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Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan


  • Eggerman, Mark
  • Panter-Brick, Catherine


A critical health-related issue in war-affected areas is how people make sense of adversity and why they show resilience in a high-risk environment. In Afghanistan, the burden of poor mental health arises in contexts of pervasive poverty, social inequality, and persistent violence. In 2006, we conducted face-to-face interviews with 1011 children (age 11-16) and 1011 adult caregivers, randomly selected in a school-based survey in three northern and central areas. Participants narrated their experiences as part of a systematic health survey, including an open-ended questionnaire on major life stressors and solutions to mitigate them. Responses were analysed using an inductive thematic approach and categorised for quantitative presentation, producing a conceptual model. For adults, the primary concern is repairing their "broken economy," the root of all miseries in social, educational, governance, and health domains. For students, frustrations focus on learning environments as well as poverty, as education is perceived as the gateway to upward social and economic mobility. Hope arises from a sense of moral and social order embodied in the expression of key cultural values: faith, family unity, service, effort, morals, and honour. These values form the bedrock of resilience, drive social aspirations, and underpin self-respect and dignity. However, economic impediments, social expectations, and cultural dictates also combine to create entrapment, as the ability to realise personal and social aspirations is frustrated by structural inequalities injurious to health and wellbeing. This study contributes to a small but growing body of work on resilience in public health and conflict settings. It demonstrates that culture functions both as an anchor for resilience and an anvil of pain, and highlights the relevance of ethnographic work in identifying what matters most in formulating social and public health policies to promote a hopeful future.

Suggested Citation

  • Eggerman, Mark & Panter-Brick, Catherine, 2010. "Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan," Social Science & Medicine, Elsevier, vol. 71(1), pages 71-83, July.
  • Handle: RePEc:eee:socmed:v:71:y:2010:i:1:p:71-83

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    References listed on IDEAS

    1. Pedersen, Duncan & Tremblay, Jacques & Errázuriz, Consuelo & Gamarra, Jeffrey, 2008. "The sequelae of political violence: Assessing trauma, suffering and dislocation in the Peruvian highlands," Social Science & Medicine, Elsevier, vol. 67(2), pages 205-217, July.
    2. Wexler, Lisa Marin & DiFluvio, Gloria & Burke, Tracey K., 2009. "Resilience and marginalized youth: Making a case for personal and collective meaning-making as part of resilience research in public health," Social Science & Medicine, Elsevier, vol. 69(4), pages 565-570, August.
    3. Panter-Brick, Catherine, 2010. "Conflict, violence, and health: Setting a new interdisciplinary agenda," Social Science & Medicine, Elsevier, vol. 70(1), pages 1-6, January.
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    5. Canvin, Krysia & Marttila, Anneli & Burstrom, Bo & Whitehead, Margaret, 2009. "Tales of the unexpected? Hidden resilience in poor households in Britain," Social Science & Medicine, Elsevier, vol. 69(2), pages 238-245, July.
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    1. Ungar, Michael, 2011. "Community resilience for youth and families: Facilitative physical and social capital in contexts of adversity," Children and Youth Services Review, Elsevier, vol. 33(9), pages 1742-1748, September.
    2. repec:eee:socmed:v:194:y:2017:i:c:p:34-41 is not listed on IDEAS
    3. Seguin, Maureen & Lewis, Ruth & Amirejibi, Tinatin & Razmadze, Mariam & Makhashvili, Nino & Roberts, Bayard, 2016. "Our flesh is here but our soul stayed there: A qualitative study on resource loss due to war and displacement among internally-displaced women in the Republic of Georgia," Social Science & Medicine, Elsevier, vol. 150(C), pages 239-247.
    4. repec:eee:socmed:v:196:y:2018:i:c:p:233-239 is not listed on IDEAS
    5. Barber, Brian K. & McNeely, Clea & Olsen, Joseph A. & Belli, Robert F. & Doty, Samuel Benjamin, 2016. "Long-term exposure to political violence: The particular injury of persistent humiliation," Social Science & Medicine, Elsevier, vol. 156(C), pages 154-166.
    6. Hobfoll, Stevan E. & Mancini, Anthony D. & Hall, Brian J. & Canetti, Daphna & Bonanno, George A., 2011. "The limits of resilience: Distress following chronic political violence among Palestinians," Social Science & Medicine, Elsevier, vol. 72(8), pages 1400-1408, April.
    7. Barber, Brian K. & Spellings, Carolyn & McNeely, Clea & Page, Paul D. & Giacaman, Rita & Arafat, Cairo & Daher, Mahmoud & El Sarraj, Eyad & Mallouh, Mohammed Abu, 2014. "Politics drives human functioning, dignity, and quality of life," Social Science & Medicine, Elsevier, vol. 122(C), pages 90-102.
    8. Li, Haibin & Liebenberg, Linda & Ungar, Michael, 2015. "Understanding service provision and utilization for vulnerable youth: Evidence from multiple informants," Children and Youth Services Review, Elsevier, vol. 56(C), pages 18-25.
    9. Rees, Susan & Thorpe, Rosamund & Tol, Wietse & Fonseca, Mira & Silove, Derrick, 2015. "Testing a cycle of family violence model in conflict-affected, low-income countries: A qualitative study from Timor-Leste," Social Science & Medicine, Elsevier, vol. 130(C), pages 284-291.
    10. Trani, Jean-Francois & Ballard, Ellis & Peña, Juan B., 2016. "Stigma of persons with disabilities in Afghanistan: Examining the pathways from stereotyping to mental distress," Social Science & Medicine, Elsevier, vol. 153(C), pages 258-265.
    11. Teerawichitchainan, Bussarawan & Korinek, Kim, 2012. "The long-term impact of war on health and wellbeing in Northern Vietnam: Some glimpses from a recent survey," Social Science & Medicine, Elsevier, vol. 74(12), pages 1995-2004.
    12. Mendelsohn, Joshua B. & Rhodes, Tim & Spiegel, Paul & Schilperoord, Marian & Burton, John Wagacha & Balasundaram, Susheela & Wong, Chunting & Ross, David A., 2014. "Bounded agency in humanitarian settings: A qualitative study of adherence to antiretroviral therapy among refugees situated in Kenya and Malaysia," Social Science & Medicine, Elsevier, vol. 120(C), pages 387-395.
    13. Schrank, Beate & Bird, Victoria & Rudnick, Abraham & Slade, Mike, 2012. "Determinants, self-management strategies and interventions for hope in people with mental disorders: Systematic search and narrative review," Social Science & Medicine, Elsevier, vol. 74(4), pages 554-564.
    14. Keys, Hunter M. & Kaiser, Bonnie N. & Kohrt, Brandon A. & Khoury, Nayla M. & Brewster, Aimée-Rika T., 2012. "Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau," Social Science & Medicine, Elsevier, vol. 75(3), pages 555-564.
    15. repec:eee:socmed:v:188:y:2017:i:c:p:100-108 is not listed on IDEAS
    16. Tay, Alvin Kuowei & Rees, Susan & Chan, Jack & Kareth, Moses & Silove, Derrick, 2015. "Examining the broader psychosocial effects of mass conflict on PTSD symptoms and functional impairment amongst West Papuan refugees resettled in Papua New Guinea (PNG)," Social Science & Medicine, Elsevier, vol. 132(C), pages 70-78.
    17. Achyuta Adhvaryu & James Fenske, 2014. "Conflict and the Formation of Political Beliefs in Africa," HiCN Working Papers 164, Households in Conflict Network.


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