Conflict and trauma in Pakistan

Author: Mashaal Gauhar

With unceasing violence in the town of Parachinar, medical experts have concluded that over 60 percent of its residents suffer from post traumatic stress disorder, more commonly referred to as PTSD. In the absence of thorough documentation, it is estimated that about 40 percent of people living in Pakistan’s turbulent tribal region suffer from PTSD. This manifests itself through ongoing anxiety, depression, and stress. Survivors in these conflict zones are often plagued by vivid nightmares, flashbacks, panic attacks and suicidal thoughts.

Sadly, Pakistan’s underfunded health care system means that very little treatment is available for the victims of PTSD. According to the Pakistan Mental Health Association, the country has only five government-run psychiatric hospitals and less than 300 qualified practising psychiatrists.

With the 18th Amendment’s devolution of health to the provinces, each province is still working to improve upon the 2001 Mental Health Ordinance. This was drafted to replace the colonial era Lunacy Act of 1912. This alone says much about the lack of awareness surrounding mental health in Pakistan. According to the Pakistan Economic Survey 2016-17, 0.42 percent of the budget is allocated to mental health.

The increasing prevalence of PTSD in Pakistan requires not only an urgent uplift in psychological support facilities, an overhaul in mental health policy and legislation but also combatting the long-standing stigma in society towards mental health. Essentially, it must be remembered that PTSD is an actual physical injury to the brain which requires the same attention as any other injury to the body would. For this reason, medical experts argue that it is more accurate to describe it as an ‘injury’ rather than a ‘disorder’.

Renowned journalist and author of Aftershock, Matthew Green explains, “Although it’s invisible, it causes lasting changes to the brain which makes it impossible for sufferers to regulate their emotions, which is why they can suffer these terrible outbursts of anger or anxiety or suicidal despair. When we start to acknowledge that it’s not all in the mind — it’s actually a microscopic injury to the brain — I think that will really help to remove the stigma. Trauma is as much a physical injury as a broken leg but it’s still considered as something you can get over with will power — but you can’t — you need the right support.”

It is estimated that about 40 percent of people living in Pakistan’s turbulent tribal region suffer from PTSD. This manifests itself through ongoing anxiety, depression, and stress. Survivors in these conflict zones are often plagued by vivid nightmares, flashbacks, panic attacks and suicidal thoughts

According to the American Psychiatric Association, PTSD is the result of a traumatic event that involves actual or threatened death or serious injury or a threat to the physical integrity of oneself or others.The term PTSD was coined in the 1980s to describe the debilitating mental anguish experienced by returning war veterans.

Symptoms of PTSD have been chronicled in ancient classics such as Deuteronomy which advises for soldiers suffering from nervous breakdown to be removed from battlefield. However, the industrialised warfare of World War I led to an unanticipated surge in the number of psychiatric casualties in the military. This led to the development of the popular term ‘shell shock.’ With today’s sophisticated weaponry, victims of PTSD extend far beyond military personnel to the hapless victims caught up in conflict zones.

As Green so aptly states, “You do not have to go to war for your mind to become uninhabitable.” Sadly, the plight of Pakistan’s countless men, women and children who remain traumatised by the horrors of conflicts are proof of this.

The writer is the founding editor of Blue Chip magazine. She tweets @MashaalGauhar

Published in Daily Times, August 6th 2017.

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