Recovering from war trauma

Dr. Ruwan M. Jayatunge M.D.

After many decades of a bitter war, Sri Lankans are, now, relieved. The Nation was overjoyed. The damage caused by the war will echo in our society for another decade.

We should take immediate measures to rebuild the Nation.

Combat trauma

Combat related stress is common among soldiers. Picture by Rukmal Gamage

Wars represent mental health emergencies. It can affect the mental well-being of individuals. Mental health is indispensable to personal well-being, family and interpersonal relationships, and contribution to community or society.

Mental health is the springboard of thinking and communication skills, learning, emotional growth, resilience, and self-esteem. Combat trauma can change the parameters of mental health towards the negative side. It can cause ailments such as PTSD, Adjustment disorders, depression, Somatization and sometimes psychotic manifestations.

The magnitude of combat trauma in Sri Lanka

Combatants as well as a large numbers of civilians including the members of the LTTE have undergone a tremendous amount of stress for the past three decades. It has become a collective trauma for the islanders. These psychological scars are unhealed and affect the person as well as society.

The circumstances of the armed conflict can produce a range of emotional and behavioural stress reactions among soldiers and civilians. The psycho-physical effects of combat have been recorded since the early days of World War 1. By 1914, British doctors working in the military hospitals noticed that many soldiers who were exposed to traumatic battle events manifested various somatic psychological ailments which they called ‘Shell Shock.’

Lessons

Between 1914 and 1918, the British Army identified 80,000 men as suffering from shellshock.

Chronic fatigue syndrome was evident during the World War II and soldiers suffered from physical symptoms including persistent fatigue, sleep disorders, emotional labiality, cognitive impairments and depression.

During the Vietnam War, 2.8 million US servicemen served in the Southeast Asia mainly in Vietnam and almost one million were exposed to active combat. By the end of the War over 50,000 Vietnam veterans were diagnosed with combat related post-traumatic Stress Disorder. It is said 20,000 veterans committed suicide in the war of the aftermath.

Effects of war trauma on Lankan soldiers

The Sri Lankan Forces were the only force in the world where its entire bayonet strength had continuously been deployed for nearly 30 years. In the Northern conflict, many soldiers underwent traumatic battle events beyond the usual human experience. No doubt, these events have caused immense trauma among the combatants.

According to our rough estimations, nearly 10 to 12 per cent of the members of the Armed Forces are suffering from combat related stress. Most of the stress reactions are undiagnosed and untreated. These psychological and emotional traumas were resulted from witnessed killings, handling human remains, exposing to life and death situations, and numerous other battle stresses.

This is a form of invisible trauma in the military. But it has direct implications on the mental health of the soldiers as well as their family members and the society at large.

Effects of war trauma on the civilians

Stanley Krippner and Teresa M. McIntyre highlight the psychological impact of war trauma on civilians. They point out that psychological and emotional injuries maybe the most enduring effects of war, yet historically they maybe the least addressed in terms of rebuilding a society and preventing future violence.

War disrupts the existing social structure and makes it very difficult for the usual social mechanisms to manage the consequences. According to Professor Daya Somasundaram disasters have an effect not only on individuals but also on their family, extended family, group, community, village and wider society. The civilians of the North and South faced the pungent effects of the war.

The civilians exposed to war were traumatized in different ways. The effects have longer-lasting consequences than destruction itself.

Sometimes unintentionally, parents inflict their psychological baggage on their children and it leads to a vicious cycle of trauma. On most occasions, the impact of war and extreme stress on civilian populations has caused numerous personality changes in them. Psychological responses to these phenomena were expressed as social aggression, alcoholism, family discard, child abuse and self-harm and suicides.

The discovery of delayed reactions of battle stress by Dr Michael Robertson of the Mayo Clinic reveals another threat of combat trauma. Those who are free of any type of combat stress signs today could be a future vulnerable group. Therefore, psycho education and effective treatment measures should be introduced to our health system.

Psychosocial rehabilitation

The major impact of war includes disintegration of the psychological well-being. Therefore, major psychosocial interventions are required to restore the damages caused by the war. Promotion of human rights and justice are the key way to reinstate the social equilibrium. The victims of war need psychosocial support and rehabilitation. Rehabilitation programs include education, vocational training, income generating projects, loans and housing that is tailored to the needs of the survivors and post disaster situation.

Evading political extremism and fundamentalism

Soon after a mass conflict like war, there is a tendency of political extremism and sometimes fundamentalism to emerge. In a post conflict, society social fabric is fragile, people are traumatized and they become easy targets to these extreme and damaging forces. Soon after the WW 1, Germany faced such a situation and NAZIS could exploit the collective trauma experienced by the German people. The Taliban fundamentalists grabbed the power at the end of the Afghan conflict. Hence, there is an impending risk that we face today and the Democratic forces have an absolute responsibility to restore peace and justice system in the Country.

Reconciliation and peace building

Reconciliation and peace building has become one of the top priorities that would ensure the triumph of Sri Lankans. Petty religious or racially based politics will damage the Nation beyond repair and it will soon open another conflict in the future. We have to learn from the past and rectify our errors, which damaged the racial harmony in Sri Lanka. People should take immediate and effective measures to reconcile, rehabilitate and reconstruct the war wrecked society.