By M. Ashfaq Yusufzai, CARE International Pakistan, Rustam
The conflict raging in parts of northwestern Pakistan has not only forced thousands of people to flee their ancestral villages, it has also deprived them of their spiritual assets: their identity and personality.
Thousands of internally displaced people (IDPs), especially women and children, are in desperate need of psychological assistance. Doctors say some 70 percent of them suffer from post-traumatic stress disorder (PTSD).
People wander back and forth like zombies outside their tents in parts of Mardan district, including this small village, swollen with almost as many displaced people as the permanent population.
Mardan, located closed to embattled Buner district, is host to 30,000 displaced persons who fled their homes to escape the military action against militants beginning in April.
“We have been examining about 200 patients per day. During the last two weeks we have seen 1,400 patients. Of them 70 percent, mostly women and children, suffer from mental problems caused by the shelling and destruction they have seen back home,” says Dr. Jawad Ali of Islamic Relief, with which CARE has partnered in its relief efforts, at the Civil Hospital Rustam.
With government and humanitarian agencies concentrating on the critical threat of illnesses such as diarrhoea and other water-borne diseases, little has been done to probe the psychological aspect of the IDPs’ health. CARE is seeking funding to provide crucial psychosocial support and education services to roughly 11,000 children and women.
“I dreamt last night that my two sons had fallen to army shelling in Swat. I woke up and wept but later found that my sons were sleeping beside me. Then I thanked Allah,” Zareena Bibi of Kabal region, Swat, told CARE. Already having lost one son and a daughter at the conflict zone, she suffers severe psychological trauma.
Dr. Kashif Muqarab at the same clinic is terribly perturbed over the scenario confronted by IDPs. “The displaced people have to face mental problems for at least five to seven years even if the conflict ends and they return home,” he says. The IDPs avoid speaking about the situation they witnessed in their native places because it reminds them of the shelling, executions by militants, headless bodies hanging from electricity poles, and charred bodies lying in pools of blood.
A seven-year-old boy examined by the doctors at the Rustam Hospital was unable to speak for three weeks, after witnessing the collapse of houses, noises and strafing from helicopters in his native town of Buner. The children urgently need psychotherapy sessions to restore their mental health. Otherwise, they risk becoming psychologically ill for their entire lives, Dr. Kashif says.
Lack of living space, frequent power outages, unhygienic food, contaminated water supplies, and homesickness are other factors contributing to the mental trauma of IDPs, who number as many as 4 million, according to the latest government figures.
“We are 332 persons staying in one tiny (12 feet by 12 feet [4 meters by 4 meters]) room at the Government Girls High School Rustam,” says Ghaffar Khan of Gorkan Buner. “Women face the brunt of the situation, because they are unable to take care of themselves and children in presence of strange men.”
A child, Jamil, 5 who happened to be the most active and mischievous in his original home in Gulkada Swat, is now reluctant to speak. Living at the same school, he faces flashbacks of what he saw in Swat, and is afraid of helicopters and airplanes passing over the school.
“He starts crying and takes refuge in my lap, fearing that helicopters will kill him, like his elder brother Usman, 7, who died on April 29 due to army shelling in Swat,” his mother Naseem Akhtar, a schoolteacher, told CARE.
Sultana, 58 and a grandmother of three, says her family had run out of money and ran from pillar to post to find some cash for daily expenses. “We had an orchard spreading over 50 acres, but we are unable to pick the produce. It is rotten now.” she says. “We used to give money to the needy and now it’s our turn to receive charity.”
“We have become a laughingstock, which is disheartening,” she adds. “My husband and son wait in queues under the scorching sun to get 20 kg. of wheat, which has thrown us into a state incomprehensible for us.”
One day soon, Sultana hopes she and her family will return to their orchard and again harvest a bounty. CARE hopes to help them cope with the bitter fruit that will grow in their hearts for much longer.