MEDICINE AND PEACE

Abstract

In this column we shall explore the stories of those who have tried to heal deficits in peace in a community at the same time as healing its ill and wounded members. The Butterfly Peace Garden is one of the most unusual of these stories. Its central characters are an artist, a doctor, and a priest… although they would say the central characters were the children of Batticaloa, an area on the strife-riven east coast of Sri Lanka. These children have lived their whole lives in the presence of an ugly asymmetrical conflict. About one-third of the population of the area is Muslim, and about two-thirds Tamil who are mainly Hindu. In the course of the violent conflict between these ethnicities, there have been village massacres, abductions, and rapes. Thousands of families have suffered repeated displacements, with consequent deprivation and malnutrition. There are thousands of war widows. The suicide rate is among the highest in the world, higher than the war casualty rates. Considerable numbers of children have been abducted by militias and forced to work as soldiers. Some children choose to join militias out of despair and revenge. Unemployment is high. Depression, alcoholism, and domestic violence are common. This project began in an orthodox way as one of a series of “Health of Children in War Zones Projects” of McMaster University’s Centre for Peace Studies (Hamilton, Canada). An epidemiological study, carefully designed to be culturally appropriate, showed that in a sample of 170 nine- to eleven-year-olds in this area, there was almost universal (95%) exposure to severely adverse experiences (threatened death or serious injury) and high exposure to loss of family members through death or “disappearance”. About one-fifth of the children suffered from post-traumatic stress disorder in the severe or very severe range of symptom intensity, and about the same proportion suffered from severe depression and unresolved grief (1). Robbie Chase was the young physician heading this project. In a Toronto cafe, he encountered Paul Hogan, a remarkable artist who had created The Spiral Garden, combining connection with the Earth and creative arts in the rehabilitation of neurologically impaired children. Together they conceived the idea of a healing garden for children affected by Sri Lanka’s war. Integral to the shaping of the idea was Father Paul Satkunanayagam, a Tamil Jesuit priest and psychologist active in the provision of children’s mental health services in the Batticaloa region. It became clear that this trio’s approach to children’s mental health was far from orthodox. War-affected youngsters were to be helped by a combination of “earthwork, artwork, heartwork, and healing”, to use the language of the Garden. As the Garden evolved, children planted seeds, tended to their growth, and harvested the fruits. There was some emphasis on medicinal herbs, now scarce in the wardamaged environment. They care for sick birds and animals that remain on the site, which once had been a monastery garden and zoo. The children begin their day in the garden on “Mud Mountain”, sculpting fanciful creatures from clay, inventing characters who persist as imaginary inhabitants of the garden. Stories grow around the characters, and songs around the stories. Dramas are produced, with brilliant masks and costumes. Painting is a much-loved art form. Clowns appear from nowhere from time to time, to tease and act outrageously (Figs. 1 and 2). “Play is children’s sacrament”, says Paul Hogan, the genius of the Garden. Once I asked him how misbehaving children were handled there. “Ah,” his eyes twinkled, “Naughtiness is children’s special sacrament”.