• Handicap International promotes a global approach to disability: the Disability Production Process (DPP). What makes it special?

The PPH is a Canadian model that proposes an anthropological reading of human development. This model takes into account the dynamics that exist between different elements of an individual’s life, such as risk factors, personal factors (impairments – the degree to which the body is affected – and disabilities – the degree to which an ability is reduced), environmental factors and lifestyle habits. This model invites us to perceive disability as a process related to a context, an ecology. In this sense, we act not only on the care of individuals, but also on their environment. This enables us to work on both the « I » and the « we » of a community, in other words, to reweave or, should I say, mend a social fabric torn apart by violence of all kinds (natural disasters, war, genocide). Our aim is to find or create a social bond that restores the power to act to the individuals who make it up. We could call thisempowerment.

• What mental health projects are you currently running around the world?

Handicap International runs a number of projects in parallel, with issues varying considerably from one population to another. We work on issues ranging from mental disorders, including traumatic ones, to intellectual disabilities and deficiencies, as well as socially-induced psychological suffering. Our contexts of intervention also vary, as we are present in prisons (in Madagascar), orphanages (in Algeria), specialized mental health centers (in Palestinian camps in Lebanon), functional rehabilitation centers(in Haiti), and refugee camps (in Kenya).

Take Rwanda, for example. We have been working in this country since 1994, in the wake of the Tutsi genocide. In 2007, we decided to develop a mental health project with a community clinic approach. We work primarily with adolescents and young adults whose parents disappeared during the genocide. These orphans, who became heads of household at an early age, were left to fend for themselves. Some became prostitutes, others abused drugs. Many stayed at home, living in total distrust of their own neighbors, the societal process underlying the genocide having profoundly undermined relationships of trust – in others, in oneself. We therefore opted for an ecological approach, considering the individual in relation to everything that connects him to the world. His body, his subjectivity and all the beings and objects present in his environment (family, culture, work, rights, health, money, etc.), formed and still form the main supports of the intervention. At present, we work with many groups of young people who have decided to « heal » themselves by pooling their « I », if we can put it that way, in the realization of projects they wish to implement for and with their community. These are often income-generating projects, such as fruit and vegetable plantations, cybercafés or charcoal stores. They can also be theater groups, or groups that help each other meet the needs of one of their members (building a house, repairing a roof). By following the wishes of the people we work with, we aim to reactivate community self-help processes that were present in Rwanda several decades ago, and which were shattered by the trauma of the Tutsi genocide.

• Who are the main players in the field?

Our aim is to strengthen local human resources. We therefore work mainly with local professionals. However, in an emergency context, we have to recruit more expatriates than in a development context, either because of a lack of local human resources, or because they are too affected by the situation itself. In a development context, we rely on the few existing resources (psychologists, social workers, nurses, psychiatrists), as well as on local resource persons. The principle is simple: we go out into the community and try to identify the « social activists » (defenders of children’s rights, women’s rights, community leaders), then offer to train and supervise them in mental health. In this way, we turn them into community workers, psychosocial development advisors and psychosocial mediators.

• In concrete terms, how do you deal with people’s trauma?

We work on the effects of trauma in the daily lives of individuals rather than on the trauma itself, starting with the effects on the community and social fabric. To do this, we start from the premise that the community itself possesses the resources to care for the individuals who make it up. We support the community in reactivating the solidarity that runs through it, through self-help groups. For example, we support the community when a child arrives in a family where the parents are absent. The choice of the child’s first name and the festivities surrounding the birth are carried out by the support group, which acts as a family. Our response to the traumatic disruption, which is expressed in various spheres of daily life, is to strengthen the social bond.

• How do you manage to reconcile your approach to disability, and more generally your conception of Man, with the conceptions of the local population?

It’s not a question of imposing our conception of disability on the populations we work with. However, every model has its own normative injunctions! This is the eternal dilemma of those who work in the humanitarian and development worlds. To intervene or not to intervene? What is our conception of the individual in the world, and is this conception compatible with that of the populations we work with? This is a question I often ask myself, as do many of my psychology colleagues who work in this transitional space we call interculturality. Through socio-anthropological studies, and when the temporality of our intervention allows, we strive to study the systems of representation and understanding of the population’s problems. We try to combine our model of understanding of human development with the way in which man’s place in this specific environment is conceived, what others call the politics of the individual. It’s not easy, and we’re constantly confronted with questions that affect every human being: what is happiness, what is living together and living freely, what is gender equality, what is developing a critical conscience? The greatest difficulty is to have an appropriate, inductive methodology for gathering this information in the different contexts in which we operate.

• Does this conceptual discrepancy lead to complications in the field, when it comes to developing your programs?

This question is above all a political one, and constantly leads us to question our own practices and their impact. For example, one of the unexpected results of our projects is that delinquency and insecurity are decreasing in a given area. Both citizens and the police bear witness to this. The question then is: are these delinquencies and insecurities an effect of social control carried out in line with what certain governments might expect of us, or are we vectors of social change in line with the democratic developments sweeping our planet? In both cases, I think it’s essential to be clear about the normative injunctions that drive us to act, and about the fact that we may also be agents of a globalized social change that is not without effect on conceptions of Man in society. Being aware of this enables us to remain alert, concerned and vigilant to the situated (contextualized) development of individuals, reducing our risk of destructiveness while maintaining a certain form of revolt. I believe that working in « humanitarianism » means learning to live with these tensions, which have to do with our commitment to combating various forms of social injustice affecting the most vulnerable populations, including people with disabilities.