The Differential Impact of War and Trauma on Kosovar Albanian Women Living in Post-War Kosova
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The Differential Impact of War and Trauma on Kosovar Albanian Women Living in Post-War Kosova Hanna Kienzler Department of Anthropology McGill University, Montreal June 2010 A thesis submitted to McGill University in partial fulfilment of the requirements of the degree of Doctor of Philosophy © 2010 Hanna Kienzler Abstract The war in Kosova had a profound impact on the lives of the civilian population and was a major cause of material destruction, disintegration of social fabrics and ill health. Throughout 1998 and 1999, the number of killings is estimated to be 10,000 with the majority of the victims being Kosovar Albanian killed by Serbian forces. An additional 863,000 civilians sought or were forced into refuge outside Kosova and 590,000 were internally displaced. Moreover, rape and torture, looting, pillaging and extortion were committed. The aim of my dissertation is to rewrite aspects of the recent belligerent history of Kosova with a focus on how history is created and transformed through bodily expressions of distress. The ethnographic study was conducted in two Kosovar villages that were hit especially hard during the war. In both villages, my research was based on participant observation which allowed me to immerse myself in Kosovar culture and the daily activities of the people under study. The dissertation is divided into four interrelated parts.The first part is based on published accounts describing how various external power regimes affected local Kosovar culture, and how the latter was continuously transformed by the local population throughout history. The second part focuses on collective memories and explores how villagers construct their community‟s past in order to give meaning to their everyday lives in a time of political and economic upheaval. The third part looks at how women create, change and, thereby, influence collective memories through bodily expressions of distress. Finally, the fourth part makes apparent how through clinical practice and traditional healing, history, collective memories and traumatic memories are negotiated and invested with new meanings and attributions. The dissertation concludes with a focus on the interrelation of collective and traumatic memories which generate and justify women‟s health problems. In this context, it is argued that patient-practitioner interaction should be perceived as an opportunity to build ethical relationships which go beyond the relatively narrow medical mandate by providing women with “tools” to create social spaces in which they can live and commemorate in a healthy way. Résumé La guerre au Kosova a eu un impact profond sur la vie de la population civile et a été une cause majeure de la destruction matérielle, de la désintégration du tissu social et de problèmes de santé. Au courant des années 1998 et 1999, le nombre de meurtres a été estimé à 10,000, la majorité des victimes étant des Albanais du Kosova tués par les forces serbes. De plus, 863,000 civils ont été recherchés ou contraints à prendre refuge en dehors du Kosova, et 590,000 ont été déplacés à l'intérieur du territoire. En outre, des viols, de la torture, des pillages et des extorsions ont été commis. L'objectif de ma thèse consiste à revoir les aspects de l'histoire récente du Kosova belligérant en mettant l'accent sur la façon dont l'histoire est créée et transformée à travers les expressions corporelles de détresse. L'étude ethnographique a été menée dans deux villages kosovars, qui ont été particulièrement touchés pendant la guerre. Dans les deux villages, ma recherche s‟est basée sur l'observation participante, qui m'a permis de me plonger dans la culture kosovare et les activités quotidiennes de la population à l'étude. La thèse est divisée en quatre parties interdépendantes. La première partie recensent les écrits traitant des différents régimes politiques externes qui ont affecté la culture locale kosovare, et comment celle-ci a été continuellement transformée par la population locale au cours de l'histoire. La deuxième partie s‟attarde aux mémoires collectives et explore comment les villageois construisent le passé de leur communauté, afin de donner un sens à leur vie quotidienne à une époque de bouleversements politiques et économiques. La troisième partie examine la façon dont les femmes créent, changent et, par conséquent, influencent les mémoires collectives à travers des expressions corporelles de détresse. Enfin, la quatrième partie met en évidence comment, à travers la pratique clinique et les rites de guérison traditionnels, les mémoires collectives et les traumatismes sont négociés et investis de nouvelles significations et attributions. La thèse conclut en mettant l'accent sur l'interdépendance des mémoires collectives et des traumatismes, qui génèrent et justifient les problèmes de santé des femmes. Dans ce contexte, il est soutenu que l'interaction patient-praticien devrait être perçue comme une occasion d'établir des relations éthiques qui