October 10 is observed as World Mental Health Day to raise awareness about mental health issues. Depression is set to become the biggest health problem by 2020 and one of the critical areas of concern remains mental health in conflict and post conflict situations.
The biggest issue in conflict studies is the conflict of data which is a result of extremely poor documentation, based almost entirely on reports by security agencies or the media. But one aspect of conflict which doesn’t require data is that people living and working in hostile environment are invisible victims of trauma.
From ethnic and communal violence to several insurrections across the country, millions suffer from stress disorders and poor mental health which go largely unrecorded and under reported. The scale of violence and the impact of the same are almost impossible to comprehend.
There is another population which is growing at frenetic pace: Internally Displaced People (IDP). The United Nations claims that more people are refugees or internally displaced today than at any time since 1994. The Syrian crisis of course has assumed emergency proportions. But a UNHCR report finds that 80 percent of world’s refugees are from developing countries. India according to the report has 506,000 internally displaced people. Based on my own experiences, my estimate is that the number is several times higher. Most of these people are forced out of their homes because of ethnic or separatist violence. In many cases the displaced are not rehabilitated; they either languish in refugee camps or seek occupation elsewhere and therefore are not accounted for.
The insurgent movements in India are as old as the nation itself. There are no official estimates of the number of people that may have been affected which includes residents, employees deputed to work in those places, care givers, security agencies and media persons. Demographics of armed violence are often described in gender stereotypes; men being more likely to be killed while women are affected in other ways. But women are as vulnerable to sexual abuse which spikes in conflict zones. Women are tortured in various ways also called ‘femicide’; widowed women with land holding often become targets of ‘witch hunting’ and these areas serve as source areas for trafficking of young girls. Children from single parent households are recruited as child soldiers and hundreds and thousands of people live immobilized due to injuries suffered in conflict.
The impact on victims of forced displacement and conflict survivors can be psychologically debilitating leading to anxiety, depression and post-traumatic stress disorder. The aid workers, security personnel and media persons too suffer from disorders, which sometimes go undiagnosed. The symptoms are not easily identifiable but can impair their functioning.
There are trauma centers in other parts of the world but in India mental health care in conflict zones is rare. The first instance where the government moved in quickly was in 2003 when the ULFA (United Liberation Front of Assam) blew up children during Independence Day parade in Assam’s Dhemaji town. Abdul Kalam, the then President of India, sent in a team of doctors for post traumatic treatment but that effort was temporary in nature.
There have been some efforts in other states too but the outreach has been disappointing. In Manipur widows of conflict have come together to help each other but there is hardly any external support. Most survivors are forgotten and forsaken. Five years after surviving the October 2008 explosion in Guwahati, Naren Tumung’s memory loss is improving but his left hand and leg are still paralysed. The government compensation fund has been exhausted though he still needs urgent medical attention. Naren, an auto rickshaw driver, has lost his livelihood and may not be able to get back to work soon. The example of Naren shows how people with disabilities before conflict as well as post conflict have compounded challenges due to the hostile situation in which they live.
Like many other issues this too is not one which is a media favourite. Even before competing priorities and budget shortfalls reduced media coverage to studio discussions, mental health related to conflict and post conflict have rarely featured in edit meetings. But awareness, advocacy and reportage of the state of mental health may help survivors heal and rebuild lives.