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 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
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.’
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
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
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.
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
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.