Abstract
A paradigm shift in disaster mental health research has renewed the emphasis on the survivors’ experiences of suffering and healing. This article highlights the importance of utilizing documentary analysis as one of the important qualitative methodologies to explore post-disaster distress of the survivors. Following Figueroa’s (2008) approach to the analysis of audio-visual texts, the methodological steps, outcomes and their salience have been illustrated through an analysis of a documentary produced by Rakesh Sharma titled Final Solution, based on post-Godhra riots in 2002 in India. The two-phased analysis involved constructionist grounded theory procedures with an initial focus on the documentary as a ‘whole’. The methodological steps, rigour and the resulting categories of survivors’ suffering (‘overwhelmed by losses’, ‘relational disruption’, ‘living a forced identity’ and ‘denial of justice and equity’) are discussed in the light of the damage a disaster causes to survivors’ experiences of self and social worlds.
Disaster mental health: traditional and new paradigms
The United Nations International Strategy for Disaster Reduction (UNISDR) has defined disaster as a ‘serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources’ (UNISDR, 2007: n.p.). As loss of lives and property or drastic negative changes in the social order and human relationships may exceed human ability and resources to address the distress, disasters give rise to substantial risk to mental and social wellbeing of survivors (Coppola, 2007). Posttraumatic stress disorder (PTSD), with its major symptoms of intrusive recollection of traumatic events, avoidance of any stimulus associated with the event, negative alternations in cognition and emotions, and heightened arousal or hypervigilance, has been used as a predominant diagnostic category in disaster mental health research within the traditional positivist paradigm to map the distress related to disaster (American Psychiatric Association, 2013). However, in recent decades, it has been challenged for the claims of universality and objectivity associated with it (Breslau, 2004; Summerfield, 1999; Young, 1995). Lewis-Fernandez and Kleinman (1994) point out that the diagnostic categories (including PTSD) used in psychiatry are based on the following assumptions about mental illness: (a) the egocentricity of self (the psychological normality and abnormality are internal to one’s own self), (b) mind–body dualism (events arise separately either in brain or in mind and there is no interaction between the two) and (c) culture as an epiphenomenon to the observed biological reality. They also contended that these assumptions may not be relevant in the study of mental illness or suffering in societies that uphold a socio-centric worldview (where seeking harmony within relationship, rather than having a sense of individual autonomy, agency and control, is the key feature of self-growth or wellbeing).
Weiss et al. (2003), in a qualitative study, explored the views of leading researchers of disaster mental health about mental health outcomes of survivors and policies related to post-disaster care. Their study showed that rather than having unanimity over PTSD as a universal outcome of disasters, some of the respondents considered PTSD as not always being meaningful and useful in all the socio-cultural settings; especially where autonomy and agency are not taken to be important notions of selfhood. Similarly, as per Bracken et al. (1995), Breslau (2004), Summerfield (1999) and Young (1995), the concept of ‘traumatic memory’ or the memory that carries with it the trauma of past to erupt into the symptoms of PTSD (especially, intrusion-avoidance), is based on the notions of self assumed to be ‘constituted through continuities of memory’ that may not be a shared meaning of self across cultures of the world (Breslau, 2004: 116).
A shift can be noticed in the contemporary disaster mental health research as it involves an interdisciplinary approach that takes into account the cultural and contextual processes shaping survivors’ experiences (Bracken et al., 1995; Pedersen, 2002; Priya, 2010, 2012b; Summerfield, 1999). Kleinman (1987: 452) emphasized such an interdisciplinary approach to avoid ‘category fallacy’, that is ‘the reification of a nosological category developed for a particular cultural group that is then applied to members of another culture for whom it lacks coherence and its validity has not been established’.
This article contributes to the use of interdisciplinary perspectives within disaster mental health research by proposing and illustrating the use of one of the innovative methods relevant for the study of survivors’ subjective experiences of intense distress within their socio-historical context. It outlines the basic premises and procedures involved in documentary analysis (or the analysis of audio-visual material or data using an ‘audio-visual data as an object of analysis’ or AVO-approach 1 as given by Figueroa, 2008), and then illustrates its usefulness for the study of the experiences of post-disaster distress within its context. For this purpose, Final Solution, a documentary based on the interviews with and observations within the socio-political settings of the survivors of post-Godhra riots in India, has been analysed and the findings are presented. Finally, the suitability of documentary analysis within an interdisciplinary perspective on disaster mental health research is discussed. But, first let us take a look at the theoretical and methodological changes within the disaster mental health research to which documentary analysis has a potential to contribute.
