Summerfield D
Medical Foundation for the Care of Victims of Torture, London.
Med Confl Surviv. 1997 Jan-Mar;13(1):3-25. doi: 10.1080/13623699708409311.
There have been more than 160 wars and armed conflicts since 1945, almost all in the Third World, and more than 50 currently. More than 90% of these are internal rather than between sovereign states. There has been a sixfold increase in the number of war refugees worldwide since 1970, who now number 1% of the global population. Ninety per cent of all casualties are civilians. A key element of modern political violence is the creation of states of terror to penetrate the entire fabric of grassroots social relations as a means of control. The valued institutions and ways of life of whole populations are routinely targeted for destruction. In the 1980s many such wars were played out on a terrain of subsistence economies. The back-drop is of environmental degradation, poverty, embedded social injustice, pressure on the nation-state, a global rise in food insecurity and a widening gulf between the wealthiest 20% and the poorest 20% in the world. The World Health Organization is warning of a health catastrophe, with life expectancy in the world's poorest countries falling by the year 2000 and one-third of the world's children undernourished. Understanding a complex and evolving set of causes and effects surrounding war is a considerable challenge to the international humanitarian field, not least the health professions. In recent years there has been a burgeoning interest in the psychological impact of the atrocities of war, and in trauma programmes based on Western psychological concepts and techniques. This individualistic focus risks neglecting the core issue: the role of a social world, invariably targeted in war and yet still embodying the capacity of survivor populations to manage their suffering, adapt and recover on a collective basis. Using the example of Mozambique, Guatemala and others, this paper will discuss the way in which contemporary war damages social and cultural forms, and the range of traditions, values and understandings which these carry. However, society and culture also engage actively with war, with changes in the social order that may come to outlast the violence itself. This paper will also pinpoint the quest for justice as an issue that may distinguish the subjective experience of war from those that arise after peacetime or natural disasters. The work of anthropologists, sociologists, historians and poets in both West and Third World, allied to the voices of survivors themselves, can help the humanitarian field to acquire a more richly textured understanding of the range of responses to war and atrocity, and outcomes over time.
自1945年以来,发生了160多次战争和武装冲突,几乎全都发生在第三世界,目前仍有50多场。其中90%以上是内战而非主权国家之间的战争。自1970年以来,全球战争难民数量增加了六倍,目前占全球人口的1%。所有伤亡人员中有90%是平民。现代政治暴力的一个关键因素是制造恐怖状态,以此作为控制手段渗透到基层社会关系的整个结构中。全体民众珍视的机构和生活方式经常成为被破坏的目标。20世纪80年代,许多这样的战争发生在生存经济的背景下。其背景是环境退化、贫困、根深蒂固的社会不公、民族国家面临的压力、全球粮食不安全状况加剧以及世界上最富有的20%与最贫穷的20%之间的差距不断扩大。世界卫生组织警告说将出现一场健康灾难,到2000年世界最贫穷国家的预期寿命将会下降,世界上三分之一的儿童营养不良。理解围绕战争的一系列复杂且不断演变的因果关系,对国际人道主义领域,尤其是卫生专业人员来说是一项重大挑战。近年来,人们对战争暴行的心理影响以及基于西方心理学概念和技术的创伤项目兴趣激增。这种个人主义的关注点有忽视核心问题的风险:社会世界的作用,它在战争中总是成为目标,但仍体现着幸存者群体集体应对苦难、适应和恢复的能力。本文将以莫桑比克、危地马拉等国为例,探讨当代战争如何破坏社会和文化形式,以及这些形式所承载的一系列传统、价值观和认知。然而,社会和文化也积极应对战争,社会秩序的变化可能会比暴力本身持续更久。本文还将指出,对正义的追求是一个可能使战争的主观体验有别于和平时期或自然灾害后的主观体验的问题。西方和第三世界的人类学家、社会学家、历史学家和诗人的工作,再加上幸存者自己的声音,有助于人道主义领域更全面地理解对战争和暴行的各种反应以及长期结果。