Click here to download the transcript from The Refugees.

While I was working on my book on depression, I became really interested in the idea that depression is a universal phenomenon. And most of the people I was talking to about depression were essentially middle-class Western people who had been through nervous breakdowns of one kind or another. And so, I went into all of these different contexts to look at how depression functioned among really poor people and among people across history. And I went into a lot of non-Western contexts and looked at depression among the Greenlandic Inuit and depression among tribes people in Senegal and talked to some people from Rwanda about what they'd been through and I had a really amazing set of experiences in Cambodia, which was actually the first place that I went in the course of this broadening set of examinations.  

And I went there because I wanted to see what happens in a country where the entire population has been subjected to enormous trauma. What is it like when it's not just a person who's had a little private trauma and who says, "Well, everyone else is OK, look what happened to me," but rather a whole country that has just been completely devastated? And so, I went to see what life was like among survivors of the Khmer Rouge. And when I got Cambodia, I talked to various people and eventually someone gave me the name of a woman who they said had done some amazing work with depressed survivors of the Khmer Rouge and gave me her phone number. And I called her up and we spoke on the phone and she didn't speak English very well and I had someone kind of help me out who spoke Cambodian. But we made an arrangement to meet each other and she set the location. It was a room upstairs from a newspaper office, sort of in the outskirts of Phnom Penh. And I said I'd bring a translator. And I got there and there was this tiny, kind of four-foot-tall woman with her hair sort of pulled back and with a kind of, already before we started talking, sort of intense expression and this kind of slightly flickering quality that I'd noticed in a lot of the people who had been through Khmer Rouge stuff, looking around.  

And we started talking and I said, "Why don't we just try to talk to each other and not have a translator?" I said, "So now, let's begin with what, what happened to you during the Khmer Rouge period."  

And she said, "Well, I didn't have such a bad time." And so, then she told me about "not such a bad time," which I thought was kind of a bad time. She said that she had worked as a secretary in the Ministry of Finance and that when Pol Pot came into power, she had managed, unlike most people who were so-called intellectuals, to pretend to be a peasant and so she had not been summarily executed immediately. She had been separated from her husband and she was with her three children. She had a daughter who was twelve, a son who was six, and an infant. And she and her three children were taken together off to a reeducation camp. And on the way out to the reeducation camp she was tied to a tree and made to watch while a battalion of soldiers raped and then murdered her daughter. She was then let free and she went on with her six-year-old son and the infant and she got to the reeducation camp in the country. And they were set to work tilling in the fields. And she spent some time tilling in the fields, and she said that was OK. She was there for a few months. And then one day she was told that somebody had reported something on her and she and her two children were taken to the killing fields. And very few people who are taken to those fields ever left them. When she got there, she was tied to a bamboo stake that was positioned over a kind of low ravine in such a way that as long as she kept her knees braced, she could stand up. But as soon as she really released them or fell asleep she would tumble over into the ravine and die at the bottom of the ravine. And her two children were tied on to her, and she stood there with her two children, and the children were screaming. And she finally said to one of the soldiers...  She said she was trying to think of something to say. She remembered the name of somebody who was kind of middle management in the Khmer Rouge.  

And she said, "Listen." She said, "You know, I was actually for a long time the mistress of this guy." She said, "And I think if you kill me, you're gonna find out, you're gonna get in a lot of trouble." She said, "I just don't think you really want to be killing me." She said, "Reeducating me is fine, but if you're the one who kills me he's going to find out and it's not gonna be good for you."  

So, this guy said, "I'm not sure I believe you but on the chance that you're right, I'm going to cut your ... the things that are tying you and I'm gonna let you go. And you go into the jungle, which starts right over there, and you get down there and don't you ever let me see you again because if I or anyone else sees you...any time, that will be the end for you." And he cut the ropes that were tying her up, and she grabbed her two children and they ran into the jungle. And they got into the jungle and they lived in the jungle on roots and on whatever they could get from the trees that were in the jungle. And she said she just kept running. She said she tried never to see another human being because she never knew, if she saw even the rustle of movement in the distance, who was on which side. After a while, because she had such poor nutrition living this way, the milk in her breasts dried up and so her infant died. So, she was left with just the six-year-old, but she managed to live with him in that way in the jungle for more than two years until the fall of Pol Pot. And finally, after two years, Pol Pot fell and she was able to come back out of the jungle.  

She came back out with this child and she made her way back to Phnom Penh. And when she got there she was wandering around in the desolation with lots of other people who were similarly, had returned to Phnom Penh. And she managed to find her husband who had also not been killed because he had, very early on, been beaten so badly about the head with heavy objects that he had become a functional idiot and he had been left as a sort of street person wandering around outside of the city because the city had been emptied out. But she'd found him, and she and he and their son were taken and they were put into a resettlement camp on the border of Thailand. And when they got to that resettlement camp, she was one of the few people there who was actually educated because almost all educated people had been found and killed. And because she was educated, she actually spoke foreign languages. And so, she was able to communicate with the foreign aid workers who had come to work in the resettlement camp. And she began talking to them. And she was given a nicer hut than most of the people who were in tents in that camp were given.  