Conceptual and methodological shifts
Besides the loss of lives and property, post-disaster distress may also be caused by a damage to social worlds (comprising family and community relationships and cultural meanings of self that pivotally shape one’s sense of selfhood) including the aggravation of the process of social exclusion faced by survivors (Summerfield, 1999; Pedersen, 2002). The concept of ‘suffering’ (or ‘social suffering’) has often been used to understand such an intense distress. Suffering is conceptualized as the intense distress experienced by a person when the intactness of his or her selfhood (or personhood) is threatened as the social world shaping that selfhood is damaged (Cassell, 2004; Kleinman, 1988a; Kleinman et al., 1998). For example, collective trauma, as observed by Abramowitz (2005) in some African countries facing ethnic conflicts, is the feeling of demoralization associated with non-adherence to the culturally valued notions of self defined by relational harmony rather than selfish intentions or behaviour in the aftermath of the disaster by oneself or the community members. Similarly, survivors may also experience intense distress out of the destruction of the relational networks in the forms of prejudice, creation or strengthening of social hierarchy and social exclusion. Priya (2007), in his ethnographic study among the survivors of an earthquake in India, observed their agony associated with being discriminated against by the villagers because of the emergence of a socio-economic hierarchy in the village caused by the loss of property and unregulated distribution of compensation money. Acharya (2000) found among some female survivors of the Latur earthquake in India, an extreme distress associated with a denial of voice due to the gender norms through forced ‘recanalization’ (a surgical operation that enables a woman, who was previously operated upon to nullify the chances of getting pregnant, to conceive a child once again), because they lost their sons in the earthquake and it was culturally desirable to have male child in the family. These examples indicate that besides the loss of family members: People can suffer from what they have lost of themselves in relation to the world of objects, events and relationships. Such suffering occurs because our intactness as persons, our coherence and integrity, come not only from intactness of the body but also from the wholeness of the web of relationships with self and others. (Cassell, 2004: 38)
To summarize, as per Cassell (2004), suffering of survivors in the post-disaster context may be understood as the intense distress associated with the threat to the enabling meaning in life or the coherence of selfhood within their damaged social worlds. The threat to the coherence of selfhood, as observed in the aforementioned examples, may be experienced in the forms of non-adherence to culturally valued norms, severing of relationships, process of prejudice or social exclusion or a denial of voice or justice.
The social worlds that comprise of relationships and cultural meanings of selves also act as resources within post-disaster settings to develop a new enabling meaning for the survivors. This process is termed as healing (Cassell, 2004; Kleinman, 1988a, 1988b).
Another vital development is the upcoming focus on the issue of equity and justice among disaster victims. David Alexander (2005) states that this perspective aims for providing a space to the voice of the survivors to understand their need for an equitable access to resources, support and rehabilitation irrespective of their gender, ethnicity, race or religion.
Qualitative research, because of its amenability to and primacy given in it to participants’ experiences and worldviews (Charmaz, 2004; Denzin and Lincoln, 2011), has been utilized by researchers of disaster mental health. Besides ethnography (Abramowitz, 2005; Priya, 2010; Young, 1995), semi-structured interview (Abramowitz, 2005; Mehta et al., 2005), case-study (Bracken et al., 1995) and other qualitative methodologies (such as the draw-and-tell conversation technique and Word Association Test; Priya, 2012a), analysis of audio-visual materials such as documentaries may prove to be a meaningful methodology to study survivors’ experiences.
