Mental illness among Pakhtuns increases
By Ashfaq Yusufzai
For CentralAsiaOnline.com
2010-06-03
PESHAWAR -- Militancy is taking a psychological toll on the dwellers of violence-wracked Malakand and the Federally Administered Tribal Areas (FATA).
Psychiatrist Mian Iftikhar Hussain at the Sarhad Hospital for Psychiatric Diseases (SHPD) attributes psychiatric problems in militancy-wracked areas to fear, stress, coping with the murders of family and friends, and seeing mutilated bodies after terrorist attacks.
Last year, the SHPD recorded about 97,000 psychiatric cases from FATA, Swat, Tank, Hangu, Darra Adamkhel and other areas hit by violence. This year so far, the number is about 22,000, including women and children who suffer from severe post-traumatic stress disorder (PTSD), he said.
“The Taliban killed my only son because he belonged to the Awami National Party. Now I am helpless”, Mushtari Begum, a widow from Buner, one of the 24 districts in Khyber Pakhtunkhwa, told Central Asia Online.
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| A Pakistani man suffering mental health problems receives anti-depressant drops at a makeshift medical centre in this 2005 file photo. Many Pakistanis in Swat, North and South Waziristan, and other conflict areas are battling post-traumatic stress disorder and other psychological problems brought on by terrorism. [ARIF ALI/AFP/Getty Images] |
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She suffers from PTSD and has taken antidepressants for years, said her doctor.
“I see my son the moment I fall asleep. He is in paradise and is inviting me every night because he feels lonely without me”, the 55-year-old housewife told her doctor.
Last month, the World Health Organisation (WHO) called for immediate measures to address the psychological problems as internally displaced persons (IDPs) are repatriated. A report released by the global health agency said most of the IDPs "suffered from various forms of mental distress". Mentally disabled children, who lack the specialised care that can prevent problems from snowballing into major health concerns, are most vulnerable. But women and children in general are a concern, the report found.
About 4% of the population suffer from severe psychiatric disorders , the WHO said, but "A much larger portion of the population suffers from transient mental health problems linked to the stress of living under conditions of conflict and violence".
The WHO has recommended management of urgent psychiatric conditions at the primary health care level, including referral to psychiatric hospitals and continued treatment of chronic psychiatric patients. Victims of severe mental traumas due to the conflict and subsequent displacement should receive psychological support, it suggested.
Disabled persons and victims of violence remained disadvantaged during distribution of humanitarian assistance, especially food, and were more susceptible to mental health problems, Prof Mohammad Shafiq, a senior psychiatrist in Mardan, told Central Asia Online.
“I had several orchards destroyed by militants. During the army operation, we stayed in Mardan district as IDPs, where we queued for food and other essential items”, Gul Jamal, a farmer from Swat at Shafiq’s clinic, said. He said the Taliban turned him from an aid contributor into an aid recipient. Now the farmer needs psychological support to restore his confidence, Shafiq said.
The provincial health department in its post-conflict rapid assessment in Swat revealed that 27 of the valley's 228 health facilities were destroyed, while 54 suffered partial damage that will cost an estimated Rs 1.2 billion (US $14m) to fix.
“This has put the population in a precarious situation because it needed urgent treatment … particularly for mental ailments”, the assessment said.
Just Peace International (JPI), an NGO that ran a project with the financial assistance of the Greek-based charity European Union Perspective, said about 85% of the displaced population living with host communities had experienced problems, since they lost their social identities when they had to leave their homes.
"The people of the conflict areas are exposed to high levels of violence", said Dr Imdad Bashir, a consulting psychiatrist with JPI. "We have so far seen 255 patients, including 177 women".
Anxiety and mistrust are common among conflict-zone residents, Bashir said. Every third person in South and North Waziristan, Bajaur and Swat suffers from depression and many women and children complain of recurring nightmares of blood-splattered bodies and homeless families living in destitution, he said.
“We are providing psychological support and medication to victims of violence in two clinics, one each based in Batkhela and Peshawar”, Bashir said.
A 12-year-old girl brought to the psychiatry ward was suffering from anxiety and fear, Dr Jawad Ali, a psychiatrist at the Khyber Teaching Hospital Peshawar said. She had witnessed a suicide bomb blast.
"The problem is most of the patients face relapses", Ali said. Victims of violence need regular psychological services, counselling and treatment to help them overcome the trauma.
The doctors cannot reach everyone, though, and part of that is society’s fault. "People do not consider (mental) trauma a health concern", Ali said.
Also, patients have shunned the JPI clinic in Batkhela out of fear of militants, Bashir said, explaining JPI was planning to establish free psychiatric clinics in other conflict zones.
"But we plan to have workshops in the violence-prone areas when law and order improves”, he said. “Now, people aren't consulting psychiatrists because of the social stigma. So (better) public awareness is needed".
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