Life in Conflict: War, Violence and the Mental Health Crisis in Kashmir

Saiee Godbole

Edited by: Shashi Shekhar Misra, Editorial Board, TLRA

It is no secret that since Independence, Kashmir has been a land of war, turmoil and conflict. There is something very eerie about this so-called breath-taking ‘paradise on earth’ not only witnessing its own ravaging through the years but also managing to somehow survive it all, even if barely. Even through the perennial chaos it has somehow emitted an echoing silence that can only be heard by the people of Kashmir. It has become a land of ever disappearing men and women, a land where an old father buries his young son, a land of countless lost generations.

Sir Feroz Khan Noon (1893 – 1970), Hari Singh (1895 – 1961), the Maharajah of Jammu and Kashmir, and Leo Amery (1873 – 1955), the Secretary of State for India and Burma, outside the Burma office in London. (Photo by Keystone/Hulton Archive)

Understanding the Modern History of Kashmir

In 1846, Maharaja Gulab Singh, originally a Dogra[1] ruler, bought the land of Jammu and Kashmir from the East India Company after signing the Treaty of Amritsar.[2] After nearly nine decades of rule, by 1930, the Kashmiri Muslims had begun to experience displeasure with Hari Singh, the then ruling Maharaja of the princely state, as they felt his policies were highly prejudiced against them. At the same time, the first ever political party from Jammu and Kashmir called the “All Jammu & Kashmir Muslim Conference” (later “All Jammu & Kashmir National Conference”, currently known as “National Conference”) was formed and a “Quit Kashmir Movement” was launched against the Maharaja in 1946[3]. In August 1947, India gained Independence from British rule and Pakistan was formed. All the Indian princely states which had not yet acceded into the Indian Union were given three options – accession with India, accession with Pakistan or to remain independent.

Maharaja Hari Singh signed ‘a standstill agreement’ with Pakistan in order to obtain a clear status quo but soon after, in October 1947,armed tribesmen from Pakistan infiltrated the valley forcing the Maharaja to seek help from the Indian Union for resistance. The then Prime Minister Jawaharlal Nehru agreed to send troops in the valley under one condition: the Maharaja would have to sign the Instrument of Accession which would lead to handing over the control of its defence, communication as well as its foreign affairs to India. And thus, Jammu and Kashmir became a part of the Union of India in October 1947.

Lord Mountbatten had accepted this accession with a remark: “It is my government’s wish that as soon as law and order have been restored in Jammu and Kashmir and her soil cleared of the invader, the question of the state’s accession should be settled by a reference to the people”.[4] This remark, coupled with the offer made by the Government of India to conduct a plebiscite or referendum to determine the future of Kashmir and then the absence of its execution, is what sparked the first fire in a never-ending war. The conflict in the region has existed ever since.

The armed conflict in the valley continued and India approached the United Nations Organisation (hereinafter “UN”) expressing its concerns over the capture of territory by Pakistan in Kashmir. In 1949, the UN proposed and mediated a ceasefire between the two countries known as the Karachi Agreement[5], but no decision on a referendum had taken place yet. The promise of a plebiscite seemed far from reality and tensions in the valley grew. Soon after this, in 1958, the Armed Forces Special Powers Act, 1958[6] (hereinafter “AFSPA”) came into existence granting special and in its broad sense, an almost unlimited power to the Indian Armed Forces for security reasons and in order to maintain public order in the “disturbed areas” of the valley. The gradually growing atrocities against civilians under AFSPA, the hanging[7] of Maqbool Bhat (a prominent separatist leader and founder of Azad Kashmir Plebiscite Front) as well as the elections of 1987 played the role of a catalyst as separatists (such as Yasin Malik of the  Jammu and Kashmir Liberation Front ) declared a war on the Indian government[8]. Since 1989, Kashmir has been put under heavy military control with over 700,000 Indian troops placed in public and private places throughout the Kashmir valley. The rise in militancy as well as military control led to the most horrific, bloody and tragic times for Jammu and Kashmir. What followed were decades of armed rebellion, political instability, unconstitutional detentions, insurgencies from Pakistan, formation of terror organisations, constant Army-terrorist crossfires and full-scale wars. The valley was no longer seemed inhabitable. Not by the sane, at least.

After being oppressed and witnessing war like conditions year after year, the people of Kashmir have grown numb and the state is experiencing one of the worst mental health crises in the world. Incessant violence since 1989 has triggered mental health related issues in the valley and has with time escalated the same. The people of Kashmir for almost three generations now, have lived an extremely dreary life. There is always a state of uncertainty amongst the people. “Will I be alive tomorrow?” “Are my loved ones safe?” “Will I get to see my family again?” are some of the questions that race in every Kashmiri’s mind all day, every day.