Qualitative documentary analysis: the AVO-approach
Figueroa (2008) has proposed an innovative way of using qualitative methodology to develop insights about human social worlds through an analysis of audio-visual materials including documentaries that may depict issues or problems of people in real time. In her article that begins with a critical review of literature on existing qualitative approaches to analyse audio-visual material, she distinguishes between ‘audio-visual data as an object of analysis’ (AVO) and ‘audio-visual material as a medium’ (AVM) approaches to study audio-visual materials. The AVM-approach may be used to analyse the audio-visual material as the objectified depiction of reality. However, the AVO-approach that Figueroa endorses, assumes the audio-visual material (a collection of narratives such as conversations, interviews, other sounds and visuals) to be a piece of reality constructed through the medium of a film, a documentary or a television programme. Figueroa emphasizes that the ‘audio-visual material is the result of social interactions between, for instance, journalists, camera-people, editors, etc.’ (2008: 3–4). For example, the editing of the sequence of events in the documentary may be done by the editor to juxtapose the experiences or views of victims of violence as well as perpetrators or commoners. Similarly, the camera work including zooming in and zooming out, besides variations in camera angles of different cameras used for shooting, may be done to emphasize the verbal or non-verbal expressions of emotions or silences and to highlight the living conditions of protagonists respectively.
The AVO-approach involves the following three important methodological considerations:
Explication of researchers’ epistemological standpoint and interpretive framework: the AVO-approach closely follows the basic tenets of new paradigms of qualitative research (Denzin and Lincoln, 2011) because it asks for an explication by the researcher about his or her epistemological position and interpretive frameworks used for the purpose of analysis besides accentuating the socio-historical context in which the audio-visual material was generated.
Considering audio-visual material as a ‘whole’ for initial analysis of data: this approach entails a close study of the whole audio-visual material by watching its contents (and how these have been represented through the sequence of events and the camera work) several times to understand the context in which the events are embedded, the perspective of the filmmaker and the broad themes or ‘macropropositions’ that emerge from the initial repeated viewing of the whole story.
Use of grounded theory procedures for the purpose of data analysis: the macropropositions are further developed or refined with the help of the coding procedures (initial, focused and axial coding) as prescribed in the grounded theory methodology.
Apparently, the AVO-approach has many overlaps with other qualitative methodologies that may be considered for disaster mental health research. However, what is unique about the AVO-approach is that the audio-visual data consists of the narratives of multiple stakeholders related to the phenomenon of disasters (e.g. survivors, perpetrators of violence or injustice, local and political leaders, etc.) that may be juxtaposed with the help of editing. Also, the use of camera work may help to understand the nuances of verbal and non-verbal communication as well as the living conditions of the survivors.
The methodology section provides an illustration of the methodological and analytic procedures involved in the AVO-approach that may be used for a study of disaster mental health. In the process of pursuing the goal of this article to understand how this approach to documentary analysis may be useful in exploring the experiences of post-disaster suffering in its socio-political context, let us go through some important details of the post-Godhra riots.
The post-Godhra communal riots
On 27 February 2002, the S6 coach of the Sabarmati Express train was attacked at Godhra railway station in Gujarat, allegedly by a large Muslim mob which resulted in the killing of 59 persons (including 26 women and 12 children). A series of violent reactions broke out after this incident in Gujarat where the Muslim community was targeted. About 2000 Muslims were killed and 2500 were reported missing within a month of the outbreak of the carnage (Hashmi, 2007). Muslims were the target of atrocities and violence. Women were raped, expectant women’s bellies were ripped, children were burnt alive, lakhs of people were homeless and displaced, and businesses and shops were destroyed and looted. Although internally displaced families took refuge in the relief camps run by non-governmental organizations (NGOs), because of the apathy of the government and lack of resources, the condition of the camps (lack of sanitation, space, food, etc.) was no better than the violence outside. The violence and discrimination inflicted by the state and Hindus, in general, have created distress and alienation in the Muslim community that has lasted for years after the riots (Priya, 2012a; Chandoke et al., 2007).
Final Solution: a brief overview of the documentary
Based on the details from the documentary and the website of the director and producer, Rakesh Sharma (n.d.) and an interview of him conducted by Nicole Wolf that is available in the Berlinale Catalogue (Wolf, 2004), we provide here an overview of the contents of the documentary.
