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

This paper considers some dilemmas relating to developing effectiveassistance with and to people who have lived through extremeevents in a civil war and ‘post-conflict’ contextwithin Sri Lanka. The tsunami which devastated many coastalareas of Sri Lanka in December 2004 and left many people withno homes or livelihood has further affected the country. A majorissue is how far the concepts and methods of western psychologyand psychiatry are appropriate to radically different culturesand contexts: in particular, how post-conflict and post-disasterpsychosocial rehabilitation may depend in complex ways on localspecifics and interact or not with biomedical notions of PTSDdiagnosis and individual therapy. The relationship between aculture and its healing rituals is a complex one. Cultural,socio-political, existential and personal meanings, expressionsand responses to civil war or traumatic events and their aftermathare likely to be mediated by each individual and the contextin which they occur. This paper details our findings and offerssome suggestions for future practice.