Psychological elements of displacement

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What IDPs really go through

 

 

 

The militancy and the military operations in FATA have caused massive damage not only to the region’s infrastructure and economy but also to the human element, both socially and psychologically. However, the Pakistani military operations and the US drone strikes in the region have compelled the inhabitants to flee the area and seek refuge elsewhere.

Since 2004, a large number of people in FATA have suffered from debilitating psychological effects of armed conflict. According to the American Academy of Clinical Psychiatrists, mass trauma such as wars, armed conflicts, acts of terror, political violence and torture affect millions of people around the world. Mass trauma events pose a major challenge for the mental health sphere and sadly there seems to be no suitable model for effective, timely and affordable care for addressing the psychological needs of mass trauma survivors especially in Pakistan.

This can be viewed presently in FATA where the people of North Waziristan have been displaced due to the military operation Zarb-e-Azb which started on June 15th, 2014. This military operation has driven a large scale displacement to neighbouring districts such as Bannu, Lakki Marwat, Karak, Dera Ismail Khan, and Kohat respectively in Khyber Paktunkhwa province. According to the FATA Disaster Management Authority (FDMA), a total of 455,000 internally displaced persons have been reported which have reportedly taken refuge in the neighbouring regions mentioned above. It is also estimated according to the (FDMA) that 74 per cent of the IDP’s are women and children and it is evident that mostly women and children suffer from psychological trauma caused by the displacement.

 

A common theme that had been emerging over the past in respect to the psychological symptoms of the FATA population are posttraumatic stress disorder (PTSD), depression, anxiety, insomnia, eating disorders, suicide ideation, avoidant behaviours, etc.

 

The military operations had a deep impact on the displaced persons of FATA. The constant exposure, witnessing such violence and now the displacement has given rise to many psychological problems leading to several serious mental illnesses. Extreme exposure to the horrendous sounds of canon shelling and firing on the militant hideouts had already been traumatising for the population and the fact that they had to be displaced resulted in adverse psychological impact and trauma. The displaced persons have high rates of mental health issues due to migration, often associated with painful transit experiences, difficult camp life and the experience of major trauma including multiple losses of family members as well as loss of property and standard of living.

A common theme that had been emerging over the past in respect to the psychological symptoms of the FATA population are posttraumatic stress disorder (PTSD), depression, anxiety, insomnia, eating disorders, suicide ideation, avoidant behaviours, etc. Feelings of despair, helplessness, insecurity, fear and stress are commonly seen also among the people of an unstable region.

According to the American Academy of Clinical Psychiatrists, it is significant to note that war trauma is not a single stressor, but a prolonged trauma period of stressors starting with the initial major shock followed by hundreds of aftershocks that may last for a considerable period of time. The chief psychiatric consequences of mass traumas are posttraumatic stress disorder (PTSD) and depression. These are clearly evident among the FATA population. An international organisation, CARE, states that 70 per cent of the displaced persons suffer from post traumatic stress disorder especially women and children. Studies investigating the psychological consequences on children, living in conflict zones have shown increased rates of mental illness in traumatised children, especially PTSD and depression. Majority of the children displaced were aged three months to eleven years making them more vulnerable to other psychological problems like separation anxiety, phobias, fear, stress, nightmares, withdrawal symptoms, insomnia, and developmental delays.

The diagnostic and statistical manual of mental disorders (DSM-5) defines PTSD as exposure to actual or threatened death, serious injury or sexual violation from one or more than one of the following scenarios: directly experiences the traumatic event, witnesses the traumatic event in person, learned that the traumatic event occurred to a close family member or a closed friend, experiences first hand repeated or extreme exposure to aversive details of the traumatic event. The disturbance, regardless of its trigger, causes clinically significant distress or impairment in the individual’s social interaction, capacity to work or other important areas of functioning.

 

The displacement as a result of military operation caused more psychological damage and trauma to the residents of FATA and made them more vulnerable to mental illnesses such as PTSD, depression, anxiety, insomnia, hyper-arousal and hyper-vigilant symptoms.

 

The displacement as a result of military operation caused more psychological damage and trauma to the residents of FATA and made them more vulnerable to mental illnesses such as PTSD, depression, anxiety, insomnia, hyper-arousal and hyper-vigilant symptoms.

It is inferred that significant morbidity in this situation is associated with three components: pre migration trauma, torture experiences during the migration and post migration influences contributing to posttraumatic stress symptoms. The inhabitants of FATA were living under harsh conditions before migration and they were already predisposed to all the psychological symptoms. The migration however, triggered the symptoms and made it much worse.

Recently, it was stated by the Arab Journal of Psychiatry, that children living in a war zone like Palestine too suffer from PTSD and the reason is mainly hearing the sounds of artillery shelling, seeing the aftermath caused by the war planes, etc. Such traumatic experiences deteriorate children’s sleep and fears which leads to nightmares, poor concentration, panic attacks and anxiety.

The recent mass displacement due to the war on terror has increased the miseries of the people of FATA in general. The influx of the IDP’s of FATA was abrupt and unplanned. The state health institutions were not prepared to accommodate so many displaced people. There is a lack of advanced medical and psychological care and the government of Pakistan is paying no heed to improve this situation. The government of Khyber Pakhtunkhwa province, however, transferred 18 doctors to Bannu to treat the IDP’s medically and psychologically. These include trauma professionals, psychologists, psychiatrists and other general medical officials, but on the whole the government of Pakistan should work out ways and develop a system which provides a consistent intervention plan for the betterment of the IDP’s socially and psychologically.

 

2 COMMENTS

  1. yes, of course it is quite evident now that such baffle approach by the government officials on care and look after their displaced citizens. my view is that from these camps there are uprising a tradition of nomadology because people don't have a land and space to live and ultimately shifting towards militancy. such transference of tendencies from responsible citizenship to terrorism are obviously effects of post traumatic stress disorder. Good work in this regard by the article producer. an excellent contribution

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