The lockdown in Kashmir is nearing four months now since the complete annexation and demotion of the Jammu and Kashmir state on 5th August 2019. The entire population is under a physical and mental siege, official and unofficial curfew, with no public transport. There are numerous reports of intensifying health crisis with people finding it hard to reach hospitals more so in emergencies. The entire population remained without any phone connectivity for more than 2 months with people not able to reach their loved ones in and outside the state. Internet access remains suspended. Because of the uncertainty, and not able to know about the wellbeing of old, unwell, and frail, the entire population has been plunged into an anxious state of being. Moreover, the political situation has created a state of despondency, hopelessness, and a sense of grief. There does not seem to be any agency or person to whom people can turn for help or support.
There have been numerous reports in international and local media about the physical health crisis due to the ongoing war-like situation, including deaths of pregnant women, cancer patients, and mostly the undocumented deaths of those not able to reach for help.
When it comes to the mental health of the besieged Kashmiri population and Kashmiris living in India and other countries, it can be summed up as a collective trauma and punishment. A recent review in the Lancet suggests that 1 in 5 people living in conflict zones suffer from mental health problems including depression, anxiety, and Post Traumatic Stress Disorder.
It is known that conflicts involving killings, disappearances, rape, torture, collective punishment, arrests and lack of access to optimum healthcare are fertile grounds for both physical and psychological morbidity and mortality. With 8 million people put under such conditions, it is not hard to fathom the hidden epidemic of mental health problems which the local population is suffering and dealing with in utter silence. Overall, it is very hard to predict the scale of the adverse psychological impact of the lockdown and associated political connotations.
Kashmir was already known for the high prevalence of mental health problems including depression, anxiety, and other stress-related disorders due to the ongoing conflict situation from many decades. One in ten has lost an immediate family member and one third has lost someone in the extended family. These figures are from a decade ago and with the current unprecedented situation when around 8 million people are being put under lockdown, one can argue that entire Kashmiri populace is experiencing some kind of psychological trauma and distress. This is worsened by the mass arrests and alleged torture which is reportedly being broadcasted on loudspeakers in some places. Thousands have been put behind bars, including minors with no legal recourse. This is a perfect breeding ground for the development of many mental disorders.
Not only Kashmiris living in the valley but those living outside India and other countries are equally suffering due to the uncertainty of the situation. A survey revealed that more than 90% of Kashmiri diaspora showing symptoms of anxiety and depression in the first month following the lockdown with predominant symptoms of acute stress, insomnia, and impending doom due to inability in contacting their loved ones.
Children are the most vulnerable group of the population who have been deprived of schools, play, and any sense of normalcy, which is essential for optimal child development. It is a known fact that childhood adversity plays a major role in the development of many psychiatric problems in later life.
A secure, stable and memorable childhood is a key to productive adulthood, to be able to lead a normal life, have families and function as a responsible member of society. With millions of children being brought up in utter confusion, siege, and uncertainty about the safety of their families, is likely to produce a generation of traumatised people like in any war zone. A sense of security is important for children growing up, but if adults are not safe themselves, how can they make sure that children grow up confident and secure. This is likely to lead children to develop behavioural problems, insomnia, irritability, poor academic performance, just to name a few.
There were some reports of a dearth of psychotropic medications but more importantly, it has been the hesitation to seek help or attend consultations with doctors which has made many to relapse in their symptoms. The attendance in the hospitals had sharply declined more so in the first two months and only desperate families would somehow try to bring their patients to the hospital when not able to manage at home. Many vulnerable psychotic patients who usually don’t seek help and roam freely on the streets have been put under risk and some have been admitted to hospital. At times they have been shot dead in the past for wandering in prohibited areas. There are also reports that people with dependence issues are relapsing due to non-availability of drugs or access to treatment. Overall, the silent epidemic of trauma has become a part of daily living in Kashmir.
One wonders how things can change for better unless the political situation improves, and there is some respite for people. Lest the basic human rights are respected and people feel safe, no amount of medication or counselling even if it was available would help. Repeated exposure to trauma, no sense of belonging, and total helplessness do not let patients recover in the best possible settings. To help recover from this psychological trauma and prevent further harm, there is a need for immediate action both politically and on the ground to address basic human rights, recourse to legal help, re-joining families, letting minors go home and finally resolution of the dispute. Doctors and therapists can only then be able to treat people.
The question remains, is anyone listening?
No comments:
Post a Comment