Civil wars divide nations along social, economic, and political lines, often pitting neighbor against neighbor. In the aftermath, countries work on reconciliation efforts to restore social cohesion. But these gains often come at the cost of reduced psychological health, worsening depression, anxiety, and trauma.
Sierra Leone, a country in West Africa, experienced a devastating civil war from 1991 to 2002. More than 50,000 people were killed, thousands more suffered amputations, and more than half the population was displaced. Much of the violence took place within communities, with members from the same villages taking up arms against each other.
“Our research suggests that talking about war atrocities can prove psychologically traumatic for people affected by war,” says Oeindrila Dube, assistant professor of politics and economics at New York University.
“Invoking war memories appears to re-open old war wounds. At the same time, the reconciliation program we examined was also shown to improve social relations in communities divided by the war.”
The program, which was designed and implemented by Fambul Tok (“Family Talk” in Krio), a Sierra Leonean non-governmental organization, brought victims face-to-face with perpetrators in community forums. Victims detailed war atrocities; perpetrators admitted to crimes and sought forgiveness for their actions; and no one was compensated financially or punished for participating. The forums in the study took place in 2011 and 2012, a decade after the country’s civil war ended.
For the study, published in the journal Science, researchers worked with the policy and research nonprofit group Innovations for Poverty Action (IPA) to conduct an independent, randomized evaluation of the program. The study took place across 200 villages, 100 of which were randomly chosen to be offered the reconciliation program. Researchers tracked 2,383 people in both sets of villages, recording their attitudes towards former combatants, their mental health, and the strength of their social ties nine and 31 months after the program.
The findings show that reconciliation had both positive and negative consequences. On the one hand, it promoted societal healing: forgiveness of former perpetrators increased substantially in program villages relative to control villages, as measured by an index of questions which gauged emotional and behavioral responses toward this group.
Trust of former combatants also increased by 22.2 percent while trust of migrants (many of whom are perceived to be former combatants) increased by 6.7 percent. In addition, social network strength increased by 11 percent, as individuals formed more friendships and relied more on one another for advice and help.
Further, those living in program villages participated more in community groups such as Parent Teacher Associations and religious organizations, and contributed more resources toward public goods, including those used to build schools and health clinics.
On the other hand, these gains came at the cost of reduced psychological health: the program worsened depression, anxiety, and trauma. For example, the prevalence of clinical PTSD, or severe trauma, was 36 percent higher in program villages than in comparison villages, where the prevalence of clinical PTSD was 8 percent. Both positive and negative effects persisted for up to 31 months after the program ended.
“This study is the first of its kind, and provides valuable evidence about an approach used to heal war afflicted communities across the world,” says Annie Duflo, executive director of Innovations for Poverty Action.
“While more research should be conducted on this topic, this study suggests that policymakers may need to restructure reconciliation processes in ways that reduce their negative psychological costs, while retaining their positive societal benefits.”
Jacobus Cilliers of Georgetown University and Bilal Siddiqi, an economist at the World Bank’s Development Research Group, are coauthors of the study.