Final Solution (Sharma, 2004) is a 2.5 hour documentary that depicts how the survivors were affected by the post-Godhra riots. The film portrays the suffering, violence and injustice inflicted on the Muslim community by highlighting a series of interviews of the survivors, witnesses, rescuers and politicians. The director tries to compare the Hindutva (the philosophy of Hindu religion) activism to political tendencies of Nazi Germany and refers to the killing of Muslims as genocide (Sharma, n.d.). The film has two parts: Part 1: ‘Pride and Genocide’ deals with the carnage and planned violent acts by the cadres of right-wing Hindutva parties such as Vishwa Hindu Parishad (VHP), Bajrang Dal, etc. and the role of the state in escalating the riots. The efforts by the then Chief Minister of Gujarat and his party cadres to reconstruct Muslims as the ‘others’ or terrorists, and thereby justify the violent acts of cadres as legitimate, is portrayed. Part 2: ‘The Hate Mandate’ provides details on the 2002 Gujarat State Assembly elections where the Godhra incident was taken as an election agenda to influence the polls. Towards the end of the film, creation of forced ghettos, alienation and boycotting of the Muslim community in schools and businesses are depicted. The documentary has won more than 10 international awards and has been screened at over 80 international film festivals.
Methodology
As mentioned earlier, the AVO-approach to documentary analysis (Figueroa, 2008) closely follows the new paradigm of qualitative research (Denzin and Lincoln, 2011) that takes the process and the findings of the research to be a co-construction involving an interpretation of the audio-visual material (the contents of which are shaped by the perspective of the filmmaker on the phenomenon being filmed). This section begins with an explication of the researchers’ epistemological stance chosen for this study. Next, it provides an account of the filmmaker’s perspective on the process of filmmaking followed by the procedures adopted in the two-phase analysis of the documentary, Final Solution, as per the AVO-approach.
Researchers’ epistemological stance
With our motivation to co-construct the experiences of the survivors of the post-Godhra riots, we adopted the social constructionist epistemological position. It posits that knowing about a reality involves a joint construction of meanings between the knower and the knowable (Gergen, 2009; Sampson, 1993). Thus, the audio-visual texts are not mere realities observed through a neutral way by the cameras and the microphones. As Figueroa (2008) points out, these are, rather, narratives generated through the perspective of the filmmaker that may be analysed through qualitative approaches by researchers.
Filmmaker’s perspective on filming the riots
As per the AVO-approach, assuming that the documentary was a product of the filmmaker’s perspective on the riots, an understanding of his professional and ideological standpoint becomes necessary. Earlier during the 1992–93 Hindu–Muslim riots in Bombay, Rakesh Sharma felt deeply moved by the plight of the survivors: ‘I couldn’t just be a filmmaker and ran a relief camp in one of the worst-affected suburbs of Bombay’ (Wolf, 2004: 2). After the post-Godhra riots, his goal was to study ‘the long-term impact of the violence in Gujarat and documenting it on video’ (Wolf, 2004: 6).
To achieve this goal, he strategically chose the time of the Gujarat State Assembly elections during November and December 2002 for obtaining suitable evidences or indicators about how the politics of hatred led to the victimization of innocent people: ‘In each sequence, you see the perpetrators, the people on the sidelines, the tangents, the key political players, etc.’ (Wolf, 2004: 2). On his approach to interviews with the survivors, he added, ‘Once it was clear to people that I wasn’t there to “sensationalize” and seek a juicy story for the nightly news bulletin, they would open up a bit more’ (Wolf, 2004: 6).
