Far and Away: Reporting from the Brink of Change

“Their practice did not involve being outside in the sun, like you’re describing, which is, after all, where you begin to feel better. There was no music or drumming to get your blood flowing again when you’re depressed, and you’re low, and you need to have your blood flowing. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. There was no acknowledgment that the depression is something invasive and external that can actually be cast out of you again.” He paused meaningfully. “Instead, they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them.” He shook his head. “We had to ask them to leave the country.”

Senegal has fewer than fifty psychiatrists to serve a population of 14 million, and almost no other doctors who have any training in psychiatry. Western-style mental health services are available only in Dakar, and not in rural areas. Nonetheless, the attitude toward those with mental illnesses is accepting in Senegal, with family members involved in care and with communities helping, for example, to feed people with mental illness who are unable to tend to themselves. While trained psychiatrists used to separate themselves from traditional healers, the lines are now breaking down, and collaboration has become commonplace. In psychiatric hospitals in Dakar, elements of the n’deup are often incorporated into group therapy, held in a traditional group circle. Animist healers are often called in to help with especially difficult cases.

As the number of Senegalese immigrants to the United States increases, there are calls for mental health treatments that are specific to the Senegalese understanding of the spirit world. No resolution of psychiatric illness can occur without deep cultural respect. The blanket assumption that modern medicine is right and that ancient ritual is mere superstition is increasingly understood to be a poor model for mental health treatment. According to William Louis Conwill, who pioneered academic study of the n’deup, “Without openness to Lebou beliefs and culture, it would be easy to dismiss n’deup spirit possession as mere suggestibility and the ritual slaying of animals as primitive superstition. N’deup’s rituals open the door between the physical world of cause-and-effect that Western health professionals typically promote, and the world of spirits who protect the Lebou from illness and catastrophe. Without acknowledgment of the true believer’s world and the power of the n’deup priestess, the counselor working with Senegalese immigrants in the US might view n’deup as nothing more than ‘smoke and mirrors,’ thereby rendering the counselor’s efforts futile.”

AFGHANISTAN

An Awakening after the Taliban

New York Times, March 10, 2002

I was in New York on September 11, 2001. Having often rushed headlong toward danger, I found myself hiding out in my house for a week and then taking the first plane out. I had grown up in New York, and a physical attack on the city wasn’t among the fears I nurtured into adulthood. When it happened, I felt like Samson after the haircut. Later, I was ashamed of my paralyzed disengagement. It was too late to volunteer in lower Manhattan, but it was not too late to help understand the war in which we’d entangled ourselves.

The most successful piece of modern diplomacy is the Marshall Plan, and I believe that if we had invested the money squandered on a pointless invasion of Iraq on rebuilding Afghanistan, we would now have a secure ally in Central Asia. Remember that 1960s Afghanistan was a center of liberalism where women wore miniskirts. Of the many brief upsurges of buoyancy on which I have reported, no other has seemed so exalted or has been so swiftly and brutally dashed.

This article, though based on the Times story I had been assigned, also includes some details from a story I did for Food & Wine about our final dinner.

The reopening of the National Gallery in Kabul in February 2002 took place in the dark. The electricity was out again, a casualty of war, and no one could get the gallery’s generator to work. A certain grimness lingered in the air. More striking than much of the art was a special display of the ripped-up drawings and broken frames left by the Taliban, lest anyone forget. Yet the mood was hopeful, victorious, even joyful. Presiding over the ceremony, Hamid Karzai, the leader of Afghanistan’s interim government, spoke emotionally of the gallery as the locus of “great hope and brightness,” where Afghan culture could come out of hiding. “This is more, so much more, than the reopening of a museum,” he declared, toasting the moment with a cup of tea. Then, with great delight, he watched Dr. Yousof Asefi perform an act of sweet triumph.