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How does one cope in a country where the equivalent of 9/11 happens almost every day? Steeped in pain, stress, and with a heady dose of denial, Pakistans children are being raised with a sense of helplessness. Psychiatrists believe large numbers of Pakistanis are suffering from Post-Traumatic Stress Disorder and little is being done to help them. Add to this the unregulated maddrassas that are springing up every 30km along the Grand Trunk Road offering free food, education, and eternal salvation and the countrys future looks bleak.
Its been a year since Zakriah Khans father was killed in a suicide attack in a mosque in Lahore. The 82-year-old was attending Friday prayers when armed gunmen struck.
93 people were killed and more than 120 were injured in nearly simultaneous attacks against two mosques of the minority Ahmadiyya Muslim Community. After the initial attack, Zakriah was caught up in a hostage situation that lasted for hours. During this time he didnt know whether his son, Gohar, was dead or alive.
33-year-old Zakriah talks mechanically about what happened. The mosques congregation had received several death threats and he had been put on security detail on the day of the incident. He tells me: They shot right at me and I dont know how they missed. My friend was stood next to me, he was killed, and my other friend on the other side was also killed. I dont know how they missed me. I thank God; he gave me a lions heart. He shows me pictures of the bullet that missed him, its lodged in a wall behind where he was standing.
Twelve months on from the devastating incident, Gohar still re-enacts the shooting. Shrapnel scars on his face show just how close he was to the gunmen.
(Courtesy of Saima Mir)
He tells me an ambulance came to get me and took me away. He talks about the shooters and the ceiling fan that fell on the worshippers as they tried to escape. Whilst Pakistans news channels pump out endless stories of suicide attacks, honour killings, and targeted shootings, little is done to deal with the psychological aftermath of these events. Here in the West, teams of trained medical professionals handle traumatic situations quickly. But for Pakistanis death, terror, and fear have become a part of daily life and psychological help is a luxury not a necessity.
Zakriah smiles when I ask if he has received any trauma counselling: They offered me help but I dont need that kind of help. I told them to help the others who need it more.
In the West Zakriahs constant need to speak about the incident a year on, and his sense of reliving the ordeal would be quickly picked up as a sign of Post-Traumatic Stress Disorder.
The World Health Organisation estimates there to be just 320 psychiatrists in Pakistan to deal with 176 million patients.
According to a report in the medical journal, The Lancet, most of these doctors are not appropriately trained to provide psychiatric care.
Dr Afzal Javed, who is the co-chair of the Psychiatry in Developing Countries arm of the World Psychiatric Association, says Pakistan is fast becoming a psychological pressure cooker. He says: Most people in Pakistan are living with a continued sense of helplessness, and rather than dealing with it they are accepting it. There is no concept of psychiatric social work in Pakistan. When youre physical well-being is not guaranteed and you dont have enough to feed your children your mental health is not a priority.
Dr Javed believes that the countrys patriarchal system is part of the problem: In Pakistan a man will never show his weaknesses to his family. So, it is rare for a man to admit that he is depressed because that will mean admitting he cant cope with his responsibility.
Consultant Psychiatrist, Farooq Naeem, has been studying the impact of traumatic events in Pakistan for the past eight years. His last report for the International Journal of Mental Health Systems explored the work of psychologists in Pakistan.
The report found that Cognitive Behavioural Therapy, which is traditionally used to help people overcome PTSD, need to be culturally adjusted to be effective in countries such as Pakistan. Because doctors are trained in English much of what is said during the talking cure is lost in translation and often misunderstood by the listener.
Dr. Farooq believes the traumatic events of Pakistans past have had a cumulative affect on the countrys psyche and now clearly colour the behaviour of its citizens. He says that, People have become very rigid, inflexible in their thinking, and confused about religion. Things are going badly wrong. Even now with the death of Bin Laden there is a blame game going on and no one is willing to take responsibility. People are unable to rationally analyse the situation and are becoming more and more angry. These are classic symptoms of Post-Traumatic Stress. You find Pakistanis have major issues around trust because they live in heightened security. After all, you never know who is living next door, your neighbours could be a suicide bomber.