And she lived in that hut and she began looking at the other people in the camp. And she saw that there were all of these poor women who had made it through the whole Khmer Rouge period and who were living in tents, and who weren't taking care of their own children; who were just lying there, in these tents completely still, completely vacant, and letting their own children wander around unfed and uncared for. And she went to the foreign aid workers and she said, "We have to do something for these people." She said at that point she didn't really have the word for depression but she said, "There's something wrong with these women. They're not doing anything. They're hardly even alive." Well, some of the foreign aid workers actually tried to get some antidepressant medication but those were still relatively early days for antidepressants, and there wasn't really very much that could be done, and finances were very tight. And so, she said, "I want to try to do something for these women."  

And she began going around and trying to stir them up. And she said over the next couple of years, she began to put together a program. And as she'd been describing all of this, we were sitting in this sort of small room and telling her own story, she'd remained very composed. But when she started to talk about these other women, she fell off the little sofa she'd been sitting on and she began to weep. She said, "They were just sitting there, and I went to them, and I finally understood that I could help them by working with them in three stages. I had to teach them three things. The first thing," she said, "was that I had to teach them to forget." She said, "Their minds were so full of the horrible things that had happened to them, and such horrible things had happened to them. And first I had to get them to tell me what those horrible things were. And then I had to talk to them and give them some other things to think about and some other things to put in their minds. Because they would never forget completely the horrible things that had happened to them but I needed to crowd out a little bit of the bad stuff that was taking up every millimeter of their consciousness." She said, "And so I began to do that, and bit by bit you could feel that their minds were beginning to open up to something else. And bit by bit, I began to feel like I was getting a little bit of forgetfulness into those minds. And when I had reached the point at which I felt they were actually beginning to forget, then I went on to the second thing. 

 And the second thing was to teach them to work. These were people who didn't know how to do anything, and even if all they could ever learn to do was to keep their own place neat and clean, they had to have something that they could start doing, and then do. And then know that they'd done it. To have some purpose in life. And maybe someday, they would clean someone else's house. They would do something for somebody else, but they would have a purpose and they would have a direction and they would have a focus." She said, "And so, I would teach them to work. And then, when I had taught them those two things -- to forget, and to work -- I would teach them the third thing, which was to perform manicures and pedicures."  

So, this had all been very emotional up until this point and I felt I couldn't burst out laughing, and I said, "Manicures and pedicures?"  

She said, "You know, the worst atrocity of all that was wrought by the Khmer Rouge was that half the country turned against the other half of the country. And people who lived through that period knew that they couldn't put any faith in anyone else. And they completely lost the habit of looking anyone else even half in the eye." She said, "And all of these women had been deprived for a long time, at any occasion, to indulge the least bit of personal vanity. I brought them to my hut, and I built a special room that I would fill with steam, and it was a pleasure for them to feel beautiful. But what was really amazing for them was that, in this context, it was something that was at once very intimate and very impersonal. And they would start because I was telling them how to do it and giving them this instruction to handle each other's fingers and each other's toes. And it meant they were touching each other. And if I had told them to begin to hold each other's hands or to have some kind of physical contact with other people, they would have shied away and they would have pulled back. They weren't ready to do anything with anyone. But in this context, they would touch each other's fingers. They would touch each other's toes. And then, because it was such a funny context, and because they felt so happy about the fact that they were, for a moment, feeling a little bit beautiful again, they would begin to laugh together. And they would begin to tell each other little bits of stories and things. And that was the way that I taught them to trust again. Because the ability to trust was the biggest thing that they had lost of all."  

She said, "And when I felt that I had really been able to teach them to forget, and to work and to trust. Then what I tried to say to them was that those were not three separate skills, but three separate parts of a single way of being in the world. And when I felt they understood that, then I said to them, ''Now you are ready. Now you are not so depressed. Now you can go into the world again.'"  

But what I, afterwards, found out was that many of those women didn't want to go into the world again. They had been so transformed by their exposure to this remarkable, charismatic woman and they all said, "But we want to come back here and we want to do more things with you." And so what Phaly Nuon did was to find that there were many children who were without parents in Cambodia at that time and at this time. And she set up an orphanage which is called The Future Light Orphanage in Phnom Penh. And it's completely staffed by the women who have come through her depression treatment program. And those women volunteer there. They're not paid, but they formed a community. 

And that community of depressed women, who have worked through their depression, are supported and managed to stave off the recurrence of that depression to some large extent by remaining part of this very tight community. And it's the largest and most successful orphanage that's been established in the wake of the Khmer Rouge. And they care for all of the lost children who there are in Cambodia. And she remains this small, really rather meek, rather quiet woman. Quiet, though she can tell a good story; she should come to the next Moth. This meek, rather quiet woman who just managed to figure out, when she was in the camps and stuck with these women who were neglecting their own children, and who were suffering from such severe, such crippling, such utterly disabling depression, this is what we have to do to get them to sit up and eventually take care of not only their own children, but all the children.  

Thanks.