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SANITY AND URBANITY

Comment: explosive remnants of war may maintain traumascapes and preclude community healing after conflict

5/18/2017

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by Layla McCay, UD/MH Director
UD/MH is often asked about how mental health principles can be applied in different conflict and post-conflict situations. This week in the medical journal The Lancet, a review was published on the public health impact of 'explosive remnants of war'. The researchers highlight that beyond the physical injuries landmines and exploded or unexploded ordinance can cause to displaced people returning home after conflict, they also seem to exert significant impact on people's mental health. This can include anxiety, depression, and post-traumatic stress disorder (though a direct causative link could not be made). These mental health effects can occur even where the explosives are present but have not caused injury.

The paper does not speculate at length upon the reasons that these explosives may be linked to mental health problems. I wonder if an important contribution is how they can affect the meaning of a place.

The concept of ‘home’ is important for people’s sense of belonging, and as such, affects their mental health and wellbeing. Place is the canvas onto which people project their personal and shared memories and expectations. A place feels like ‘home’ because it brims with personal landmarks (the café at which we spent hours laughing with friends, the first apartment we lived in, the park bench from which our child leapt, playing astronaut). For many, home is, by definition, a safe place (or at least there are places where we know we can go to feel safe). Yet when people return home after conflict, they sometimes find that conflict has changed the meaning of the place that was once home. It is difficult to recognise. Personal landmarks become superimposed with physical and memory landmarks of fear and pain and sorrow and unease and trauma. When people lose the ability to reliably differentiate between safe and threatening, their perception of home evolves into a traumascape of disconnection and distrust.

Urban design has an important role to play in helping the feeling of a place revert to 'home' after conflict. This means healing without forgetting: reducing the physical scars of conflict, and designing a place that engenders confidence and pride, that supports mental health and wellbeing, such as reliable infrastructure, green spaces, social spaces, places to walk and exercise, and places to feel safe. Engaging residents in designing the right approach to rebuilding can have benefits in also rebuilding the community: strengthening social capital and trust, while empowering people to take control of a place and help bring back the meaning of the place as a home they recognise.

Explosive remnants of war, such as landmines, can confound these efforts, because a place can never feel entirely safe. War is still just beyond the doorstep. In avoiding and fearing the open spaces where people might otherwise have exercised, socialised, relaxed, and enjoyed nature, the prospect of finding home may be held in a state of suspended animation. People cannot trust their home not to harm them, and so they wait, walled in and tense.

The Lancet paper reports that international support for mine action is declining. And yet it is an essential part of rebuilding - not just physical rebuilding, but a rebuilding a community's trust that they are home.

For more on this topic, read UD/MH Fellow Sophie Gleizes on traumascapes.
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