The situation in Kashmir is no mystery these days when it
comes to the international media, organisations of repute, and academics. Kashmir is ‘normal’ when it comes to the Indian
government and Indian media houses. For
Kashmiris who live in a total information blackout, day to day survival is the
only thing which matters. Being a
psychiatrist who has trained and worked in Kashmir, I cannot stop thinking
about the mental anguish, fear and uncertainty which the entire population is
facing. Not able to get through to loved
ones locally or from outside the state, just makes the agony worse. I had
numerous calls from people around the world, strong men and women, breaking
down in tears, experiencing panic attacks and some deciding to go back into the
unknown, just to be with the family, no matter what the consequences. After all, is it not better to share the
tears and pain than face the numbness on your own.
With all the major news outlets around the world talking
about lack of access to healthcare, baby food and essential medicines, many reputed
journals like the Lancet and the British Medical Journal (BMJ) wrote editorials
urging and cautioning about the worsening of health of besieged population. Not
only the physical health but the ongoing mental trauma people experience made
worse by virtually living in an open prison with total information blockade. As a doctor, I was relieved like many other
likeminded professionals who understand the need for professional organisations
to raise their voice and at times question politicians, when it comes to the
health, safety and wellbeing of people.
Then came the time to face reality, that not all doctors who work under
strict professional and moral code, no matter in which country they practice,
writing scathing criticism of the Lancet and how dare it take a view on the
ongoing suffering of millions of people.
The reality started hitting when in some of the WhatsApp groups; doctors
started signing petitions and even planned on trolling the Lancet journal on
social media, arguing that it will prevent others from following the Lancet. The minute I questioned them, asking don’t you
need to look at the evidence, the reports of looming health disaster, shortages
of medication, the result was not different. National interest comes first; the
mood of the nation comes first, no matter if eight million people are caged in
their homes not having access to basic amenities necessary to sustain life.
Then came the open letters from Indian Medical Association
(IMA), various other doctors organisations and even the Indian Veterinary
Association (IVA), not only criticising the Lancet, but at the same time
showing complete disregard for human beings and health concerns with total and
complete lack of empathy. It would be hard to argue if this is in context of
the totalitarian state policies which is taking root in India, racism,
communalism or just mob mentality. After all I have trained, worked, debated,
and argued with same clinicians for years now and we have always been humans
and friends at the end. Did I question myself? Yes, I did. I went back into
history, terrified how doctors in Nazi Germany assisted the state in most
inhumane experiments and interventions using the same arguments of national
interest as my current colleagues from India or Indian origin seem to put forth. Looking at the letters they wrote to the
Lancet journal, one does not have to be an academic or a professional to see
that apart from jargon of interfering into the internal matters of a country,
there is almost no scientific argument which could put the Lancet’s editorial
concerns on the wrong side.
If this was not enough, a news article published in the
daily newspaper The Hindu published on the 22nd August 2019, wherein
the current President of the Indian Psychiatric Society (IPS) was planning to
protest against the Lancet editorial at the International Conference of World
Psychiatric Association in Lisbon. Not only that, he also claimed that IPS has
thirty members from Kashmir and the Lancet should have contacted them first,
arguing there are hardly any mental health issues and if there are they are due
to the inference of a neighbouring country, a favourite of the current
political disposition to dismiss any idea about welfare of Kashmiris. He also questions why the Lancet didn’t
publish something when as per him; there was a publication about mental health
issues published in 2006. The official letter issued by the President of IPS
looks like a dossier from ministry of external affairs talking about Pakistan,
terrorism and Osama Bin Laden. In no way does it come across as a letter
drafted by a professional body representing highly educated psychiatrists of a
country. There is no evidence based argument, no references to any scientific
research whatsoever which could have proved the Lancet wrong. The letter talks
about coming generations of Indians especially doctors and students carrying an
unpleasant memory. What about millions caged at gun point and children staying
home trying to avoid the barbed wires?
As a Kashmiri psychiatrist who happens to be a member of IPS
as well, I would like to know did IPS at any point try to contact their
registered members in Kashmir or did they just splash their names on the letter
used to criticise the Lancet. How does a national organisation representing
almost all psychiatrists in the country makes videos, issues political
statements and politicise about Pakistan, but at no point thinks of questioning
the politicians about policies which are putting the physical and mental
wellbeing of millions of people at risk. One does not have to be a scientist to
understand that putting an entire population in siege, arresting their
children, cutting off their all communication links will scar them
psychologically forever, more so when the exposure to trauma is more than 70%.
One out of ten people have lost a loved one directly to the current conflict
and one out of three has lost someone in their extended families. There are hundreds of publications in peer
reviewed journals from local Kashmiri psychiatrists, orthopaedics, surgeons,
sociologists, and other specialities talking about the mental and physical
morbidity as a direct result of on-going war like situation in Kashmir. This
will only get worse and no matter what professional jingoism will say, the
reality of mental scarring is real.
Lastly, the members of any organisation have every right to
question the decisions made by their representatives, may it be a country or a
professional body. Would the politically
minded office bearers of IMA and IPS clarify if they had consulted their
members before making sweepings statements, made fun of the scientific premise
they claim to follow, shown utter contempt of their terms of reference and more
importantly denigrated the pain and suffering of millions of people than
becoming their voice. I am sure if there was a responsible body in the country,
all these doctors would lose their licences to practice due to probity issues
and not adhering to the code of conduct which no doctor should forget. Will the
members of IPS ask their president to resign remains to be seen? When the siege
is over, I am sure the Kashmiri psychiatrists will have a story to tell and
many more scientific papers to write on the very trauma inflicted on them and
their loved ones.
‘Dear Indian
Psychiatry Society.... Psychiatry has come a long way from just using chains...
!’ , wrote a friend to me who happens to be an Indian psychiatrist as well.
