be asking yourself is, after Tumutu, what next? Will I leave here the same as I was before? And on that note, the training ended. The techniques deployed by the NEPI trainers were impressive. They used high drama, evocative imagery, preaching, question-and-answer routines, and pedagogical instruction. They personally challenged the trainees, taught practical problem solving, pushed trainees to identify opportunities in their environment, and taught lessons about personal presentation, demeanor, social performance, and social relationships. As with the case of Koli, there was no moral relativism in this space: there was good, and there was bad. There was right, and there was wrong. The stakes were high, and ex-combatants had to make a choice to be on the right side or the wrong side of postconflict history. NEPI trainers like Sam and Mabel offered a particular vision of how to ‘‘be in the world’’ within the limits of the possible in postconflict Liberia. They were willing to accept that transformation takes a long time and that it might be partial and incomplete. The consequences for failing to change were clear: ‘‘negative’’ careers of armed robbery, imprisonment, and death, or even the renewal of war. They made no promises about the quality of the postconflict peace available to the audience or any promises about Liberia’s future. NEPI’s training lessons resonated with psychosocial messages for postconflict change in the mainstream media, in UN public information campaigns, in other NGO trainings, in schools, and across society at large. The Guthrie Plantation boys were latecomers to the challenge of postconflict transformation and they had done wrong. Liberian society was willing and able to ‘‘forget,’’ but its willingness was contingent upon the trainees’ being able to demonstrate personal transformation through their behaviors and actions. NEPI trainers tried to make it clear to the trainees that although the ex-combatants had physical authority over the civilian population for a

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relatively unbroken period of fourteen years, the tables were now turned. Forgiveness was contingent and could be retracted. They also made it clear that the trainees were going to have to struggle to find a place in the postwar moral and social order and that they were going to have to do so in conditions of poverty and under public scrutiny and skepticism. One of NEPI’s goals was to break down personal and collective resistance while imparting a positive vision and a new, postconflict subjectivity. A critical step in doing so was to disabuse ex-combatants of their preconceptions about postconflict life. For example, many former fighters believed that they could not get jobs or a visa to the United States if they registered as ex-combatants. NEPI reassured them that neither assumption was true. Ex-combatants often shook their heads during training and murmured that the kind of self-transformation NEPI advocated was hard. NEPI countered these assertions by presenting themselves as role models of success: ‘‘Look at us. See? We did it. So can you.’’ NEPI tried their best to scare and inspire the Guthrie trainees into social change. They told them that they would be burned or killed by an angry mob if they were caught stealing, that they would go crazy from drugs, and that their lives would be filled with prostitution and family rejection. Perhaps most powerfully, however, NEPI threatened their ex-combatant audiences with the probability that they would be left behind by the rest of Liberia and by the world and become ridiculous or irrelevant. Excombatants had lost power in Liberia, and the international community and ‘‘Ma Ellen’’ had all the power. If the trainees refused to play by the new rules, they would be cast aside while everyone else got money, school, careers, families, farms, nice clothes, and food and got to travel to America. For ex-combatants, though, there were hurdles to change. One handsome thirty-year-old ex-combatant named Robert longed to become an electrical engineer but still didn’t know how to read. Another ex-combatant named George learned during the DDRR agricultural training that he had an aptitude and a love for farming, but the death of his parents and extended family meant that he had no claim to farmland or the resources to obtain some. A pervasive rumor network conveyed discouraging news of people being cheated out of land after working for years to purchase deeds; of NGOs refusing to hire ex-combatants; and of friends who had tried and failed to acclimate to postconflict life. But unlike Landmine Action and other vocational programs, NEPI also provided hope and encouragement to Robert, George, and their peers. In the face of overwhelming, soul-crushing odds, they told the trainees, who

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Figure 5. ‘‘Education Is the Key to Success: Go for It.’’ Photo by author.

were so potentially violent and so vulnerable in their temporal displacement from the world, that ‘‘the opportunities will be there for them when they are ready to pursue them.’’ NEPI promised that the world had not left them behind, that NGOs, the Liberian state, UNMIL, and their families would support them as they started their lives over at the age of twenty-seven, thirty, or forty. While new opportunities do exist in the postconflict environment, the challenges are enormous. It is around these contexts of hope, perception, opportunity, and restriction that violent riots occasionally erupted in the Landmine Action DDRR camp. They talked to the excombatants as parents would, and the Guthrie Boys boys and girls listened.

NEPI The story of NEPI’s origins is significant for understanding its particular approach to ex-combatant rehabilitation. Three Liberian men, Morlee Zawoo, Klubosumo Johnson Borh, and Zelleh Korubah, founded NEPI in 1997 after going through the LWF/WS trauma-healing program in the course of their own ex-combatant demobilization and trauma counseling. They were then trained as trauma healers for LWF/WS and functioned for a time as a subcontracting unit for LWF/WS before becoming a fully independent Liberian NGO. NEPI’s mission was to provide trauma recovery services to demobilizing rebels and soldiers. In the late 1990s, NEPI worked on an ad hoc basis subcontracting ex-combatant training work from the LWF/WS. All of their trainers were ex-combatants, and many worked as volunteers until salaried positions were created for them. At the end of the war in 2003, NEPI was

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able to find regular work doing ex-combatant demobilization through the DDRR process. Unlike many NGOs, NEPI often acted in loco parentis for excombatants. During a several-day visit to NEPI’s field office in Voinjama, I witnessed ex-combatants living near their office routinely come to NEPI when they had fights, when they got into trouble, or when they were moved to violence. NEPI provided counseling and support to ex-combatants to help them find alternatives to acting with aggression. NEPI also went into the community to act as moral witnesses who vouched for population that was widely distrusted, disenfranchised, and unfairly persecuted and penalized. In doing so, NEPI workers functioned as fictive kin who stood as a barrier between ex-combatants’ experiences of social ostracism and their potential slide into ‘‘social death.’’ I had the opportunity to observe how an NGO acted as a fictive ‘‘parent’’ for ex-combatant youths on a cool, rainy evening when two young men came by the NEPI office to report that one of the men’s brothers had been badly beaten in town. He had blood in his eyes and had to be taken to the local hospital. They had come to NEPI for two reasons. First, the brother needed help advocating with the local police, who were renowned for imprisoning and persecuting ex-combatants. Second, he had come to talk to the NEPI staff about his deep, personal desire to avenge his brother by beating or killing his brother’s assailant. The NEPI staff received many similar drop-ins from local excombatants during my extended stay there, and they told me that they were routinely called on to act as neutral mediators in high-risk conflicts involving ex-combatants. As a first-stop drop-in point for the ex-combatant community, NEPI discourages ex-combatants from bringing grievances directly to the police station and encourages them instead to come to NEPI so that it might act as an advocate within a discriminatory legal system. NEPI workers counseled ex-combatants embroiled in conflicts over land, property, religion, and drug abuse, as well as those involved in interpersonal conflicts with friends, family, teachers, and fellow students. Like other local NGO workers, NEPI psychosocial workers are part of a vast, informal, constabulary of care. Similar to the informal counseling given to Koli (Chapter 5), NEPI employees were able to act as informal advocates because they were politically neutral, independent, and sustained a consistent message of nonviolence, personal transformation, and collective change. As advocates, NEPI staff performed a vital role of trusted neutrality and fair-mindedness to a community that was widely despised. As

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role models, NEPI staff were embodied reminders of the need and possibility for enduring postconflict transformation, even when the adoption of peace subjectivities in a hostile environment seemed irrational. In the NEPI framework, trauma is more than just a mental or psychological disorder; it is the consequence of a moral rupture—a breach of personal responsibility, social responsibility, and morality between excombatants and everyone else. Thus NEPI eschewed neutrality, and unhesitatingly asserted that the deeds committed by fighters were morally bad and wrong. They emphasized that fighters had the opportunity to become innocent again if they were willing to renounce their evil ways and commit themselves to doing good. They blamed powerful warlords and business agents for recruiting people who fought rather than the fighters themselves, and this offered NEPI workers a rhetorical path toward offering redemption to ex-combatants. NEPI’s chief trainer liked to say, ‘‘Trauma doesn’t sleep. It’s like a cassette operating off of a battery. The more you play the tape, the more the battery loses life.’’ He taught his employees that the dynamics of trauma were a major impediment to renouncing violence. Trauma kept combatant memories alive and kept the ex-combatant nakedly exposed to the vicissitudes of unbearable moral conscience. According to NEPI staff, the persistent, unacknowledged cycle of unremitting trauma drove ex-combatants struggling with reintegration into madness and drug and alcohol abuse. Trauma also drove ex-combatants into the ghettos, where peer support helped former fighters forget about the lessons of rehabilitation and return to their old ways. NEPI’s moral origins in the Christian-based LWF/WS program were evident in their focus on moral accountability and forgiveness. In contrast to psychotherapeutic and psychoanalytic approaches to ex-combatant rehabilitation, which downplay moral accountability, the NEPI program emphasizes that ex-combatants recognize the moral nature of their past actions and undergo a moral reckoning. Surrounded by peers going through the same kind of soul-searching, ex-combatants could change themselves by acknowledging past lives of violence and foreswearing violence in the future. NEPI was exposed to the funding vicissitudes that battered their NGO peers and made similar compromises in order to survive and thrive in the shifting postconflict institutional landscape. One of the remarkable aspects of the NEPI initiative is its continued commitment to sustained relationships with ex-combatants after training. They offset the administrative costs

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of ex-combatant advocacy by writing line items for community peacebuilding, violence prevention, and monitoring and evaluating ‘‘self-initiatives’’ into international NGO grants for human rights and GBV initiatives. But at a personal level, NEPI staff seemed to feel connected to all former fighters seeking their help and gave counsel and emotional support freely.

The Problem of the Youth What emerges from the previous sections is a sense of the intense visibility of ex-combatants in postconflict social life. This was not a rhetorical strategy on the part of the NEPI trainers, nor was it an exaggerated fear held by street youth. While many ex-combatants had reintegrated into postconflict life as successfully as Joseph and Sumo, other ex-combatants, or youth who were believed to be ex-combatants, were watched closely in their communities for indications of latent violence or for a resistance to community reintegration. They were, in a way, a vulnerable population that had fewer rights and protections than other Liberians as a result of their personal histories of violence and lived just on the precipice of social abandonment. ‘‘Security-mindedness,’’ or the habitus of violence, was well-known and widely recognizable, and it was believed to be closely connected to excombatant status (for a different perspective, see Menzel 2011). In my interviews, people described it through physical characteristics, although as the first section in this chapter showed, threat could be communicated through verbal cues, posture, or intersubjective perception as well. According to many of my interviewees, the latent possibility of violence was displayed through their eyes, their hair, their touch, and their clothing. Yellowed or bloodshot eyes suggested alcohol or drug use, and eyes that followed one’s movements with a leer or a steady, watchful, unbroken gaze warned of the possibility for menace. Unkempt, untrimmed hair or dreadlocks suggested a disregard for middle-class propriety. Inappropriate grabbing and touching or uninvited questions were a reminder that one’s body and activities were unprotected and under surveillance. Certain articles of clothing also symbolized possible ex-combatant affiliations, like red or black basketball jerseys, ski caps, bandannas, or camouflage pants, shirts, or jackets. This contrasted with the mainstream, professional, postconflict civilian dress code of light-colored shirts and khaki pants, shorts, or blue jeans.

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Certain features of mental illness, best indexed in a proposed (but rejected) psychiatric classification associated with complex trauma called Disorders of Extreme Stress Not Otherwise Specified (DESNOS), were also attributed to ex-combatants. A diagnosis of DESNOS involves ‘‘alterations in six areas of functioning: (1) regulation of affect and impulses, (2) attention or consciousness, (3) self-perception, (4) relations with others, (5) somatization, and (6) systems of meaning.’’1 Some psychiatrists who work in non-Western contexts have endorsed DESNOS as a common descriptive framework for youth who have been exposed to combat. DESNOS’s features (see Table 5) align closely with the ‘‘security-mindedness’’ and the expressions of aggression that were commonly reported among youth in postconflict Liberia and were intensely targeted by psychosocial, mental health, and trauma-healing interventions. An ethnographic snippet helps illustrate civilians’ fear of ex-combatant violence. While I was driving through Old Road Market, a large commercial intersection in central Monrovia, Adolphus, the truck driver I was traveling with, stopped to pick up a few items. After Adolphus asked me about my research, he assured me that the war was over, that all of Monrovia and all of Liberia were safe, and that no one worried about that anymore. When Adolphus stepped out of the car to run an errand, a man with dreadlocks and the faint smell of whisky spoke to me through my open window, inquiring where I was going and what I was doing in the country. Before I had said a word, Adolphus ran back to the car, launched himself across my seat to roll up the window, turned on the engine, and shouted dissembling information to the dreadlocked man. As we drove away, he shouted at me, ‘‘THOSE people, you can NEVER tell them anything about yourself. They will come to your house and kill you! They will not think about it, they will just try to get information from you and then they will come and steal and god-knows-what and kill you! You can only lie to those people or they will find you!’’ In the postconflict period, fear of ex-combatants merged with a fear of youth more generally. While it is estimated that nearly 70 percent of excombatants returned to their parents’ homes or villages (Pugel 2007), adults across Liberia complained that the youth—and not just ex-combatants— did not listen, learn, or show any respect. For their part, the youth complained that adults did not want to teach them or help them go to school or want them to succeed. Adults and youth had little faith in each other. The core thread of social order—social reproduction—was worn thin. It was not that adults were not able to provide youth with the apprenticeship

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Table 5. Diagnostic Criteria for Disorders of Extreme Stress Not Otherwise Specified (DESNOS) I. Alteration in Regulation of Affect and Impulses (A and 1 of B–F required)

A. B. C. D. E.

Affect Regulation (2) Modulated Anger Self-Destructive Suicidal Preoccupation Difficulty Modulating Sexual Involvement F. Excessive Risk Taking

II. Alterations in Attention or Consciousness (A or B required)

A. Amnesia B. Transient Dissociative Episodes and Depersonalization

III. Alterations in Self-Perception (two of A–F required)

A. B. C. D. E. F.

IV. Alterations in Relations with Others (one of A–C required)

A. Inability to Trust B. Revictimization C. Victimizing Others

V. Somatization (two of A–E required)

A. B. C. D. E.

VI. Alteration in Systems of Meaning (A or B required)

A. Despair and Hopelessness B. Loss of Previously Sustaining Belief

Ineffectiveness Permanent Damage Guilt and Responsibility Shame Nobody Can Understand Minimizing

Digestive System Chronic Pain Cardiopulmonary Symptoms Conversion Symptoms Sexual Symptoms

or educational opportunities they needed to succeed in the postwar world or even that the legal, judicial, and security contexts were fundamentally unstable. Many adults and youth had been abandoned and/or had abandoned others and were still ‘‘just sitting,’’ abandoned in the years after the war. During a short focus group with ten men and women at Tumutu, I gained some insight into recent ex-combatants’ postconflict ambitions. All of the participants had been recruited to fight as minors and were now

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between twenty-five and forty years old. Just under half of the participants wanted careers in rice farming and animal husbandry, but three group members wanted to pursue careers in robotics, engineering, and graphic design. Their immediate postwar plans, though, were revealing. Five of the focus group participants stated that they intended to live on their own. They wanted to return to the neighborhoods and towns where their families lived, but they felt that they were ‘‘too big’’ to go back to live with their parents, who were ‘‘old and could not work.’’ They did not want to burden or ‘‘embarrass’’ their parents with the responsibility of feeding and worrying about them. Several men worried that their wives’ and children’s education had been permanently impaired by the war and by the relationships and responsibilities that had accumulated over their adulthoods. In contrast, four people said that they were going to be returning to live with their families; one woman announced that she intended to become the ‘‘family head’’ who would care for her parents and for the other children in her parents’ home. One man said that he intended to move to Monrovia’s West Point area, a notorious ghetto with a high concentration of excombatants, so that he could live with his friends and they could ‘‘help and support each other.’’ The overwhelming intention to be ‘‘on my own,’’ regardless of the conditions of labor, suggests a change in Liberian social demography. Prior to the war, from 1960 to 1985, there had been an increasing cash dependence of the labor sector and migration away from traditional, rural, subsistence farming as a result of the rapid expansion of the huge rubber cultivation and iron-ore mining industries. If one wasn’t making money in the towns and cities or living off of someone who was, one was obligated to return to family villages to work on farms. However, the two economies existed in parallel; one economy acted as a feeder economy for laborers and resources for the second, which yielded wages and mobility. That trend contrasts sharply with the postwar plans of demobilizing excombatants and other youth. As several of the Guthrie students complained during their careers class, ‘‘Because of the war, we don’t have a taste for farming anymore,’’ nor did they have the complex skills, training, or tutelage necessary to succeed as subsistence farmers in a challenging tropical agricultural landscape with a contentious land reform problem. But literacy skills, technical skills, and life skills also remained inaccessible. Under DDRR, special ‘‘accelerated’’ programs were developed to enable people

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with elementary educations to get through primary school and high school in two years. The educational outcomes of these training programs were poor. NGOs also provided job-training programs through DDRR, but many youth did not learn enough skills to make themselves marketable. Postwar DDRR processes often assumed that there would be a familial or social presence to provide a stable context for the desocialized excombatant, thus enabling reintegration. The World Bank, for example, wrote: Reintegration of child soldiers should emphasize three components: family reunification, psychosocial support and education, and economic opportunity. Family reunification—or, where that is not possible, foster placement or support for independent living—is crucial to successful reintegration. Psychosocial support, including traditional rituals and family and community mediation, is central to addressing the asocial and aggressive behavior learned by child soldiers, and to helping them recover from stressful experiences. Finally, education and economic opportunities must be individually determined and must include family livelihood needs. (Varhey 2002, 3) Many ex-combatants, as well as noncombatant youth like Valentine, depended on the international community to act in loco parentis, but NGOs were not eager to take on this role with grown adults. Consequently, tens of thousands of postwar Liberian youth struggled to find a holistic experience of security in their own lives. Research among ex-combatant populations in 2008 has found high rates of suicidal ideation, drug abuse, depression, and PTSD among ex-combatant populations, across age groups (Johnson et al. 2008). Researchers also found that ex-combatants in Liberia were almost three times as likely as noncombatants to have possible traumatic brain injury, which was nearly always undiagnosed and often had physical and mental health consequences (Johnson et al. 2008). In the immediate aftermath of the war, youth and children needed parental sponsors: parents, grandparents, aunts and uncles, or elder siblings to help rebuild their lives. For those who lacked familial sponsors, NGOs offered partial, incomplete, and time-limited avenues for reintegration and protection. But one of the challenges confronted by ex-combatants was that

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the world into which they were returning was filled with unstable institutions, fluctuating rules, and unknown laws—and was very different from the ‘‘normal’’ lives they had lived before the war. Many youths’ families were poor and struggling and were often barely present in the lives of their children. With families that were remote and distant, and an unstable government that could not offer a meaningful social safety net, NGOs functioned as the permanent structures of excombatants’ postconflict lives. They knew the terrain of services well and could recount programs and projects that had opened and closed, along with stories about premature enrollment cutoffs, promised projects that might be on their way, and local efforts youth associations were making to ‘‘develop themselves’’ as individuals and to assert themselves into local and national politics. Liberia lost a generation of people who could provide youth with the skills needed to succeed at subsistence agricultural labor. These youth had lost the social networks, monetary and social capital, and skills needed to go into business. Without the physical presence of living elders or close relationships to them, the moral wisdom, historical consciousness, and cultural traditions that had shaped the moral and ethical participation of youth in everyday social life had been eclipsed.