Analysis of narratives using an AVO-approach
As Figueroa (2008) asserted, the audio-visual material has to be watched several times to understand the socio-historical contexts of the events and to develop macropropositions or topics (broader themes about the phenomenon under study) that may be refined further through the process of grounded theory analysis. Our interpretive framework was that of suffering as associated with coherence of selfhood (Cassell, 2004; Kleinman, 1988a; Kleinman et al., 1998) and the equity perspective on disaster mental health (Alexander, 2005). The language spoken by people depicted in the documentary was Hindi (and Gujarati in a few scenes). As the first step of the analytic process, we watched the movie several times and could observe the socio-political context of hatred and violence and its consequences for the survivors in terms of their suffering, their national and religious identity, and their relationship with other religious groups. This resulted in the following macropropositions or topics along with their definitions:
As the second step of the analytic process, the smaller units of the audio-visual texts had to be analysed through open, focused and axial coding procedures of constructionist grounded theory (Charmaz, 2000, 2014) for the purpose of locating the exemplars for and comparing and refining the macropropositions. Rather than line-by-line coding, the open coding procedure involved incident-by-incident coding. The qualitative data included narratives in these incidents or scenes that included interviews with survivors, political party cadres, priests and common persons, the speeches of politicians and religious activists given in the election campaign and rallies, and the visuals of survivors’ living conditions. While watching these data repeatedly for the purpose of analysis, we also focused on the sequence of events presented in the documentary as it helped to understand the experiences and confessions of victims and other stakeholders such as perpetrators, politicians and people of the same or different religious background living in their neighbourhood. A focus on the camera work that involved zooming in and zooming out, besides the use of one of the two cameras in covering the speakers and the other one in showing the expressions of accompanying people or the living conditions of the speakers, helped us understand the verbal and non-verbal behaviours (including silence) of people. Furthermore, some sequences of the documentary also highlighted the precarious situations for people inclined towards exploring injustice done to the victims. For example, when the documentary crew wanted to cover the doctors, staff or the victims of riots in a hospital, they were sternly told to leave the premises.
As per the strategy suggested by Pidgeon and Henwood (1997), full transcripts of the documentary were taken to be the narratives, parts of which became the exemplars to the codes or final categories. The analysis utilized the process of constant comparison of data with data, data with codes and codes with codes as per the guidelines by Charmaz (2014). The open or initial codes are provisional, which also facilitates a constant comparison among them and the narratives they are based on. Thus, the narratives of the survivors and others associated with their social worlds were compared across various incidents. For example, the narratives of distress of the survivors were coded in one incident as ‘disruption to relationship with village community’. However, in another incident, another survivor’s narrative was coded as ‘end of friendship with the people of other religion’. We compared these codes and it resulted in a more refined initial code, ‘relational disruptions’. This initial code emerged as a focus code because it could categorize narratives incisively. A constant comparison of narratives with this focus code helped us refine its meaning and exemplars as it emerged as a category, ‘relational disruptions’ with a definition, ‘distress over loss of relationship with people or place one used to relate to’. Axial coding led to the constant comparison of the focus codes and their regrouping into categories and sub-categories. For example, ‘fear of disruptions to potential future relationships’ emerged as a sub-category of the category, ‘relational disruptions’.
It may be noted that we used the social constructionist epistemological position (how socio-political context shaped the experiences of the survivors) and interpretive framework of ‘suffering as a threat to the coherence of selfhood’ and equity perspective. The categories and its definitions indicating the aspects of suffering as a threat to the coherence of selfhood may be noticed as shaped by the interpretive frameworks. As per Charmaz’s (2000, 2014) guidelines, researchers’ reflexivity about their epistemological position and interpretive framework used for co-construction of survivors’ experiences formed the quality criteria of analysis. The analysis resulted in the following categories (and their definitions) of suffering of the survivor of the post-Godhra riots:
Within the second phase of AVO-analysis, locating the exemplars for the initial macropropositions and comparing and refining them with the help of coding procedures of constructionist grounded theory led to the final categories presented above. This process has been summarized in Table 1, which shows the associations among the initial macropropositions and the final categories. For example, it shows how the narratives that formed the exemplars for the final category, ‘relational disruptions’ were not only associated with the macroproposition, ‘relational disruptions’ but also ‘distress related to post-disaster events’.
Associations between initial macropropositions and final categories.
Results
The categories of suffering of the survivors indicate that several aspects of subjective experiences or selfhood were lost or damaged. Let us now understand these facets of post-disaster suffering in some detail. The names of the survivors have been changed to protect their identity and to exercise research ethics. Also, the survivors whose narratives are mentioned in this section belonged to the Muslim community unless otherwise specified.
