1 “Thinking too much” in the Central Plateau: An apprenticeship approach to treating local distress in Haiti Bonnie N. Kaiser and Kristen E. McLean Beneath the mango tree Mari ’s family took her to a local hospital when she stopped eating for several days. It was the latest episode of a recurrent illness that members of her community – a small rural town in Haiti’s Central Plateau – refer to as reflechi twòp (“thinking too much”). During such episodes, Mari often sits alone beneath a mango tree for hours on end, her chin resting on one palm, seeming distracted and far away. She often experiences headaches and trouble sleeping, and more often than not the episodes of thinking distract her from eating. Mari would not think towards a solution; she merely reflected (reflechi) on her myriad problems. Some are the same problems faced by most Haitians today: poverty, hunger, and unemployment. But for Mari, the central problem – the one that dominates her thoughts, passing through her mind repeatedly as though on a reel of film – is her husband Toma’s illness. For the past year, Toma has experienced bouts of extreme bodily pain, leaving him incapacitated, unable to work or care for his family. During a particularly bad episode, Mari and members of Toma’s extended family took him to the local clinic. It consisted of a small building with one doctor and two auxiliary nurses, a laboratory, and a small pharmacy, making it one of the better-equipped facilities in the region. Normally the journey would have taken several hours, with Toma carried on a mattress in a wheelbarrow. But considering the urgency of his condition, the neighbors scraped together enough money for a motorcycle taxi. At the clinic, the family wept audibly, as though already mourning his loss, none more so than Mari.