Chapter 7

Redemption Time

Following years of hate, killings, and destroying of our own country and ourselves, we have all agreed that enough is enough, and that we should stop. We need to replace hate with love, killing with helping each other to live, and joining our hearts and hands together to move our one Liberia forward. Remember—the hate, killing, and destroying ourselves has to stop, and now is that time. —Message from UNMIL Radio

The Architecture of Postconflict Time In this chapter, I widen the lens from a study of specific mental health and psychosocial interventions to examine how mass human rights interventions worked as a form of social engineering in postconflict life. In the ethnographic narratives that follow, I focus on the strategies deployed to reengineer public sentiment en masse: media and advertising campaigns, public spectacles like traditional healing rituals and the Liberian Truth and Reconciliation Commission, and community-based human rights training. Through these efforts, Liberians and international NGOs participated in a project of producing ‘‘normal’’ peace subjectivities, or what Michael Herzfeld called ‘‘producing sameness’’ (1992, 75). Although these interventions deserve far more attention than the space they will be afforded here, I have aggregated them together in this chapter

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to give a sense of how interventions that targeted populations en masse shared the attributes of preceding psychosocial interventions at individual and community levels and resonated with each other in order to create a total environment of postconflict transformation (cf. Goffman’s total institution [1961]). Producing peace subjectivities meant that the international humanitarian community, in dialogue with the Liberian population, had to create a lived experience of transitional time and space. Within postconflict time-space, fundamental rules of social order were being reworked through human rights education initiatives. Issues of cultural norms and cultural heritage were repurposed into prepackaged rituals of reconciliation, sponsored by international donors. Issues of justice, morality, and forgiveness were tested through high-profile Truth and Reconciliation Commission (TRC) campaigns, which were widely regarded as a national experiment. In the meantime, the language of postconflict transformation was echoed repeatedly through mass media outlets like billboards, radio, and public dramas that offered a new dialogic language for the resolution of daily disputes in postconflict appropriate ways. At stake was nothing less than the reconstitution of Liberian social order (see Wrong 1994). These initiatives took place against the backdrop of a fervently religious environment, which contributed to the sense of risk, vulnerability, and momentousness that filled the air. Postconflict time was not just a time for transformation but a messianic time, and everything had a quality of divine judgment or divine retribution. From the pulpits, in daily prayer meetings, and in prayers in homes and workplaces, Christian Liberians, who constituted approximately 85 percent of the population, issued salvation promises and called for forgiveness and redemption. As shown in the film The Redemption of General Butt Naked (Strauss and Anastation 2011) and Gwendolyn Heaner’s (2010) important study ‘‘Destroying the Destroyer of Your Destiny: Pentecostalism and Charismatic Christianity in Post-Conflict Liberia,’’ Christianity—especially the Pentecostal, Seventh-day Adventist, and Prosperity Gospels ministries that multiplied in the five years after the war—provided living subtexts for many of the national discussions taking place about confronting the evils of the past and finding redemption. Previous chapters have already shown how debates over biblical texts, church teachings, and private prayer surfaced in psychosocial counseling, GBV training sessions, and human rights education initiatives. From the scriptural debates encountered by Second Chance to the religiously informed moral injunctions expressed by Liberian workers for Sante´

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Humanitaire, LWF/WS, and NEPI, religion served as a vital source of information about how to confront and forget the past, manage the present, and prepare for the future. Moreover, religion also served as a vital material and social resource. Churches in Liberia, as in other postconflict locations, served as sites for the material distribution of humanitarian aid (see Shaw 2007) and the reconstruction of social, moral, and professional networks. In many respects, churches rivaled the reach of that of humanitarian NGOs in counseling and intervention, access to food, clothing, and shelter, and the range of concerns involving public and private morals. Through ecumenical networks, youth accessed meals, shelter, and religious counseling, and church prayer groups often overlapped with self-help organizations and charitable giving societies. These ongoing practices simultaneously created an independent environment of persuasion and coercion that sustained hope for the possibility of personal and national transformation and sustained a fear of reversion to war. The sacredness of postconflict time cannot be separated from the nature of time itself in the moment of postconflict transformation. Ruti Teitel, a prominent scholar of TRCs, has often mentioned the importance of restructuring the experience of time in postconflict contexts (see Teitel 2000, 182). For the architects of TRCs, temporality, or the separation of wartime from postwar peacetime, distinguished truth commissions from other institutions that took root in postwar societies. Through human rights training, the Liberian TRC, and public media campaigns to shift popular opinion regarding politics, violence, and economic participation, it was possible to map the legal and normative innovations that were influencing public debates about good and evil, right and wrong. When Koli said that he knew the war was over for him after ‘‘they’’ cut his dreadlocks off, he suggested that rituals like demobilization and elections had what one might call ‘‘magical’’ properties. Anthropologists have long examined how rituals and events work with a changing social sense of space and time to create a sense of magical or spiritual transformation. In the theory of rites de passage, Arnold van Gennep’s studies of religious transformation and Victor Turner’s studies of traditional healing explored the concept of ritual liminality. Turner, in particular, demonstrated how ritual structures created liminal moments that permitted the emergence of ‘‘antistructure,’’ or moments in the ritual process when the norms of the community are symbolically altered and social metamorphosis becomes possible (van Gennep 2010; Turner 1967, 1969). One can well imagine that

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a climate of insecurity and uncertainty, coupled with the liminal architecture of postconflict transition time and the fervent religiosity of the postconflict moment, created an uncanny sense of change in the air. In an already fevered spiritual environment, humanitarian messaging brought the force of global moral authority to bear on Liberian social life. Postconflict time was set apart from prewar ‘‘normal time,’’ which was also a contested period of intense political violence, and from wartime. Reconstruction, rehabilitation, and redemption were the social dramas of the day, and all of Liberian society was under an injunction to pass through the postconflict process or risk having failed at postwar transformation. But as the narrative of a human rights training in Lofa County later in the chapter shows, the process of social transformation was primed through the magic of postconflict time but was realized through a long, hard slog through the daily details of Liberian lives. In weekly human rights training sessions in small communities across the country, Liberian trainers educated civilians on the new rules of postconflict life. While they held in their hands scripts of human rights training materials, they freely imagined a world of human rights, liberal justice, and state-bureaucratic management, and compelled their audiences to change their behaviors to fit their ideals of a postconflict state. Expatriate and Liberian elites, UNMIL peacekeepers, humanitarian aid workers, and social and religious leaders also self-consciously enacted rituals of peacebuilding and peacekeeping in ordinary interactions. Ritualization created the structural conditions for the enactment of national-scale liminality and thereby ‘‘set the stage’’ in the social drama of transformation: ‘‘The power of ritual is not to solve problems but to reframe them. . . . Ritualization . . . entails three key components—1) setting apart a domain of practice as somehow ‘other than’ everyday life, 2) reordering participants’ experiences within that domain by foregrounding new connections among existing cultural concepts, and (3) grounding these new associations in embodied practice’’ (Lester 2007, 370–371; Bell 1992). Postconflict transitions were meant to create political bridges between the past and the future, to transform the symbolic order of justice and morality, and to transform taken-for-granted perceptions of reality. Just as important, however, postconflict transitions were meant to be temporary—to have beginnings and ends. Humanitarian actors, including peacekeepers, NGO workers, and bureaucrats for UN organizations, continuously demarcated postconflict time in speech, print, and practice, especially regarding

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specific rituals of collective crisis and transformation. These included the start of refugee repatriation, the closure of refugee and IDP camps, the opening and closure of DDRR, voter registration for the 2005 elections, the presidential campaign season, and parliamentary elections. Every transition was heralded at its debut, emphasized as temporary during its existence, and celebrated through orchestrated public events at their closure. UNMIL orchestrated public rituals of handover from UNMIL’s police authority to the Liberian National Police. It drew down the UNMIL peacekeeping mission with fanfare and closed military checkpoints ceremoniously. The emotional context of these postconflict rituals was important for their success. They sustained Liberian anxiety and hope about what might happen once UNMIL left and kept the focus on the uncertain future rather than the traumatic past. Would the war break out again? Would politicians be able to participate in a legitimate democracy? Would ordinary Liberians indeed have new human rights? What could Liberia gain as a free, sovereign, and independent nation? Although these concerns were a constant source of tension in public and private discussions, they created a distance between the two militarized contexts of Liberia-at-war and Liberia-atpeace. The presence of UNMIL shifted the emotional landscape of postconflict recovery from terror to security to a future of unknown possibilities. While NGOs gladly suggested pathways to individual and national redemption, it is important to note that this sense of frenetic transition was buoyed by the physical, economic, and sensory transformations of postconflict space. Businesses tentatively repainted storefronts, then resurrected import and capital networks, and gradually reconstructed buildings, hotels, and homes. While blue-helmeted peacekeepers assumed their posts at former combatant-controlled roadblocks, governments and aid agencies imported and erected new Liberian flags and flagpoles and rebuilt schools. In the countryside, NGOs distributed farm tools, aluminum roofing, medicine, and ran public education campaigns. Roads improved, traffic became unbearable, U.S. dollars mingled with Liberian liberty dollars, and buildings rose. As air conditioners, cars, and generators became more widely available, their presence in middle-class households grew as luxuries and as status symbols. Generators rumbled, powering construction equipment, video clubs, homes, offices, businesses, clinics, and discothe`ques. Slowly Liberia changed from a bombed-out wasteland of shattered buildings and terrified persons into an environment of busy productivity. And the language of postconflict transformation was posted on billboards everywhere.

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Public Media Campaigns In the early decades of the twentieth century, American and European social scientists recognized that advertising was a powerful instrument of social engineering. Whether the intent was to produce particular kinds of citizens or to sell commercial products, advertising could be deployed as a powerful tool to produce secular nationalism (Alexander and Schmidt 1996), pursue colonial or national pacification (May 1980; Chiang 2001), change public desires, prejudices, and sentiments (Myrdal 1995), or obtain support for particular visions of the state (Scott 1998). In particular, Gunnar Myrdal, a Swedish Nobel Laureate, economist, sociologist, and political scientist, advocated the use of advertising as a mechanism of social engineering. He believed that social engineering could be used effectively to address entrenched societal problems like American racism, economic development, and democratization. His theories strongly informed the thinking of advertising giants like David Ogilvy, who used his theories to transform modern advertising, and Mustafa Kamal Atatu¨rk, who deployed social engineering techniques endorsed by intellectuals in the social sciences to transform Turkey into a modern, secular nation-state. In the aftermath of the Liberian war, UNMIL and several international organizations provided funding and equipment to sponsor radio stations like STAR Radio, Sky FM, and Radio Veritas. UNMIL communications departments also founded regional radio stations, trained broadcasters and deejays, and purchased advertising time to run public media campaigns. Through these venues, information about DDRR, voter registration, elections, and criminal activity were transmitted to the public, as were messages about violence, human rights, public civility, and even public hygiene. Radio jingles, radio plays, public theater, and billboards exhorted, instructed, and created forums for debate in Liberian English and local languages. Radio and public theater were central elements of a mass ‘‘hearts and minds’’ campaign to transform public consciousness, to change individual behavior at a collective scale, and to drum postconflict messages into the minds of Liberians through repetition, day in and day out. While the voices of popular Liberian radio personalities hummed soothing postconflict messages in the background of postconflict daily life, UNMIL messaging was repeated in daily interpersonal encounters between UNMIL officers and local populations. Before the radio stations were set up, UNMIL communications officers broadcast the end of the war to

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Table 6. Billboard Slogans We Are All Liberians. Leave Tribal Violence Behind. Act Within the Law: Stop Violence! Violence Leads to Jail. Don’t Fight! Peace Yes! War, Never Again! Liberians, Get Up and Vote! It Is Your Right.

anyone who would listen. One UNMIL communications officer, a former Turkish journalist named Serif Turgut, recounted to me that when she arrived in 2003, she brokered personal friendships with warlords to facilitate disarmament; slept in UNMIL tents in insecure sites to advertise the presence of the international community; and bartered, begged, and commanded Liberians into demobilization. Her continual message, for the duration of her time in Liberia, was that despite the visible landscape of war, peace had come, and she carried that message into day-to-day interactions with beer vendors, fighters, auto mechanics, and restaurateurs. Her words echoed those of Liberian NGO workers and Liberian public media campaigns: ‘‘The time for carrying a gun is done’’; ‘‘There is peace now. You can’t do this anymore.’’ The campaigns had an important effect on postconflict language and attempted to wedge open new modes of postwar communication. Billboard slogans (see Table 6) provided instruction in postconflict rhetoric, and the phrases ‘‘forgiveness,’’ ‘‘stop violence,’’ ‘‘peace,’’ and ‘‘human rights’’ became linguistic signifiers of postconflict sympathies. Words like ‘‘peace,’’ ‘‘violence,’’ ‘‘war,’’ and ‘‘education’’ had open meanings that could be situationally borrowed upon and strategically deployed in the context of social engagement. In contrast, the language used in radio dramas and public service announcements (see Table 7) was intended to have very specific dialogic intent. Radio dramas provided specific, turn-by-turn utterances that were meant to model conflict resolution techniques in intimate social life. Some of the topics covered included negotiations over sex, condoms, and family size and how to turn in one’s friends to the authorities for criminal behavior. They also extended into domestic conflicts over parental

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Table 7. Public Service Announcements: STAR Radio Freedom of movement is a right everyone enjoys as a human being. When you block the roads and destroy properties during nonpeaceful demonstrations, you deny others their right to free movement. Why engage in nonpeaceful demonstrations? Why destroy properties? Avoid violent demonstrations. Say no to violence, and let’s resolve issues peacefully! The respect for human dignity and the rights of all members of the human family is the foundation of freedom, justice, and peace in a society. Respect human dignity. Respect the rule of law. In building a new Liberia, education must be the focus of us all. If you are not educated, you will certainly be poor by the educated. Say no to ignorance and yes to education! Education is the key to success! What do you do when violation occurs? Report the violation to the nearest human rights monitor in your community. If there is none, there are several human rights organizations in and around Monrovia. Go and report the issue and they will speak on your behalf. Don’t take the law into your hands by either fighting or destroying properties. A society with total disregard for human rights is prone to division and destruction. Respect human dignity. It’s the best way forward! The first step toward building a sustainable democracy is a respect for human rights. Stop violations of all kinds and respect human dignity! What is violation? Violation means doing wrong action against another human being which denies his or her rights. For instance, if you kill another person, you deny him or her the right to life. When you force a woman into bed, you violate her right as a human being. When you stop someone from saying his feelings, you deny him his right to freedom of expression. Stop violations in all forms and respect the rule of law! Everyone is equal before the law. Discrimination is the pillar of division. Let us all put aside tribal, religious, and political differences and work toward building a peaceful Liberia. One Liberia, One People. United we stand, divided we fall!

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and child rights and responsibilities, especially regarding school fees and school attendance. Media campaigns constantly reminded Liberians that postwar life demanded new minimum standards of ethical behavior and offered a language for accomplishing new, peaceful ends.

Human Rights and Customary Law Five years after the war had ended, NEPI struggled to obtain funding for community-based trauma-healing and ex-combatant rehabilitation. In order to continue to function, they had become subcontractors for larger NGOs and offered marketable services, like human rights education, GBV education, needs assessments, and monitoring and evaluation studies, that extended beyond NEPI’s core competency in ex-combatant demobilization. Through human rights trainings, the humanitarian community sought to transform all Liberians into homo civicus—participants in civil society who could act in the interest of the community and nation. Foreign institutions sought to change the Liberian citizenry by developing Liberian civil society, an apolitical public space in which citizens could work out their values, affiliations, and political priorities through public discourse. In humanitarian discourse, human rights created the possibility for the promotion of mass social change, normative correction, rule of law, democratization, and social reintegration (see James 2010). The ethos of these interventions was oriented toward the restoration of social order under a new juridical framework of laws, morals, and ethics, but often the ambitions of the interventions outpaced the ability and the will of the Liberian state’s own reforms. Although human rights initiatives have never been conventionally classed as a form of psychosocial intervention, the text that follows reveals the substantive overlaps between the interventions described in previous chapters and the human rights education trainings carried out across the country. Discussions of human rights, like discussions of violence, trauma, and social reintegration, became a site for contesting norms over social roles, political rights, and economic institutions that mattered in Liberians’ everyday lives. Thus, on a cool, gray morning in May 2008 in a Liberian village on the Sierra Leonean border, I joined thirty men and women who had convened inside a burned-out shell of a former town hall. Their village was at the end of a long, narrow dirt road, and on the way to the training, the NEPI trainer

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and I passed many other villages that had been destroyed and were now melting back into the bush. The recently repatriated villagers had just returned from Sierra Leone and Guinea after a decade away; but here the village had survived because village residents had returned during the war to farm, take care of their property, or see family, so it had never been truly abandoned. My guide, Philip, wore a NEPI ID card on a shoelace around his neck and carried a folder with the human rights training documents. This was his sixth or seventh visit to the village. What follows is a detailed illustration of a typical human rights education event that was carried out on a recurring basis. Philip opened the discussion. ‘‘What can we do for the government? We can pay taxes.’’ He noted, ‘‘But you might say, ‘We don’t have a toilet, we don’t have a water pump, we don’t have anything. What can the government do for us?’ ’’ Answering his own question, he said, The government can be a mediator between NGOs and the land business to get development. We have to pay revenue for the government. The government provides general protection, because anyone can enter [Liberia] with arms, but the first thing the government has to provide is general protection. You have to know what your taxes are paying for. The reason I am paying $5 is for the right to build schools to learn, the right to have a good market ground, and the right to repair this town hall. It’s our right to ask government to pay for specific development. We can’t just go and say that we want help. We have to know the specific activity we want help for. We have to help the government, and the government, too, can help us. Government is Good. But we refuse to help the government. We know what a government is for. We are a democracy. Government is by the people and for the people. We need to pay our taxes and carry on development, and if we do, and government doesn’t, we can stand up for our rights! But if your rights are abused, you can take the person to the human rights office to fight for your rights. If I have money and you don’t, I can abuse you. THIS is why we have human rights now. If you see wrong, you must rush to protect your rights. If you are a child or an adult, you have rights. If I take you to court and spend

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a lot of money, and bought myself [paid bribes], you can talk to the human rights monitor. You can go complain to the commissioner. Don’t be afraid of government officials. Don’t think that if I go there they will do bad things to me. You don’t want to be afraid of government officials. After ascribing human rights monitors extraordinary legal authority, Philip tried to explain what rights were and why they were important. He stressed that there was a correct and an incorrect usage of the term. Mocking his audience, he joked, ‘‘You’re always knocking at the door saying, ‘I have a right over that woman, I have a right over that child.’ But first you have to know what is your right!’’ People whispered and began to laugh. Then a woman pointed at a man and said, ‘‘He is my husband, and if I ask him to do something and he goes and does something different, I have a right to sue that person, because that is my right. If you ask your husband to do something, he must do it, because that is your right!’’ Philip wisely concurred, but he noted that she couldn’t claim anyone as her spouse without obtaining government documents (a marriage license). A general sigh passed through the crowd as the enormity of the bureaucracy of human rights overtook them. Sensing a growing interest, Philip tried to untangle the problem of children’s human rights, arguing that human rights discourses meant that children had a right to care and recognition in their families. When it comes to rights, you have to be very humble. If someone offends you, you have a right in that particular area. If you and your wife stay [live] together but have no documents, and you say, ‘‘Wife! Don’t go!’’ and she goes, you have your wife under your arm, and you have the right to tell her not to go. From the day you are born, the will you are born with, it is the will you have. If I impose my will on someone, it is wrong. Little boys and little girls have the right to be born, to grow, to become themselves, to have freedom of movement, to have freedom of speech. You cannot say that ‘‘because you are small, you are lying.’’ It is his or her right to speak. Philip concluded, ‘‘The boy had a right to speak. A person has a right to discuss what they are going to tell you! Parents must include children in

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Figure 6. Human rights training, Lofa County. Photo by author.

the family discussion. They may know something that can resolve the problem. You cannot say to the little boy, ‘I raised you, I born you, so what can you tell me that I don’t know?’ Maybe the child has seen something you didn’t see?!’’ After offering a parable, Philip moved into the problem of child custody. He acknowledged that family separations, child-sharing agreements, and adoption had confused issues of legal and financial responsibility, but he emphasized to his audience that adults, again, ‘‘needed papers’’ to prove their children were theirs: ‘‘You have to get paper to be the caretaker of a child. You have to take care of that child. Or else that child will go, and inquire, and the child can complain against you if you are abusing or molesting them, and they can go to the government to find another caretaker. At the age of eighteen, that child’s property is his own, and you cannot keep it from him.’’ Similar to the GBV trainings examined earlier, the audience took the information presented by an NGO worker to be factual even though many of his assertions were legally incorrect, unreasonable for the local context,

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or bureaucratically unfeasible. Liberian NGO workers were the faces of the new human rights rule book in an information-thin environment, and they offered an authoritative moral and legal voice. As interlocutors between the village, the government, and the international human rights system, NGO workers emphasized that human rights were not only real, they were actively defended by UNMIL’s military peacekeeping force, whose presence was everywhere, as everyone could plainly see. Despite the fact that Philip’s arguments challenged the wealth-in-people basis of customary law (Bledsoe 1980) that had been enforced throughout the region for centuries, the village residents listened carefully to human rights’ legal challenges to the principles of child fealty, obedience to elders, and other child-rearing practices. Then, realizing that human rights challenged conventional practices for structuring families, managing familial labor, and assigning familial responsibility, the village erupted into an argument over parental responsibilities and childhood obligations. One man, having heard of the inheritance law, asked about the distribution of property among three orphaned children. He posed the following puzzle: ‘‘If an adult raised one child, and the other two children were reared by someone else or survived on their own, was not the adult entitled to their land inheritance [as payment for having raised the child]?’’ Philip replied, ‘‘No. The property must be divided equally between the three children when they reach maturity. You cannot say that the big brother will take care of everything [for his younger two siblings]. The children have equal right to the property. Property must be shared. If you sell the property, you cannot sell the big brother’s portion or the small brother’s portion; you can only sell your own portion. If you have a problem with this, go to the human rights office in Voinjama. The human rights office can help.’’ The idealized government Philip described—from human rights offices to land deeds to education laws and child custody regulations to marriage contracts and deeds of divorce—showed a belief in an active, daily bureaucratic intervention at most stages of the life course. Although the village was far removed from the possibility of government intervention at the time he spoke, he projected an ideal of government bureaucracy that argued for a social contract between the people and government, a relation of mutual responsibility and mutual protection that vastly exceeded the finances, human resources, and juridical resolve available from the government.