vont au-delà du mandat relativement étroit de la médecine en offrant aux femmes des «outils» pour créer des espaces sociaux dans lesquels elles peuvent vivre et commémorer de façon saine. Table of Contents Acknowledgements Introduction 1 PART I: KOSOVA’S MASTERS AND THEIR INFLUENCE ON THE LOCAL POPULATION THROUGHOUT HISTORY 26 Chapter 1: Kosova’s Post-Conflict Administration and Its Effects on the Lives of the Citizens 27 1.1 Sovereignty versus Imperialism 31 Chapter 2: Kosova’s Masters and Their Influence on Local Culture, Resources and Ways of Organization 33 2.1 Patterns of Political and Social Organization Prior to the Arrival of the Ottomans 33 2.2 The Influence of the Ottoman Empire on Kosova‟s Political and Social Organization 37 2.3 Between Assimilation and Expulsion: Albanian Politics From 1912-1945 40 2.4 Yugoslav Politics and Kosovar Social Organization under Tito 44 2.5 Prelude to the War 46 2.6 The Conflict in Kosova 50 2.7 Exploring Historical and Social Change 54 PART II: THE PAST IN THE PRESENT: COLLECTIVE MEMORIES, HISTORIES AND IDENTITIES IN THE CONTEXT OF CONFLICT 56 Chapter 3: The Establishment and Development of Collective Memory Studies 58 3.1 The Origins of Collective Memory Studies 61 3.2 New Questions and New Approaches 65 Chapter 4: Memory and Identity Practices in the Context of War 69 4.1 Sites of Memory, Commemorative Performance and Mourning 71 4.2 The Power of Narratives and Truth-Making Practices 74 4.3 The Dynamics of Counter-Memory and Disqualified Knowledge 77 4.4 The Selective and Constructive Nature of (Collective) Memory 80 Chapter 5: The Power of Collective Memory in Krusha e Madhe and Pastasel 84 5.1 Krusha e Madhe: Remembering Past Hardships and Dealing with Present Challenges 85 5.2 Pastasel: The Power of Myths and Testimonies for the Present Social and Political Organization 122 PART III: VIEWS AND CONCEPTUALIZATIONS OF AND DISCUSSIONS ON TRAUMATIC MEMORY AND MODES OF EXPRESSING DISTRESS 155 Chapter 6: The Cultural Construction and Conceptualization of War- Trauma and PTSD 157 Chapter 7: Debating War-Trauma and PTSD from Psychiatric Perspectives 160 7.1 Universalistic Approaches to Traumatic Distress 160 7.2 PTSD: A Euro-American Invention 167 7.3 Building Bridges between Different Psychiatric Approaches 171 Chapter 8: Anthropological Contributions to Discourses on War-Trauma and PTSD 175 8.1 Linkages between Violence and Personal and Social Well- Being 176 8.2 Social Suffering and Local Idioms of Distress 179 Chapter 9: Narratives of Symptoms and Illness Experiences of Women in Krusha e Madhe and Pastasel 184 9.1 Triggers of War-Related and Traumatic Memories 185 9.2 Temporal Narratives of Symptoms 193 9.3 Multiple Etiologies: Traumatic Events, Economic Problems and Interpersonal Conflicts 206 9.4 Modes and Concepts of Distress: Nervoz, Mërzitna, Msysh and T‟bone 219 PART IV: HEALTH-SEEKING AND HEALING IN THE AFTERMATH OF WAR 238 Chapter 10: The Cultural Contexts of Health-Seeking, Healing and Medical Efficacy 238 Chapter 11: Psychiatric Responses to War-Trauma and Trauma-Related Health Problems 245 11.1 The Politics of Humanitarian and Psychiatric Interventions 246 Chapter 12: Anthropological Responses to Psychiatric Intervention Strategies in War-Torn Societies 255 12.1 The Politics of Humanitarian Aid 255 12.2 Trauma Focused Psychiatric Interventions versus Indigenous Healing Traditions 258 12.3 Critical Standpoints on Anthropological Authority 261 Chapter 13: Health-Seeking and Healing Practices in Kosova 264 13.1 The Biomedical Beliefs and Practices of General Practitioners, Psychiatrists and Psychologists 269 13.2 Healing the Afflicted 299 13.3 Places of Healing 333 Conclusion: Creating and Transforming History through Collective Memory and Bodily Expressions of Distress 354 Epilogue 371 Appendices Appendix A: Map of Kosova 382 Appendix B: Map of Rahovec 384 Appendix C: Names of the Victims of the Massacre in Pastasel 385 Appendix D: Eyewitness Reports of the Atrocities Committed in the Municipality of Rahovec 386 Appendix E: Photographs Documenting the Atrocities Committed in the Municipality of Rahovec 387 Bibliography 388 Acknowledgements The more I learned about how the war had affected the two Kosovar village communities, Krusha e Madhe and Pastasel, the less I understood how it was possible for human beings to kill, torture and humiliate so many people, to destroy their livelihoods and to get away with it. Although the destruction seemed so overwhelming and total, the survivors of indescribable violence and hardship taught me that the Serbian military and paramilitary forces had not succeeded in their attempt to subjugate them. Upon their return from refuge, the villagers rolled up their sleeves to rebuild their communities, their homes, their lives. They did so in memory of their loved ones who the war had violently taken from them and with a vision of providing future generations an environment worth living in. They have my greatest respect. I owe my deepest gratitude to the communities of Krusha e Madhe and Pastasel for their hospitality, interest in my research, immense support and trust.