Kashmir: the mental price of
conflict By Sana Altaf
SRINAGAR - Maheen was nine years old when
she witnessed the death of her elder brother. At
the age of 10 she saw the dead body of her
neighbor, killed in the crossfire between Kashmiri
rebels and Indian security forces, his guts spilt
out on the road.
The incidents left Maheen
restless, irritable and insomniac, for which she
was prescribed five milligrams of Valium by a local
physician. But even in her
sleep she was haunted by the horror she had
witnessed.
Just two months later, Maheen
witnessed a bomb blast that killed five people
before her eyes. Her situation worsened when she
lost her father to cardiac arrest and witnessed
the death of a cousin, who was also caught in the
crossfire between the warring sides.
Maheen started experiencing serious panic
attacks, would sometimes become unconscious and
often relive the events that had led to her
distress. Soon, doctors at the Psychiatric
Diseases Hospital of Srinagar had diagnosed Maheen
for severe post-traumatic stress disorder (PTSD)
at the age of 15.
Though Maheen, now 26,
is still under medication, her doctor says she
often feels sad and breaks down into tears
unexpectedly. He concludes that the events in her
childhood and early adulthood are deeply etched
into her mind.
Maheen is not alone in her
plight. Twenty-three years of conflict have led to
the unprecedented growth of psychiatric disorders
in the region, particularly anxiety disorder,
panic disorder, sleep disorder, depression,
obsessive-compulsive disorder and, most commonly,
PTSD, which has impacted thousands of people in
the region.
In October 2011, a study
conducted at Sher-e-Kashmir Institute of Medical
Sciences revealed that 55% of Kashmir's population
suffers from various kinds of mental disorders.
Based on his patient population study,
psychiatrist Mushtaq Margoob says that 58% of the
population has been through some kind of mental
trauma, leaving more than 800,000 Valley-dwellers
suffering from PTSD.
Arshad Hussain, a
local psychiatrist, stressed that persistently
witnessing traumatic events like unnatural deaths,
blasts, gun battles and other violent incidents
obviously takes a severe toll on a person's mental
health.
The number of patients attending
Kashmir's sole mental health hospital has
increased from 1,200 in 1989 to 100,000 in 2011.
The Out Patients Department of Psychiatry at Shri
Maharaja Hari Singh hospital in Srinagar, which
was founded in 2008, receives an average of
150-200 patients a day, most of them young boys
and girls.
Although no comprehensive study
on children's mental health has been conducted in
Kashmir, Hussain believes, "The conflict has
undoubtedly given rise to [an unprecedented rate
of] psychiatric disorders among children in
Kashmir," with PTSD being most prevalent.
Hussain described a four-year-old girl who
went "completely numb for months after witnessing
a gun battle between troops and militants in her
own house."
"The effect of witnessing a
bomb blast or seeing a dead body is much more
[taxing] on children than on adults," he said.
"Adults have [the capacity] to reason it out -
children don't."
The problem is
particularly grave amongst children living in
orphanages, which, doctors say, are breeding
grounds for psychiatric disorders.
A
research report [1] on the prevalence of disorders
among children in Kashmir's orphanages, undertaken
by a host of local medical practitioners, found
that just over 40% of all orphans aged between
five and 12 years suffer from PTSD, followed by
major depressive disorder (MDD), which has been
diagnosed in 25% of all orphans.
Conversion disorder is present in 12.5% of
orphaned children, panic disorder in 9.38%,
attention deficit hyperkinetic disorder (ADHD) in
6.25% and seizure disorder in 6.2% . Margoob, who
collaborated on the study, explained that
orphanages only provide children with their basic
physical needs like food, clothing and shelter,
while neglecting their psychological and emotional
health.
"If a particular child is good at
painting or sports, their talent remains
unexplored, thereby negatively affecting the
child's mental and intellectual development,"
Margoob said.
Like children, the female
population has been severely affected by violence
and bloodshed in the region.
Records from
the Psychiatric Diseases Hospital reveal that 15%
of women are suffering from prolonged trauma and
stress manifesting in symptoms such as frequent
palpitations, lack of interest or motivation,
sleep disorders and appetite loss.
A full
70-80% of all cases of acute depression are women,
16% of whom have PTSD. Many of these women are
either widows or the wives of disappeared husbands
- referred to in the region as "half widows" - who
are commonly diagnosed with anxiety, stress,
irrational fear, depression, PTSD and various
phobias.
Despite the growing incidence of
mental disorders, Kashmir has only one official
institution dedicated to psychiatric care, located
in Srinagar. Two local general hospitals are
equipped with an "out patients department" for
psychiatry. No facilities are available at
district level. People from far flung areas are
forced to travel to Srinagar for treatment. Not a
single department capable of tackling the issue of
child psychiatry exists in the region.
Sociologist point out that conflict has
cast a dark shroud over Kashmir under which scores
of people suffer from severe depression, tension,
suicidal tendencies and, often, extreme isolation
and loneliness.
Mental disorders have also
taken their toll on society as a whole, straining
everything from familial relationships to
student-teacher dynamics, said B A Dabla, a
sociologist at the University of Kashmir.
Besides a lack of facilities, he told IPS,
social taboos restrict people from seeking
treatment for their conditions.
"A large
number of people do not turn up for treatment and
live with their illness. Only a very small number
of people receive treatment at all," he said.
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