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At the same time, Philip did not realize that his response overturned a long history of eldest brothers’ custodial rights in lands and properties, as well as their right to exercise decisive authority over younger siblings. Moreover, his response suggested that there was a new level—the human rights office—of bureaucratic oversight over land and kinship. Moving on to child labor, Philip told his skeptical but credulous audience, ‘‘If you put your children in school, but you use a child as property and don’t send a child to school, the government will take that child away from you and find another caretaker. Because, if the way that you are taking care of that person feels bad, that child will get spoiled and die. You cannot do that and develop the nation. Government says that we must develop the nation! It is the child’s right to learn and you to farm. Two brothers have the same right to go to school. You cannot say, ‘‘You’re the boy or eldest, and you can go to school,’’ while ‘‘You will stay home, your brother will go to school.’’ An elderly woman sitting at my left raised her hand and opened the contested terrain of men’s and women’s respective responsibilities to children. She asked, ‘‘What if you sit with someone [live with them], and you and your husband bear three or four children and are having those children go to school. School fee time comes, but the man doesn’t pay. The woman goes to get credit to put the children in school. When the woman says, ‘Let’s go pay [the debt],’ the man doesn’t care. What should the woman do?’’ The audience, knowing the woman and her story, volunteered a response. They advised her to turn to the other people in the house and to call other members of the community into the house and explain the situation. In response to their recommendation that she seek counsel from the greater community to help persuade her husband to ‘‘see’’ his responsibility, she simply laughed at the futility of their suggestion. A brief attack on the character of the young men of the town ensued, and some villagers protested. ‘‘People are here to settle this matter. Men won’t change. Men are afraid to change. As for me, I won’t do this thing again. Young men must follow this case.’’ Then a fight broke out between the men and the women. Across the circle, men and women shouted, ‘‘It’s your right to ask for children’s school fees, uniform costs, and feeding! Especially in this case, since he’s the one who sent you to go and borrow money.’’ Philip intervened, addressing the old woman who had posed the question. ‘‘Don’t worry, Ol’ Ma, all your money will be refunded.’’

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Then, while goats meandered and babies yawned, Philip created another stir by returning to marriage—specifically, the practice of arranged marriages, dowry payments, and bride prices. He said, ‘‘If you promise marriage to anyone, to any man or any boy, and the time comes, and you see a new face and you spoil the promise, the promise is incomplete. You do not have to pay the debt owed to a husband or wife before you become a husband or wife.’’ Turning to the men, Philip added, ‘‘Don’t seek five hundred or two thousand [Liberian] dollars’ credit, and say, ‘Don’t worry, I will marry you, and I will pay you, but you and we will be together.’ You don’t marry the woman because of the debt that has to be paid. Human rights says that we should avoid that.’’ Philip was signaling a fundamental shift in global expectations of local gender relations. Turning to the men again, he argued, ‘‘You may choose to share or give your property to the person you marry, but in case of marriage dissolution, that person must share in a portion of your property. The only thing the woman can’t take part in is property that was specifically given to you.’’ To the women, who were now aligned on one side of the burned-out town hall together, Philip lectured, Don’t be with someone—not in a traditional marriage, not in a government marriage—who can send you away empty-handed, saying, ‘‘Go. I don’t want you.’’ Don’t be with someone who, if you have to go to a clinic or hospital [and incur fees for which you are responsible], will treat you as he wishes. Get a marriage certificate from the government to protect your rights! But if you are a woman and you don’t go through the process, if you go to court you will be charged because the government will not recognize that man’s responsibility to you. All marriages should be legal. If you don’t, you will lose, because you won’t carry anything. But if you do a traditional marriage, and carry Kola and pay forty dollars, it will not count. You have to go through the government. A man in the audience spoke up, giving insight into the mutual uncertainty around marriage and mating that existed between men and women: ‘‘If a man wants to marry a woman and the woman refuses, what should you do?’’

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Philip, suddenly cast as advice-giver to the lovelorn, broke the bad news: ‘‘If you say I love you and I want to marry you, but she says no, maybe the woman doesn’t want you. You can’t force a woman to marry you. Before you can marry a woman, you have to plan. You have to take time, observe the person’s ways, look at how they are, and see if that person’s ways can cope with yours. If any problem arises between you and this woman, the woman showed her feelings to you, and you forced her. So you have no rights.’’ Another man demanded, ‘‘What if you are with a woman, and the woman has a child with you, and then refuses to marry you. But she promised. What can you do?’’ Philip replied, ‘‘Sorry. You can’t do anything.’’ Throughout the remainder of the morning, Philip continued to field questions about divorce, children’s custody arrangements, debt, and duty. One last speaker, a grown man attempting to resume his education, laid his problem at Philip’s feet: ‘‘I’m in school, so I have no money for a car. But my woman has a business.’’ He demanded that she help him, but she had refused. He argued, ‘‘A wife is responsible for supporting a husband if he cannot support himself!’’ Philip disagreed, and the eventful human rights training drew to a close. Like most human rights educators, Philip had no legal training. His knowledge of human rights law came from the same sources that many of the members of his audience were familiar with—mass media campaigns and NGO trainings—and his human rights training materials were produced by an international NGO. In the absence of a body of coherent Liberian laws concerning marriage, the family, property distribution, and land tenure, Philip became an unofficial arbiter of disputes that were far beyond his capacity to adjudicate. Remembering that Philip’s visits were made weekly, over many months, it is striking to consider how Philip’s vision of the ‘‘new normal’’ had a quality of postconflict psychosocial normalization. His presence affirmed that the village was still a part of the world, and his lessons were a way for the village to participate in the powerful forces that were transforming the country and ending the war. His vision of a new Liberian middle-class morality and a new Liberian state bureaucracy persuaded local villagers that ‘‘someone was in charge’’ and that there was a vision in place for the palpable social transformations under way. The human rights ideals he articulated helped explain and mollify the painful uncertainty, doubt, and fear that surrounded the decisions of everyday life. The men and women in

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Philip’s audience might not have been entirely persuaded by his explanations and they may not have considered his ‘‘rulings’’ binding, but they were soothed by their apparent rationality and by their appearance in their reconstructing village. In this fashion, the interaction between the global and the local advanced the project of postconflict reconstruction through the production of ‘‘sameness’’ in collective ideals regarding human rights. Most of the questions posed to human rights workers concerned fundamental confusion about moral right and moral certainty in the foundational social roles of male, female, mother, father, husband, wife, chief, farmer, student, and suitor. Philip spoke to their uncertainty in a way that both the Liberian government and local tradition were fundamentally unable to. And although the community listened skeptically to Philip’s claims regarding travel, marriage and child custody documentation, fee payments for landownership, and government transparency, village chiefs, town mayors, schoolteachers, and local religious leaders all attended the sessions faithfully and brought problems to be resolved. Philip, as the ‘‘one who knows the world of NGOs,’’ was accorded the status of teacher and expert. His human rights training gave him the authority to address—often without challenge—some of the most foundational moral problems of social and community life, which have long been relegated to the domain of tradition (or pseudo-traditions bureaucratized into colonial policies of indirect rule, like the Paramount Chief System or the Rules and Regulations Governing the Hinterland of Liberia). His projections of human rights ideals sought to fit rural Liberians into an idealized future state in which laws existed to govern land tenure, family composition, child custody, marriage, and marriage dissolution.

Rituals of Reconciliation Look, Liberians. What you’ve heard about someone during the war, well, forget it. If we will have peace in Liberia, we must learn to reconcile and forget our differences. —Radio campaign

While peacekeepers and expatriate NGO workers accused Liberians of being culpable for the war and for inhibiting reconstruction, Liberians

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blamed themselves and each other for ruining their country. For many Liberians, the traumas of war were understood as personal failures to keep people safe, alive, or healthy; or as failures of the community and nation to protect their homes, keep their youth safe, and elect responsible leaders. As the previous section demonstrated, within the context of postwar rehabilitation, Liberians scrutinized their interpersonal interactions and studied their social histories to find the causes of the war and revised political, economic, and development narratives to find solutions. Just below the surface of encouraging anthems of hope and national pride, Liberians and expatriates voiced fears that war was an intrinsic property of their national character. As Allen (2008) and others have reported for Uganda, culturally sensitive reconciliation and rehabilitation practices were in fashion in the international humanitarian community for much of the period spanning Liberia’s postconflict reconstruction. The principle underlying culturally sensitive conflict resolution mechanisms posited that indigenous knowledge, practices, and rituals could serve as platforms for postwar reconstruction by offering pathways into traditional conceptions of healing, forgiveness, and community resocialization. International institutions theorized that the forgiveness and rehabilitation that were achieved through indigenous rituals would be more authentic and would have greater and deeper meaning than externally imposed efforts to bring communities and populations together. However, in Liberia, as with Rwanda’s Gacaca tribunals and Uganda’s reintegration ceremonies for former child soldiers from the Lord’s Resistance Army, the meaning of community reintegration rituals often changed in the process of their realization. NGOs like Save the Children and Community Habitat Finance International (better known as CHF) undertook dozens of initiatives from 2003 to 2005 to reenact ritual sacrifices, broker intercommunity peace contracts, and hold events like football games, peacebuilding conferences, and ‘‘peace festivals’’ between communities that had experienced ethnic hostilities during the conflict. These initiatives were sponsored by high-profile institutions like USAID and the United Nations Development Program (UNDP) and received considerable attention in the early years after the war. Although funding for these kinds of interventions had largely dissipated by the time I began my research, retrospective interviews I conducted with

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community leaders, NGO workers, and Liberian employees of donor agencies suggested that these events had been generally well received, if of marginal utility. One project, sponsored by USAID’s subcontractor LCIP (through its private subcontractor Development Alternatives International [DAI]), attempted to bring together Loma and Mandingo populations in the Voinjama district of Lofa County, a ‘‘most affected area’’ in postconflict parlance. It was typical in its ambitions, strategies, and scope. The DAI project, working with a Liberian women’s NGO (Voinjama District Women Organization for Peace and Development [VODWOPEDE]), sought to promote peaceful cohabitation between the Loma and Mandingo communities and to facilitate the reintegration of ex-combatants. To do so, it used humanitarian funds to emphasize the physical reconstruction of spaces for secret societies and ritual institutions. It sponsored traditional cleansing and healing processes and encouraged conflict resolution using meetings in palaver huts. In internal documents, the project claimed the following achievements: 1. It rebuilt fourteen female zoe¯s’ (traditional female leaders) houses in fourteen towns. 2. It paid male zoe¯s to conduct animal sacrifices on three mountains and at the Lofa River, and purchased the livestock for sacrifice. 3. It sponsored traditional cleansing ceremonies, called Zalakai-Zalayei, in eight communities. 4. On August 19, 2005, it sponsored a peace festival for approximately 1,400 people. 5. It purchased livestock and materials for animal sacrifices to conduct cleansing ceremonies, and to appease the spirits of the ancestors. 6. It provided footballs for youth sports. 7. It facilitated the ‘‘reorganization’’ of ‘‘cultural troupes’’ in twenty communities, and distributed ‘‘cultural materials such as drums, sese, and dancing costumes.’’ As previous critiques of ‘‘traditional ceremonies’’ have noted, the internationally sponsored resurrection of institutions like Poro and Sande secret societies had substantial limitations. These programs often inadvertently contributed to the reestablishment of leadership structures that were perceived to be antidemocratic, exploitative of youth labor and resources, and

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discriminatory against women. Moreover, the source of the ‘‘cultural knowledge’’ concerning forgiveness and rehabilitation rituals was often questionable and far removed from serious ethnological investigation of traditional practices. The programs were also often exploited by local communities for their material rather than cultural or symbolic benefits. However, the DAI report that documented these activities concluded that they were helpful in that ‘‘The meetings were all geared towards creating a favorable environment for the successful implementation of the Traditional Peace Festival and Cleansing Ceremonies.’’ The report furthermore placed a strong emphasis on psychosocial support that accompanied the traditional healing rituals, town meetings, focus group discussions, and individual counseling. The ‘‘psychosocial intent’’ of the activities, though never defined, is repeated throughout the report, but one can infer a practice-based understanding of psychosocial ‘‘well-being.’’ It focused on achieving ‘‘ends’’—the successful implementation of the peace festival— through intercommunity cooperation and dialogue rather than an abstract ideal of authentic personal forgiveness and catharsis. One imagines that the individual counselors on hand were present to manage the expressed words and sentiments of participants, to offer neutral, postconflict examples of language and behavior, and to intervene when memories of the past became too ‘‘present’’ in the present. All of the tasks represented here are performative acts that declare the end of conflict and entreat the beginnings of peace by providing behavioral models for ‘‘peace subjectivities,’’ as well as guidance for the postconflict reorganization of social structure (referring to the zoe¯s). In the aftermath of the project, DAI found that community tensions had diminished and that ex-combatant reintegration was taking place. The project was declared a success, and DAI recommended that USAID support a peace festival in the region on an annual basis. The half-lives of the projects among the participants, however, were more ambiguous. In interviews with people who participated in community peacebuilding efforts across Liberia, individual accounts of their utility vary. For local residents, the most striking feature of these initiatives was the largesse exhibited by the NGOs through their distribution of livestock, their reconstruction of local community buildings, and their attention to local politics. The peacebuilding attributes of the programs were faint in their minds. Ex-combatants who spent their DDRR labor terms laying bricks in ruined villages alongside members of opposing factions remembered the intended symbolism of

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these events and the conversations that sometimes transpired during work group lunch sessions. Some found them meaningful while others regarded them as notable but insufficient attempts to change people’s characters. The Liberian NGO workers employed by international organizations were reluctant to comment on their benefits or their deficits, but it was clear that they harbored some doubts as to the real value of the programs they had enacted. The latter’s decision to share the documentation from these projects with me, long after their direct supervisors had departed for other postings, demonstrated their interest in critiquing the events. In contrast, the expatriate NGO workers who oversaw the projects experienced the reconciliation initiatives as emotionally powerful ordeals with tremendous symbolic importance. Though some humanitarian workers viewed the customary rituals as vapid while others viewed them as having great cultural significance, all expatriates involved in the process believed in the instrumental power of cultural rituals when used for humanitarian ends. One expatriate of CHF, who happened to be a college friend of mine, had led a similar set of projects in Nimba County from 2003 to 2005. After stipulating that CHF had taken an active hand in advancing the peacebuilding projects, he told me that CHF had identified a local ritual of establishing ‘‘contracts’’ between Mandingo and Mano and Gio communities. CHF encouraged local village leaders to participate in a ceremony in which both sets of leaders signed a contract of mutual peace and goodwill, drawn up by CHF. My college friend recalled the tears in the elderly leaders’ eyes when they signed the contract and believed that it was an authentically cathartic experience for the hundreds of Nimbanean residents present. He subsequently noted that even if the ritual was artificially constructed, he genuinely believed that simply bringing together village leaders and youth around the process of organizing these events constituted a mode of peacebuilding. Community-based reconciliation projects that drew upon selectively identified cultures and traditions were, effectively, experimental humanitarian initiatives, and they were understood as such by their humanitarian sponsors. Humanitarian institutions viewed ‘‘traditional rituals’’ and ‘‘traditional healing practices’’ as highly instrumentalist approaches to collective transformation that could reshape and remold malleable Liberian subjectivities. (This assumption of human malleability was shared across humanitarian space and is a common theme in early social science theories about social engineering.) Most of these ritual events, however, were constructed

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according to a process that could only result in a dramatic event of atonement, absolution, and redemption. The NGO-driven process terminated at the apex of the experience, and postconflict life continued to unfold after the NGO returned to the capital to file its reports. World Bank guidelines for NGO-sponsored traditional healing rituals advised that NGOs keep a close watch over the process and prohibit traditional practices if they might lead to unintended consequences or abuses. Tradition could be meaningful and it might help communities recover from trauma and experience psychosocial healing, but one could allow it to go only so far. Writing of the need to subordinate ‘‘cultural rituals’’ to NGO oversight, a World Bank report advises, Communities’ own rituals and traditional healing can often help people affected by trauma reintegrate back into normal life. Many of these rituals take the form of symbolic cleansing, of washing away the blood or the traumatic memories, of driving away bad spirits and calling ancestors for assistance. While rituals and cleansing ceremonies can be very helpful in dealing with milder forms of psychosocial stress, and assist communities in coping with returnees from conflict, they should be approached with caution. In some instances, rituals may be damaging, as for example when rituals involve female genital mutilation performed by members of secret societies. When in doubt, agencies should consult grassroots NGOs and women’s groups to assess local rituals. (Baingana and Bannon 2004)

TRC and the Healing Process When a single community healing ritual might incorporate as many as 1,400 people across fourteen towns, it is worth asking how many Liberians come into contact with these projects. Given their scale and their duration, how could these practices not yield some kind of social or cultural shift? With dozens of NGOs concerned about the collective trauma of the Liberian population, hundreds of personnel and millions of dollars were spent on uncoordinated community-based peacebuilding initiatives in the years immediately after the war. On a much grander, scale, however, were the efforts of the Liberian TRC, which was established in 2005 with the support of the international community. The Liberian legislature passed the Liberian TRC into law in

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2006, and the original duration of the TRC was to take place from 2006 to 2008, but it extended into 2009 as a result of early administrative and procedural failures and an initial loss of public credibility. In The Act to Establish the Truth and Reconciliation Commission (TRC) of Liberia, passed by the National Transitional Legislative Assembly on May 12, 2005, the commission was charged with the task of investigating ‘‘gross human rights violations and violations of international humanitarian law as well as abuses that occurred, including massacres, sexual violations, murder, extrajudicial killings and economic crimes, such as the exploitation of natural or public resources to perpetuate armed conflicts,’’ for the entire period of Liberia’s destabilization (1979 to 2003). The central task of my research, however, was not to study the TRC process, and ultimately most of the testimony-taking that took place for the TRC occurred during late 2007 and 2008, after I had concluded my principal periods of fieldwork. Although I did interview several TRC commissioners in the course of my research (like Jerome Verdier Sr., the TRC’s chairperson), many of my interviews were conducted during periods of early TRC formation and thus were inconclusive. However, in a fairly limited way, I can report on the introduction of the TRC to the Liberian population, how news of the TRC was received by the Liberian population, what initial promises were made, and how the process of the TRC intersected with Liberian civilians’ everyday expectations and experiences. According to the TRC’s ten commissioners, the goal of the commission was to promote social processes of healing, remembrance, and forgiveness and to create a documentary history of the Liberian war’s human rights violations. The commission included Liberians who were prominent in the fields of law, journalism, and peace activism, representatives from religious institutions and Liberian NGOs, and many who were conversant with the language of trauma and psychosocial recovery. One commissioner, Dede Dolopei, had a background in peacebuilding and psychosocial counseling; another commissioner, Oumu Syllah, had a professional background in social work in Liberia and Sierra Leone. In public presentations, interviews, and the media, the TRC commissioners continually emphasized the TRC’s healing capacity, especially its potential to resolve trauma and promote national healing. According to the commissioners, ‘‘TRC is the first step in the healing process.’’ The TRC process followed the course of postconflict transition—it occurred over a bounded period and was meant to follow a trajectory of admission, confession, expiation, and forgiveness. As a mechanism

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for confronting the violence of the past, the TRC was thought to be an important solution to the collective problem of social, cultural, and normative demoralization. The culmination of the TRC process, the TRC final report, was expected to achieve multiple ends, including making recommendations for a war crimes tribunal and identifying war criminals for prosecution. This structure yielded a generalized suspicion throughout the Liberian population that the TRC was an instrument of political revenge that could be easily manipulated. It was also regarded as a ‘‘toothless tiger’’ whose principal function was to line politicians’ pockets. Many people were concerned that the Liberian government was working against the TRC to keep it weak and ineffectual so that formerly active warlords in the government could avoid prosecution. Others made the astute observation that the TRC was an international ‘‘experiment’’ that NGOs hoped would magically solve the current problems of Liberian postconflict society. Despite the negativity surrounding the TRC process, some Liberian civilians were cautiously optimistic and viewed it as a form of humanitarian social engineering that could be helpful. Michael, a taxi driver, commented, ‘‘So, the international community is going to bring this thing called a TRC to us. We can try it and if it works, that will be good, and if it does not work, so it will be.’’ Others thought that the TRC was at best a risky venture and at worst a foregone conclusion. While some feared that ‘‘bad people’’ would indict the innocent by falsely ‘‘calling out their name’’ in association with war atrocities, others wanted national political leaders to be held accountable for their war crimes and to be forced to speak publicly about their actions. Unfortunately the TRC’s initial efforts were hampered by the unethical and embarrassing behavior of the commissioners. They reportedly sought direct financial contributions and ever larger salaries while protesting that they lacked sufficient financial resources, international expertise, basic infrastructure like electricity and computers, and basic materials like printer paper. Rumors of dissent and infighting among the commissioners traveled across Monrovia. With the judicial implications of the TRC process still in question, the TRC’s moral and legal authority rapidly eroded, and it struggled to gain public trust. Soon public incidents of people openly challenging the TRC were being reported. One acquaintance of mine, an entrepreneur and a University of Liberia student, publicly criticized a TRC commissioner when he came to

