Post-Traumatic Stress Disorder: Tending to Heal Neglected Wounds in Somalia

Prof. Lori Zoellner teaching a child with graduate student. Photo credit to University of Washington

Post-Traumatic Stress Disorder (PTSD) is just what the name implies: an overwhelming, often debilitating anxiety that follows a traumatic event in someone’s life. It could be the death of a loved one, a physical assault, or really anything you might find traumatising. Many associate PTSD with soldiers returning from war, but for thousands living in Somalia, there is no escape from the near-constant conflict that’s plagued the North African country for over two decades.

“People are frightened by killings, diseases, and hunger,” international studies professor Daniel Chirot said.

Somalia’s government collapsed in 1991, leading to infighting between regional clans. The current central leadership is weak, and cannot effectively enforce their laws in large portions of the country. This power vacuum led to regional fighting, extremism, and an untold number of human rights violations against the Somali people. As expected, PTSD rates are high in Somalia, but traditional Islamic beliefs, language and cultural differences, and limited access to care are holding sufferers back from seeking help. 

A team of UW psychologists and behavioral scientists recently won a grant through the Population Health Initiative, which awarded five pilot research grants to faculty-led teams to address a human-centered issue in global health. 

They are aiming to develop an effective and low-cost PTSD treatment within community mosques in Somalia. According to the researchers, no Islamic-focused trauma treatments currently exist. 

“Mental health is a new thing to the world,” Chirot said. 

“In the past, there was no such thing as mental health and most traditional cultures consider mental issues as your family’s own business.” 

This team has been working with the Somali Reconciliation Institute for about five years. The founder and director of the SRI, Duniya Lang, approached UW psychology professor and team member Lori Zoellner about creating a program to promote trauma-focused reconciliation within the Somali community.

“We want to develop a program that fits with the Islamic faith and also with the Somali culture,” Zoellner said.

Their approach to healing is a brief series of community-led meetings in mosques around the country. Faith leaders and community members lead group discussions on Islamic trauma healing for six sessions.

“We are not viewing this as a therapy,”  Zoellner said. “It is about promoting healing and reconciliation. We worked hard to put in Islamic principles and so every session begins with a supplication written by the local Imam and tea and snacks. Tea is very important in Somali culture as far as building community and having tea together.”

Men and women are separated into groups in hopes of making each more comfortable during the session. Group leaders read prophet narratives from the Quran and discuss how they relate to shifts in thinking and beliefs people experience after a traumatic event. 

There is also individual time of Doha, in which they have time to talk to Allah about their trauma experience and pray. 

“In lower and middle income countries, it is very unlikely for them to train hundreds or thousands of mental health workers in a short time,”  Zoellner said. “If we want programs that have a reach for promoting trauma healing, it really needs to shift to the community and to lay-leaders so that the interventions don’t involve mental health professionals, but to involve people who are respected in their communities.”

Their biggest obstacle is funding, so grants like the Population Health Initiative make their fieldwork in Somalia possible. The team also partnered with Abu-Bakr Islamic center, and received funding from the National Institute of Mental Health as well as the Global Population Health grant that enabled the team to begin this intervention in Somalia. They hope to expand this Islamic based treatment method to the global Muslim community in the near future.

“The greatest value I see in the project is that it is community based,” co-investigator Jake Bentley said. “Once lay-leaders are trained, they can benefit their own communities and they can train other lay-leaders as well. Once it works, it will be a self-sustaining intervention.”

Source: The Daily of the University of Washington