Mitt Meets the Brits

London gets a crash course in the 2012 election.

LONDON — The U.S. presidential contest usually attracts a great deal of interest around the world, especially in Britain. But until this week, that interest had yet to ignite. To be fair, the 2008 race was hard to top as a spectacle value, featuring two potential historic candidates on the Democratic side and the advent of Tea Party dynamo Sarah Palin. But it has still been striking how little interest the Barack Obama-Mitt Romney contest has sparked here in Old Europe. This has changed in a hurry with Romney's arrival in London this week.

The day before Romney's visit, Fleet Street started to take interest. The left-leaning Guardian said Romney is under pressure to define his foreign policy, while the right-of-center Daily Telegraph quoted an anonymous advisor promising Romney would abandon Obama's "coolness" towards London. The unnamed aide also caused a bit of a dust-up by promising to restore the "Anglo-Saxon" relations between the two countries -- a  phrase loaded when discussing a president whose Kenyan family lived under British colonialism. Romney may also have offended his hosts by suggesting that Britain may not be quite up to the task of hosting the Olympics, telling reporters before a meeting with Prime Minister David Cameron that reports of strikes and trouble with private security firms were "not something which is encouraging." London's voluble mayor Boris Johnson even took to the streets, telling a London crowd, 'There's a guy called Mitt Romney who wants to know whether we are ready. Are we ready? Yes we are!'

Romney remains something of an unknown quantity in Britain. Like many U.S. presidential challengers, the former Massachusetts governor is a neophyte on foreign affairs. And his visits to what his advisors are calling three key allies -- Britain, Israel and Poland -- are an attempt to burnish his international credentials with hosts who are guaranteed  not to embarrass him and give him a polite, warm reception. The timing of the London stop has the added benefit of invoking Romney's successful management of the 2002 Salt Lake City Olympics. So, as the British public finally begins to tune in to the great race across the pond, what do they see?

With the possible exception of George W. Bush in 2004, presidential incumbents have had a built-in advantage with Britons, as the old maxim "better the devil you know" tends to apply to foreign governments and media. This goes double for Obama: When he came into office three and a half years ago, he had an extraordinarily high approval rating abroad. Most British papers -- even the conservative ones -- greeted his 2008 win as historic. The Guardian fulsomely praised the result, writing at the time, "[T]he American people yesterday stood in the eye of history and made an emphatic choice for change for themselves and the world."

But Obama's primary advantage back then -- not being Bush -- has lost some of its effectiveness this time around. The most recent Pew Global Attitudes survey, published last month, shows that approval of the president's policies is declining in most of the world. The fall has been most pronounced in China and in Muslim countries, but there have also been significant drops in Europe and Japan, where confidence in him as an individual remains relatively robust. In Britain, opposition to drone strikes against terrorist suspects outweighs support, and approval of the United States generally, though still higher than under Bush, is down from Obama's early days.

For much of the British press, Obama got off to a bumpy start because of his decision to give back -- or not renew the loan of -- the Winston Churchill bust lent to the White House after 9/11. Many commentators chose to interpret this as a sign of anti-British sentiment from the half-Kenyan president, and the Daily Telegraph took to publishing an annual list of Obama's top 10 insults against Britain (if you're wondering, No. 1 so far for 2012 is "Siding with Argentina over the Falklands"). Still, Cameron has been keen to cultivate good relations. When the Obamas came on a state visit last year, for instance, it was all smiles, and they even joined together in hosting a barbecue for British servicemen in the garden of No. 10 Downing St. And on Cameron's return visit to the United States this year, the two men were shown sharing jokes and enjoying each other's company at a basketball game in Ohio.

Obama's personal ratings remain high with the British, but there is a general sense that he is a conventional politician who finds governing a lot more difficult than campaigning. Given the sky-high expectations that accompanied him into office, a return to Earth was probably inevitable.

But what of Romney? When it comes to the Republican candidate, there is no record on which to assess the popularity of his foreign policies, but there has been some coverage of his statements and ideas as well as his team of advisors in the British media.

When Romney unveiled his lineup of national security and foreign policy advisors, it included a number of retreads from the Bush administration, provoking comment that Romney had been captured by unilateralist hawks and neoconservatives. This impression was only reinforced at the beginning of the year when former U.N. ambassador John Bolton joined the Romney campaign.

Many abroad saw this as a sign that the candidate was trying to shore up his support with the Republican right at home. But it also scared the pigeons, especially in more multilateralist Europe. Given Bolton's well-known criticisms of a diplomatic approach to resolving the Iran nuclear dispute, and given that Romney has criticized Obama for failing to support Israel more strongly, there are concerns -- so far expressed informally -- that a Romney presidency could increase the risk of another major conflict in the Middle East.