The Transmission of Trauma

The mental health of a person is affected by a lot of factors like genetics, surroundings, experiences as well as their social circumstances. Every aspect of an individuals’ life has an effect on their mind, shaping and programming it to function in a certain way. Unstable surroundings, trauma and a hostile atmosphere has an adverse effect on an individual’s mental well-being. Various psychological studies have shown that war and conflict can cause serious mental trauma and damage to a person. For example, a study conducted amongst the soldiers of the United States Army in 2015,attempting to study the increase in the suicide rate of soldiers, showed that over thirty percent (30.1%) of soldiers suffered from an internalising disorder[9], whereas only 20.6% suffered an externalising disorder[10].

Traumatic events can have a profound and lasting impact on the emotional, cognitive, behavioral and physiological functioning of an individual. No age group is immune from exposure to trauma, and its consequences. The effects of trauma in terms of psychopathology are well understood in the case of adults, while as in the case of children they have only recently begun to be understood. In a turmoil situation, civilian casualties have been found to outnumber military casualties by 3:1[11]. The most common traumatic event experienced is witnessing the killing of a close relative, followed by witnessing the arrest and torture of a close relative. The reason that war has such an impact on the victims is due to their witnessing of the destruction of a social world that represents and embodies their history, their living values and most importantly, their identity. There exist many examples of the same like the Guatemalan Mayans who had 70,000 civilians slaughtered in the 1980s, the Rohingya refugee crisis of 2015, the citizens of Iraq and Iran experiencing the ongoing conflicts in their countries. The effects of the conflicts are clearly seen on the psyche of these people.

 

Kashmiri residents walk past Indian paramilitary troopers as they stand guard during curfew and restrictions in downtown Srinagar due to the unrest in Kashmir sparked by the killing of Hizbul Mujahieed. (Photo Credits: TAUSEEF MUSTAFA/AFP)

According to the data provided by the World Health Organisation (hereinafter “WHO”) through a review of 129 studies in 39 countries, out of the total number of persons who have experienced war or war like conflicts in the previous 10 years of their life, 22% will experience depression, anxiety, post- traumatic stress disorder, bipolar disorder or schizophrenia. WHO’s review estimated prevalence of mental disorders among conflict-affected populations at any specific point in time to be 13% for mild forms of depression, anxiety, and post-traumatic stress disorder and 4% for moderate forms of these disorders. The effects of war on the victims are grave in nature and require years of treatment and still, in certain cases are not ever completely cured.

Keeping in mind the turbulent history and the gloomy present of Kashmir, one can easily recognise the roots and reasons of this mental health problem. The valley has been under perennial conflict for over seven decades now resulting in its ongoing mental health crisis. According to a mental health report of 2015, 1.8 million adults in the valley showed signs of mental distress. That is roughly 45% of the total population of Kashmir. 41% of the population showed signs of depression, 26% suffered from anxiety and about 19% showed symptoms of Post-Traumatic Stress Disorder. A startling 93% of Kashmiris have experienced conflict related trauma, said the report, and until 2015 there existed just one state psychiatry hospital in the region and one government OPD for the whole of Kashmir (Government Medical College, Srinagar). This report had been collected and published based on the data provided by the OPD of the hospital, which only included the reported cases.

Security personnel (back) stand guard a street under the clock tower at Lalchowk during a lockdown in Srinagar on August 12, 2019. (Photo Credits: TAUSEEF MUSTAFA/AFP)

In 1989, the year the conflict escalated, around 1,700 people visited Kashmir’s only psychiatric hospital.. There exists a year wise break up from 1985 to 2006 of the number of patients who visited the psychiatric department, and it shows a clear gradual increase in the number of patients through the years. The Kashmiri doctors believe that out of 100, not more than 10 people who are in need of medical care for mental health problems visit the psychiatry department. This shows that even these numbers, though high, are still not indicative of the actual number of existing cases at a particular period of time.

Year

Number of Patients

1985

775

1989

1700

1994

18000

1996

20000

1999

35000

2001

38000

2002

45000

2003

50000

2004

70000

2006

82000

A Kashmiri child looks on as Indian paramilitary soldiers patrol a street in the village of Kreeri Pattan. (Photo Credits: AFP PHOTO/TAUSEEF MUSTAFA)

