Health Horizons

The Destruction of a Museum Is Tough to Cure

Tailoring healthcare to help people whose urban art and culture is under attack.

Islamic State militants bombed a temple in the ancient ruins of Palmyra, Syria. (SANA via AP, File)

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When the Islamist militants stopped him along the banks of a river in Mali, Mohammed Touré knew he had trouble. He was assisting an uncle with moving crates to Bamako, and what was inside could mean his life was in danger: The insurgents who had seized control of his city might kill him over books.

The destruction of urban culture and art and the people who produce it is a frequent part of armed conflict. A few years ago, Islamists threatened Timbuktu, Mali’s ancient cultures. Last week, the ISIS-controlled city of Palmyra, Syria, made headlines for another example of the same phenomenon: the murder of antiquities scholar Khaled al-Asaad, 83, followed by the bombing of Baalshamin Temple, a part of the ancient ruins al-Asaad had spent his life protecting in the 2,000-year-old city. Both the man and the temple were irreplaceable parts of Palmyra’s urban culture.

It has long been established that violence and disruption of war can cause psychological trauma, with symptoms ranging from anxiety to nightmares and beyond. (In Syria, for instance, the WHO estimates some 600,000 people are experiencing these mental health issues.) But the destruction of culture — above and beyond the other, more obvious harms of conflict — can also pose a distinct threat to the health of people living through atrocities.

Arthur Kleinman, a Harvard psychiatrist and medical anthropology professor, notes that such destruction of culture is often specific and intentional. An expert on China, he describes when, during the Cultural Revolution, “almost everything that had been a part of a Chinese tradition was stood on its head …. The people who were most valued in Confucian values were the scholars, the intellectuals, the elderly, et cetera. It just reversed that,” in an upheaval that confused and traumatized many. (Prior to the murder of al-Asaad, ISIS militants held him and demanded information on artifacts — to destroy items they deem heretical, it now appears.)

Examples of attacks on culture can be found through the decades. In 2012, Islamist insurgents captured Timbuktu and banned all music. In 2001, the Taliban destroyed giant Buddha statues in Bamiyan, Afghanistan, blocking the tourism that once supported many locals. In 1993, Croatian belligerents bombed the five-century-old bridge at Mostar, Bosnia, a particularly disheartening part of that war; in the 1970s, the communist-agrarian Khmer Rouge decimated not only the Cambodian population, but also urban, Buddhist culture.

In each case, the damage has been publicly grieved — yet few mental health studies examine the impact of cultural destruction specifically. The mental impact is tough to pull apart from the myriad other psychological traumas atrocities can create. “I think the only way you do that is by interviewing people, being with them, and seeing what’s happened to their own meaning system and their own practices,” says Kleinman.

But that’s not to say that nobody’s acting. Relief organizations have begun to include a specific focus on mental health. Sphere, a group that sets minimum standards for humanitarian aid, added mental healthcare to its handbooks a few years ago, as did the World Health Organization.

Those plans, when carried out to the fullest, range from accommodations for people who have existing complex psychiatric impairments to “psychological first aid” to people distressed just after a frightening incident. Often, they include standard therapy in unusual circumstances — as in the case of Canadian psychiatrist Saleem al-Nuaimi, who provides mental healthcare to Syrians via Skype.

In addition, the post-conflict period is considered a unique opportunity to scale up mental healthcare systems. These efforts are nascent and underpowered — and they tend to focus on a biomedical model that emphasizes medication for individual patients. But they do include a move toward accommodating existing cultural beliefs among the group being served. (Appeals to diversity are part of the plan too. Kleinman’s work includes a critique of clinical cultural competence, and the WHO’s guide to mental health in emergencies notes, “Do not assume that all local cultural practices are helpful or that all local people are supportive of particular practices.”)

All that said, few mental health organizations have focused specifically on addressing the loss of music, books, art, architecture, religious knowledge, and the intellectual and creative people associated with them specifically as a means of bolstering psychological well-being. Research that might assist such an effort is lacking.

Outside of healthcare systems, however, there are models of self-healing worth noting. If recent examples are any indicator, the revival of culture might improve people’s lives in myriad ways. The conflict in Timbuktu a few years ago has brought increased attention to cataloging and preserving libraries of ancient Arabic-language texts in the city. Although informed by war, that work exemplified how culture resolves conflict by transcending it. “We believe that the manuscripts of the cultural heritage have always lived through armed conflict,” says Susana Molins-Lliteras of the Tombouctou Manuscripts Project, an independent research project at University of Cape Town in South Africa. “Our main aim is to research the manuscripts in an intellectual fashion.”

The idea tends to be a point of agreement with people for whom a culture is home. In fact, it is often they who head efforts at cultural preservation, as al-Asaad once did. About Malians, Molins-Lliteras says, “They are very attached to manuscripts as part of family heritage.”

Touré escaped the insurgents’ punishment after he was stopped moving manuscripts out of Timbuktu to avert their arson by Islamists. Abdel Kader Haidara, Touré’s uncle and an inheritor of a hereditary guardianship of libraries, came to the rescue. Alerted by phone, Haidara pulled favors, argued and secured paperwork. Within a day, his nephew was freed — averting further trauma and continuing a project that would eventually move over 99 percent of the ancient texts to safety.

The “Health Horizons: Innovation and the Informal Economy” column is made possible with the support of the Rockefeller Foundation.

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M. Sophia Newman is a freelance writer and an editor with a substantial background in global health and health research. She wrote Next City's Health Horizons column from 2015 to 2016 and has reported from Bangladesh, India, Nepal, Kenya, Ghana, South Africa, and the United States on a wide range of topics. See more at msophianewman.com.​

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Tags: healthcarehealthcrime

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