Overwhelmed by losses
Meaning in life or a sense of coherence of selfhood may be shattered due to loss of life of a family member or due to the feeling of helplessness while witnessing barbaric acts meted out to one’s own family members. Survivors’ shared experiences were often characterized by an intense feeling of meaninglessness resulting from the losses of family members and/or sexual assault on oneself or family members, and a deep sense of anguish and guilt about being helpless while watching the barbaric acts of violent mobs. In the rural cultural settings of India, where one of the major goals of a mother’s life is to nurture their children, women who lost their children in the riots experienced intense distress. A woman who saw her son and daughter killed in the riots narrated her feeling of meaninglessness besides sharing her helplessness over how her son tried to save her before he was killed: That’s my son as a kid and that’s Tara [her daughter; indicating towards a family photograph]. My son’s pants were taken off before Bhanu and his son hurled him into the fire. They stabbed me but the dagger fell off. My son said, ‘Mummy, run away before they kill you.’ He was burning … still he was thinking of me, not himself [sobs]. Only I know how I live. … My heart is filled with despair. Women who tried to escape the fire were raped. Some clamped their mouth, some took off their clothes. Shanu, standing next to me was pregnant. Her womb was split open. The fetus impaled on a sword!
Another mother, whose daughters were sexually assaulted and killed, expressed her helplessness in stopping the barbaric act: God is not going to forgive those people … I didn’t know what to do … Had I come out, they would have raped me and killed me too. What could I do as a mother? I could not bear to watch.
Relational disruptions
Disasters such as riots may affect the social world of the survivors in terms of severing the long-standing interpersonal relationships that shape one’s sense of selfhood. Some survivors shared their sorrow and anger over the loss of relationships with the friends of other religions. One Hindu girl child narrated about her Muslim friend: Her name is Heena. She used to be my friend earlier … but not anymore. We do not play together now. … She does not even know that Ramsevaks (the devotees of Lord Ram killed in the Godhra-train incident) were killed.
In another scene, a Muslim kindergarten student shared his new criteria for friendship that he would be friends only with a Muslim. In an interaction with him, when the filmmaker revealed his religion to be Hindusim, the child appeared to be a bit shocked because he had become friendly with the filmmaker. But, the child was also not ready to accept a friend (the filmmaker) to be Hindu. The child said, ‘No. You are a Muslim’.
Some survivors were also distressed over the difficulty that sexually assaulted unmarried girls in the family might have to face in getting married because of the taboo (of being ‘impure’ after the assault) associated with being sexually assaulted. A man at Kalol shared his agony: In many cases, if the girls were unmarried … at the time of being raped, no rape complaints were lodged by their parents or family because they feared it would be difficult to marry them off.
Living forced identities
For the survivors, social or religious identity that defines one’s selfhood became the reason for being a target of prejudice and social exclusion. Survivors’ perceptions of being labelled as a problematic ‘other’ reverberated in the views of Hindu priests and the right-winged Hindutva party leaders too. One such leader narrated: Our Muslims are like ‘our disease’… ‘our headache’… ‘our problem’.
Survivors shared their distress of being labelled as being a problematic, harmful or hated ‘other’ in the society, in general. A man who lost his niece and nephew in the riots was deeply anguished amidst hatred for Muslims as he shared that nothing except his Election Identity Card could help him claim that he is not a citizen of some other country: I am an Indian, I will remain an Indian. See my card number. If I lose this, it will be difficult to get another. My name is Indian L. A. Khan, an Indian. This is my identity. If I lose this card how will I give India the proof of my being an Indian? If I have this, I can at least say I am an Indian. … [sobs] … I love India. India is my country and I love it.
When they applied for a job, some Muslim young men reported being labelled and discriminated against at potential workplaces, as one of them expressed: Educated Muslims do not get jobs. First, they ask you your name. The name itself gets a reaction … ‘M-class [Muslim class]! Muslims! We do not need you. H-class [Hindu class]! Hindu is fine!’
Denial of justice and equity
One’s coherence of selfhood is also associated with the feeling of being equal to others in the society or having equal access to justice (and other resources for survival and rehabilitation at the time of crisis or violence). Some survivors expressed their agony because of a denial of their victimhood and justice by the government. Deliberately denying the incidents of killings and rapes in many areas (like Naroda Patiya), under-reporting deaths and accusing the Muslims of lying were the sources of distress. A man at Ahmedabad shared: I lost 10 members of my family. He [indicating towards another person] lost 19. My mother, grandmother, grandfather, aunt, sister-in-law, two nieces, a nephew … and a brother … He lost his entire family. They burnt, hacked and killed in front of us. The police removed the names of main culprits from the report because they were from VHP. Some arrests have been made but the VHP people roam free.
