Conflict in the Indian Kashmir Valley II: psychosocial impact

Abstract

BackgroundIndia and Pakistan have disputed ownership of the Kashmir Valley region for many years, resulting in high levels of exposure to violence among the civilian population of Kashmir (India). A survey was done as part of routine programme evaluation to assess confrontation with violence and its consequences on mental health, health service usage, and socio-economic functioning.MethodsWe undertook a two-stage cluster household survey in two districts of Kashmir (India) using questionnaires adapted from other conflict areas. Analysis was stratified for gender.ResultsOver one-third of respondents (n = 510) were found to have symptoms of psychological distress (33.3%, CI: 28.3–38.4); women scoring significantly higher (OR 2.5; CI: 1.7–3.6). A third of respondents had contemplated suicide (33.3%, CI: 28.3–38.4). Feelings of insecurity were associated with higher levels of psychological distress for both genders (males: OR 2.4, CI: 1.3–4.4; females: OR 1.9, CI: 1.1–3.3). Among males, violation of modesty, (OR 3.3, CI: 1.6–6.8), forced displacement, (OR 3.5, CI: 1.7–7.1), and physical disability resulting from violence (OR 2.7, CI: 1.2–5.9) were associated with greater levels of psychological distress; for women, risk factors for psychological distress included dependency on others for daily living (OR 2.4, CI: 1.3–4.8), the witnessing of killing (OR 1.9, CI: 1.1–3.4), and torture (OR 2.1, CI: 1.2–3.7). Self-rated poor health (male: OR 4.4, CI: 2.4–8.1; female: OR 3.4, CI: 2.0–5.8) and being unable to work (male: OR 6.7, CI: 3.5–13.0; female: OR 2.6, CI: 1.5–4.4) were associated with mental distress.ConclusionThe ongoing conflict exacts a huge toll on the communities' mental well-being. We found high levels of psychological distress that impacts on daily life and places a burden on the health system. Ongoing feelings of personal vulnerability (not feeling safe) was associated with high levels of psychological distress. Community mental health programmes should be considered as a way reduce the pressure on the health system and improve socio-economic functioning of those suffering from mental health problems.

Conflict in Kashmir: Psychosocial Consequences on Children

“…Such happenings create a sense of mistrust, insecurity, and helplessness in the lives of common people and their children. A study conducted by Jong et al (2008) in Kashmir showed that almost half of the respondents (48.1 %) mentioned that they felt safe only occasionally or never, and they had to suffer crackdowns, frisking by security forces, roundup raids, damage to property, burning of houses, mistreatment, humiliation, and threats. It was found that nearly one in ten people (9.4 %) lost one or more members of their nuclear family because of violence.…”

“…People dealt with stress by isolating themselves (22.3 %) or becoming aggressive (16 %). In another study, Jong et al (2008) reported frequent direct confrontations with violence since the start of conflict, including exposure to crossfire (85.7 %), round up raids (82.7 %), the witnessing of torture (66.9 %), rape (13.3 %), and self-experience of forced labor (33.7 %), arrests/kidnapping (16.9 %), torture (12.9 %), and sexual violence (11.6 %). Males reported more confrontations with violence than females.…”

“…They are not able to come out of this aura and feel suppressed. A study done by Jong et al (2008) revealed that Kashmiri women are among the worst sufferers of sexual violence in the world. Interestingly, the figure is much higher than that of Sierra Leone, Sri Lanka and Chechnya.…”

Borderlands and Borderlines: Re-negotiating Boundaries in Jammu and Kashmir

“…This gender dimension is further substantiated by the study titled "Conflict in the Kashmir Valley II: Psychological Impact," by a team from Medicins Sans Frontiers (MSF) which specifically stratified the data for gender (Kaz de Jong et al 2008). Published in 2008, this survey by MSF was done to evaluate the exposure of the civilian population to violence and its consequences on mental health and is particularly significant in what it reveals about life in rural areas at the height of the armed conflict.…”

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“…According to another study in post war Serbia, 13.0% participants had symptoms of PTSD, and 49.2% had symptoms of depression [24]. According to a survey in the Indian Kashmir valley, the ongoing conflict in the valley had a huge toll on the psychosocial health of the population with over one third of the participants having symptoms of psychological distress and majority of them being women [25]. According to an epidemiological study, 48% of the Somali and 32% of Rwandese refugees living in a refugee settlement were found to be suffering from PTSD [26].…”