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Perspectives of illness and resilience in the Peruvian highlands: a cross-sectional follow-up study

Armed conflict, guerrilla warfare, and political violence have contributed to the burden of disease and disability, especially among civilian populations of Peru. The effects of war and political violence can be long lasting and can determine the capacity of people to reconstruct their lives long after wars have ended. The current project is a cross-sectional, qualitative, follow-up study among Quechua populations of the South Central Peruvian highlands who were exposed to twenty years of protracted violence between1980-2000. The previous study was conducted by Pedersen et al (2008) and revealed that of all respondents who had been exposed to violence, one in four (N=92) reported symptoms compatible with the DSM-III-R diagnosis of PTSD. However, due to the absence of mental health services in the province, it was virtually impossible to refer those cases for treatment and follow-up. It has been ten years since the first survey, and a subsample of the number of PTSD positive cases that were detected in 2000, were relocated and interviewed to elicit narratives on the experiences of distress, mental illness, coping and resilience for Quechua individuals of this highland region. The study was conducted in Ayacucho, Peru in four rural communities as well as one urban setting. Semi-structured interviews were carried out with 17 informants who met the compatibility of PTSD in 2000, half of whom continued to have PTSD symptoms in 2011. The findings indicate that individuals express more distress about the tremendous difficulties of surviving in the present day than about the trauma symptoms of the war. Findings suggest that although informants continued to have symptoms of distress, they found resilience in certain community resources, including social, cultural and economic resources. The data reveals that postwar psychosocial health cannot be separated from the broader political and economic structures. / Les conflits armés, la guérilla, et la violence politique ont contribué à les repensions de fléaux, la morbidité au niveau de pertes en vies humaines et les incapacités, surtout parmi les populations civiles du Pérou. Les effets de la guerre et de la violence politique peuvent languir et permet de déterminer la capacité des gens à reconstruire leur vie longtemps après la fin des guerres. Le projet en cours est une étude de suivi, transversale, qualitative chez les populations quechua des hautes terres de South Central Pérou qui ont été exposées à vingt ans de violence entre 1980-2000. Le but de l'étude était d'obtenir des récits sur les expériences de détresses, la maladie mentale, l'adaptation et la résilience des personnes quechua de cette région montagneuse. L'étude a été menée à Ayacucho, au Pérou dans quatre communautés rurales ainsi que d'un milieu urbain. Des entrevues semi-structurées ont été menées par 17 informateurs qui ont rencontré la compatibilité de stress post-traumatique en 2000, dont la moitié ont continué à avoir des symptômes de PTSD. Les résultats indiquent que les individus expriment plus de détresse due aux énormes difficultés de survie a l'époque actuelle contrairement aux symptômes de traumatisme de la guerre. Les résultats suggèrent que, bien que les informateurs ont continué à avoir des symptômes de détresse, ils ont trouvé un support morale aux niveau des ressources communautaires, sociales, culturelles et économiques mis à leur disposition. Les données révèlent que la sante psychosociale d'après-guerre ne peut pas être séparée des structures politiques et économiques.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.117147
Date January 2013
CreatorsD'souza, Nicole
ContributorsDuncan Pedersen (Internal/Supervisor), Laurence J Kirmayer (Internal/Cosupervisor2)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Formatapplication/pdf
CoverageMaster of Science (Department of Psychiatry)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
RelationElectronically-submitted theses.

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