Why did the World Bank send an analyst to Angola?
It was a long time before I was able to answer that question, so frequently asked. The answer is that I was sent for the very skills for which we were trained: to be an analyst.
The dimensions of the problems in Angola are overwhelming: 30 years of civil war, 550,000 people dead, 3.5 million people displaced from their homes and living in minimal to no shelter, 10 million land mines still in the ground, 150,000 amputees of all genders and ages, 150,000 orphans, HIV-seropositive rates estimated to be as high as 40 percent of the total population, massive morbidity and mortality from diarrhea and other diseases, and constant political instability in a country governed by two hostile groups, each holding half the land mass and half the wealth.
I felt quite ignorant as I was briefed at the World Bank in Washington, D.C. What could I offer? The people briefing me said that the Bank, with all its expertise, was failing to reach the people in Angola and improve their plight because the people were so “depressed” they did not participate in the opportunities offered.
I began to ask questions. Who were the heroes? What is the state of the family structure? What was the role of religion? How did the culture define the role of women and children and elderly? What was the celebratory system for the culture?
As the Bank staffers answered, they began to do what people do in such consultations. They began to synthesize and create new ideas — ideas of how the World Bank could help these people recover their spirit and energy in order to make use of the investments made by the Bank toward civil reconstruction. This is not a typical endeavor for the World Bank. Necessity, in this case, demanded invention.
Finally, it was decided that a mission to investigate ways to facilitate the Bank's mission was in order. I would accompany two Brazilian women, who had done something similar in Brazil, and who spoke Portuguese (the official language of Angola), and the chief of the Angola section of the World Bank's International Development Bank. Our goal was to hold a conference with writers, politicians, leaders of non-governmental organizations (e.g., Food for Peace, World Vision, Red Cross, Planned Parenthood) to test the feasibility of some marketing-style intervention to address the most urgent social needs. My role was to interview many leaders in all sectors of society to “diagnose” the most urgent problems and the level of possible intervention.
The experience was astounding; one could almost say life-changing. We were unprepared to be thrown into a milieu like Luanda, Angola. I fell back on a lesson of my early analytic education: “When in a moment of confusion, tie yourself to the mast of listening and associating and making only the most judicious interventions.” It was strange to find myself thinking of such principles, learned in the quiet and clean offices of our teachers in the beginnings of our psychoanalytic education, while sitting amidst ruin, disease, grotesque poverty, and seething hostility. However, the principle worked. I did learn. People did begin to offer more information than they had anticipated as our interviews progressed.
The adaptive capacities of the people of Angola are tremendous. The plight of women is terrible, but women are also the mainstay of the culture. Children are not highly valued in the Bantu culture, but they are the future. And here a great problem was evident. In many places, mothers are seen holding their babies, or small girls holding the latest babies of their mothers, and there is very little sign of attachment interaction. The babies thrash in the arms of mothers who are too worn out and depressed to engage the child. This is the next generation of damaged people being raised before our eyes. In little more than a decade these children will be soldiers and mothers.
Fine young men, handsome in their military uniforms, strut the streets and highways and villages carrying automatic rifles. The international community wants them “demilitarized.” I spoke with an army general who asked about the country's problems as I saw them. One problem we focused on was that of demilitarization.
“I don't think it is a good idea to undress these men and take away their weapons at the same time,” I said.
“How do we proceed?” he asked.
“I believe it dangerous to remove these very important symbols of power from these young men and turn them out into a society with no work or social position. I think they should be disarmed but not undressed. They should be trained as civil reconstruction corps to do socially esteemed work and paid by the international community, if necessary,” I responded.
“You're talking about castration!” the general exclaimed. Here was psychoanalysis functioning in Luanda.
It may seem silly to think of celebration and festival and marketing “interpretive” ideas, but in the setting of war-torn Africa celebration and destruction can co-exist comfortably. The concept is to identify issues, then to identify infrastructure that can convey those ideas to help people deal with what has befallen them. The means can be anything: street theater, television and radio advertising, posters, free samples with messages written upon them.
The presence of a psychoanalyst participating with an interdisciplinary team was a first for the World Bank. Several of our colleagues are doing some form of this applied psychoanalysis in diplomatic and civilian settings. The most important idea is that a psychoanalyst has something to offer. That which we take for granted is received as new and fresh in settings far different than the consulting room. Our knowledge of human development, human suffering, and treatment is transportable not only to other cultures but to vastly different workplaces where it can be taught. We will not be teaching Food For Peace workers to be therapists, but we can teach them to use simple ideas about mother-infant attachment so that they can give more than just food to these devastated women. Possibly we can help the next generation.
Now the task is to gain funding from the Bank or other sources for an actual long-term project. Since my visit, Ali Gallagher, a candidate in the Houston-Galveston Institute, visited under the auspices of the U.S. ambassador to Angola. Her findings agreed with mine. We have decided to pursue a joint project: setting up regular visits by psychoanalysts to Angola to address the psychological needs of the people through the existing infrastructure of nongovernmental organizations.
Harvey L. Rich, M.D., is president and chair of the Board of Directors of the American Psychoanalytic Foundation.