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concern that these accounts may sometimes be falsified or counterfeited to gain access to aid. This is part of what James labels the ‘victim culture’ of Haiti, which has been created by aid agencies’ interventions. To some extent, the inconsistency of narratives reflects the instability of aid organizations themselves. “International and national humanitarian and development aid assemblages are frequently impermanent, accountable to their own donors and stakeholders outside the ‘local’ realm, and may not maintain a permanent gaze upon the suffering of aid receivers because of finite resources, especially for those who suffer under conditions of chronic insecurity” (James, 2010, 112).

James also discusses the distress associated with being unable to locate one’s kin after a catastrophe. Speaking of a 60-year-old woman whose son went missing in 1992, she writes, “Her perpetual torment is not knowing if he is dead. If he is, her inability to lay his body to rest through proper funerary rites leaves her in a state of moral limbo in which she is vulnerable to haunting and persecution by the zonbi, an aspect of the disembodied soul of the deceased” (138).

Dissociative Phenomena and Other Folk Diagnoses

Various forms of possession trance and other dissociative phenomena may be common in Haiti, in part because of their relationship to Vodou practices (Bourguignon, 2004, p. 558). Spirit possession by Vodou spirits (lwa-s) can give women the power to become diagnosticians, healers, or leaders within their communities, and can have different meanings depending on the person’s experience. According to Bourguignon, a striking feature of possession trance is that the spirits possessing women usually maintain the person’s basic motivations; dissociation is “in the service of the self”. In situations of subordination or oppression, acting out the identity of powerful spirits in trance possession provides women with an acceptable (and consciously deniable) way to express unconscious or forbidden wishes, thoughts and feelings.

Sezisman, which literally means “seized-up-ness” or “surprised-ness”, is a state of paralysis usually provoked by sudden shock involving great rage, anger, indignation or sadness, or more rarely extreme happiness (Bourguignon, 1984; Nicolas, DeSilva, Grey & Gonzalez-Eastep, 2006). Frequent causes include: receiving sad news concerning a loved one, witnessing a traumatic event, seeing dead bodies, experiencing family crisis or narcissistic injuries (insults, getting fired). In brief, sezisman is brought on by the shock of unexpected events or situations. Specific catalysts of sezisman concern woman: it is believed that delivering bad or shocking news to a pregnant woman might cause a miscarriage, premature delivery, deformation of the fetus, the woman’s death or a contamination of breast milk (let gate, see also Farmer 1988). Great efforts are thus made to protect pregnant woman from bad news. According to Haitians, sezisman involves the movement of blood to the head, potentially causing loss of vision, headache, increased blood pressure, strokes, heart attacks, death (See: Laguerre 1981, 1987). The person

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