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his church to recruit testimony-givers. He told me that in front of approximately a thousand people, ‘‘I stood up and said, ‘All we hear from you TRC people is you don’t have enough money. You commissioners get US$3,000 per month, and we small people get maybe US$30 per month. TRC is all about the money business. We want to hear about a war crimes tribunal!’ ’’ With the TRC’s failure imminent, the international community reorganized its efforts and reactivated the Liberian TRC in 2007. In the ensuing two years, the TRC obtained over twenty thousand testimonials from political leaders, war leaders, and civilians in all fifteen of Liberia’s counties, from Liberians living abroad in Europe, and from Liberians in Minnesota, Chicago, Atlanta, Philadelphia, Washington, D.C., Newark (New Jersey), and New York City. TRC advocates believed that truth and reconciliation were good for Liberians as individuals and for Liberia as a nation. National and international leaders made outsized promises of the hope, redemption, forgiveness, and security the TRC could bring. Through confession, expiation, and absolution, the process of testimony-giving could create a social dynamic of narrative-driven therapeutics that could put an emotional distance between the violence of the past and the goals of the future. Out of stories of the violence of the past would emerge legal and political reforms that would prevent the past from happening again. But at the same time, the TRC was meant to be a tool for the conservation of memory. Liberians were promised that they would have open access to the commission’s final report and its recommendations, and many testimony proceedings were conducted in public forums. Expatriates, in particular, were vocal about the need to produce a documentary history of the war that would be available to the entire Liberian population. There seemed to be a sense in the strange time-out-of-time postconflict moment that the postwar period was outside of history and that if records weren’t taken then, they would be lost forever. Although the final efforts of the Liberian TRC were generally reported to be excellent and its product—the report—was highly lauded, the outcomes of the Liberian TRC process for the Liberian population were rather ambiguous. The TRC process produced a final report that summarized the history of the Liberian conflict, gave detailed summaries of Liberians’ testimonies, and made a series of recommendations for post-TRC legal reforms, reparations, memorializations, and prosecutions. But the final report was delivered with the public dissension of two of the ten TRC commissioners,

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and this, along with the public wavering of key members of government about giving testimony, left the report in a crisis of political legitimacy. Moreover, the TRC final report, which was supposed to be made available to the entire Liberian population, was made available as a digital PDF that could be downloaded from the TRC Web site—a cruel irony in a country that, as of 2009, ranked among the last in the world in World Bank statistics on Internet usage, electricity consumption, and mobile phone access. The question of the social effects of the TRC remains a problem. By the time of my most recent visit, in 2012, few people talked about the TRC anymore, and most people focused on the present and the future. But during its time, the discourse used by the TRC gained in power, dispersion, and colloquial usage far more than its institutional and legal intent might have suggested. Talk of reconciliation, truth, and forgiveness filled social space, shaped Liberian and humanitarian dialogues, and altered Liberians’ imaginaries of what ‘‘moral’’ meant in postconflict social life. But it also had unintended consequences. The introduction of TRC language into daily life often served as a discursive strategy for justifying and excusing postconflict wrongdoers like rapists, thieves, and swindlers. It became a powerful language of defense for politicians and business leaders with reputations for having committed war crimes. The message of the TRC—while not necessarily borne out through Liberians’ relationship with the process itself—was part of an already saturated environment calling for human rights, forgiveness, the rule of law, and peace. Consider Agnes, the psychosocial worker from Chapter 1. In her story of the pastor who demanded that a child rapist receive forgiveness, the language of forgiveness and reconciliation emerged as a powerful mechanism of social control and as a prompt by the powerful to elide social accountability. For Agnes, the language of the TRC connoted amnesty for wartime criminal acts, just as forgiveness and amnesty coexisted in her postconflict world. During one of our interviews, she described an incident that suggested the impossibility of resolving trauma through the TRC. One afternoon, at the height of the TRC’s testimony-taking, Agnes gestured forty feet from where we sat, into the courtyard outside her clinic: ‘‘During the war, I saw a woman there, with a baby on her back. They had a mortar and a pestle, and they forced her to put her infant baby in the mortar and crush her to death. This woman . . . she carried this baby in her belly for such a long time, she loves this baby, cares for her, does everything so that she can live. . . . And then, in one thing they made her a victim and a perpetrator. So tell me, what will the TRC do for this woman?’’

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The language of the TRC seemed to demand reconciliation and forgiveness in the face of incomprehensibly tortuous injustices. For Agnes, TRC discourse created a sense of moral entrapment and an imperative to behave in a way that was inconsistent with her memories and her convictions. She did not forgive. She would not forget. But she had internalized the message that it was her responsibility to ‘‘forgive’’ and ‘‘forget about it’’ for her own good and for the good of the country. The effect of the TRC, in Agnes’s case, was not to give her a voice or an opportunity to offer testimony but instead to constrain her unquenchable rage and silence her moral protest. Agnes’s ambivalence about justice and memory was captured in the following narrative, given that same day. There was a woman and her husband who lived with their two daughters and loved their children very much. When the war came, they were at a checkpoint, and the husband was shot dead by the commander. Things got confused at the checkpoint, and the mother and her daughter got separated from the other daughter, and they fled to Guinea. After the war, they [the mother and daughter] learned that the other daughter was alive in Monrovia. They made contact with her, so that they could see each other again. They were happy to learn that the daughter in Monrovia was living with a man who was so good to her, who loved her so much, who was becoming everything a husband should be. When the mother arrived in Monrovia, she saw right away that her daughter’s beloved husband was the same man who had killed her own husband at the checkpoint. Her daughter didn’t know this, but as soon as the commander saw his old mother-in-law, he knew, and what was the mother supposed to do? If she doesn’t tell her daughter, her daughter may find out later, and then she and her mother will have problems. If she does tell her, she may destroy her daughter’s happiness. So what is a Truth and Reconciliation Commission going to do for that woman? Tell me! What is the TRC going to do for her? For all its rhetoric about healing and national repair, the TRC served to close doors for personal expressions of grief and memory even as it opened a national public discussion about guilt, wrongdoing, and survival. Agnes was a survivor. She was a prominent NGO worker who lived a functional

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life in her postconflict world. But it’s clear from her words that rather than helping her renarrativize her wartime experiences into postwar memory, the TRC was a mocking reminder of all that could not be repaired, could not be made whole, and could not be reconciled in postconflict life. And she had been through trauma counseling, worked in ex-combatant rehabilitation, supported the TRC and humanitarian mental health efforts, and was a religious woman who was trying to live a good Christian life. Agnes’s questions remain unanswered. Does postconflict healing really mean making peace with a national past, confessing one’s sins, overcoming one’s traumas, and moving hopefully into an uncertain future? Or, instead, is it continuing to live with one’s traumas, trying to manage their ambivalent expressions over years and years, and building a bulwark of time, family, labor, and friendship in between the past and the present? For Agnes, and for my own grandparents, no amount of history-taking and history remaking was able to heal the fact that after war, all that remained was life, with grief, memory, guilt, and the uncertain future that lay ahead. There was no trauma healing; there was only the management of memories. Overcoming trauma meant having managed one’s memories well enough to build a life in the aftermath of having survived.

Chapter 8

The Healers

By helping people and helping communities heal themselves, we’d be helping our fragmented, suffering country mend itself. —Leymah Gbowee

The Double Consciousness of Psychosocial Work In the years immediately following the end of the war, newly minted trauma-healing and psychosocial counselors appeared to be running amok, administering counseling willy-nilly without credentials, oversight, or supervision. Critics, with or without evidence, believed that this constituted a real crisis. First, they worried that ‘‘irresponsibly provided’’ trauma healing and psychosocial counseling would either have no effect on vulnerable populations seeking real aid or have harmful effects. Second, they believed that ineffective trauma programs wasted humanitarian resources. Third, as described in Chapter 2, they believed that the lack of coordination among trauma-healing programs and their chaotic implementation constituted a direct threat to the authority of the MOHSW, the WHO, and humanitarian coordination groups like the MHPCC. However legitimate these concerns about governance and quality control were, they often did not reflect the personal and professional experiences of psychosocial workers or the postconflict peacebuilding work they engaged in with Liberian audiences. The spaces where psychosocial labor took place were also ‘‘home’’ for local social workers; and ‘‘home’’ could

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be disturbingly violent. Psychosocial workers in postconflict Liberia lived and worked in a dystopic world in which the boundary that separated violence and morality was constantly moving. The violence of the past was not neatly tucked away behind an imaginary historical boundary dividing the past and the present. Violence persisted as a part of present social experience, and it had a tendency to suddenly erupt in daily vicissitudes in which social workers were often victims or bystanders. Two journal entries written by Harley, a psychosocial worker who took my course in Social Work Interviewing at Mother Patern College, shed light on this hidden domain of postwar experience. The first entry describes an incident of domestic violence: ‘‘I witnessed a wedding ceremony between a couple that lived together for one year before their wedding. But before the wedding, the mother of the bride told her daughter that this man wasn’t the rightful person for her to get marry [sic] to because she observed him to be somebody with a very bad behavior and tainted character. Her daughter didn’t listen and she went into a hurried marriage. Two years after the wedding, her daughter’s husband killed himself and her daughter. Before killing the girl, he broke every part on her body and he also broke all her teeth in her mouth. This fellow actually was a former rebel general for Charles Taylor during the Liberian civil crisis. According to him, he killed his wife because he noticed that she was loving to somebody [having an affair] at her working place.’’ In another incident, Harley observed violence disrupt a funeral event: ‘‘A mother of seven children died from a heart attack two weeks ago. At the funeral service, her sister accused the seven children for being responsible for the death of their mother while giving a tribute [a eulogy] to her sister. The entire funeral service came to a standstill after she made this remark because the seven children decided to rush to her to beat her for what she said. This situation brought the funeral service to an abrupt end. Serious confusion erupted, and family members began to quarrel among themselves.’’ These narratives remind us that psychosocial workers often found themselves straddling competing realities. They lived in environments of latent violence, and they worked in NGO environments that were strongly pacifistic and orderly. In the office everyday, they worked with expatriate managers who chose not to know about their two-hour commutes, the insufficiency of their salaries, or the dangers in their personal lives. Their

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bosses corrected them for going ‘‘off-script,’’ reprimanded them for innovating techniques in their counseling encounters, and targeted them for their irritation when postconflict recovery seemed frustratingly slow. Moreover, Liberian psychosocial workers had precious little control over their professional lives. NGO workers had to stand by in silence as NGO leaders made decisions about how to deploy financial resources, embarrassed the organization in community-based trainings, or were fleeced in the markets. All but one of the hallmarks of colonial rule—the intent to stay forever— could be found in NGO offices. At the same time, many psychosocial workers formed close friendships with expatriate managers around shared passions: fighting gender-based violence, protecting the mentally ill, believing in the redemptive potential of the TRC, or ensuring the safety of the children in Liberia’s orphanages. The experience of humanitarian employment created a common affective experience and emotional language with international expatriates that served as an important referent for postconflict legitimacy. Social work was, for psychosocial workers, a site of struggle against the conditions of extreme violence through the act of recognition and through directed labor to ameliorate suffering. Their moral commitments were redirected from the personal to the collective, and their professional and personal lives and subjectivities became sites of struggle on behalf of their many co-nationals. They shared a critique of Liberia’s senseless violence, corruption, and self-destruction with foreign expatriates, and they shared a knowledge of the terminal character of humanitarian intervention. Psychosocial work demanded many acts of faith. In order to invest in one’s career, pursue additional training, and make family sacrifices, psychosocial workers needed to believe that a postconflict transition would take place and that there would be jobs for them in the postwar system that emerged. In order to believe this, psychosocial workers needed to have confidence that the international humanitarian system would eventually hand over its entire structure (and funding) to the Liberian state, which would discharge the priorities of the humanitarian community with minimal interruption. Specifically, psychosocial workers hoped that the state would be able to provide mental health services, or support a vast roll of trained social workers, at some point in the distant future and that NGOs would not depart until then. From 2003 to 2009, this was more wish, or political vision, than fact.

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Psychosocial workers also had to believe, at some level, in human rights discourse and humanitarian intent in order to perform their tasks. People who were not able to demonstrate their commitment to humanitarian priorities were soon discovered and then released from their duties. Finally, psychosocial workers had to hold onto the vision offered by humanitarian NGOs for a ‘‘post-postconflict’’ future. For many psychosocial workers, finding their personal moral center involved threading the needle between two different worlds. For me, this tension resonated with W. E. B. Du Bois’s description of double consciousness: ‘‘It is a peculiar sensation, this doubleconsciousness, this sense of always looking at one’s self through the eyes of others, of measuring one’s soul by the tape of a world that looks on in amused contempt and pity. One ever feels his two-ness—an American, a Negro; two souls, two thoughts, two unreconciled strivings; two warring ideals in one dark body, whose dogged strength alone keeps it from being torn asunder’’ (2007, 8). How did trauma healers understand their own structural roles in the transformation of postconflict society, and what did they expect of themselves as agents of social transformation? Psychosocial workers’ lives were rarely more orderly than those of the people they assisted, but they were vocal advocates of morality, normalcy, and social order. As the mediators, translators, negotiators, and reconcilers of the ‘‘culture contact’’ between global humanitarianism and Liberian need, psychosocial workers were simultaneously absorbed with managing their own lives. One woman, a former member of the Armed Forces of Liberia, simultaneously pursued three separate careers in business, in an NGO, and in government. Another woman who, in her psychosocial interventions, was a vocal advocate of Christian marriage and monogamy had a troubled home life with a husband who slept around and abandoned her for months at a time for his own NGO job. She hadn’t allowed him to touch her in over three years because she was afraid of contracting an STD. Balancing the private and the public could be overwhelming; thus many Liberian psychosocial workers regarded the job as a job and left their psychosocial careers to pursue alternative employment as managers, nurses, drivers, or electricians when the opportunities became available. But others found meaningful lives and a personal politics in the work of trauma healing and built their identities around it. There were rewards for people who were able to sustain global discourses of human rights and peacebuilding amid impossible conditions.

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Expatriate humanitarians shared morality tales of ‘‘local heroes’’ with each other, and job offers often followed. Following the impetus toward indigenization described in earlier chapters, expatriates placed Liberian role models of postconflict aspirations in management positions within Liberian government offices and NGOs.

Fata: Politicization Through Psychosocial Work I met Fata, a neatly coiffed woman in her late thirties, through my position as an instructor at Mother Patern College. Together we conducted a series of life history interviews that culminated in the following narrative of psychosocial worker politicization. Fata was born in a town in central Liberia. Her early childhood was happy. She went to a mission school and regularly attended church, and her family treated her well. Before the war, when she was fourteen years old, an ‘‘old man,’’ a nearby neighbor, called her over to his house for some help. She dutifully went, and he raped her. Fata became pregnant. Her parents didn’t believe that she had been raped, and they accused her of sleeping around. They declared that they ‘‘wouldn’t support such a bad child,’’ and they kicked her out of their home. Not knowing what to do or where to go, Fata fled to Monrovia to try to continue her education. She enrolled in school, and she gave birth to a daughter. She lived alone and worked for her rent, but often she couldn’t afford food. Sometimes her friends at school saved their lunch scraps for her. Because she was hungry, she couldn’t nurse her daughter, nor could she afford clean water for formula. The baby was sick, and the medicines cost money. Fata’s daughter survived, and when the war came to Monrovia, Fata had done well academically, was well regarded professionally, and her prospects were good. She was in her early twenties, and she was working, studying, and raising her daughter. Then her brother, who had also come to Monrovia, told her that Doe’s AFL was hunting down people from ethnicities known to be sympathetic to Charles Taylor’s NPFL forces. He encouraged her to seek refuge at a known safe zone, St. Peter’s Lutheran Church in central Monrovia. She made her way there with her daughter and her ward, a six-year-old girl she had taken in from a cousin.

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On the night of July 29, 1990, Fata found herself at the center of one of the most notorious massacres of the Liberian conflict. After dark, approximately two hundred AFL forces came into the compound and proceeded to murder at least six hundred of the two thousand people seeking refuge. When the AFL soldiers opened the door to the chamber she shared with a dozen other people, she happened to be located near the door. She grabbed her daughter and her ward and hid behind some sacks near the door while the gunmen shot blindly at everyone else in the room. She and her daughter were unharmed, but her ward had been shot. Early the following morning, Fata and the two girls fled St. Peter’s by sneaking past the drunk and stoned soldiers passed out across the compound. Holding her daughter’s hand and carrying her ward’s body over her shoulder while she bled out onto her, she wandered through the streets of Sinkor, an upper-class neighborhood with gated compounds and multistory homes, calling for help. Passing gate after gate, she begged for medical assistance or for somewhere to hide, but everyone who saw the blood on her thought she had been involved in combat (she believed) and refused to allow her to come in. Finally a family let her in. Soon they declared the little girl dead and buried her body in their compound. They let Fata and her daughter stay and rest for a short while but soon forced her back into the streets. Then Fata learned to run. In the months that followed she moved from IDP camp to IDP camp and gradually made her way to the Guinea border. When she arrived in Guinea, she was exhausted, out of money, and utterly traumatized. In her mind, she kept reliving the walk on those deserted Sinkor streets on the morning after the massacre, calling for help, realizing no one would help. Fata was alone with her daughter in a camp in Guinea, and she needed to earn some money to survive. Jobs were available for psychosocial workers, and she applied. She thought that the work would be temporary, and she felt that it was not her ‘‘calling,’’ but she hoped that it might serve as a stepping stone to a more prestigious NGO position. Then she attended her training. Initially I had planned to be a medical person, doing medicine. And it didn’t work out because the war interrupted my schooling. So I went back, and then somewhere in 1994 I began working with

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the NGOs during the war, when they came in, and then at first I saw it as a job. I didn’t see it as a profession or something that would encourage me to be a social worker, and then I thought I would work for three years, four years down the road. Then I went into a training called Delta, Development Education Team in Action. It was developed in South Africa and somewhere in Ireland, there is a base there, we did a training there. It was called ‘‘a training for transformation.’’ It was developed from the philosophy of Paulo Freire, the use of his principles, a lot of his principles, where they talked about a lot of his principles, his leadership, and they also talked a lot about advocacy. It was all about a radical approach about issues, relating to people. In her next words, the political impact of her training emerges. When I got into that training, then I realized that people are being disadvantaged, many people are suffering, many people’s rights are being abused, people do not have equal access to resources, and in general, looking at the political system, the whole structure of the world and things, the colonization of Africa and all these other things, these issues, have come to make more poverty, people have come to be more poor, and people’s basic needs are not met. And the national government—I mean, people just want things for themselves. And why should other people suffer when the world should be equal? Fata described her years as a psychosocial worker as empowering: ‘‘So, I came to develop the likeness [a liking] for advocating for people, and then I decided I would try to find a place to go and then learn more about it.’’ Over time, she followed her job back into Liberia and learned she could obtain an associate’s degree in social work at Mother Patern College through a workshop in Gbarnga. She said, ‘‘I had better go for that. So I left from Gbarnga—I was in Gbarnga then, I went to Monrovia. I enrolled in Mother Patern’s class in social work, so basically, that’s how I got interested. Because of how I can advocate for people who are suffering. How can people’s needs be met who are powerless—how can their needs be heard? Who will talk for them, to empower them?’’

