Between 2007 and 2008, the People's Rural Development Association (PRDA), with support from Oxfam and McGill University's Trauma and Global Health Program, carried out a study to examine how three communities in Sri Lanka were recovering their sense of well-being in the wake of disasters.

Elizabeth Stevens writes regularly about humanitarian emergencies for Oxfam America and Oxfam International. She recently wrote "Collaboration in Crises: Lessons in community participation from the Oxfam International tsunami research program," a summary report on studies carried out by Oxfam partner organisations in India and Sri Lanka from 2005-2008.

Like a gift from a distant relative whose good intentions don't involve actually getting to know you, humanitarian aid can miss the mark. The charitable gesture by the giver becomes the hat you wouldn't wear in a million years or, in the case of disaster survivors, the house that drives you crazy.

There is more to helping communities recover from disasters than largesse, just as there is more to mental health than popping pills; both were themes of a new study by the People's Rural Development Association (PRDA) on community well-being in Sri Lanka.

Chamindra Weerackody, who conceived and led the study, grew up in rural Sri Lanka. After the tsunami of 2004, he watched with dismay as aid workers trooped into villages offering an array of psychosocial programmes that completely disregarded local customs, values and relationships. From New Age therapies to hard-core psychiatric drug treatments, the programmes had one thing in common: an outsider's point of view.

Mental health workers weren't the only ones who were scarily out of touch with local perspectives. Weerackody points to a newly built settlement perched on the side of a hill in Hambantota district.

The houses are so close together that neighbours are getting on each others' nerves, and women don't have enough space to carry out their traditional work of spinning coconut fibre into yarn. The location is far from the community's temple, school and fishing boats. And whatever solid waste system the aid provider who built this place had in mind, it isn't working.

But when it comes to peace of mind, the knock-out blow is this: the kitchens are designed in a way that is thought to bring bad luck.

"The way that these people are settled at the moment in their houses, it is very difficult for them to recover," he says. "They may continue to live in unhappiness."

Seeking a peaceful mind

A perspective that was often lacking in the tsunami aid response, says Weerackody, was that of community well-being. Aid providers who were focused on maximising their speed and outputs (like the number of fishing boats delivered and houses built) often paid little attention to the psychological impact of their work on the communities. Psychosocial workers wore a different set of blinders: most were steeped in a western model of mental health that focuses on individuals - a concept that doesn't translate well to tight-knit Sri Lankan communities.

"At the core of the rural village is social and economic interdependence," says Weerackody. In this context, "If you want individual well-being, you have to improve community well-being."

What constitutes well-being? Weerackody left that to each community to decide. Groups of women, men, children and youth were given a chance to define their criteria for happiness, rank them in order of importance, and then articulate how they felt their communities were progressing or deteriorating over time.

Their choices were surprising, with social and mental health concerns like "living in harmony with neighbours," and "having a peaceful mind" in many cases trumping what we think of as the basics for survival, like secure shelter and nutritious food. So much for making assumptions.

We're all psychosocial workers

What are some of the implications of the research for aid providers?

Firstly, every aid provider is a psychosocial worker in disguise: "When designing interventions, aid workers should look at how they will improve people's happiness and social cohesion," Weerackody says. "Every intervention should look at the psychosocial aspects."

Secondly, psychosocial workers should advocate for aid that contributes to the well-being not just of individuals, but of communities as a whole. As he puts it, "You cannot separate psychological concerns from material and social concerns."

Thirdly, if you want to measure the success of an aid programme, consider using the communities' criteria - not just your own.

And lastly, to learn about what communities care about most, you must take the time to listen well.

Listening is the crux of the matter. Without it, you can build someone a house, but with it, perhaps you can help build a home, a better living, a stronger community, and a recovery.

For more information on the research, please visit www.oxfamamerica.org/fieldstudies.

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