d’anthropologie culturelle (CANTHEL) at the Université Paris Cité in France.
She applied the "Page 99 Test" to her new book, The Work of Disaster: Crisis and Care Along a Himalayan Fault Line, with the following results:
Page 99 of The Work of Disaster tells a story called “Vishal’s Medicine.” Vishal was a man I met in an earthquake-affected village in rural Nepal who received psychosocial counseling and medication after the disaster. He was one of many people who discovered such treatments because of the seismic rupture and the post-earthquake humanitarian psychosocial interventions that followed. Around the time of the earthquakes, Vishal had been suffering from troubling episodes of incoherent wandering in the forest which he described as jangali, wildness. The story on page 99 takes place three years after the post-disaster mental health program phased out, during a follow-up trip I made back to Nepal to explore the afterlives of humanitarian intervention.Visit Aidan Seale-Feldman's website.
I think readers opening the book to page 99 would get a clear idea of some of the core issues I address in the work as a whole. In fact, I used to give talks that would start with a photograph of Vishal’s medicine: three blister packs of pills–red, blue, and green–on a plastic shopping bag laid out on a patch of Himalayan earth [image left].I felt this image and the story that accompanied it cut to the heart of the key question that I raise in the book: What are the consequences of transient care, in a world of cascading disasters?
Vishal’s story is exemplary for multiple reasons. Like many of the clients treated by the post- disaster psychosocial program, Vishal did not conform to humanitarian assumptions of the “earthquake victim.” Vishal’s suffering began before the earthquakes, and he was prescribed antipsychotic and antidepressant medication by an NGO because he happened to live in the disaster zone. When humanitarians deemed the “crisis” of mental health in Nepal to be over, Vishal was once again left to manage his affliction on his own in a region with minimal access to psychopharmaceuticals. The temporary prescription of psychiatric drugs in the earthquake- affected districts is one of the most troubling aspects of the story of disaster and mental health in Nepal.
At the same time, Vishal’s story confounds our (now well established) anthropological expectations that humanitarian interventions are solely a form of violence, or that global mental health is simply a mode of medical imperialism. Despite the obstacles of access, after the program phased out Vishal chose to continue taking the medication he discovered through the work of disaster, whatever the cost. Vishal continued his treatment because it made him feel better and allowed him to return to health, which he defined as being able to care for his children, his animals, and to work the land. Ultimately Vishal’s challenge was one of chronicity. When I met him years later, he was strong and had just come from planting rice, but he was also ambivalent about the efficacy of his treatment. He worried that he might have to take psychiatric drugs for life. The story of Vishal’s medicine not only raises questions regarding the ethics of brief humanitarian psychosocial interventions but it is also an example of what disaster generates, and the limits and possibilities of transient care.
--Marshal Zeringue










