Mental health conditions of traumatized people in Vanni alarming: Report

(March 30, Jaffna, Sri Lanka Guardian) The professionals of the Psycho Social Coordinating Committee of the Vanni Region in its report has documented the prevailing alarming mental health conditions of the civilians in the so-called safe zone in Vanni.

The report of the professionals is a true story of the trauma of a people, who are forced to live day and night in the bunkers, amidst torrents of SLA shelling and hundreds becoming casualty everyday.

It was mentioned in the report, released on Friday, that many children are traumatized by witnessing their loved ones either being killed or being injured by shelling.

“Many families and children were not able to express their grief normally when their loved ones were killed by shelling since they had to hurriedly leave those places in order protect their own lives”.

Dr. J. Sivamanoharan and S. Edmond Reginold, professionals of mental health working in Vanni said the question that haunts the minds of these 330.000 people facing the brunt of war is “whether a humanitarian catastrophe faced by them is deliberately ignored by the international community and whether the instruments of humanitarian intervention have given up Wanni people for good?”

Full text of the report follows:

PSYCHO SOCIAL CO-ORDINATING COMMITTEE WANNI REGION

Maththalan,
Mullaitheevu
Sri Lanka

27th March, 2009

THE PSYCHOSOCIAL SITUATION OF CIVILIANS
LIVING IN THE WAR ZONE IN WANNI, SRI LANKA

A very intensive and fierce war is currently being fought between the government forces and the Liberation Tigers of Thamil Eelam, in Wanni in the North of Sri Lanka. As a result of this intense war more than 330,000 internally displaced people are forced to live in a very narrow coastal stretch which is roughly twelve kilometers long and one and a half kilometers wide. This coastal area, stretching from Maththalan to Mullivaikkal, has been unilaterally declared by the Sri Lankan Government as a ‘no fire zone’.

More than 3000 people have already been killed and more than seven thousand have been injured as a result of shelling which includes artillery, multi barrel, cluster and mortar shells and long range gun fire carried out by the forces of the Sri Lankan Government into the so called ‘no fire zone’. The number of casualties caused by the shelling is quite high since a population which is more than 330,000 is forced to live in a very small area which is less than 30 square kilo meters. It is admitted that this coastal belt is inhospitable and quite unfit for human habitation.

The situation of the civilians living in this war-torn area is further affected by the acute shortage of food prevailing in the same area. The people living here depend totally on food items brought into this area by the ICRC. Sixteen civilian deaths caused by starvation have already been reported by the hospital at Maththalan. The medical institutions functioning in this area are unable to treat the hundreds of civilians who are injured by shelling which takes place within the no fire zone daily as hardly any medicine is available at this makeshift hospital.

It is a very challenging task to assess and to articulate the psychological and the psychosocial impact of the war on the civilians living currently in Wanni. Many families have already lost one or more of their loved ones due to shelling and air attacks. Thousands of civilians have been wounded by shelling and more than five thousand wounded civilians have already been transferred to hospitals in Government controlled areas for further treatment.

Since indiscriminate shelling is carried out within the ‘no fire zone’, the civilians here live with continuous fear of being either killed or being injured by the explosion of artillery and other type of shells. Most of the people spend their days and nights in safety bunkers in order to protect themselves from the horrifying shelling carried out in this area.

State of Children

Sixty five thousand school going children are being affected by this prolonged war as 288 schools failed to reopen in Wanni from the beginning of the current year. Roughly 7800 children who should have been admitted to grade one this year have lost the chance of beginning their education while 13,000 pre-school children have lost the opportunity of gaining pre-school education.

Parents who are affected by the present war situation tend to vent their stress on their children. Spanking of children has increased since many children have become restless due to lack of educational facilities and play activities. Leaving behind their homes, schools and friends has deeply affected these children. Children seem to have outgrown their youth state. The games they play have military connotations and this is a very unhealthy symptom.

Due to scarcity of food and especially due to lack of nutritious food normal physical and mental development of children are affected. Because of the traumatic experiences that mothers go through as a result of the war there is the danger of many children being born in the future with many physical and mental deficiencies. It is recorded that infant mortality rate is high in Wanni. As far as the hospital records are aware of, number of children admitted and dismissed as dead in the period between 1st January, 2009 to date is 128. But the fact remains that many children have not been admitted to hospital and have met their deaths in their own homes and have been quietly buried. In a sense the hospital records are incomplete.

Many children are traumatized by witnessing their loved ones either being killed or being injured by shelling. Many families and children were not able to express their grief normally when their loved ones were killed by shelling since they had to hurriedly leave those places in order protect their own lives. It is important to remember that the Tamil society has elaborate rituals to help people grieve the loss of their loved ones. The most remarkable observation is that all forms of religious burial services have been given up totally.

Care of the elderly and people with special needs

The elderly have become very vulnerable to disease because of the acute shortage of food and lack of medical facilities. Due to the intense war many elderly people have been abandoned by their children and many families are separated permanently resulting in social chaos.

There are several institutions in Wanni that care for children, the elderly, unwed mothers, people with learning disabilities and the mentally ill. In spite of the ongoing war these institutions were doing their best in taking care of their members. But Currently those who manage these institutions are struggling to provide adequate food and other necessities to those in their care. Even these institutions are undergoing military attack indiscriminately.

It is quite important to take into consideration that we are dealing with a society which has already been affected by a three decade long war and the Tsunami which devastated the coastal belt of South Asia and Sri Lanka in December 2004. People who had their own houses are now forced to live a subhuman life under tarpaulin sheets, exposed to extreme heat, in an area that is not at all conducive for the existence of a large number of people.

Having gone through multiple displacements in a short period of time, the people in Wanni are left with depleted financial resources. The people here pass each moment fearing the explosions of destructive shells. They are forced to witness their loved ones being killed and injured. There is no medicine and no medical facilities to treat the injured. Due to acute scarcity of food the prices of food items have skyrocketed and finding food has become a very challenging task. This is a looming starvation situation.

The unending war, indiscriminate shelling, acute shortage of food, lack of medicine and medical facilities and the inability to fulfill the basic needs of life such as having proper toilette facilities have deeply affected the physical and psychological wellbeing of civilians now living in this war zone. A strong sense of frustration has crept in among the people living in Wanni as they are forced to face an extremely trying situation.

Due to stressors caused by this ongoing war, the people have become quite anxious and impatient and manifestation of mutual anger and irritation are easily observed on the roads, in public places and in family relationships. Many civilians have been treated for clinical depression and for anxiety disorders at the mental health unit at Maththalan hospital. Many are losing their zest for life and suicidal ideations are widely found among these patients. Since many are going through traumatic experiences, there is the danger of more patients to be identified with PTSD (Post Traumatic Stress Disorder).

In addition to the untold hardships faced by the Tamil civilians living in the war zone, what is most painful for these people is the failure of the international community to intervene effectively in this conflict and the failure to bring an end to their suffering. The question that haunts the minds of these 330.000 people facing the brunt of war is “ whether a humanitarian catastrophe faced by them is deliberately ignored by the international community and whether the instruments of humanitarian intervention have given up Wanni people for good?

Dr.J.Sivamanoharan
Acting Doctor in charge
Mental Health Unit
Maththalan Hospital

S.Edmund Reginald o.m.i.
Co-ordinator
Psychosocial Co-ordinating Committee
Wanni Region

-Sri Lanka Guardian