Although Dr Javed agrees with Dr Naeems view that the Pakistani psyche is deeply troubled, he makes the point that Post-Traumatic Stress Disorder can only be diagnosed after a traumatic incident has ended. In a country like Pakistan there is no post and only ever present stress. He stated that, This is a continuous problem and people have developed mechanisms to cope with it. Family and religion are often major comforts at such time but can also be a hindrance. For example if youve lost a relative family members comfort you by telling you it is Gods will. But stating that you dont accept it as such can alienate you from the very people who are supporting you. This leads to denial and as this builds into further stress and frustration you see retaliation against others. Add to this a loss of understanding and empathy, and people begin to feel Ive lost everything so why should anyone else have anything
Pakistan is not equipped to provide the help its people require. Dr Javed believes it is a sort of blessing that people are not coming forward. He adds: Pakistan does not have the infrastructure needed to help these people. We dont have enough psychiatrists and those we do have are based in the cities. Balochistan has only three or four psychiatrists and they are all in Quetta. Its a similar story in Sindh and Punjab.
He concluded on an ominous note: We need to train the countrys General Practitioners and medical professionals, along with non-medical professionals to be able to deal with this situation before things get much worse.
Saima Mir is an award-winning multi-media journalist who has worked for BBC News, The Guardian and The Times of London. She is currently reporting stories from Pakistan with the help of the Commonwealth Broadcast Associations World View Award in the United Kingdom.
EXCLUSIVE: The PTSD Pandemic in Pakistan | The Crescent Post
EXCLUSIVE: The PTSD Pandemic in Pakistan | The Crescent Post
I really feel for the ordinary people in pakistan who are going through a very tough time....you need to give equal importance to mental health and its not a thing you can ignore.....i once saw a IIT guy in a hospital in chennai....his parents were teaching him abcd...i was like WTF?then they told my dad he got affected mentally after a girl rejected him
.we are all fragile in one way or the other....the gov. needs to do something about the number of doctors.... 320 docs for 170 million people?
i am pretty sure there are a lot more Psychiatrists in chennai alone
.
Its been a year since Zakriah Khans father was killed in a suicide attack in a mosque in Lahore. The 82-year-old was attending Friday prayers when armed gunmen struck.
93 people were killed and more than 120 were injured in nearly simultaneous attacks against two mosques of the minority Ahmadiyya Muslim Community. After the initial attack, Zakriah was caught up in a hostage situation that lasted for hours. During this time he didnt know whether his son, Gohar, was dead or alive.
33-year-old Zakriah talks mechanically about what happened. The mosques congregation had received several death threats and he had been put on security detail on the day of the incident. He tells me: They shot right at me and I dont know how they missed. My friend was stood next to me, he was killed, and my other friend on the other side was also killed. I dont know how they missed me. I thank God; he gave me a lions heart. He shows me pictures of the bullet that missed him, its lodged in a wall behind where he was standing.
Twelve months on from the devastating incident, Gohar still re-enacts the shooting. Shrapnel scars on his face show just how close he was to the gunmen.
(Courtesy of Saima Mir)
He tells me an ambulance came to get me and took me away. He talks about the shooters and the ceiling fan that fell on the worshippers as they tried to escape. Whilst Pakistans news channels pump out endless stories of suicide attacks, honour killings, and targeted shootings, little is done to deal with the psychological aftermath of these events. Here in the West, teams of trained medical professionals handle traumatic situations quickly. But for Pakistanis death, terror, and fear have become a part of daily life and psychological help is a luxury not a necessity.
Zakriah smiles when I ask if he has received any trauma counselling: They offered me help but I dont need that kind of help. I told them to help the others who need it more.
In the West Zakriahs constant need to speak about the incident a year on, and his sense of reliving the ordeal would be quickly picked up as a sign of Post-Traumatic Stress Disorder.The World Health Organisation estimates there to be just 320 psychiatrists in Pakistan to deal with 176 million patients.
