"We Are All Alive ... But Dead": Cultural Meanings of War Trauma in the Tamil Diaspora and Implications for Service Delivery

Providing culturally appropriate mental health services to war-affected refugees residing in the West continues to pose many challenges. Gaining firsthand knowledge from the refugee communities themselves is crucial to improving our knowledge and guiding our interventions. The purpose of this study is to understand perceptions of war trauma in the Tamil diaspora. Fifty-one Sri Lankan Tamils living in the Greater Toronto Area, Canada, were interviewed. Transcripts were thematically analyzed using content analysis. Findings indicate that war trauma is not viewed by the diaspora as a pathological notion. Positioned within a moral context, and independent from isolated events of war, manifestations of war trauma were discussed at an interpersonal and collective level. Diagnostic categories, including post-traumatic stress disorder (PTSD), do not seem to fully capture the breadth of war trauma in this diaspora community. Implications for service delivery, and for incorporating the unique aspects of suffering resulting from a fragmented community, are discussed.