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Like Fata, prior to the war many Liberian psychosocial workers were educated, literate, and highly motivated individuals pursuing careers in government, medicine, education, and business or were talented students with professional ambitions. Their paths into social work were often circuitous and unexpected and often contingent upon their being literate and articulate in English. Many initially perceived trauma healing and psychosocial work as little more than a strategy for economic survival until their ‘‘real lives’’ could resume. The details of psychosocial labor were secondary. Once Fata was ‘‘in,’’ the category of social worker became a form of personal, professional, and political identification. Fata’s liking for the work had two central elements. Having succeeded in overcoming numerous hurdles to first-time NGO employment, Fata had—and was seen by others to have—an NGO ‘‘stamp of approval’’ that would make it easier for her to successfully pursue positions with other NGOs. Fata had hoped to be able to use her job to get work in another sector of humanitarian action altogether—perhaps logistics or medicine. She has successfully navigated the terrain of NGO employment in an unbroken career path for nearly twenty years. But the process of becoming a psychosocial worker resulted in a more personal and political kind of transformation for Fata. According to her, the more she immersed herself in psychosocial work, the more she came to see the job as being ‘‘for her.’’ The more she came to love being a psychosocial worker, the more her symptoms of trauma abated. Through her training and practice of psychosocial counseling, Fata found personal, political, and moral solidarity with her clients that changed the way she understood her own place in the world.1 For Fata, an opportunity to work for an NGO came at a critical moment of personal desperation. But through training, her understanding of her own labor became radicalized. She started to understand her personal biography of suffering, her survival of the St. Peter’s massacre, and her experience as a refugee as part of a bigger picture of fighting violence and injustice. In her telling, her training and counseling provoked a critical self-interrogation that shifted her own personal subjectivity from ‘‘victim’’ to ‘‘counselor/ activist.’’ Through these experiences, her identity of ‘‘social worker’’ was transformed from one that was opportunistic to one that was simultaneously professional, political, and replete with moral responsibility and authority. NGOs that hired social workers for their advocacy, education, or intervention programs proved to be one of the best sites of upward mobility

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and professional development. Professional success inside NGO institutions could lead to management positions, then expatriate placements, and ultimately to international NGO worker status. Humanitarian institutions did not intend to create alternative employment economies per se, but the longue dure´e of the Liberian conflict created a de facto employment economy with professional trajectories that could account for an entire adult career. Therefore, it was quite reasonable that in my class at Mother Patern College, all of my students but three (who intended to work for Mother Patern, MOHSW, and the Liberian National Police) aspired to social work careers in the international NGO sector. They did not see the paradox of their professional goals: their long-term plans for employment were predicated upon short-term humanitarian service with UNICEF, the GBV Unit at the International Rescue Committee, or the Child Protection Unit at LWF/WS. After humanitarian withdrawal, it seemed unlikely that the entire sector of social work would continue to exist in an empirically meaningful way.

A Labor Theory of Psychosocial Work When I began to interview the healers in humanitarian institutions—the Liberian psychosocial workers who carried out these international projects of social repair—I did not anticipate a story of transformation. I expected to find that Liberian NGO workers would perceive themselves as be a subaltern population, carrying out foreign-imposed dictates for social repair, but holding onto a reservoir of irritation and criticism. I was wrong and was subsequently compelled to reevaluate my entire understanding of humanitarian labor, humanitarian labor economies, and humanitarian authority. Certainly, Liberian NGO workers expressed anger toward expatriate managers who were unable to adapt modular NGO interventions to local Liberian contexts. They were shocked and frustrated by the wide income disparities between expatriate and local workers. Some felt that they were forced to submit to humiliating forms of supervision, micromanagement, and arbitrary rules of employment that could be ruthlessly enforced. However, although Liberian NGO workers often found themselves frustrated, angry, and resentful, many of them loved their work. They believed in what they were doing. They were convinced that they were saving their country. The structuration (Giddens 1987) of identity, labor, and trauma among

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Liberian social workers provides the frame through which psychosocial workers engage in psychosocial activism in their personal and professional lives. In order to understand this important experiential paradox, it might be helpful to offer a labor theory of psychosocial work—the process of entering into the psychosocial labor market, being trained within a humanitarian psychosocial framework, assimilating the values and skills of the labor force, and integrating the production of psychosocial labor into one’s core identity. Most Liberian psychosocial workers were originally drawn to the profession because it offered an opportunity for economic survival in a devastating context. They gained access to these careers through various forms of educational and social capital accrued during their years as the children or youth of prewar middle-class Liberian life. During their training, they underwent a kind of moral reeducation, and that experience provided them with the principles and pedagogical orientation of their psychosocial approach. Then, once they had attained a professional status, social workers often felt that because of their status, they had a social responsibility to act as public role models. Many believed that their personal and professional lives must be examples of moral rectitude and drew upon their personal lives and histories as lessons for their audiences. Fata was not alone in experiencing psychosocial work as a site of politicization. Many prominent Liberians who became active in government, politics, and public policy, like S. Tomorlah Varpileh (the former deputy minister at MOHSW, the minister of youth and sport), Leymah Gbowee (Nobel Peace Prize laureate), and Etmuniah Tarpeh (former director of World Vision, former minister of youth and sport, and current minister of education), passed through the LWF/WS’s trauma-healing program at various points during the war as employees, not as consumers. This suggests that employment within locally adapted psychosocial training programs functioned as a ‘‘school’’ for the politicization of the Liberian middle class and that its precepts are likely to have an ongoing, disseminative influence on Liberian governance and public policy. For example, the award-winning documentary Pray the Devil Back to Hell opens with Leymah Gbowee describing her flight from a violent militia when she was five months pregnant, holding her son’s hand and not being able to ease her son’s hunger when he asked her for a doughnut. Her narrative quickly moves into the war experiences of others that she had heard as a psychosocial worker, especially those of a woman who descended into

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madness after witnessing the murder of her husband. Leymah describes how the woman was asked to dance, sing, and clap while a group of soldiers murdered her husband. She concluded, ‘‘When they asked her to sing, her husband’s blood flashed on her, and she just went off. To this day, she is still singing and clapping that song, to this day.’’ As a social worker, Leymah describes her experience of listening to stories of suffering like these: ‘‘We just broke down and cried because it hurt that there was no outlet for the Liberians.’’ She again refers to her social work experience when she describes her politicization into the Women of Liberian Mass Action for Peace, which has received credit for helping end the war in 2003: ‘‘Sitting with these people who had nothing . . . and holding their hands and hugging their kids and seeing that they still had hope . . . that was where I got baptized into the women’s movement.’’ Similar to Fata’s story, Leymah Gbowee’s autobiography recounted how the war interrupted her promising childhood just as she graduated from high school and prevented her from going to college. She married and had several children, but her husband grew violent soon after they married. Trapped between war and domestic violence, Gbowee described how she felt that she had been reduced to nothing. She was a shell of her former self, and she lacked self-esteem and any sense that she had a future worth living for. It wasn’t until she left her husband, found a new partner, and began her professional training in the LWF/WS Trauma Healing Program (and later earned an associate’s degree in social work at Mother Patern College) that she regained her confidence, her identity, and her sense of purpose in life. Moreover, her new sense of purpose had distinctly political and national ambitions. Katherine, a child protection officer for an NGO, offers a more typical example of politicization through psychosocial work. She often told her clients and audiences that she sought to live her life as a positive example to her Liberian peers. Katherine had entered into the NGO professional circuit in the mid-1990s after she fled her Monrovia home to an IDP camp close by. As an IDP, she was hired to help facilitate the first DDRR process and soon came to relish the moral authority that came with her position as an ex-combatant rehabilitation counselor. In her training sessions on child protection, Katherine routinely drew upon her own family life in Monrovia, and on stories of her husband and her three children, to encourage rural families to support their children’s schooling by feeding them, paying their school fees, allowing them to rest, and helping them with their homework.

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But Katherine also regarded the lessons she had learned as a psychosocial trainer as a source for her political activism in Monrovia. There she became a vocal critic of the government’s failure to create employment and educational opportunities for young men and women and believed that it should be a national priority to create a ‘‘Boy’s Camp’’ and ‘‘Girl’s Camp’’ system to resocialize Liberian youth into Liberian civil and economic life. In interview after interview,2 I learned that the overwhelming phenomenology of Liberian psychosocial worker experience was one of empowerment. Liberian psychosocial workers became politicized through their process of training in trauma healing and psychosocial intervention; and they saw their trauma-healing and psychosocial activities in a political context—as an act of national healing and reunification. Perhaps because Liberian psychosocial workers lived lives in which the concept of trauma was sensate, acting on trauma made intimate sense. The labor resonated emotionally with practitioners, while the politics of bringing together the healing of individual trauma and the healing of national trauma had a logical immediacy. Consequently, psychosocial work was a domain from which thousands of Liberians reestablished professional identity, moral rectitude, and political location in postwar Liberia. Psychosocial training and psychosocial labor spoke deeply to Liberian men and women’s pasts, presents, and hopes for the future. It was more than technocratic—it was a moral mission. Their employers, the humanitarian NGOs, might be guilty of many sins, but they were there to save Liberia from herself and to help Liberians onto a path of righteousness through democracy, human rights, and trauma healing. Liberian employees understood themselves as the handmaidens of the present who would become the leaders of the future. This transformation occurred in many different ways, all of which have to do with factors that are generalizable to the broader psychosocial worker population. First, just having a job and being able to provide for her children gave Gbowee a sense of competence and a surety of place in the world that were crucial to her personal recovery. Second, she wrote that the process of doing ‘‘trauma healing was a little like therapy’’ (Gbowee and Mithers 2011, 81). The work of trauma healing positioned her as a witness of people’s suffering, a student of the Liberian war’s history, and an interpreter of both. With only the literature on psychosocial work in humanitarian contexts as a reference, one would not be able to predict that humanitarian employment—especially as a trauma healer—could prove to be a site for

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personal redemption. While some limited, important research has examined the problems of burnout, secondary traumatic stress, and countertraumatization among trauma healers in conflict environments, little attention has been paid to the social and relational worlds of the trauma healers themselves.

Becoming a Psychosocial Worker Let us turn our attention to Liberian psychosocial workers’ process of training and formation. In the wartime refugee and IDP camps and in postconflict Liberia, NGOs needed to hire many Liberians to implement psychosocial programs in order to access the populations they had received funding to assist. Liberian psychosocial staff were needed for more than the routine execution of project-related tasks. They were needed as interlocutors between global humanitarian priorities and local concerns; as cultural brokers who could bring NGOs and local populations into closer alignment; and as salesmen of NGO programmatic agendas. In their role as ‘‘sellers’’ of NGO activities to voluntary participants, Liberian ‘‘local staff’’ had to persuade other Liberians that the time invested in psychosocial projects was well spent. In order to prove that NGO projects were relevant to Liberians’ lives, NGO workers engaged in various forms of linguistic and cultural translation, or what Merry has called ‘‘appropriation and translation’’ (Merry 2005).3 Liberian employees needed certain language and written competencies, but they also needed to know how to do ‘‘NGO-speak,’’ that is, what to say, how to say it, and when to say it, in a way that was consistent with NGO priorities. The process of producing mental health workers is itself a phenomenon of the articulation between global humanitarian culture and ‘‘on-theground’’ programs. The process of appropriation and translation involved transforming the subjectivity of the NGO worker as much as it demanded a shift in locally adapted programs’ language and practices. The training to become a trauma healer or psychosocial worker demanded a subjective dualism, a balance of empathic identification with processes of abstraction, generalization, and technical knowledge and practice. By the time a psychosocial worker began to practice, he or she had already shifted into a transformed subjective role of being a ‘‘post-post-trauma’’ sufferer, in possession of a new armature for fighting pain and promoting healing.

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Humanitarian employers generally assumed that potential local staff had experienced trauma, so many programs applied the same conditions as NEPI did: potential psychosocial workers needed to complete traumatraining programs, which included a component of group and individual counseling for the potential psychosocial worker’s presumed traumatic experiences. Consequently, at one point or another during the Liberian war, many hundreds of Liberians had been trained by NGOs to conduct trauma-healing work and, on their path to NGO professionalism, had participated in trauma-treatment activities. Most were trained similarly and in a manner consistent with international conventions on trauma-healing training. Although there were some differences in time frame, curriculum, and therapeutic intervention (trainings might be as short as two days or as long as two months), the training structure generally included the following components: (1) an introduction, (2) contextualization (or localization), (3) cultural sensitivity, (4) trauma education, (5) trainee trauma narratives, and (6) counseling. To help trainings resonate with psychosocial workers, key techniques of personalization included role-play exercises, self-questionnaires, and key points quizzes. The role-play exercises and the self-questionnaires continually mediated between situating the trainee as the service provider and as traumatized service-seeker, and trainers were challenged to question their own experiences, moral intuitions, assumptions, and convictions about appropriate responses. In this section, I would like to review the components of the trauma TOTs in order to situate psychosocial workers’ subjective experiences within the training structure. This section is based on training materials shared by staff from MDM, CVT, and Second Chance and on publicly available training documents produced for other contexts. While the classification in what follows is mine, it reflects NGO workers’ memories and reflections on their training experiences. Not all trainings included each of these components, nor were they necessarily implemented in the order I have presented them. They varied based on particular NGO mandates, funding conditionality, and program structures. But the components described in what follows offer a sense of the building blocks of the trauma trainer process that produces subjective transformation. Introduction

Training sessions opened with welcomes, personal introductions, ice breakers, and brief exercises in cultural difference. They then moved into a

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discussion of the ground rules for the training, including the need for confidentiality and the need to maintain an environment of respectful speech and listening. The topic of the training was introduced and usually included the textbook definitions for concepts like ‘‘trauma,’’ ‘‘PTSD,’’ ‘‘culture,’’ and ‘‘counseling.’’ Contextualization

The training sessions then moved into a process of contextualization, in which trainers asked trainees to describe their environments (e.g., IDP or refugee camps), the history of the recent conflict, aspects of the recent conflict that had led to trauma, and aspects of the recent past that had destroyed stability in people’s lives. Trainers then asked their future healers to engage in a process of imaginative reflection. They asked the trainees to empathize with the life histories and life experiences of the victims of war they had described by posing questions for discussion like the following: ‘‘What do you imagine some of your challenges would be, and how might you face those challenges?’’ ‘‘What emotions would you be experiencing?’’ Through this task, the trainers initiated a process of amplifying abstract empathy by invoking experiences and memories within their trainee counselors that could then inform the counseling process. Trainers also provided historical and statistical information about the violence, displacement, and death caused by the war. In doing so, they often surprised their trainees and provided them with a transformed awareness of the Liberian war as an experience that was scaled, widespread, and systemic rather than personal and biographical. In doing so, they transformed trainees’ personal experiences into sympathy for people as individuals affected by a shared historical and structural set of forces. Cultural Sensitivity

By the time the Liberian conflict began, the principle of cultural sensitivity had become an important component of trauma-counseling training in conflict settings. Trainers encouraged counselors to momentarily become ‘‘native anthropologists’’ and demonstrate cultural sensitivity by relating to their own culture and the cultures of their imagined clients as key informants, external observers, and insiders. This process was intended to identify cultural, logistical, and linguistic barriers to help-seeking behavior, such as an inability to speak English, a lack of information about available services, cultural prejudices regarding

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mental health, concerns regarding hidden financial costs, and a lack of cultural sensitivity by service providers. Cultural sensitivity training was a particularly helpful framework for educating psychosocial workers in the ‘‘salesmanship’’ component of psychosocial recruitment because it identified barriers to entry and offered resolutions to those barriers. Typical questions during this part of the training might include: ‘‘In your culture, how might you handle this conflict or problem?’’ ‘‘What is your self-identity?’’ ‘‘What gives you a sense of belonging?’’ ‘‘What are your valued institutions, emotions, relations, approaches to solving problems, etcetera?’’ Discussions of cultural sensitivity also invited attention to ethnicity/ tribe, gender, sexual orientation, social class, attitudes, spiritual beliefs and practices, and physical and mental abilities, thus constituting a form of expatriate ethnographic investigation. It was in this component, for example, that expatriates might have first learned of Open Mole. This component also gave trainers an opportunity to address the concept of resilience, to discuss the importance of social and community support for trauma victims, to inform trainees about the role of religion and local culture in healing processes, and to alert them to cultural sensitivity issues in NGO and clinical encounters. Trauma Education

The trauma education component was didactic and based on a lecture-andresponse format. Trainers provided technical expertise on the physical and emotional symptoms of PTSD, diagnosing mental illnesses, and assessing debility. Trainees were also taught to understand how Liberians might be more or less vulnerable to PTSD based on age, dose-response relationships (how the quantity and severity of trauma affects mental health outcomes), types of trauma, substance abuse, and available social support. Sometimes training participants were introduced to an expanded definition of traumatic stressors to increase their receptivity to atypical trauma narratives; or trainees might learn about the neuroscience of PTSD or other mental illnesses. Here trauma was clearly differentiated from other major mental illnesses (e.g., depression, anxiety, psychosis). Trainers emphasized to the counselors that they were principally concerned with people suffering from trauma, depression, and anxiety, not psychosis, substance abuse, or other major mental illnesses requiring psychiatric care, which required referrals to other service providers.

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Trainee Trauma Narratives

In this component, trauma healers were encouraged to share their own experiences with trauma. At that moment, the line that differentiated the trainee from the patient was a thin one, demarcated only by their recent movements through the training pedagogies of abstract empathy, contextualization and generalization, the acquisition of an insider/outsider viewpoint to culture, and technical expertise. Through specific rules like empathic listening, noninterruption, and extended time to share personal stories, the training environment was made to resemble a group therapy environment. Trainees were encouraged to share ‘‘a painful experience’’ and to describe to the group how it affected them physically, mentally, and emotionally. They were also encouraged to share their needs at the moment of the trauma, to recall which responses had been helpful and hurtful as they tried to manage the experience, and to discuss how their life had been permanently changed by the traumatic experience. Counseling

The counseling component addressed the interventions the trainees were expected to practice within the NGOs’ programs, including community sensitization and outreach sessions, group therapy interventions, individual counseling, and provision of referral resources. Most interventions highlighted the use of empathic listening and oriented their trainees to recruit patients into a secondary set of psychosocial programs, including ‘‘motherchild bonding’’ groups, kids clubs, sports groups, art therapy programs, and occupational training for ex-combatants. Initiatives using labor-intensive, lengthy therapies like cognitive-behavioral therapies might be briefly introduced, only to be downplayed as a therapy that was beyond the resource capacities of the organization. During the counseling training sections, a great deal of attention was paid to trainee self-care, issues of secondary traumatization, transference, and retraumatization. The training structure was consistent with emerging standards for humanitarian intervention in mental health and psychosocial well-being (see Chapter 1).4 It derives from dozens of TOT manuals I’ve reviewed in the offices of psychosocial programs in Liberia and in the gray papers on mental health, trauma healing, and social work counseling. Through my interviews with psychosocial workers, it was clear that this type of training was relevant in the Liberian context. The themes described here are in line

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with those of leading scholarship and theories of practice in international humanitarian circuits. Although challenging concepts like resilience, culture, co-morbidity, and social support were addressed in cursory and uncritical ways, they were still offered to local staff as part of their technical tool kit for carrying out psychosocial intervention. Let’s return to Loupou’s story (Chapter 5) to consider how trauma training and counseling facilitated a subjective political, professional, and personal transformation. When NEPI found Loupou, she determined that a job with a Liberian NGO offered a more secure and respectable route to reintegration than seeking out international NGO services or trying to find a job in the private sector or in government. But as an ex-combatant, Loupou was required to undergo counseling and training from NEPI’s organizational leaders. Loupou’s training as a psychosocial counselor with NEPI followed a clear process delineated by her NEPI superiors, which they derived from their own experience with ex-combatant demobilization and trauma counseling. Loupou had to narrate her trauma history, in her own words, from beginning to end, under supervision, without omitting key traumatic events of violence and vulnerability. The narrative had to link her past with her present, account for all of her experiences of victimization and aggression, and locate responsibility and authority in appropriate actors. She was required to tell everything and conceal nothing. She said that it was hard to do. Loupou’s process points us to the flexible meanings of the trauma narrative itself. Through it, Loupou isolated her experiences of violence from her understanding of her subjective self but still integrated the experiences into an autobiographic narrative that she can orate, manage, and reinterpret as her need for the narrative changes and expands. From a strategy for survival, her involvement with psychosocial counseling became a process of critical self-reflection that helped her alleviate her symptoms of trauma, reflect on her social, political, and economic rights, and experience solidarity with others in such a way that she was able to become an agent of healing rather than a victim or an agent of harm.