Other survivors shared their distress over a disparity in the access to resources or support in the face of the disaster. Besides the abrupt and untimely closing down of certain relief camps for them, the Muslim survivors also faced the distressing conditions of direct or indirect hindrances in availing medical treatment for the injured family members. An ambulance driver at Ahmadabad talked about the survivors’ distress of being denied an equitable medical support: We did get calls to transport the injured to the hospital. On the way, we would be stopped frequently on suspicion merely because ambulance organizers were Muslims. … At least 500–700 patients were taken there. There were many doctors with a bad attitude. Many wouldn’t even try to stop the bleeding which is normally a primary thing to do as to prevent blood loss would facilitate the chance of survival. We find that many deaths were caused because of negligence from the part of the doctors.
Discussion
Following the premises and procedures of the AVO-approach, this article attempted to illustrate documentary analysis as a meaningful qualitative methodology to explore the experiences of mental health of the disaster survivors. Following an emerging interdisciplinary paradigm on disaster mental health that gives primacy to the survivors’ experiences of suffering and healing within their socio-cultural context, we took up the analysis of the documentary, Final Solution, based on the survivors’ experiences in the socio-political context of the post-Godhra riots. As noted at the beginning of this paper, the theoretical shifts within the domain of disaster mental health are intricately associated with the methodological ones. The inter-disciplinary turn focusing on the study of suffering and healing among the disaster survivors has been facilitated by qualitative methodologies, as these enable a co-construction of survivors’ experiences within the post-disaster socio-historical context. Before we discuss this important theme, some deliberation on the process and scientific rigour of the documentary analysis as followed in this study is warranted.
Figueroa (2008) contended that a qualitative analysis of audio-visual material such as television news or a documentary thus far had followed a semiological approach (inquiring how a filmmaker’s perspective on the phenomena being filmed may have been shaped by the social interactions within the media organizations), but not a methodology that took up a systematic analysis of this special kind of data by generating and refining themes about the phenomenon under study incorporating the context and overall story it tended to convey. In her article, Figueroa, at the outset, highlighted the need to find out a way to integrate the semiological analysis with the systematic analytic approach of grounded theory to analyse the audio-visual material and for this she proposed the AVO-approach. For our analysis of Final Solution, we utilized the integration of the semiological analysis with the grounded theory approach.
In our study, we illustrated how the audio-visual material was a product of the filmmaker, Rakesh Sharma’s perspective (to study the long-term socio-political and psycho-social consequences of the post-Godhra communal riots) on the subject matter (post-Godhra riots) being filmed. As mentioned earlier, he did not want to merely show the miseries of the survivors but also planned to show how communal hatred was evoked for political gains for which the survivors had to pay the price through deaths, injuries and sexual assault. These goals of his led to setting the context of the documentary as he entered the riot-affected areas during the months leading up to the State Assembly elections in Gujarat, showing his observations of the political parties’ preparations for elections alongside the interviews with the survivors, perpetrators and commoners, to throw light on the antecedents and the consequences of the communal riots. Thus, the semiological understanding about the documentary provided an insight into the context of the audio-visual narratives. Watching the documentary several times with a critical understanding of the context of violence led to the emergence of the macropropositions, to be refined further with the help of constructionist grounded theory analysis. Such an understanding of the context of people’s lived experiences, besides the researchers’ specialized knowledge (epistemological position and interpretive framework) form the bedrock of constructionist grounded theory analysis (Charmaz, 2014). On the one hand, respecting the documentary as a whole along with its socio-political context (facilitated by the semiological understanding) and on the other, explicating the researchers’ specialized knowledge that led to the co-construction of the finding of the documentary analysis, aided to the validity of the qualitative study of audio-visual material. As Figueroa (2008: 10) points out: The researcher thus moves from the global audio-visual text to its smaller sub-units so as not to disrupt the structure of meaning of the text before she or he has a chance to interpret it. It is important to … employ one’s own contextual and scholarly knowledge, albeit in a flexible way, and to intertwine the hypothesis grounded in the observation of the data with one’s contextual knowledge and well-suited social theory about the empirical material under study…. These procedures would give more validity to grounded theory, while at the same time allowing latent meanings to emerge from the interpretation of the texts in addition to respecting their structure of meaning.