There have been reports that the British military is making contingency plans supporting a U.S. military operation against Iran, but there is no great enthusiasm in London for such action. Following the NATO intervention in Libya, where Britain and France seemed keener on action than the United States, British officials have been working closely with their U.S. counterparts on Syria and have responded well to Obama's reluctance to go it alone. So if Romney means what he says about reasserting American primacy, he may find that does not go down so well in London.

Romney's identification of Russia as America's "No. 1 geopolitical foe" also raised eyebrows abroad. At a recent high-level seminar on Russian foreign policy in London, there was some bafflement expressed as to what he was on about. Although Russia is a BRIC, as former British Foreign Secretary Douglas Hurd put it on the BBC, Moscow "is in the lift going down," while the so-called emerging economies are going up. The almost universal consensus in Europe is that China, not Russia, poses the greatest geopolitical challenge to the United States.

The three stops on Romney's foreign tour also suggest a backward-looking vision. London may be a key ally, but is not a rising power. Poland is good place to go to ensure a friendly reception to his message that his opponent has been weak on Russia, but Moscow is not a global challenger to Washington anymore. Israel is both an obvious choice to ensure support from the right in his own party and a safe one, given the strained relations between Obama and Israeli Prime Minister Benjamin Netanyahu. But what of the new powers that have emerged on the global stage since the turn of the century: India, China, Brazil, or even Turkey?

Perhaps a trip to one of these would have been too risky. But many outside the United States are expecting Romney to acknowledge at some point in the campaign that he gets that the world is changing and that America has to work with others to get things done. And while it is true that informed British observers of U.S. presidential campaigns discount much of the foreign-policy rhetoric they hear, they do expect candidates for one of the most powerful posts in global politics to demonstrate that they have answers to the challenges the world faces.

Romney could score points with Europeans, including the British, by reassuring them that the inevitable future U.S. focus on Asia does not mean turning away from Europe. The candidate's London stop may not be off to the smoothest start. But if Romney really regards the relationship with London as "special," as one of his advisors told a British journalist, that will go down well with a people who still attach huge importance to being close to Washington and to being seen by other countries to be so.


Democracy Lab

A Country with Fourteen Psychiatrists

Libya is trying to build a new democracy. But that's a tall order for a society plagued by bad memories.

The sun-baked streets of Misrata have a semblance of normality these days. The city's main drag, Tripoli Street, the site of weeks of brutal urban warfare a year ago, is still broken and bullet-scarred, but below the pocked facades of the buildings are shops and fast food joints. There are carloads of families on the roads and a gentle hum of activity amid the summer heat.

But at the center of town, there's an eerie exhibit, a makeshift museum to the days of war. Televisions bombard visitors with a continuous montage of the worst horrors of the conflict: Young men cut down by bullets on wobbly phone camera footage, the bodies of wounded children and babies shown in gruesome close-ups. The walls are papered with passport-style photos of the 1,500 people who died inside the city or fighting for it on the frontlines nearby. The man at the desk doesn't ask for tickets; instead he shows visitors the goriest pictures he can find of the wounded and dying in last year's war.

It's a reminder of the ghosts that continue to haunt Libya even as it struggles to move into a new era. Earlier this month, many of the country's citizens drew hope from their first free elections in over four decades. Yet painful memories are reverberating. Many Libyans appear to be caught between a desire to forget and an obsessive need to remember and revisit the bloodshed of the past year. For some, there is little choice.

"Imagine a ten-year-old who can tell the difference between a bullet from an AK, a tank, and a sniper," says Ali Shenaba, the founder and manager of the museum. He points to a photograph showing four small children, two boys and two girls. They were his neighbors' children, killed by tank fire as the family tried to flee the fighting raging around their home on this street. "Every time you see the house, you remember those kids," he says.

Dr. Mustafa Al Shagmani, a clinical psychologist educated at Rennes University in France, leads a team of 24 mental health specialists in the city. In the past three months they have treated around 700 patients, ages two to eighty.

He says that a recent World Health Organization (WHO) study found that 21,000 out of the city's population of 250,000 were suffering from psychological trauma. Misrata is believed to be one of the worst affected areas in the country.

"We have neurosis, anxiety, OCD [obsessive compulsive disorder], physical symptoms like diarrhea. Children are some of the worst affected," he said. Al Shagmani explains that young people, especially those who have lost parents, are struggling at school, fighting with classmates, or showing listlessness or an inability to concentrate.

It's difficult to know how long the psychological effects of the conflict will last -- or the extent of the population that has been affected. The country lacks the resources for diagnosing, much less treating, mental health problems.

The Deputy Minister of Health, Adel Mohamed Abushoffa, describes the lack of resources as critical. "We have a real shortage of psychiatrists. We currently have just fourteen in the whole country," he told the WHO. Libya currently has a population of around 6.4 million, according to the World Bank.

