Suicide in Three East African Pastoralist Communities and the Role of Researcher Outsiders for Positive Transformation: A Case Study.

We examine cultural understandings and practices surrounding suicide in Pokot, Samburu, and Turkana pastoralists in north-central Kenya--three geographically overlapping and mutually interacting pastoralist communities. We collected our data in the context of a study of poverty, violence, and distress. In all three communities, stigma associated with suicide circumscribed individual responses to the World Health Organization's Self-Report Questionnaire, which led to an ethnographic sub-study of suicide building upon our long-standing research in East Africa on distress, violence, and death. As is true for most of sub-Saharan Africa, reliable statistical data are non-existent for these communities. Thus, we deliberately avoid making assertions about generalizable statistical trends. Rather, we take the position that ethnographically nuanced studies like the one we offer here provide a necessary basis for the respectful collection of accurate quantitative data on this important and troubling practice. Moreover, our central point in this paper is that positive transformational work relating to suicide is most likely when researcher outsiders practice 'deep engagement' while respectfully restricting their role to (1) iterative, community-driven approaches that contextualize suicide; and (2) sharing contextualized analyses with other practitioners. We contend that situating suicide within a broader cultural framework that includes attitudes and practices surrounding other forms of death is essential to both aspects of anthropological-outsiders' role.

Documenting the health consequences of endemic warfare in three pastoralist communities of northern Kenya: a conceptual framework.

Violent conflict represents the third most important source of mortality around the world, yet violence-related mortality remains profoundly undercounted (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002). As a step toward documenting the consequences of even the "smallest wars" we offer a conceptual framework for a recently initiated project that comparatively examines the direct and indirect consequences of intercommunity violence among Pokot, Samburu, and Turkana herding communities of Northern Kenya. While a substantial body of work has accumulated on the social responses to this violence very little is known about the differential impacts on community health. Based on our cumulative ethnographic experience in the area, we offer a conceptual framework that merges a context-sensitive ethnographic approach with a comparative epidemiological one centered on documenting the lived experience of violence and inequality. In this paper, we provide evidence for the importance of a contextualized approach detailing how social environments that include chronic episodes of violence produce variations in health. We do so by presenting the results of previous work to highlight what is known and follow this by identifying what remains to be understood about how violence, inequality, and health interact in these communities. While much is known about the importance of access to livestock herds for health, nutrition, and child growth in this difficult physical environment, far less is known about how the social responses to violence interact with access to herds to create new patterns of nutrition and health. With respect to pastoralists, additional areas that remain only nominally understood include age-specific mortality patterns, reproductive health, and psychosocial/mental health, topics that we view as central to the current study. In sum, we suggest that health offers one of the most useful tools for examining the costs of violence by creating opportunities for advocacy.