Trauma Of Daily Violence
In Jammu And Kashmir
Telling Upon Mental HealthBy Syed Junaid Hashmi
20 June, 2007
Countercurrents.orgRavaged by conflict, traumatized by lack of accountability and strangled by social taboos, people in Jammu and Kashmiri have been both witness to and victims of violence which has had a significant effect on their mental health. While a sustainable political solution to "K" problem seems far away, psychological wounds inflicted by violence and impunity on the Kashmiri society continue to increase and go well beyond socio-economic problems.
Studies and survey's conducted by various reputed organizations and institutes have confirmed that Psychological problems have been increasing in Jammu and Kashmir. According to one survey conducted by state mental health society (SMHS), around 80,000 people from Kashmir valley visited various mental health professionals during the year 2005-2006 and nearly three-fourths were diagnosed with serious psychological disorders. This represents an over twenty percent increase from 2005 and reveals that the emotional and mental damage caused by the conflict continues to surge.
A survey report on Jammu and Kashmir by a Holland-based humanitarian group M‚decins Sans FrontiŠres (MSF) maintains that a third of its respondents suffered from psychological distress. Nearly one in 10 people reported having lost one or more members of their immediate family due to violence in the period from 1989-2005. The survey reported that almost half ( 48.1%) of the respondents said they felt only occasionally or never safe.
It also indicated that violence or the threat of physical violence seems to have had a significant effect on the mental health of people. It revealed that respondents suffered from high levels of anxiety such as nervousness, tension and extensive worrying.
The survey stated that a substantial number of people interviewed by them admitted to having thoughts about ending their life (33.9%). "Such a high percentage of suicidal tendencies within a population holding strong religious beliefs that condemn the act of suicide, is a worrying indicator of the level of despair and hopelessness in which people in Jammu and Kashmir are living," stressed a neurologist.
The survey also indicated high rates of physical complaints including headaches (23.5%), body pains such as joint and back complaints (20.5%), and abdominal complaints (16.9%). It reported that poor health placed a substantial burden on the area's health facilities, with most people saying they visit health clinics frequently ( 63.9%); some even four times or more. Medicine consumption was also high, with over one-third taking six or more medicines in the previous 30 days (37.9%).
According to MSF, Interviewees reported witnessing (73.3%) and directly experiencing themselves ( 44.1%), physical and psychological mistreatment, such as humiliation and threats thus causing extensive damage to their psychological health. A shocking finding of the survey was that torture appeared to be widespread suggesting that a strategy of intimidation and fear has been employed by army and paramilitary forces.
Maintaining that sexual violence has impinged upon the mental health of people in Jammu and Kashmir more than physical violence, the survey reported that sexual violence has been used as a common strategy to intimidate people in conflict. 11.6% of interviewees said they had been victims of sexual violence since 1989. Almost two-thirds of the people interviewed (63.9%) by MSF had heard over a similar period about cases of rape, while one in seven had witnessed rape.
The worst hit have been the children among whom the major effect of the violence reported in this survey has been fear (24.6%). School-related problems also scored highly, such as being unable to attend school (15.5%) and having problems studying ( 16.3%) due to the lack of professional teachers and study material.Respondents told the surveyors that people deal with stress by isolating themselves (22.3%) or becoming aggressive (16%). They further informed them that talking confidentially to someone they trust is helpful when confronted with tension ( 89.4%). It is essentially this survey which brought out the real picture of the mental health of people in Jammu and Kashmir. The findings of the survey revealed a bleak picture of the mental health of people in the conflict-afflicted region and raised important questions about the government's failure to adequately provide mental health services to the population.
Overburdened, understaffed, and in-demand, this is the state of mental health care in Kashmir. The Psychiatric Diseases Hospital at Kaathi Darwaza is the only refuge for mental patients in Kashmir, and its doctors, facilities, and supplies have long been grossly inadequate. According to one report, records from the out-patient department (OPD) of Srinagar's Hospital for Psychiatric Diseases show that more than 300 people arrive every day.
It stated that most self-admitting patients are women aged between 16 to 25. Because of the social stigma associated with psychological disorders, doctors believe that no more than 10 percent of those in need of psychiatric care are actually approaching the hospital. One outcome of this under-treated trauma is an increase in teenage girl suicides.
According to another report published in a local daily, 19-year-old Jameela witnessed her aunt being killed while working in the kitchen and later also witnessed a shootout in her locality. With no history of psychiatric problems, she began suffering from post-traumatic stress disorders: recurrent, intrusive and distressing recollection of the events, marked irritability, outbursts of anger, difficulty in concentrating, sleeplessness, sadness, and disinterest in all social, domestic and college activities. Following a minor altercation with her sister, she consumed pesticide and ended her life.
A statistical report of the state health and medical education department revealed that on an average, two to three cases of attempted suicide are admitted into Srinagar's two main hospitals on regular basis. A large number of people from the villages die on the way or in local health centers.
Psychologists maintain that people living at a place ravaged by conflict are often faced with a number of Psychological problems. They say that the physical environment in which people live and survive has a direct bearing on their mental health. "Stress caused by feelings of insecurity and dependency can deplete physical and psychological buoyancy leading to varied mental problems, this has happened in most of the cases in Jammu and Kashmir," said Dr.Adarsh Bhargav He maintained that crackdowns, frisking by security forces and round-up raids in villages have a deep impact on the mental health of the people. "When you find yourself in the middle of a situation where your movement gets restricted, where you have to follow orders, where you are abused and humiliated, where your imaginations fail to take a flight and where your identity always remains a suspect, you are bound to suffer from Psychological disorders," added the young practicing Psychologist.
A young neurologist Dr.Nida who is presently doing her masters from a reputed institute in Delhi maintained that since 1990, the number of mental patients in Kashmir Valley have increased from 1500 to nearly 1 Lakh in 2006.
"Around 60 to 70 percent of these patients are suffering from depression, bipolar disorder or schizophrenia; all of these disorders are of serious nature, apart from these problems, there are many other psychological complications associated with violence which can be easily noticed among the people in Kashmir valley," added Dr.Nida.
She maintained that situation has come to a stage where people feel so unsafe that they prefer staying in hospital than going home. Increasing psychological and neurological problems among the people in Jammu and Kashmir begs further discussion of the continuing situation of impunity in Kashmir for those who perpetrate acts of terror and violence without any fear of being caught and held accountable. Until this atmosphere of impunity is not addressed, psychological problems are bound to increase.
Writer is a journalist, presently working with jammu and kashmir's largest circulated daily and highly reputed daily "The Kashmir Times". He can be contacted at [email protected]
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