As far as criteria of rigour in qualitative research goes, credibility or respecting the entirety and context of the narratives and researchers’ reflexivity about the epistemological standpoint and interpretive framework are of critical importance (Charmaz, 2014; Denzin and Lincoln, 2011; Lincoln et al., 2011).
Returning to the theme of how documentary analysis as a qualitative methodology facilitated the exploration of survivors’ experiences of suffering, it is important to realize that qualitative research is rendered meaningful when the nature of experiential or social reality being studied is considered to be shaped within the cultural and socio-political context (Denzin and Lincoln, 2011). The cultural context prevailing in the post-disaster period may shape one’s meaning of relationship and a loss of or a damage to that as depicted in the categories of ‘overwhelmed by losses’ and ‘relational disruption’. For instance, in this study, the AVO-approach helped us understand how the mothers (who, in their cultural setting, had the primary goal of nurturing their children besides taking care of other household activities) felt overwhelmed by the feelings of meaninglessness arising from the loss of relationship and helplessness due to their inability to save their children from getting killed or sexually assaulted. Furthermore, some survivors’ suffering associated with the abrupt severing of relationship with the community members of the other religion (in the rural Indian setting where harmony within relationships is culturally valued; Sinha, 1990) could also be co-constructed through the AVO-approach. This approach to qualitative analysis helped us understand how relationships, which are one of the important aspects of selfhood or personhood, may be susceptible to damage (Cassell, 2004) and how in the post-disaster settings particularly, the ruining of relational networks may lead to intense suffering (Kleinman et al., 1998).
As observed through the categories of ‘living forced identities’ and ‘denial of justice and equity’, survivors’ suffering was associated with prejudice and social exclusion based on their religious identity (that defines one’s sense of selfhood) and a denial of right to equality and justice (that constitutes one’s coherence of selfhood). The AVO-approach helped us explore the impact of this hierarchy in terms of forcing the survivors to live the identity of being a ‘hated other’ or a ‘problematic or evil other’. Similarly, the religion-based hierarchy also led to the denial of police protection, medical facilities and proper rehabilitation to the survivors as explicated through the analysis of their experiences in their socio-political context. As per Cassell (2004) and Kleinman et al. (1998), suffering due to being forcibly assigned a hated social identity and due to a denial of right to equality and justice can be understood as a threat to the selfhood of the survivors, as one would like to have a personal space where he/she is not subjugated to an inferior identity, an inferior or disadvantageous position and where one can utilize the ‘ability to redress the injury by others and by the state’ (Cassell, 2004: 39).
Conclusion
We note in this study that in the socio-political violence, social worlds or the relational networks of the survivors may get damaged, especially in developing countries, through atrocities, mass execution, social divide and hatred (Kienzler, 2008; Pedersen, 2002; Summerfield, 2005). As Bracken et al. (1995), Summerfield (1999) and Abramowitz (2005) have pointed out, these have led primarily to the experiences of intense distress or suffering (arising out of threats to the coherence of survivors’ selfhood) rather than mere prevalence of psychiatric disorders such as PTSD. As this paper attempted to illustrate, various features of such post-disaster suffering may be amenable to documentary analysis through an AVO-approach that utilizes basic premises and rigour of qualitative research (Denzin and Lincoln, 2011).
Although this study demonstrated that survivors’ suffering was associated with the cultural and socio-political contexts of the post-violence period, such contexts may become salient for the survivors’ plight even in the aftermath of natural disasters. Researchers such as Acharya (2000), Priya (2004, 2010), Jones-Deweever and Hartmann (2006) and Weiss et al. (2003) have highlighted that the dynamic socio-political context in the aftermath of a natural disaster may have the potential to re-traumatize the survivors. Documentary analysis, thus, may be a useful qualitative methodology to study survivors’ experiences of suffering and healing in the aftermath of natural as well as human-made disasters.
Footnotes
Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