Psychosocial Work Becoming a psychosocial worker was rather different from the process of psychosocial work. Psychosocial workers became such through opening

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new conceptual frameworks and humanitarian positionalities. Psychosocial work, on the other hand, was conducted with the intent to conserve intimate relationships, sustain existing living arrangements, and conserve social dynamics that reflected the status quo of social structure while simultaneously talking about social change at an ideological level. While training sessions might have emphasized helping people escape abusive relationships, prosecuting sexual violence, or resolving local conflicts by using legal systems, psychosocial workers, in practice, tended to try to sustain a social status quo while advocating transformative agendas. As we have seen throughout this book, psychosocial workers drew upon the resources and justifications at their disposal to dispense the interventions they felt were most appropriate—and those interventions tended to be moral rather than psychological in nature. In psychosocial encounters, social workers often felt empowered by their position to provide moral guidance regarding the constitution of the family, the relationship between husbands and wives, and abuse and separation or divorce. In my interviews with psychosocial workers, they explained the significance of their counseling work by reminding me that the country had lost its morality during the war. It was their responsibility to help clients ‘‘see the right path to good behavior.’’ Through psychosocial interactions with clients, they advised people to pursue standards of behavior that they believed exemplified global middle-class values, humanitarian priorities, Christian morality, and local norms. Their moral work was at the center of the relationship between counselors and counseled; to Liberian social workers, offering moral counsel is a foundational aspect of the act of social work recognition. In one of his journal entries, John, a psychosocial worker for a Christian NGO, shared the story of a local girl named Asatu, who had been beaten severely by her mother. The narrative is presented with all the relevant detail he chose to share with me. Asatu’s family often sent her to the Gbarnga market to purchase food for her mother’s dinner preparations. She usually hurried home from the market by taking a fen-fen (a motorcycle taxi), but on this particular day, no fen-fen could be found. Asatu’s father was a teacher. He worked two shifts at a local school, one in the morning and one in the evening. In the late afternoon, Asatu’s mother was often rushing to cook him dinner. Asatu tried to get home as quickly as she could on foot and eventually arrived on a motorcycle. After explaining the situation to her father, he was

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convinced of her guiltlessness, but her mother proceeded to beat her severely, leaving marks across her body. Asatu was taken to Phebe Hospital where John, the social worker, first met her. John, then an ecumenical minister (which he considers his first social work job), gave her counseling. In his field notes, he wrote: While observing the patients, I saw Asatu withdrawn, to I went to her and spoke. I said, ‘‘Hello, my sister.’’ Asatu was silent. I said again, ‘‘Hello, my sister!’’ Asatu said slowly, ‘‘Hello, my brother.’’ I decided to keep conversation with her, so I introduced myself, but she was not interested due to the severe pain. I managed to make some breakthroughs by giving her minimal encouragement and a passage of Scripture, John 3:16: ‘‘For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.’’ I used this passage because Asatu was sitting alone, not willing to communicate with anybody sitting around her. Every morning, at the outpatient department, we had devotion with the patients and we allowed them to talk with each other as a form of therapy. This made Asatu open up to me, and then the interview began. I asked, ‘‘Sis Asatu, what happened to you?’’ Asatu said, ‘‘My mother beat me severely, accusing me of coming from my boyfriend’s house instead of the market where she sent me to buy foodstuffs. She usually sent me to the market and tells me to come back home [quickly], but I need a motorbike to come back quickly. Yesterday, they had a football game on the county field, so it was difficult for me to find a motorbike to take me to and from. So I had to walk from . . . to . . . to buy the foodstuffs. When I came back, my mother didn’t ask me, but she jumped on me and started beating on me. Everyone talked to her but she refused to listen to them. My father even tried to stop her but it was null and void. My mother does not love me, so when I leave this hospital, I will go to my auntie’s house.’’ While the client was talking, I continued to use minimal encouragement and resources. Then after, I used self-disclosure. I told the client, ‘‘One day, my father beat on me without any concrete reason, but I continued to respect my parents until I began to stay on my own.’’

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This made Asatu feel fine, and she promised to go home. Asatu said, ‘‘My brother, thank you for talking with me, because I was actually discouraged and frustrated.’’ I replied, ‘‘Good-bye, sis Asatu. May God bless you.’’ Asatu was escorted to the main road after she received her treatment and was discharged. This passage illustrates a banal incident of counseling in postconflict Liberian life. Drawing on the Bible and local African folktales, John, the Liberian social worker, offered guidance regarding appropriate emotional and moral responses to conditions of violence and suffering. Like the pastors criticized by Agnes and the human rights educator from NEPI, John fell into the postconflict tropes of ‘‘forgive, for now is a time of reconciliation’’ and ‘‘turn the other cheek.’’ These tropes were sincere, but they had significant moral and political implications. Asatu was pressured to tolerate a condition of familial abuse to uphold the nuclear family unit. Agnes’s pastor supported a paradigm of ‘‘forgiveness’’ for child sexual assault, despite the fact that it sustained a culture of impunity and an environment of intense insecurity. However, John also did ‘‘moral missionary’’ work through his counseling. For John, as well as other Liberian NGO workers, the Christian Bible was an excellent source of guidance and inspiration in social work counseling. With roughly 85 percent of the Liberian population reporting Christian affiliation, his reference to John 3:16 was warmly received by Asatu. In context, it indexed a local meaning of sympathy and solidarity that might not be readily apparent to an outside interpreter, or what Luhrmann, in other contexts, has called metakinesis (2004). That NGO workers persistently inserted their own religious and moral subjectivities into their social work is perhaps not surprising. That they perceived doing so to be central to the process of the psychosocial interaction may itself be more significant. In John’s discussion of his counseling, he pointed to his use of Scripture and to the public discussion of the morning’s Bible devotion as crucial to his own initiation of engagement with Asatu and to the creation of a space for ‘‘therapeutic talking’’ in the outpatient clinic. Citing a Bible verse gave him entry into her narrative; and the environment of biblical discourse created a metacontext for psychosocial engagement, yielding counseling that was both therapeutic and sanctified. NGOs tended to support secularism but could not balance it against their concerns about cultural sensitivity in a densely religious environment. In

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John’s own journals he admitted that he may have erred in advancing his own preference for an outcome in the course of the interaction and identified his use of Scripture as a possible flaw. Liberians called upon psychosocial workers to listen closely to the horrific aspects of their compatriots’ life histories and act upon them. They were routinely approached to act as interrogators and interpreters or introduced themselves into situations as conflict-resolution experts. They made plans, prescribed courses of action, and disseminated judgments freely. Psychosocial workers often provided tactical guidance and direction to clients that advanced normative agendas in all situations—but quite noticeably in cases of domestic violence and rape. During a mental health clinic day in Gbarnga in 2007, I sat off to the side as a tall, sad woman complained of physical and emotional abuse from her husband and her five children. Her husband beat her constantly, humiliated her, and worked her like a dog. Lately he had started encouraging all five of her children to join in the abuse. Her life was unlivable. She wanted to leave. Her complaint of Open Mole seemed to be a ruse to access psychosocial assistance inside the clinical tent, or at least it was interpreted as such by the mental health workers. Once inside, she requested NGO assistance through relocation and some modest financial aid. (Another NGO in the region had opened a shelter for battered women, and she may have been looking for a place in that shelter but had come to the wrong NGO.) During her interview, she seemed to be asking the mental health workers to support her decision to leave her abusive husband and family and to help her leave safely. Over the next twenty minutes, the mental health workers discouraged her from leaving her family and advised her ‘‘not to break up the household.’’ They barraged her with the phrases ‘‘Now is a time of forgiveness’’ and ‘‘We must make peace.’’ The tall woman became silent, and tears flowed from her eyes. The psychosocial workers told her, ‘‘We will not say that it is ok for you to leave your husband. You must find love in your marriage again.’’ They told her that they were trained as conflict-resolution specialists, and they encouraged her to return, with her husband, the following week for some ‘‘talking’’ counseling. They promised her that with their assistance and some good talking to help open the gates of communication between her and her husband, things would improve.

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The woman left quietly, looking heartbroken and betrayed. Afterward the mental health workers told me that even though they didn’t know anything about her family or background, she was probably lying to try to punish a husband she suspected of having an affair. ‘‘Talking therapy is best,’’ they agreed. These narratives serve as a reminder that psychosocial counseling is, above all, a form of social interaction—with all of the evasion, resistance, and apathy those can entail. In professional and personal interactions, psychosocial counselors could be quite tough. When clients disagreed with the psychosocial workers’ lectures or counsel, they were more likely to avoid another encounter than argue with a Liberian NGO worker. Some of this toughness was accentuated by the moral superiority that NGO employment connoted. As NGO employees, psychosocial workers wore the mantle of global moral authority that was widely associated with humanitarian institutions. In clinical and community contexts, they held the status of doctors or ‘‘bosses,’’ and they could be gatekeepers of NGO resources and services. Sometimes, however, the social workers were themselves callous or selectively blind to certain kinds of violence in their own and their clients’ social worlds.5 Female psychosocial counselors did not always ally with victims of sexual and domestic violence; many female social workers believed that women were sexual predators who were to be feared and distrusted by their own children, parents, or spouses. Similarly, child protection officers did not necessarily treat children with dignity and respect. Many believed that the younger generation had been completely morally corrupted and described children as lazy, parasitic, disrespectful, and sources of constant irritation and greed. Women seeking divorce were often counseled to forgive and forget. The work of trauma healing itself prompted radical realignments of identity, affinity, and solidarity in social workers, but it was not always clear where those lines of solidarity lay. The act of counseling foregrounds the relational skills of the healer and the sufferer, and information, moral guidance, and emotional labor (in the form of empathy) are transacted in the context of the interaction. The interaction itself is dialogic in the Bakhtinian sense. The cultural matter of the encounter is grounded in words and rhetoric that are directed toward another, awaiting a future answer: ‘‘It provokes an answer, anticipates it, and structures itself in the answer’s direction. Forming itself in an atmosphere of the already spoken, the word

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is at the same time determined by that which has not yet been said but which is needed and in act anticipated by the answering word. Such is the situation of any living dialogue’’ (1981, 280). One key element in the trauma-healing dialogue is the subjective stance of ‘‘local staff’’ providers of trauma healing and psychosocial counseling. As strange or misplaced as some may have seemed, all of the interventions conducted during my research were done with sincerity and a striking lack of cynicism. This seems to be an important qualifier. Liberian psychosocial workers were transformed by their direct experiences of violence and trauma, and they were indirectly shaped by the transformation of social structures that the war had created. In their work as moral missionaries, they applied themselves to the task of social change with political zeal and a vast reservoir of goodwill and good intentions. At the same time, they also advanced their own moral and political projects through their professional psychosocial interactions. Having undergone a process of personal and professional transformation that had moved them from the status of trauma victim to psychosocial professional to professional advocate to political advocate, they sought to use their professional positions and their moral authority to effect social and political change. ‘‘Being’’ a Liberian psychosocial worker involved recognition, professionalization, radicalization, and then solidarity. ‘‘Doing’’ social work in Liberia involved an act of empathy and recognition that was positioned and decidedly political.

Conclusion Psychosocial workers were enmeshed in the same global project of radical social change and structural reconstruction as were the Liberians they counseled. In their lives and experiences, they often bridged the reality of existing as the objects of humanitarian aid and as the agent and purveyor of global therapies for local distress. Through their ‘‘native’’ status as locals and as sufferers, humanitarian agencies gained access to the world of local experience. Humanitarian ‘‘local staff’’ conducting trauma healing and psychosocial work bridged numerous divisions that were simultaneously intrinsic to and invisible from the intervention process. They acted as intermediaries and bridged language and cultural barriers between expatriate managers and local populations. They translated international training materials about mental health into categories that were relevant to local

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populations. They stimulated local awareness by drawing on common experiences and histories of which NGOs were unaware. Regardless of the technical or effective value of psychosocial workers’ labor, becoming a social worker or a trauma healer continues to be an important domain of postconflict experience for thousands of Liberians. In their personal and professional lives, they attempt to recognize and address the sufferings of the past in order to resolve the disabling psychiatric and social sequelae of the present. They do the difficult work of listening, recognizing, and witnessing the pain of others while suspending their own histories and experiences to assert a calm professionalism. They proselytize. Then, when they return to their personal lives, they draw on their professional status and experience to forge a new middle-class morality for themselves, their families and communities, and the nation of Liberia. From nonstate, humanitarian institutions, Liberian psychosocial workers became vigorous advocates for state presence. Students who passed through the Mother Patern College were inculcated with a sense of patriotic commitment to help rebuild their country; they were taught that staterecognized governing boards and licensing credentials were matters of national sovereignty. Through their work, Liberian psychosocial workers also directed Liberians to act as though the Liberian state was an effective institution. They sent Liberians with domestic or civil complaints to state agencies to resolve local disputes and normative and legal issues and to discover their legal rights and obligations. During the human rights training sessions described in earlier chapters, in which the trainers made unsubstantiated recommendations regarding land tenure, marital law, and child custody, we saw how psychosocial workers ignored the functional and legal limitations of the existing state apparatus in order to imagine the state into existence in their prescriptions to local populations. This was a fundamentally political act. Whether they turned to a temporarily nonfunctional state apparatus to do state-like things or insisted that people believe in the presence of a state in its empirical absence, Liberian psychosocial workers were setting forth pathways for the believability of a functioning Liberian state. Speaking against the recent history of Liberia and gesturing toward a vision of the future, they asked their countrymen to believe that a state existed, that it could provide bureaucratic and rational government, and that it would work in the interests of the people.

Notes

Chapter 1 1. SAPA-AFP 2007. More than a year later, a popular outcry arose against the ‘‘social problem’’ of lesbianism at a five-day national women’s conference at Monrovia’s city hall. The conference, titled ‘‘Advancing Women’s Human Rights in Peace Building, Recovery and Development in Liberia,’’ was convened by the United Nations Development Fund for Women (UNIFEM), Liberia’s Ministry of Gender, and other members of the Gender Taskforce. During a section on gender-based violence (GBV), which the organizers hoped would highlight rape, domestic violence, and female genital mutilation in order to lay a foundation for a national plan of action on GBV, women from around the country spoke out against the assault by women on the nation’s collective morality and specifically invoked the Willis Knuckles event. The women at the conference had been carefully selected to represent a broad cross-section of Liberian regional and ethnic diversity, and when they gained the platform, they decried promiscuous women wearing tight clothing, prostitutes, and lesbians as indicative of the nation’s trauma and moral collapse. Many people I spoke with linked prostitution to the unresolved mental illness caused by the trauma of being raped, pointing to the abstract female prostitute’s loss of self-respect, scanty attire, use of drugs, and rejection of collective codes of modesty. 2. In 2009, NEPI changed its name to the Network for Empowerment and Programme Initiatives. 3. Psychoanalytic, cognitive-behavioral, and cultural explanations have been developed that follow different variables to arrive at the same conclusive framing. 4. For recent history, see Sawyer and Institute for Contemporary Studies 1992; Ellis 1999; Adebajo and International Peace Academy 2002; Sundiata 2003; Moran 2006; Dunn 2009; and Waugh 2011. 5. For an anthropological consideration of peacekeeping regimes and their effects, see Rubinstein 2005; Marcus 2005; Ghosh 1994; Polman 2003; Besteman 2009; and Greenhouse, Mertz, and Warren 2002. Chapter 2 1. JFK Hospital was built in 1968 as a gift from the U.S. government. For decades, JFK Hospital was administered by U.S. doctors and hospital administrators, and was

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sustained by a combination of U.S. funds, Liberian revenue, and international debt. For much of its history, funding for the JFK Hospital has consumed the lion’s share of the Liberian MOHSW budget, but it has functioned as a separate administrative entity within the Liberian health sector, and its administrator has traditionally been appointed by the Liberian president. Katherine Mills operated within the JFK sphere of administration, and was staffed by internationally trained psychologists and psychiatrists who also provided private medical care to Monrovia’s elite and expatriate communities. 2. See ‘‘Mental Health Financing’’ 2003; ‘‘Mental Health Legislation and Human Rights’’ 2003; ‘‘Planning and Budgeting to Deliver Services for Mental Health’’ 2003; ‘‘Mental Health Policy, Plans and Programmes’’ 2005; and IASC, 2007. 3. Jensen currently serves as the senior mental health advisor to the Euro Health Group. He also has a private practice in Denmark and specializes in treating refugees and torture survivors. 4. Medications regularly available included benzhexol, carbamazepine, phenytoin, phenobarbitone, fluphenzine, haloperidol, trifluoperazine, amitriptyline, chlorpromazine, valproic acid, paroxetine, benzodiazepine, and sertraline. Chapter 3 1. Recommended adaptations include cultural competency efforts in diagnosis and research, better efforts at translation of mental health assessment instruments, and qualitative research-informed modifications in global mental health research. 2. In this they were not alone. Several of the ex-combatants I interviewed at rehabilitation projects also expressed continued support for Charles Taylor. They told me that they were convinced that he was a victim of an international conspiracy to imprison him so that the international community could ‘‘embarrass Liberia’’ and take her natural resources. 3. Some popular film examples include The Best Years of Our Lives (1946); The Manchurian Candidate (1962); Jarhead (2005); Memento (2000); Reign over Me (2007); and In the Valley of Elah (2007). Chapter 4 1. After a 2011 Amnesty International report documented human rights violations in Liberia’s prison system, the conditions for storytelling in Monrovia’s Central Prison were fraught. Prison guards and administrators were sensitive to outsiders coming in and asking questions. Prisoners, however, were keen to talk about their personal worries, prison conditions, and legal woes, but the sight of someone recording them without their directed dictation was unsettling. This was a recurrent theme in most of my ethnographic practice, even when I obtained verbal informed consent to observe individual interventions. See Amnesty International, ‘‘Good Intentions Are Not Enough: The Struggle to Reform Liberia’s Prisons,’’ report issued September 2011 (Index: Afr 34/001/2011).

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2. ‘‘Then Peter came up and said to him, ’Lord, how often will my brother sin against me, and I forgive him? As many as seven times?’ Jesus said to him, ’I do not say to you seven times, but seventy times seven.’ ’’ 3. In 2003 I worked as a consultant for CVT to conduct a needs-assessment survey in the conflict-affected areas of southern Guinea, sponsored by the WHO (see Abramowitz 2005). In 2005 I returned to CVT’s new Liberia bureau to conduct research on trauma-related mental illness in Liberia’s most-affected counties. The study was preemptively terminated due to logistical issues and rumors of preelection violence. Chapter 5 1. The materialist foundation of some ‘‘loving’’ relationships may have long preceded the war (Moran 2006; Chernoff 2003). 2. Ironically, the institutions most responsible for the abandonment of female circumcision are the Seventh-day Adventist and Pentecostal churches, which are widely ignored by the international community as a solution to the problem of widespread female circumcision. The churches insist that conversion means the abandonment of ‘‘forest-business,’’ which includes the secret Sande societies were FGM occurs. International GBV ideology requires that violence against women originate in a secular, rights-based framework rather than religion. 3. Some anthropologists of development have critiqued participatory approaches as manipulative, arguing that they obtain local ‘‘buy-in’’ while fitting interventions to organizations’ programmatic goals and the resources they are willing to commit. The coercive potential of participatory approaches have not been fully explored in this chapter, but they should be taken into consideration as a possible outcome of GBV trainings. Chapter 6 1. See Luxemborg et al. 2001a, 2001b. Chapter 8 1. A number of studies show that globally, NGO-based psychosocial programs tend to create radical solidarity between local staff and their NGO clients. 2. Research for this chapter is based on interviews, life histories, social worker journals, and participant observation work conducted in 2005–2008. My process for learning about the experiences and life worlds of social workers required a dedicated data collection process that stood apart from my other research activities, including retrospective interviews with the leaders of two dozen defunct trauma-healing NGOs involved in DDRR and life history interviews with dozens of social workers, psychosocial agents, and mental health workers. I also drew from social work training journals written during a course I taught called Social Work Interviewing Skills at Mother Patern College. As part of their training in social work interviewing skills, students

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were assigned to keep weekly journals in which they recorded ‘‘stories’’ of social interaction around them and provided commentary on the interactions they observed. These narratives provided intimate insight into psychosocial worker observations and interactions that I didn’t always have access to, in short format and simple language. In this section, I draw on their journal entries with their permission (obtained during individual research interviews after the conclusion of the course). All of them were actively employed at some of the leading NGO programs in the country. 3. Merry (2005) has postulated that local workers in humanitarian NGOs participate in a process of ‘‘appropriation and translation.’’ They use the fundamental structures of global programs and apply them to a local setting but sustain a degree of interpretive flexibility so that interventions are locally relevant while simultaneously opening spaces for social change. 4. Much of this training structure is reflected in the many frameworks taught by such programs as the Harvard Program in Refugee Trauma, the International Trauma Studies Program at Columbia University, postgraduate course offerings and research at the London School of Hygiene and Tropical Medicine, and the International Society for Traumatic Stress Studies. See Weine et al. 2002.This framework also reflects the priorities of World Bank tool kits (Baingana and Banner 2004; IASC 2007) and psychosocial working group reports. 5. Social work students interpreted this as a result of the normalization of their wartime experiences. Confronted with their own stories, they began an iterative process of self-reflection, in which they began to question the extent to which they had come to take for granted the violence in their everyday lives. This process of reflexivity conflicted with their self-conscious identities as helpers and healers and forced them to question whether they had occasionally been perpetrators of violence or had been rendered moral and psychological victims of the war that had engulfed their lives for more than a decade. Out of the moments of moral crisis that then ensued, new narratives and life histories were provided that transformed how students’ related to their psychosocial labor.