Witnessing constant violence and living under never ending curfews and restrictions takes a heavy toll on an individual’s psychology. The effect of both of these are evident in one case study. A 52-year old woman, a resident of Kashmir, suffered from severe mental health problems. She lost her daughter and her son was missing and had supposedly “disappeared”. She stated that almost every night, she woke up crying from her sleep, mourning the loss of her daughter and waiting for the return of her son, and unfortunately, she was not the only one, she said. ‘Almost every house in Kashmir has at least one such tragic case of either dead or missing persons’. Every resident of Kashmir has witnessed violence and armed conflict in their life. Countless families have lost their loved ones to militant attacks as well as military detentions. On 6th August 2019, Article 370 of the Constitution of India, that granted Jammu and Kashmir its ‘special constitutional status’ was repealed causing significantly more tensions and unease in the valley. Soon after, the entire region was put under an unprecedented lockdown which included a complete communications blackout. This was apparently done with the purpose of preventing terrorism and similar fissiparous activities as stated by the Government of India. The lockdown in the state is still ongoing and 4G internet connectivity still has not been completely restored. Due to the imposition of such a lockdown, uncertainty increased as all economic and social activities came to a standstill. Kashmir had zero communication with the outside world. Schools were shut down with no further notice regarding reopening thereby causing anxiety amongst the students who were to give their board exams in the following academic year. Students belonging to Kashmir, studying in various schools and colleges across the country, had no mode of contacting their families back home for months on end. Roads were cut off, landline and cell phone lines were shut down, thousands of Kashmiris were arrested including the top elected officials and this led to a serious chaos in the valley further worsening the mental condition of the people. The people of Kashmir were completely isolated. Bilal Sultan, a politician from Kashmir, was arrested and placed in jail with hardened criminals and is stated to have slipped into a depression due to such a traumatic experience. Nida Rehman, another resident of Kashmir, who wished to open a non-profit organisation to raise awareness for mental health issues, was herself diagnosed with acute depression by a psychiatrist. Not to forget the many families who have been separated from their loved ones or have lost their loved ones due to the situation in the valley and now experience feelings of heightened fear, depression and anxiety. Dr. Arshad Hussain, a psychiatrist who has co-authored a study with ActionAid , called Kashmir one of the “saddest places in the world”. The region’s widespread human rights violations and the untreated trauma of the residents has further deepened this problem.

Missing Treatment

Despite the widespread trauma, Kashmir lacks the facilities and the tools for the treatment of people suffering from mental health problems. The mental health studies discussed above estimated that only 6.4% of people experiencing mental illnesses had visited a psychiatrist and only 12.6% actually sought any kind of medical help. While a part of this is due to the stigma around mental illness, the larger problem is the inaccessibility of such treatments to the patients in rural areas due to the lack of infrastructure. In addition to the barriers above, the endless check points and high security in and around the areas further discourages people from stepping out to seek the help they need, resulting in worsening of their mental health conditions.

Need for a Collective Response

Substantial and sustainable improvements can be achieved only when a comprehensive strategy for mental health which incorporates both prevention and care elements is adopted. The first and foremost step of any cause is to create awareness amongst the people. To familiarise people with the concept of mental health. By creating awareness, it becomes feasible to have open conversations and discussions about the topic.  It is imperative to educate people about the types of mental illnesses and their possible causes so as to help remove the stigma surrounding it. Workshops for the same purpose can be organised encouraging people to participate in such conversations. As discussed above, Kashmir is not well equipped to handle such a crisis. It is in dire need of more psychiatry OPDs and doctors. Funds need to be pooled in to build the kind of infrastructure that could cater to the needs of the public. Further, support groups can help an individual realise that he/she is not alone in facing such problems and can help accelerate the personal recovery of an individual through collective healing. Support groups also aid in the growth and betterment of a person suffering from mental health problems as they bring in the community feeling and support.

While the above-mentioned recommendations can help make a huge difference, they cannot satisfy the need for a permanent solution: a solution to end the war in Jammu and Kashmir, a solution for the welfare of its people that has been denied and delayed for decades. Justice for, and rights of, the people need to be restored in the valley. The war and violence has led to generations of Kashmiris leading a life of instability, fear and trauma.

The beautiful valley of Kashmir is now a gloomy sight where uncertainty looms in the air, weariness sits on the trees and despair lives in peoples’ homes, as it faces one of the biggest mental health crises in the world.

Photo by Waseem Andrabi/Hindustan Times

Saiee Godbole is a student at Symbiosis Law School, Pune.


Cover Photo Credits: RAKESH BAKSHI/AFP

Notes:

[1] A clan inhabiting northern India, especially the mountaneous regions of present Himachal Pradesh & Jammu-Kashmir.

[2] Dewan Parvez, A History of Kashmir (Manas Publications, Delhi, 2008).

[3] “Quit Kashmir Memorandum to the British Cabinet Mission on behalf of the All Jammu and

Kashmir National Conference”, 1946, Abdullah Sheikh Muhammad.

[4] Thomas Bruce Millar,” The Commonwealth and the United Nations “( 1967).

[5] Signed on 27th July, 1949.

[6] Act 28 of 1958.

[7] Hanged on 11th February, 1984 at Tihar Jail in Delhi.

[8] Praveen Swami, India, Pakistan and the Secret Jihad: The Covert War in Kashmir, 1947-2004 (Asian Security Studies, Delhi, 2206).

[9] Emotional and behavioural disorders, where patients usually keep their problems to themselves, or internalize the problems.

[10] A study cited in Military Medicine, Volume 180, Issue 10, October 2015, pages 1041–1051.

[11]  Margoob, et al. Defeat Depression Programme JK-Practitioner 200613Suppl 1123–124.

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