WUNRN
The
Federally Administered Tribal Area (FATA) is strategically located between the
Pakistan-Afghanistan border and the settled areas of KPK(Khyber pakhtunkhwa).
PAKISTAN-KHYBER REGION - WAR
WEARY & DISPLACED FOR YEARS, WOMEN ARE TRAUMATIZED, SHORT ON AID, CARE
- Some
fled on foot, others boarded trucks along with luggage, rations and cattle.
Many were separated from families, or collapsed from exhaustion along the way.
They don’t know where their next meal will come from, or how they will provide
for their children.
In the
vast refugee camps of the Khyber Pakhtunkhwa (KP) province, civilians who fled
the Pakistan Army’s military offensive against the Taliban in the country’s
northern Waziristan Agency now walk around in a state of delirious confusion.
Medical officials here say that
almost all the 870,000 internally displaced people in KP are deeply traumatised
by over a decade of war in the
“We examined about 300,000
patients at the psychiatry wards of the KP hospital in 2013. 200,000 were of
the Federally Administered Tribal Areas. This included 145,000 women and 55,000
children,” said Muhammad Wajid, a psychiatrist at the Khyber Pakhtunkhwa Teaching
Hospital in
Now, as
the army conducts air raids on the 11,585-square-kilometre North Waziristan
Agency in a determined bid to wipe out the Taliban, war-weary civilians are
once again bearing the brunt of the conflict, forced to leave their ancestral
homes and seek refuge in neighbouring KP where shelter, clean water, food and
medical supplies are stretched thin.
IDPs have been streaming in
since the military operation began on June 15, reaching close to a million by
mid-July, officials here say. So far, aid has come in the form of food rations
and medical supplies for the wounded, as well as those left dehydrated by the
scorching 45-degree heat.
But very little is being done
to address the psychological trauma that affects nearly everyone in these
camps.
“The displaced population has
been living in rented houses or with relatives where they lack water,
sanitation and food due to which they are facing water and food-borne
ailments,” Consultant Psychiatrist Dr. Mian Iftikhar Hussain tells IPS. “But
the main problems are psychological disorders, which are ‘unseen’.”
Sitting in front of the
Iftikhar Psychiatric Hospital in Peshawar, capital of KP and 250 miles from the
largest refugee camp in Bannu, 50-year-old Zarsheda Bibi tells IPS her entire
family fled Waziristan, leaving everything behind.
Far worse than the loss of her
home and possessions, she says, is the loss of her one-year-old grandson, who
died on the long and arduous journey to KP. “She doesn’t sleep properly because
she dreams of her deceased grandson every night,” says Iftikhar, who is
treating Bibi for post-traumatic stress disorder (PTSD).
According to Javid Khan, an
official with the National Disaster Management Authority, PTSD is one of the
most common ailments among the displaced.
He recounts to IPS his recent
interaction with a woman in a camp in Bannu, whose husband was killed by
shelling in Miramshah, the headquarters of
“Now she is completely
disoriented and extremely concerned about the future of her three sons and one
daughter,” he says, adding that those who were uprooted are sure to develop
long as well as short-term disorders as a result of prolonged stress, anxiety
and fear.
Other conditions could include
de-personalisation, classified by DSM-IV as a dissociative disorder in which a
person experiences out-of-body feelings and severe disorientation; as well as
de-realisation, an alteration in perceptions of the external world to the point
that it appears unreal, or ‘dream-like’.
Experts
say that people torn from their native villages, thrust into completely new
surroundings and experiencing insecurity on a daily basis are highly
susceptible to these types of conditions, which are associated with severe
trauma.
Khan says women and children,
who comprise 73 percent of IDPs according to the World Health Organisation
(WHO), are likely to be disproportionately impacted by PTSD, as well as
disorders related to anxiety, stress, panic and depression.
Muhammad Junaid, a psychologist
working with the displaced, says that victims are also suffering from poor
self-esteem, as they are forced to occupy tents and shacks, in extremely
unsanitary conditions.
Mothers are particularly
impacted by their inability to provide for their families, he tells IPS, adding
that permanent phobias are not uncommon.
Another major concern among
health officials here is how the situation will affect children, many of whom
are at a very sensitive age.
“From childhood to adolescence,
a child passes through dramatic phases of physical and mental development,”
Junaid says. “During this transition, they gain their identity, grow physically
and establish familial relationships, as well as bonds with their community and
society as a whole.”
Ripped from their ancestral
homes and traditional communities, he says, this process will be interrupted,
resulting in long-term mental conditions unless properly addressed.
Parents are equally worried
about what displacement might mean for their children’s education.
“Two of my sons are very good
at their studies,” Muhammad Arif, a shopkeeper from Mirali, an administrative
division in
Even if they were to return to
After nearly a month in the
camp, Arif’s 10-year-old son Sadiq has all but given up hope. Through tears, he
tells IPS that children like him have “no sleep, no play, no education.”
“I don’t know what the future
holds for us,” he says.
For long-time health experts in
the region, the situation is a frightening climax of a crisis that has been
building for years, ever since the army began a crackdown on insurgents in the
rugged, mountainous regions of northern
“Around 50 percent of the
residents of FATA have suffered psychological problems due to militancy and
subsequent military operations,” Muhammad Wajid, a psychiatrist at the Khyber
Pakhtunkhwa Teaching Hospital in
“We have examined about 300,000
patients at the psychiatry wards of the KP hospital in 2013; 200,000 of them
belonged to FATA. This included 145,000 women and 55,000 children,” he says.
Since 2005, nearly 2.1 million
FATA residents have taken refuge in KP, according to Javid, posing a real
challenge to the local government, which has struggled to balance the needs of
the displaced with its own impoverished local population.
The latest wave of refugees has
only added to the government’s woes, and many in the region fear the situation
is on a knife’s edge, especially in the holy month of Ramadan, when there is a
desperate need for proper sanitation and food to break the daily fast.