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Index

Page numbers in boldface indicate photographs. Action Against Hunger, 52 Action for Churches Together (ACT), 8, 21 actor-network theory, 36 An Act to Amend the New Penal Code Chapter 14 Sections 14.70 and 14.71 and to Provide for Gang Rape (2005), 128–30 The Act to Establish the Truth and Reconciliation Commission (TRC) of Liberia (2005), 205 An Act to Govern the Devolution of Estates and Establish Rights of Inheritance for Spouses of Both Statutory and Customary Marriages (2003), 127 African Methodist Episcopal (A.M.E.) Church, 162 Agamben, Giorgio, 20 Allen, Tim, 200 American Psychiatric Association, 14. See also Diagnostic and Statistical Manual (APA) Amnesty International report on Liberia’s prison system (2011), 238n1 anthropology, discipline of: challenge of representing Liberian agency and cultural continuity, 87–88; concept of the psychosocial, 92; mid-twentieth century studies of medicine and society, 92; trauma studies, 89–90; views of violence (as ‘‘anticulture’’ or anti-language), 123; views of violence as social action, 123–24 Anti-Terrorist Unit (ATU), 139 Armed Forces of Liberia (AFL), 115–16; and gender-based violence, 128, 131; and massacre at St. Peter’s Lutheran Church (1990), 215–16

Asakaba gang, 29 Association of Female Lawyers of Liberia (AFELL), 130, 131 Atatu¨rk, Mustafa Kemal, 188 Bakhtin, Mikhail, 233–34 Ballah, Immanuel, 51 Baron, Nancy, 163 Beah, Ishmael, 163–64 Benedict, Ruth, 92 billboard images and slogans, 120, 189 Bong County, 71, 79; mental health interviews, 1; Open Mole cases, 107; Sante´ Humanitaire’s mental health activities, 101–2, 104–8; trauma counseling by the CVT, 99, 101 Booker T. Washington Institute, 162 Borh, Klubosumo Johnson, 174 Bosnia, 6, 10; ICC recognition of rape as weapon of war, 124–25; peacekeeping interventions and GBV programming, 125; UN peacekeeping mission in, 19 Brain Fag, 81 Brilliant, Sister Barbara, 52, 54 Brown, Jarvis, 48, 49–53, 54–55, 56, 59 Bryant, Charles Gyude, 16 Camp Schiefflin, 162 Cap Anamur (German emergency medical NGO), 36, 38, 51, 52, 58 Carter Center, 21, 57–59 Center for Justice and Peace Studies, 162, 163 Center for Victims of Torture (CVT), 6, 36, 40–41, 52, 56, 97–101, 239n3; and certification requirements for trauma

256 Index Center for Victims of Torture (CVT) (continued ) counselors, 53–54; departure from Liberia, 59; group therapy process, 99–101; individual therapy, 99; PSAs, 40–41, 98–101; psychosocial counseling and postconflict trauma healing and model, 40–41, 97–101 Center of Excellence for Mental Health, 59 Centers for Disease Control (CDC) (US), 125 Cherue, Vivian, 57 children: child custody, 151, 154, 194; child labor laws, 196; child mortality rate, 24; human rights, 193–94; sexual violence against, 122 child soldiers, 163–65; DDRR and Guthrie Plantation project, 161, 165–74, 180; longitudinal studies, 164; process of resocialization, 165–66; ‘‘securitymindedness’’ and latent possibility of violence, 158–60, 177–78. See also DDRR (Disarmament, Demobilization, Rehabilitation, and Reintegration) program; excombatant rehabilitation Christian Children’s Fund, 56 Christianity, 25–26, 72, 117, 184–85; Bibles/ Scripture, 96, 231–32; forgiveness and reconciliation discourse, 3–4, 184, 231; and GBV training, 153; and psychosocial counseling, 96, 231–32; role in abandonment of female circumcision, 239n2 Christian NGOs. See NGOs, faith-based collective trauma: defining, 66; and relationship between individual trauma, 4, 33. See also trauma in postconflict Liberia Collier, Paul, 22 Columbia University, 57 community-based GBV trainings: expatriate NGO trainers, 156–57; Liberian trainers, 141–55 community-based human rights and customary law training, 186, 191–99, 194; child labor laws, 196; children’s rights, 193–94; inheritance law, 195; marriage and divorce laws, 197–98; NEPI, 191–99; social roles, 199; wealth-in-people basis of customary law, 195. See also legal system, Liberian community-based reconciliation projects and rituals, 186–87, 199–204; DAI report,

201–3; forgiveness discourse, 3–4, 208–10, 231, 232; power of rituals, 186; psychosocial intent, 202; reintegration rituals and events, 200–202 Community Habitat Finance International (CHF), 8, 200, 203 Coˆte d’Ivoire: civil war, 33; Liberian war refugees, 18, 20, 24–25, 37, 139 Coulter, Chris, 24, 27, 87–88, 123, 165 ‘‘country medicine,’’ 116, 148; marijuana use, 112, 116; and Open Mole, 105, 110, 112 crime. See violence cycle-of-violence thesis, 13–17 Daniel, E. Valentine, 11, 30 Das, Veena, 28 DDRR (Disarmament, Demobilization, Rehabilitation, and Reintegration) program, 2–3, 29, 42–44, 160–77, 180–81, 221; forgiveness messages, 172–73; and gender-based violence, 132; Guthrie Plantation project (2008), 161, 165–74, 180; humanitarian scale effects, 9; and IDP camps, 221–22; International Crisis Group report on (2004), 160; international donors and support, 42–43; longitudinal studies of demobilized child soldiers, 164; NGOs acting as fictive kin/parents and advocates, 69–70, 175–76, 181–82; psychosocial rehabilitation, 160–77, 180–81; Sante´ Humanitaire and psychosocial counseling, 102–3, 161. See also excombatant rehabilitation demobilization. See DDRR (Disarmament, Demobilization, Rehabilitation, and Reintegration) program; ex-combatant rehabilitation Democratic Republic of the Congo, 19, 101 Department for International Development (DFID) (UK), 125 DESNOS (Disorders of Extreme Stress Not Otherwise Specified), 178, 179. See also excombatant rehabilitation ‘‘Destroying the Destroyer of Your Destiny: Pentecostalism and Charismatic Christianity in Post-Conflict Liberia’’ (Heaner), 184 Development Alternatives International (DAI): Psychosocial Resource Center

Index 257 within JFK Hospital, 55–56; report on reconciliation and community reintegration, 201–3 Devereux, George, 76 Diagnostic and Statistical Manual (APA): DSM-IV, 14, 81; DSM-V, 89 dissociation, trauma-related, 76, 77–78, 81–82 Doe, Samuel, 26, 215–16 domestic violence, 77, 129, 140, 212; and cycle-of-violence thesis, 15; and psychosocial work, 232, 233. See also genderbased violence (GBV) interventions ‘‘double consciousness,’’ 211–15 drug use/drug abuse and trauma, 67–68, 70; country medicine, 112, 116; diazepam, 67–68, 70; marijuana, 43, 68, 70, 81, 112, 116; and psychosis-risk in trauma survivors, 81; and self-management of trauma, 67–68, 70. See also psychiatric medications Du Bois, W. E. B., 214 Duncan, J. Oliver, 49–50 Durkheim, Emile, 65–66 Dyncorp, 21, 23 Economic Community Monitoring Group (ECOMOG), 112 Economic Community of West African States (ECOWAS), 18 Enloe, Cynthia, 122–23 Erikson, Erik H., theory of psychosocial development, 92 E. S. Grant Mental Health Hospital (Monrovia), 37, 38, 51, 57, 58, 59, 73–74, 104 European Community Humanitarian Office (ECHO), 21, 125 ex-combatant rehabilitation, 2–3, 158–82, 221; ‘‘crisis of the youth’’ and Liberia’s postconflict challenges, 26, 177–82; DDRR processes, 2–3, 29, 42, 160–77, 180–81, 221; diagnostic criteria for DESNOS, 178, 179; education, 180–81; ex-combatants’ preconceptions about postconflict life, 173–74; families and reintegration, 181–82; female ex-combatants and rape/ GBV, 120–21; forgiveness messages, 172–73, 176; and GBV interventions, 137–41; Guthrie Plantation project (2008),

161, 165–74, 180; humanitarian scale effects, 9; moral accountability messages, 176; and NEPI, 9, 162, 167–77; NGOs acting as fictive kin/parents and advocates, 69–70, 175–76, 181–82; postconflict preconceptions and ambitions, 173–74, 179–81; process of resocialization, 165–66; ‘‘security-mindedness’’ and latent possibility of violence, 158–60, 177–78; and trauma, 176, 178, 179. See also DDRR (Disarmament, Demobilization, Rehabilitation, and Reintegration) program expatriate NGO workers: directing community-based GBV trainings, 156; and GBV interventions, 131–33, 156–57; and ‘‘GBV primordialism,’’ 132–33; and impetus toward indigenization, 215; Liberian NGO workers’ attitudes toward, 219; men’s and women’s different experiences, 131–33, 156; and postconflict reconciliation initiatives, 203; rape victims, 132. See also NGOs, humanitarian families, reintegrated, 24–25; community reintegration rituals and events, 200–202; GBV training addressing, 145–47; NGOs acting as fictive kin/parents, 69–70, 175–76, 181–82. See also DDRR (Disarmament, Demobilization, Rehabilitation, and Reintegration) program female circumcision, 30, 122, 133, 144, 239n2 feminist activism, global, 124–27 Ferme, Marianne, 87 forgiveness and reconciliation discourse, 3–4, 208–10, 231, 232; and communitybased reconciliation projects and rituals, 3–4, 208–10, 231, 232; in DDRR and excombatant rehabilitation, 172–73, 176; Liberian Christians, 3–4, 184, 231; and NGO behavioral therapies with goal of building peace subjectivities, 96–97; and rape/rapists, 3–4, 208–9; and the TRC, 208–10 Foya Town, 158 Freire, Paulo, 216 Freud, Sigmund, 15 Gay, John, 24 Gbarnga, 3; mental health outpatient clinics, 9, 102, 110, 232; Taylor’s plantation, 139

258 Index Gbowee, Leymah, 8, 220–21, 222 GBV. See gender-based violence (GBV) interventions gender roles, 28, 122–23, 142, 199 gender-based violence (GBV) interventions, 118–57; community-based training, 141–55, 156–57; contrasted to psychosocial interventions, 118–20, 130–31; and diagnostic of power in postconflict humanitarian aid, 119–20; and expatriate NGO workers, 131–33, 156–57; female circumcision, 122, 133, 144, 239n2; female ex-combatants, 120–21, 140–41; ‘‘GBV primordialism’’ and Liberian culture, 132–33; the gendering of violence, 120–24; and ‘‘harmful traditional practices,’’ 122, 144–45, 239n2; international community and human rights laws, 124–27; Liberian NGOs and domestic institutions, 131, 140–41; Liberian trainers, 141–55; and Ministry of Gender, 119, 130, 131; narrative of a young female ex-combatant, 137–41; NGO cultures of intervention, 124–27, 131–33, 156–57; off-limit topics, 144–45; participatory development approaches, 143, 149, 239n3; postwar collapse of gender protections, 133–41; postwar humanitarian intervention and peacekeeping operations, 124–27; postwar sexual violence, 121–24, 128–30, 132–36; rape accusations and trials, 133–36; and the rape law (criminalization of rape), 128–30; SEA (sexual exploitation and abuse) education, 154–55; and Sirleaf’s presidential campaign, 127–28; status of Liberian legal and customary law, 124–30, 145–47; and UN Security Council Resolution 1325, 125–27; and the Willis Knuckles event, 237n1 Ghana, 18, 20, 24–25, 37, 38, 95 global health statistics, 23–24; child mortality, 24; life expectancy, 24; median age of population, 24, 26 Goffman, Erving, 184 Grant, Edward S., 37, 42–43, 48, 49–50 Greenfields Project, 51 GTZ (Deutsche Gesellschaft fu¨r Internationale Zusammenarbeit) (Germany), 125 Guinea: Liberian war refugees, 8–9, 18, 20, 24–25, 37, 40, 127, 139, 146, 192, 209, 216; NGO report on gender-based violence in

refugee camps, 127; trauma counseling by the CVT, 40–41, 99 Guthrie Plantation: NEPI career-training class session, 167–74, 180; psychosocial rehabilitation project (2008), 161, 165–74, 180. See also ex-combatant rehabilitation Gwenigale, Walter, 56–57, 60 Haiti, 19, 125 ‘‘harmful traditional practices,’’ 122, 144–45, 239n2 Harvard Program in Refugee Trauma, 240n4 Harvard University, 57, 59 Heaner, Gwendolyn, 184 Herzfeld, Michael, 183 Hoffman, Danny, 24, 87, 165 Holy Ghost Mental Home, 50–51 humanitarian intervention in Liberia, 18–23, 36–60; adoption of first-five-year recovery time frame, 22–23; funding the DDRR process, 42–44; GBV interventions, 119–20, 124–27; and global feminist activism, 124–27; the ‘‘interventionscape,’’ 36; ‘‘networked interaction,’’ 36; and people’s experiences as beneficiaries of humanitarian social engineering, 25–26; role in mental health infrastructure and policy development, 8–9, 37–60; as ‘‘state of exception,’’ 20; UN Cluster System to coordinate aid, 20, 45–46; UN Security Council Resolution 1325 and GBV intervention, 125–27; UN Security Council Resolution 1497 establishing peacekeeping mission, 19; UN Security Council Resolution 1509 establishing UNMIL, 19–20. See also NGOs, humanitarian; United Nations Mission in Liberia (UNMIL) human rights: AI report on Liberia’s prison system (2011), 238n1; children’s, 193–94; community-based training, 186, 191–99, 194; gender-based violence (GBV) and international human rights law, 124–27; gender-based violence (GBV) and Liberian laws, 127–30; UNMIL Human Rights Division, 135 Human Rights Watch, 161 indigenization: and management positions in government offices and NGOs, 215; and mental health policy in postconflict Liberia, 47–52

Index 259 inheritance law, 127, 130, 146, 152, 195 Inter-Agency Standing Committee’s (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings, 12–13 internally-displaced person (IDP) camps, 18, 20, 25, 216, 221 International Classification of Disorders (ICD), 14, 81 International Committee of the Red Cross (ICRC), 21 International Criminal Court (ICC), 124–25 International Crisis Group (ICG): report on Liberia’s DDRR process (2004), 160; report on Liberia’s postconflict peacekeeping and reconstruction (2004), 21–22 International Day in Support of Victims of Torture, 26 International Rescue Committee (IRC), 21, 151 International Society for Traumatic Stress Studies, 240n4 International Trauma Studies Program at Columbia University, 240n4 interventionscape, concept of, 36 James, Erica, 27 Jensen, Soeren, 48–49, 50–52, 55, 238n3 John F. Kennedy (JFK) Hospital, 37, 41, 49, 51, 57, 58, 237–38n1; Psychosocial Resource Center, 52, 55–56 Joint Implementation Unit (JIU), 43, 161–63. See also United Nations Mission in Liberia (UNMIL) Joscheck, Frank, 52–53 Kardiner, Abram, 81, 92 Katherine Mills Rehabilitation Institute, 37, 37, 38, 41, 49, 57, 237–38n1 kidnapping, 144, 150–51; and gender-based violence, 2, 30, 137–38 Knuckles, Willis, 1–2, 237n1 Koro, 81 Korubah, Zelleh, 174 Kosovo peacekeeping and GBV programming, 125 Kpelle people and traditions, 2, 105, 107, 111, 146 Kupe, Sumo, 95–97 labor theory of psychosocial work, 219–23 Landmine Action, 166–67, 174

Latour, Bruno, 36 legal system, Liberian, 28–29, 30; child custody, 151, 194; child labor, 196; community-based customary law training, 186, 191–99; GBV training, 145–48, 151–52; and gender-based violence, 124–30, 145–47; inheritance law, 127, 130, 146, 152, 195; marriage and divorce laws, 197–98; Paramount Chief System, 199; rape law, 128–30; and a ‘‘state of exception,’’ 20; wealth-in-people basis of customary law, 195 Leopard societies, 30, 145 lesbianism, ‘‘social problem’’ of, 1, 237n1 Liberia Community Infrastructure Program (LCIP), 201; DDRR process and excombatant rehabilitation, 162–63; Psychosocial Resource Center at JFK Hospital, 55–56 Liberia Gender-Based Violence Task Force, 131 Liberian Civil War, 24; AFL massacre at St. Peter’s Lutheran Church, 215–16; genderbased violence, 120–23, 133, 137–41; and health infrastructure, 37–42; lasting social disorder wrought by, 24; LURD fighters’ seizure of Guthrie Rubber Plantation, 165. See also Taylor, Charles Liberian Department of Defense, 23 Liberian National Police (LNP), 22–23, 128, 131, 134, 219 Liberian psychosocial workers. See psychosocial workers, Liberian Liberian Social Work Association, 51 Liberians United for Reconciliation and Democracy (LURD), 115 Liberia Partner’s Forum (Washington, D.C.) (2007), 56 Liberia’s postconflict reconstruction, 17–23; application of R2P doctrine, 19; Collier and the time frame for postconflict recovery, 22–23; expectations of success (failure as not an option), 19, 21–22; international investors, 23; introduction of humanitarian NGOs, 20–21; return and repatriation efforts, 20; UN Cluster System for humanitarian coordination, 20, 45–46; UN peacekeeping, 19–23. See also mental health infrastructure in Liberia; mental health policy in Liberia

260 Index Lofa County: community-based human rights training in, 186, 191–99, 194; NGOsponsored reconciliation and cohabitation between Loma and Mandingo people, 201; trauma counseling by the CVT, 99, 101 Loma populations, 2, 201 A Long Way Gone (Beah), 163–64 Lutheran World Federation/World Service (LWF/WS), 6, 8, 39–40, 55, 185; and DDRR process, 162, 174; GBV training, 114; and Liberian psychosocial workers, 39, 114–17; Trauma Healing Program, 8, 39, 162, 174, 176, 220, 221; traumatraining manual (Peace Building Training Handbook for Trainers and Trainees), 40 magic and rituals, 148; and curative properties of Western medications, 113; and postconflict time, 185–86 Mandingo populations, 201 marijuana use, 43, 68, 70; country medicine, 112, 116; and psychosis-risk in trauma survivors, 81 marriage and divorce laws, 197–98 Massachusetts General Hospital, 57, 59 Me´decins Du Monde (MDM), 6, 9, 36, 51, 52, 57 Me´decins Sans Frontie`res (MSF), 21, 36, 102 media campaigns, postconflict, 25–26, 28, 188–91; billboard slogans, 120, 189, 189; public service announcements, 190. See also radio stations mental health, definitions of, 13, 14 Mental Health and Psychosocial Coordination Committee (MHPCC), 47–48, 51–56; debate over professionalization (certification and accreditation), 53–54; and drafting of national health policy, 53, 54–56, 57; Psychosocial Resource Center within JFK Hospital, 52, 55–56 mental health and psychosocial interventions. See psychosocial interventions and trauma healing mental health and psychosocial support (MHPSS), 13 mental health infrastructure in Liberia, 37–42; and the civil war, 37–42; and MHPCC, 47–48, 51–56, 57; new ‘‘shadow cluster’’ to coordinate mental health, 51–52, 55; reopening Grant Hospital for

psychiatric care, 51; and UN Health Cluster system, 45–46 mental health policy in Liberia, 32–60; (1994–2003), 37–45; (2004–2006), 45–52; (2007–2009), 52–56; (2010–2013), 56–60; Brown’s role, 48, 49–53, 54–55, 56, 59; changing priorities, 56; commissioning development of, 47–52, 53, 54–55; development of, 56–60; indigenization and nationalization of mental health services, 47–52, 58–59; international humanitarian agencies, 8–9, 37–60; Jensen’s role, 48–49, 50–52; and MHPCC, 47–48, 51–56, 57; and MOHSW, 32–33, 36, 41, 46–52, 56–60; national legislation, 57–58; new ‘‘shadow cluster’’ to coordinate mental health, 51–52, 55; professionalization issues, 53–54, 59; shifting authority and oversight, 45–52; training-of-trainers (TOT) model, 8, 39, 42, 223–28 mental illness, definitions of, 13, 14 Merry, Sally, 223, 240n3 Ministry of Gender, Liberian, 119, 130, 131, 237n1 Ministry of Health and Social Welfare (MOHSW), Liberian, 32–33, 36, 41, 46–52, 56–60, 151, 219; development of national mental health plan and legislation, 47–52, 56–60; monthly coordination meetings, 58–59; new headquarters, 59 Ministry of Youth and Sports, Liberian, 46–47, 55 Monrovia Central Prison, 95–97, 238n1 Moran, Mary, 25, 133 Mother Patern College of Nursing and Social Work, 36, 52, 59, 217, 221, 235; accreditation and credentialing, 54; author’s position and students, 67, 212, 215, 219, 239n2 Myrdal, Gunnar, 188 National Association of Psychosocial Workers, 59 National Association of Social Workers (NASW), 54, 59 National Commission on DDRR (NCDDRR), 57 National Ex-Combatant Peacebuilding Initiative (NEPI), 9, 55, 174–77, 185;