"Not a lot of time or resources were devoted to mental health under the Qaddafi regime," explains Inka Weissbecker, global mental health advisor for the International Medical Corps, who worked in Libya last year. "People couldn't access care. It was very stigmatized. Even if they were very ill they might not go to the hospital. Mental health problems were a very private thing."

In some instances, she says, families with relatives suffering from severe mental health problems have dealt with it by locking them in their rooms.

"It's very shameful to admit to symptoms because people believe it's a sign of weakness," confirms Dr. Omar Reda, a Libyan-born psychiatrist practicing in Portland, Oregon, who is the temporary Mental Health Coordinator in Libya. "Maybe you don't pray enough, maybe you are a weak Muslim, maybe you are affected by the evil eye. We try to explain that these are normal responses to an abnormal situation."

It seems likely that the collective trauma among Libyans will have an impact on their efforts to build a new, democratic, post-Qaddafi state. But it's also impossible to predict what the effects will be.

According to Stanford University psychiatry professor Daryn Reicherter, while scientists now understand a great deal about post-traumatic stress in individual cases, they have yet to understand precisely how widespread experiences of trauma affect societies that are emerging from periods of mass violence. "This is an important social issue, and it has been ignored in the past," says Reicherter. "And I believe the reason it's been ignored is because of the great stigma of mental illness." Still, he adds, it's clear enough that the impact can't be good: "It's got to affect the functioning of the social fabric."

Majdi Al Shadeed, a 27-year-old former rebel fighter, has struggled since the war. His problems include the classic symptoms of post-traumatic stress disorder (PTSD): debilitating insomnia, nightmares, and regular flashbacks to the faces of the two men he killed during the fighting.

He struggles with his short-term memory and attention. He's lost three phones this month and his laptop computer twice in the month before. A job working for an international company was challenging. He now works as a security guard. Nonetheless, he hasn't sought help for his problems. "It's easier to forget," he shrugs.

Al Shadeed faces an additional problem. As a member of a generally pro-Qaddafi tribe, he faces the opprobrium of relatives and neighbors. He was ostracized in his hometown, but was then covertly approached by relatives seeking help to recover the bodies of dead Qaddafi loyalists he had fought. It was an impossible task, but the requests left him distressed and deeply confused.

The fault line between the two sides in the conflict remains. This is a society where the war's victors and defeated live in uneasy proximity.

"It's important to be inclusive of all elements of society, [including] people who were Qaddafi supporters or thought to be Qaddafi supporters," says Inka Weissbecker. "A lot of them are suffering and need help."

Dr. Al Shagmani has been working with regime soldiers who are now prisoners, and he's seen the same symptoms there. "They have the same kind of problems." He argues that many loyalists must also deal with a further problem: guilt.

But for many in the towns that supported Qaddafi, there's little likelihood of receiving professional psychological support. There are logistical reasons for this. Facilities are concentrated in the country's two largest cities, Tripoli and Benghazi, where the country's two psychiatric hospitals are. There's also little willingness to reward those who many continue to see as their enemies.

In May, aid organizations were expelled from the city of Sirte, which witnessed a brutal siege in the final days of the war when Qaddafi made his final stand there. The towns scattered across the Nafusa mountain range south of Tripoli also saw heavy fighting and continuing tribal clashes, but according to Dr. Reda, there's just one mental health specialist to look after all 600,000 of the people living there.

With formal facilities in short supply, some people, especially veterans, are turning to their own methods of numbing the pain. "They're self-medicating," explains Dr. Najid Assaid, a Benghazi-based psychiatrist. "People use hash, cannabis, alcohol."

Other doctors also warn of widespread abuse of illegal and prescription drugs by traumatized veterans. "We are seeing more and more people on the streets," says Dr. Reda. "They are fighting because they are intoxicated. People at the checkpoints are using lots of drugs. That's a bad combination -- and a dangerous one."

It also complicates treatment. Alcohol is illegal in Libya and its consumption a taboo topic. "Many of these young boys are dealing with a double stigma," Dr. Reda explains. "They are having to hide the symptoms of PTSD -- anger, nightmares -- and then hiding their alcohol problems. They find a country that does not help and families that don't understand them."

Mental health experts say that the trauma of the war will eventually recede for the vast majority. Many are confident that Libya will improve its mental health facilities. "I think there is a real momentum right now in Libya around mental health," says Inka Weissbecker.

But for the moment, many of the fighters remain lost and angry. Some feel excluded from the new political order that they fought to bring into existence.

"We feel like strangers," said Abdul Hadi Oweinat, a 25-year-old fighter from the Tripoli brigade. "We're the ones that started it and we feel like strangers." He thinks that many of the people who ran in the elections were close to Qaddafi. "My life used to be better than it is now. Before the revolution, I knew who my enemies were."