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Monday, 4 March 2013

Nepal - Country of fear

Nepal - Country of fear
In Nepal, irrespective of all types of instability, whether in politics, the economy and development, the only all-time stable thing is “fear’’. In the future, the degree of fear in the population is likely to increase. Nepal is heading towards becoming a “country of fear”. Everyday, political and social narrations documented in the media and discussed in the public sphere point in this direction. The fear lords, the politicians, shamelessly talk about Nepal becoming like Afghanistan, Cambodia, Rwanda or Sri Lanka all the time. It is hard to understand who these politicians are trying to intimidate or if they are merely reflecting the state of their own failure and mental vulnerability. The question is: Do we still continue listening silently to  political gossip or is there anything that we can do immediately to protect ourselves from becoming worse?

Let’s discuss the mental and traumatic state of once conflict-ridden countries like Afghanistan, Cambodia, Rwanda and Sri Lanka. If Nepal’s fear lord politicians tragically lead the country towards a conflict - violent or otherwise - what kind of scenario is likely to arise in front of us? What do we do then? In Afghanistan, more than two decades of conflict has led to widespread human suffering and population displacement. Many studies have found that nearly half of the population has experienced traumatic events. Two-thirds of the people have suffered mental disorders like depression, anxiety and post-traumatic stress disorder (PTSD). The disabled and women have a poorer mental health status. Direct relations have been found between the mental health status and traumatic events. Larger populations are dependent on religious and spiritual practices to cope with mental trauma and disorder.

Cambodia has had a long history of violence, highlighted by the civil war in the 1970s. Studies conducted 10 years after the end of the fighting have found that more than 80 per cent of the refugees felt depressed and had a number of psychological complaints despite good access to medical services. High levels of trauma and symptoms of mental disorder were reported despite a majority of the respondents having a sound social support system and good employment. These studies found that changes in the structure of society have led to a breakdown of the existing protective networks such as village chiefs and elders in rural communities, especially for women and children. Traditional healers (monks, mediums and traditional birth attendants), who played an important role in maintaining the mental health of communities in the past, have lost their designated positions following the conflict.

The Rwandan genocide took place in 1994. It was a mass slaughter where, over the course of 100 days (April to mid-July), approximately 500,000 people in the East African state were killed. The physical and mental health problems of the survivors of the genocide in Rwanda have been well documented. In a recent community-based study examining 2,091 individuals, nearly one-third of the participants were found to be dealing with PTSD. The study suggests that without a successful reconciliation programme, it is almost impossible that the individuals dealing with PTSD will recover.

In Sri Lanka, the conflict between the majority Sinhala and the minority Tamil populations lasted for nearly 30 years. One of the first studies that looked into the psychological effects of the conflict on the civilian population reported that only 6 per cent of the study population had not experienced any war stress. Mental disorders were seen in two-thirds of the population. Somatisation, PTSD, anxiety disorder, major depression, alcohol and drug misuse and functional disability were the major disorders seen among the population. The breakdown in Tamil society led to women taking on more responsibilities, which in turn made them more vulnerable to stress. Children and adolescents had a higher level of mental health morbidity. Women have an increased vulnerability to psychological consequences of conflict. There is consistent evidence of higher rates of trauma-related psychological problems in children. The association between gender-based violence and common mental disorders is well known.

However, in the case of Nepal, these issues are severely undermined. There is lack of study. There is no knowledge. Taking the experience of these conflict-ruined countries as a reference, one can imagine the mental toll in Nepali society. However, it is important to note that all the above mentioned countries, except Afghanistan, have already started to perform socially and economically far better than Nepal. Sadly, hundreds of thousands of victims of the conflict era have been waiting for justice and mental peace, but there is no hope yet. The political class has inflicted terrible psychological damage on Nepali society. It is simply boiling to explode.

Before it gets worse, I suggest to the political class: Please change your narration. Rather than providing help, you have already done so much harm to our generation. Let’s acknowledge it. Do not make intimidating statements that Nepal is becoming another Rwanda or Cambodia. Let’s make the mental trauma, fear and torture suffered by the people, as a result of the 10-year long armed conflict and the political instability of the post-conflict period, a major political narration of the present time. If these issues do not get space in political narration and are not addressed, the mental state of Nepali society is likely to become worse.