Index 261 acting as fictive kin/parents and advocates, 175–76; community-based human rights training, 191–99; counseling for psychosocial workers, 224; and DDRR process, 162, 167–77; female ex-combatants’ work, 140; Guthrie Plantation career training class-session, 167–74, 180; mission, 174–75; training for psychosocial workers, 228; trauma in the NEPI framework, 176. See also ex-combatant rehabilitation National Patriotic Front of Liberia (NPFL), 29; hostage-taking and bush wives, 137–38; and Taylor, 111–12, 137–38, 215–16 National Transitional Government of Liberia (NTGL), 16, 18, 19, 42, 127 National Transitional Legislative Assembly, 205 Natsios, Andrew, 16 ‘‘networked interaction,’’ 36 NGOs, faith-based, 21, 229–32. See also Lutheran World Federation/World Service (LWF/WS) NGOs, humanitarian, 6–9, 20–21; acting as fictive kin/parents and advocates, 69–70, 175–76, 181–82; DDRR process and excombatant rehabilitation, 69–70, 161–63, 181–82; expatriate staff, 131–33, 156–57, 203, 215, 219; GBV interventions, 124–27, 130–33, 141–55, 156–57; and ‘‘GBV proxy’’ for other psychosocial interventions, 119; meaning of trauma and healing/rehabilitation for, 11–15; and peace subjectivities, 6, 113–17; postconflict reconciliation initiatives, 200–204; scale effects, 7–9, 39. See also humanitarian intervention in Liberia; psychosocial workers, Liberian NGOs, Liberian, 21, 43–44; and DDRR process, 43–44, 162–63, 167–77, 181–82; GBV interventions, 131, 140–41; and the MHPCC, 55; scale effects, 8 Nguyen, Vinh-Kim, 93 Nimba County, 94, 144–45, 203 non-governmental organizations. See NGOs, faith-based; NGOs, humanitarian; NGOs, Liberian normality: defining/Liberian understandings of, 62–66, 198–99; finding the ‘‘new normal,’’ 17, 61–66, 198–99; and

forgetting, 65; postconflict renormalization and dynamic of violence, 25, 28–29, 30, 123–24, 128–30, 136; and trauma (as interchangeable referents), 27, 64–65, 76 Ogilvy, David, 188 Open Mole, 2, 81, 104–13; case studies, 108–13; and counseling (talk therapy), 108–10, 112; and gender-based violence, 232; psychiatric medications, 107, 108–11, 113; and PTSD, 106, 107, 108, 112; Sante´ Humanitaire’s Psych Team and patients, 104–13; symptoms and diagnoses, 106–7, 108, 110; traditional ‘‘country medicine’’ and herbal treatments, 105, 110, 112; treatments, 105–7, 108–10, 111, 112 participatory development approaches and GBV trainings, 143, 149, 239n3 peace subjectivities, 6, 69, 94–97, 113–17, 159, 168, 176, 183–84, 202. See also forgiveness and reconciliation discourse pidgin psychiatry, 11 police forces, 23, 187. See also Liberian National Police (LNP) Poro societies, 30, 122, 145, 201–2 postconflict time, 20, 22, 28, 30, 183–87; architecture of, 183–87; Collier’s first-fiveyear time frame for economic recovery, 22–23; magic, rituals, and social space/ time, 185–86; religiosity and spiritual environment, 184–86; as ‘‘state of exception,’’ 20, 22; total environment of postconflict transformation, 184 posttraumatic stress disorder (PTSD), 13, 70–75; challenges to utility of diagnoses in non-European contexts, 44–45, 86, 88–89; definitions, 13, 14; DSM-IV and V, 81, 89; Open Mole diagnosis, 106, 107, 108, 112; psychosocial training and education in symptoms of, 226; and traumatic memory, 11, 89; and traumatic psychosis, 81; and vernacularization of trauma in Liberia, 11, 70–75 Pray the Devil Back to Hell (documentary film), 220–21 professionalization and psychosocial trauma counselors, 53–54, 59 prostitution, 122, 237n1

262 Index psychiatric medications, 238n4; access, 51, 52–53, 59; Open Mole treatments (antipsychotic and antidepressant), 107, 108–11, 113. See also drug use/drug abuse and trauma psychosis, trauma-related, 77–82 ‘‘psychosocial,’’ a genealogy of the term, 13, 36, 91–93; and anthropology, 92; and ‘‘black box’’ relationships, 91, 93; definition of psychosocial disorders, 13, 14; early twentieth-century psychoanalytic discourse, 91; Erikson’s theory of ego development stages, 92; and Halliday, 91–92; late 1950s research in psychology and disease, 91–92; mid-twentieth century studies of medicine and society, 91–92; the 1960s, 93 psychosocial agents (PSAs), 40–41, 98–101 psychosocial interventions and trauma healing, 9–17, 91–117; containment of symptoms and management of trauma, 6, 10; contrasted to GBV interventions, 118–20, 130–31; the CVT model, 40–41, 97–101; cycle-of-violence thesis, 13–17; DDRR and ex-combatant rehabilitation, 158–82; definitions, 12–13, 14; ‘‘GBV proxy’’ for, 119; a genealogy of the term ‘‘psychosocial,’’ 13, 36, 91–93; humanitarian scale effects in, 7–9, 39; IASC guidelines, 12–13; individual and group counseling, 91–117; modes of, 12; NGOs and meaning of trauma and healing/rehabilitation, 11–13; NGOs’ behavioral therapies for building peace subjectivities, 6–7, 94, 95–97; NGOs’ technologies of psychosocial intervention for humanitarian problems, 6, 93–94; outpatient clinics, 9, 101–13, 161, 232; and paraprofessional psychosocial agents (PSAs), 40–41, 98–101; social effects, 10 psychosocial work, 228–34; double consciousness of, 211–15; labor theory of, 219–23; moral guidance, 229–34; politicization through, 215–19, 220–22, 235; as social interaction, 233; training to become a psychosocial worker, 39, 223–28. See also psychosocial workers, Liberian psychosocial workers, Liberian, 1–4, 9, 11, 27, 113–17, 211–35; accreditation and certification, 53–54, 59; acts of faith/

confidence required, 213–14; as advocates for Liberian state presence and rebuilding, 235; becoming a psychosocial worker (TOT model), 8, 39, 42, 223–28; contextualization (localization), 225; counseling training, 227–28, 240n4; cultural sensitivity training, 225–26; and double consciousness of psychosocial work, 211–15; engagement in ‘‘appropriation and translation,’’ 73, 223, 240n3; individual counseling for presumed trauma, 224; interviews and data collection regarding, 239n2; a labor theory of psychosocial work, 219–23; learning key techniques of personalization, 224; as ‘‘local staff,’’ 223–24, 234; long-term careers and professionalization, 27, 218–19; on meaning of trauma, 11, 75; moral ideals, moral guidance, and peace subjectivities, 6, 113–17, 222, 229–34; perceptions of the nature of their work, 214–15, 218; and pidgin psychiatry, 11; politicization, 215–19, 220–22, 235; toughness and moral authority, 233, 240n5; trainee trauma narratives, 227; trauma education, 226; the work itself, 228–34 radio stations, 118, 188–91, 199; Radio Veritas, 188; Sky FM, 188; STAR Radio, 188, 190 rape: criminalization by Liberia’s rape law, 128–30; and discourse of forgiveness and reconciliation, 3–4, 208–9; of expatriate NGO workers, 132; GBV training session topic, 150, 154; ICC recognition as weapon of war, 124–25; during Liberian Civil War, 120–21. See also gender-based violence (GBV) interventions The Redemption of General Butt Naked (Strauss and Anastation), 184 religiosity, Liberian: and postconflict spiritual environment, 25–26, 184–86; and wartime relationship between political and spiritual realms, 79–80. See also Christianity Right to Protect (R2P) doctrine, 19, 22 rites de passage, 185 Rules and Regulations Governing the Hinterland of Liberia, 145, 199 rupture, routines of, 27–28, 64, 87

Index 263 Sande societies, 30, 122, 145, 201–2, 239n2 Sante´ Humanitaire (medical humanitarian NGO), 101–13, 161, 184–85; and DDRR process, 102–3, 161; Open Mole case studies, 108–13; Open Mole patients, 104–13; outpatient clinics and Liberian Psych Team, 101–13, 161; and tiersmondisme (‘‘third-worldism’’), 102; and ‘‘traditional women’s groups,’’ 102 Save the Children, 6, 21, 56, 127, 151, 200 scale effects, 7–9, 39, 80, 188 Second Chance Liberia, 95–97, 184–85 secret societies: Leopard, 30, 145; Poro, 30, 122, 145, 201–2; Sande, 30, 201–2 ‘‘security-mindedness,’’ 158–60, 177–78. See also ex-combatant rehabilitation Sierra Leone, 26, 37, 40; Coulter on postconflict recovery, 24, 27, 87–88, 123; demobilized child soldiers and rehabilitation, 163–64; postwar family reunions, 24–25; postwar identities and gender roles, 123; trauma counseling by the CVT, 40–41, 98–99 Sirleaf, Ellen Johnson, 23, 83–84; campaign for Liberian presidency, 28, 127–28; gender issues and GBV, 127–28 ‘‘Sister Sarah,’’ 50–51 Smile, International, 162 social action: psychosocial work as, 233; violence as, 123–24 sociality, 4–7; and anthropology discipline, 89–90; of trauma, 4–7, 164. See also ‘‘psychosocial,’’ a genealogy of the term sovereignty, 6–7, 19–22, 19–23; accreditation and credentialing of psychosocial counselors, 54, 235; and application of R2P doctrine, 19; and humanitarian intervention, 6–7, 19–23, 28, 84, 86; ‘‘state of exception,’’ 20, 22 St. Peter’s Lutheran Church massacre (1990), 215–16 Tarpeh, Etmuniah, 220 Taylor, Charles, 18–19; all-female Presidential Guard at Executive Mansion, 139–40; Anti-Terrorist Unit (ATU), 139; departure from Liberia, 18, 82–83, 140; election of 1997 and presidency, 21, 139–40; NPFL forces and the war, 111–12,

137–38, 215–16; postwar network of loyal ex-combatant Taylorites, 82–86, 238n2 tiers-mondisme (‘‘third-worldism’’), 102 time, postconflict. See postconflict time Tomorlah Varpileh, S., 220 ‘‘traditional women’s groups’’ and medical humanitarian NGOs, 9, 102 training-of-trainers (TOT) model for Liberian psychosocial workers, 8, 39, 42, 223–28; contextualization (localization), 225; counseling training, 227–28, 240n4; cultural sensitivity training, 225–26; individual counseling for the worker’s presumed trauma, 224; introduction, 224–25; and key techniques of personalization, 224; trainee trauma narratives, 227; trauma education, 226. See also psychosocial workers, Liberian trauma in postconflict Liberia, 10–11, 61–90; and behavioral/moral self-management, 66–70; collective, 4, 33, 66; definitions, 13, 14, 66; diagnostic criteria for DESNOS, 178, 179; dissociation (trauma-related), 76, 77–78, 81–82; and Durkheim on social suffering, 65–66; and finding the ‘‘new normal,’’ 17, 61–66, 198–99; and global PTSD discourse, 11, 70–75; and ideas of ‘‘victimcy,’’ 86–90; individual/collective, 4, 33; local assessments of the scale, severity, and scope, 80; local knowledge and emic epidemiologies, 80–82; necessity of interdisciplinary research, 88–90; NEPI framework, 176; and the normal, 27, 64–65, 76; Open Mole, 2, 81, 104–13; psychosis (trauma-related), 77–82; rates of psychological distress, 61, 94–95; resulting from social humiliation or loss in social status, 74; the sociality of, 4–7, 164; as station on a continuum of mental illness, 73–74; vernacularization of, 10–11, 70–82; and violence, 76–77; and Western popular cultural depictions of trauma, 86–87, 238n3; and Western psychiatric paradigms, 81. See also posttraumatic stress disorder (PTSD); psychosocial interventions and trauma healing Truth and Reconciliation Commission (TRC), Liberian, 4, 184, 185, 204–10; commissioners, 205; corruption and dissent, 206–7; discourse of forgiveness

264 Index Truth and Reconciliation Commission (TRC) (continued ) and reconciliation, 208–10; establishment, 204–5; final report, 206, 207–8; goals, 205; how the population received, 206; reactivation (2007), 207; and Teitel, 185 Tumutu Plantation, 167, 179–80 Turner, Victor, 185 UNAIDS, 49–50 UN Cluster Coordination System, 20, 45–46 UN Convention on the Rights of the Child, 93 UN Declaration on the Elimination of Violence Against Women (1993), 124 UNESCO trauma-training manual (Psychosocial Skills Training Manual), 40 UN High Commission for Refugees (UNHCR), 18, 20, 32–33; DDRR process for ex-combatant rehabilitation, 163; and gender-based violence in Liberia, 127; IDP camps, 18, 216, 221 UNICEF, 34, 96, 130, 161 United Nations Development Fund for Women (UNIFEM), 237n1 United Nations Development Program (UNDP), 200 United Nations Humanitarian Information Center (HIC), 21 United Nations Mission in Liberia (UNMIL), 6, 19–23, 83, 84; closure of Holy Ghost Mental Home, 50–51; concern over witchcraft ordeals, 144–45; DDRR process for ex-combatant rehabilitation, 42, 160–63, 166; establishment (Security Council Resolution 1509), 19–20; GBV interventions, 129–30, 132, 135, 154; and Guthrie Plantation project, 166; handing police authority to LNP, 187; Health Cluster, 45–46; Human Rights Division, 135; Humanitarian Information Center, 44; Joint Implementation Unit (JIU), 43, 161–63; media campaigns, 28, 118, 188–89; postconflict reconstruction and necessity of success, 19–20, 21–22; restoration of MOHSW, 41; Situation Report on failed justice system in GBV cases, 129–30 United Nations Mission in Sierra Leone (UNAMSIL), 21

United Nations Observer Mission in Liberia (UNOMIL), 49 UN Office of Coordination of Humanitarian Affairs (UN-OCHA), 46 UN Security Council: Resolution 1325 (GBV intervention in peacekeeping operations and postconflict reconstruction), 125–27; Resolution 1497 (establishing peacekeeping mission in Liberia), 19; Resolution 1509 (establishing UNMIL), 19–20 UN World Conference on Human Rights (Vienna 1993), 124 U.S. Agency for International Development (USAID), 16, 52; and CVT trauma counseling in West Africa, 98; DDRR process and ex-combatant rehabilitation, 43, 162, 163; GBV programming, 125; and National Association of Psychosocial Workers, 59; Rebuilding Basic Health Care Program, 59; sponsoring public rituals of reconciliation and community reintegration, 200–201 U.S. Department of State’s Bureau of Population, Refugees, and Migration, 98 University of Liberia, 49, 57, 59 Utas, Mats, 24, 87 Van Gennep, Arnold, 185 Verdier, Jerome, Sr., 205 victimcy, and trauma, 86–90 violence: anthropological views, 123–24; as ‘‘anti-culture’’ or anti-language, 123; and culture, 123–24; cycle-of-violence thesis, 13–17; everyday life and postconflict renormalization, 25, 28, 29–30, 123–24, 128–30, 136; ex-combatants’ ‘‘securitymindedness’’ (and latent possibility of violence), 158–60, 177–78; gendering of, 120–24; postwar sexual violence, 121–24, 128–30, 132–36; as social action, 123–24. See also gender-based violence (GBV) interventions Voinjama District Women Organization for Peace and Development (VODWOPEDE), 201 WHO Mental Health Atlas, 41 witchcraft ordeals, 30, 53; as off-limit topic for GBV trainings, 144; postwar resurgence of, 122, 144–45, 239n2

Index 265 Women of Liberian Mass Action for Peace, 221 women’s peace movement, Liberian, 127–30, 221 World Bank, 21; definitions of postconflict mental health, 13, 14; guidelines for NGOsponsored traditional healing rituals, 204; and Liberia’s mental health policy, 56; on reintegration of child soldiers, 181 World Health Organization (WHO), 32–33, 39, 46–50; and DDRR process, 42–43, 49–50; definitions of health, 13; and development of national mental health plan/

policy and legislation, 48–50, 56; study of gender-based violence during Liberian civil war, 120–21; trauma-training manual (Psychosocial Skills Training Manual), 40 youth of postconflict Liberia, 26, 177–82. See also DDRR (Disarmament, Demobilization, Rehabilitation, and Reintegration) program; ex-combatant rehabilitation Zawoo, Morlee, 174

Acknowledgments

Anthropological research in Liberia was often chaotic, and it would have been impossible without the friends and strangers who gave me love, conversation, shelter, and safety. These are Olivia Braeker, Marcie Friedman, Frank Joschek, Shadi Nasrallah, and Serif Turgut. Further thanks go to Sister Barbara Brillant, Jon Hubbard, Peter Kadzis, Bindi Patel, Regina Reza, Rick Gallagher, Meg Riggs, and George Brown for helping me find housing and employment and for sponsoring visas for this project. In humanitarian crises, the anthropological task of ‘‘getting in’’ involves risk and trust, and the organizations that welcomed my research deserve particular recognition for opening their programs to scrutiny. These include Cap Anamur, the Center for Victims of Torture, Development Alternatives International, the E. S. Grant Mental Health Hospital, the Lutheran World Federation/World Service, Mother Patern School of Nursing and Social Work, Me´decins du Monde, the National Ex-Combatant Peacebuilding Initiative, and Second Chance Liberia. They granted me access to patients, clients, records, local staff members, program activities, and program documents. The unrecognized expatriate and local staff who work for NGOs are the unsung heroes of postconflict reconstruction because against reason, logic, and empirical evidence, they live their hope that the future will be better than the past. I thank them for their commitment to innovation, relevance, and action in the face of danger and uncertainty. My thanks go to everyone who spent hours talking to me about psychosocial interventions and the complicated details of postconflict Liberian reconstruction. I cannot list them all, but I must make particular mention of Peter Armstrong, Boima Baifaie, Judith Bassler, Sebastien Brignano, Beverlee Bruce, Jeanette Carter, Janice Cooper, Tom Crick, Joseph Dah, Bernice Dahn, Tom Dempsey, Alexander DeVort, Jessica Donovan, Fre´de´rique Drogoul, Loupou Flomo, Benjamin Harris, David Henderson, Judy and John Gay, Isaac Gorvego, Gwendolyn Heaner, Denis Hynes, Michael Jaung, Søren Buus Jensen,

268 Acknowledgments

Kirsten Johnson, Orlando Kanswen, Joseph Kpukouyou, Sumo Kupe, David Mehdeh, Jean-Baptiste Mikulu, Segbe Nyanfor, Raj Panjabi, Dove Pressnall, Bob Reed, Benjamin Rempell, Nate Richardson, Peter Roley, Jack Saul, Frantz Sawyer, Janet Shriberg, Sara Siebert, Verlon Stone, Dereje Terefe, Anthony Valcke, Vamsi Vasireddy, Amy-Jo Versolato, David Waines, Christina Wilson, Prince Wreh, and Morlee Gugu Zawoo. I would like to thank all of my former students of Social Work Interviewing at Mother Patern College, the members of the MDM Psych Team, LWF/WS trainers, NEPI staff, and Second Chance staff. They trusted that the time and effort that went into their talks with me would be made worthwhile through publication. Dozens more Liberian men and women shared the intimate stories of their war experiences and related the postconflict reconstructions of their personal lives. In the interest of confidentiality, I cannot name them here, but I am deeply grateful to them for the gift of their time, their stories, and their trust. I have many scholarly debts. The earliest are to Dessima Williams and Gordy Feldman, Ira Cohen, Peter Guarnaccia, and Dorothy Hodgson. Intellectually, I am principally indebted to my advisors and mentors, Arthur Kleinman, Byron Good, Michael Herzfeld, and Ibrahim Sundiata. Catherine Panter-Brick, Neil Aggarwal, Andrea Allen, Sabrina Peric, Meredith Marten, and Mary Moran read parts of the manuscript at various stages, and my colleagues Lance Gravlee, Alyson Young, Noelle Sullivan, and Peter Collings provided guidance leading to publication. Joa˜o Biehl’s counsel to tell my truth encouraged me to finish the book just as I was ready to abandon the project. Since 2003, this research has been generously supported through grants from the National Science Foundation, Rutgers University, the MIT-Mellon Fellowship on NGOs and Forced Migration, the Weatherhead Center for International Affairs at Harvard University, and Harvard Medical School. Completion of this book took place with support from Harvard University, the NIMH Postdoctoral Fellowship in Psychiatric Epidemiology at the Johns Hopkins Bloomberg School of Public Health, and the University of Florida. Research for this book was carried out under Harvard University IRB Protocols 噛F12272, 噛F14092, and 噛F14338. Finally I thank my family, especially my grandparents, my parents’ gifts of babysitting, my husband’s wisdom, friendship, and pragmatism, and my three children, for the beauty, meaning, and love they have brought to my life.