According to a report in the medical journal, The Lancet, most of these doctors are not appropriately trained to provide psychiatric care.Dr Afzal Javed, who is the co-chair of the Psychiatry in Developing Countries arm of the World Psychiatric Association, says Pakistan is fast becoming a psychological pressure cooker. He says: Most people in Pakistan are living with a continued sense of helplessness, and rather than dealing with it they are accepting it. There is no concept of psychiatric social work in Pakistan. When youre physical well-being is not guaranteed and you dont have enough to feed your children your mental health is not a priority.
Dr Javed believes that the countrys patriarchal system is part of the problem: In Pakistan a man will never show his weaknesses to his family. So, it is rare for a man to admit that he is depressed because that will mean admitting he cant cope with his responsibility.
Consultant Psychiatrist, Farooq Naeem, has been studying the impact of traumatic events in Pakistan for the past eight years. His last report for the International Journal of Mental Health Systems explored the work of psychologists in Pakistan.
The report found that Cognitive Behavioural Therapy, which is traditionally used to help people overcome PTSD, need to be culturally adjusted to be effective in countries such as Pakistan. Because doctors are trained in English much of what is said during the talking cure is lost in translation and often misunderstood by the listener.
Dr. Farooq believes the traumatic events of Pakistans past have had a cumulative affect on the countrys psyche and now clearly colour the behaviour of its citizens. He says that, People have become very rigid, inflexible in their thinking, and confused about religion. Things are going badly wrong. Even now with the death of Bin Laden there is a blame game going on and no one is willing to take responsibility. People are unable to rationally analyse the situation and are becoming more and more angry. These are classic symptoms of Post-Traumatic Stress. You find Pakistanis have major issues around trust because they live in heightened security. After all, you never know who is living next door, your neighbours could be a suicide bomber.
Although Dr Javed agrees with Dr Naeems view that the Pakistani psyche is deeply troubled, he makes the point that Post-Traumatic Stress Disorder can only be diagnosed after a traumatic incident has ended. In a country like Pakistan there is no post and only ever present stress. He stated that, This is a continuous problem and people have developed mechanisms to cope with it. Family and religion are often major comforts at such time but can also be a hindrance. For example if youve lost a relative family members comfort you by telling you it is Gods will. But stating that you dont accept it as such can alienate you from the very people who are supporting you. This leads to denial and as this builds into further stress and frustration you see retaliation against others. Add to this a loss of understanding and empathy, and people begin to feel Ive lost everything so why should anyone else have anything
Pakistan is not equipped to provide the help its people require. Dr Javed believes it is a sort of blessing that people are not coming forward. He adds: Pakistan does not have the infrastructure needed to help these people. We dont have enough psychiatrists and those we do have are based in the cities. Balochistan has only three or four psychiatrists and they are all in Quetta. Its a similar story in Sindh and Punjab.
He concluded on an ominous note: We need to train the countrys General Practitioners and medical professionals, along with non-medical professionals to be able to deal with this situation before things get much worse.
Saima Mir is an award-winning multi-media journalist who has worked for BBC News, The Guardian and The Times of London. She is currently reporting stories from Pakistan with the help of the Commonwealth Broadcast Associations World View Award in the United Kingdom.
EXCLUSIVE: The PTSD Pandemic in Pakistan | The Crescent Post
EXCLUSIVE: The PTSD Pandemic in Pakistan | The Crescent Post
I really feel for the ordinary people in pakistan who are going through a very tough time....you need to give equal importance to mental health and its not a thing you can ignore.....i once saw a IIT guy in a hospital in chennai....his parents were teaching him abcd...i was like WTF?then they told my dad he got affected mentally after a girl rejected him
.we are all fragile in one way or the other....the gov. needs to do something about the number of doctors.... 320 docs for 170 million people? i am pretty sure there are a lot more Psychiatrists in chennai alone.
