Pakistan: Help at hand for traumatized conflict victims

PESHAWAR, 29 March 2010 (IRIN) -  Nearly a year after the army defeated the Taliban in Pakistan's Swat Valley, a district of North West Frontier Province, the physical impact of the conflict is plain to see in damaged or destroyed buildings, but the underlying psychosocial impact is harder to gauge.

"We were displaced during the conflict, but in the days before we left our village I saw so many terrible sights, I simply cannot get them out of my mind," said Faseeha Bibi, 32. "I saw people I knew with limbs and faces blown off, and other terrible things."

Bibi's family returned to their home village near Mingora in Swat in September 2009, but Bibi's painful memories have been so bad that she decided in January to leave for Peshawar with her three children.

"I decided to move away for a while because I could not put the memories of horror behind me. My condition was affecting the kids," she said, adding that she hoped to re-join her husband in their village when she felt stronger.

Shama Shaukat, a paediatrician who has visited camps for internally displaced persons (IDPs) and also conflict areas as a volunteer health worker, told IRIN there was a lot of trauma among IDPs and returnees.

"The women and children in particular have suffered. During the displacement their physical needs were met but not their emotional ones. I have seen 10-year-olds who behave like infants, sucking their thumbs or trying to sit in their mother's laps," she said.

The 950,000 or so people who have returned, according to the UN Refugee Agency (UNHCR), to homes in the conflict zone do not always realize they may be suffering mental distress, Shaukat said.

"I used to be a very active man. I wasn't injured in any way, but now I just don't feel like doing anything at all. My fields are ruined because I can't get myself out of bed," Abdul Hassan, 35, told IRIN on the phone from Mingora.

He recently received counselling and recognizes now that he is depressed. "My brother and a brother-in-law died in the fighting. That affected me more than I realized, but I'm getting help now," he said.

Bibi said she had no idea her mental condition could be improved by counselling or other expert help. "I don't believe just talking about it can help. Only time will heal my wounds," she said.

"Friend's House"

Help for Bibi, Hassan and many others like them has come through a UNHCR initiative under which counselling centres, each known as a "Friend's House", have been set up.

"Trained psychologists at these centres provide counselling and psychosocial support to people suffering from trauma, mostly women or children. A team of social mobilizers holds community meetings, visits public places and disseminates information about the welfare centres," Rabia Ali, public information assistant at UNHCR's Peshawar office, said.

Initially, five centres were set up in Swat in November last year. Since then, 20 more have been set up in Swat and Lower Dir because of the positive response they received from communities.

"The conflict in Swat and adjacent areas took a heavy toll on its inhabitants. Now that many people have returned to their homes, they are faced with many challenges, ranging from trauma to lack of access to services," Ali told IRIN.

According to official figures, there is only one doctor for every 6,993 people in the tribal territories that have seen the brunt of fighting. Access to any kind of psychological care is even harder to obtain.

"We suffer many problems. There is no infrastructure and limited means of earning a livelihood. But our mental state and the constant sense of despondency or fear is more crippling than anything else we have faced," said Hassan.

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