Tuesday, August 31, 2010

Addressing Mental Health in Pakistan Along With Cultural Needs


By: Mahmood Iqbal
August 31, 2010

Akora Khattak, Pakistan - As International Medical Corps makes mental health care a priority in our emergency relief efforts, we are providing psychosocial services to help Pakistanis cope with the enormous emotional toll of the floods. In addition to providing individual and group support sessions through our mobile clinics, we also deployed a female psychologist to deliver specialized care to women and children.

“We have been witnessing behavioral changes, particularly in women,” said Dr. Sanam Rahim, a female psychologist working at our clinic in the civil hospital in Akora Khattak, about 9 miles east of Nowshera. “The majority have psychosomatic symptoms and increasingly complain of body aches and other illnesses.” Dr. Rahim is able to provide culturally-sensitive care to Pakistani women who feel more comfortable consulting with a female doctor.

Having already had extensive experience working with the internally displaced people in violence-torn Buner District, Dr. Rahim notes that the worst natural calamity in recent history has caused severe mental stress and psychological reactions among flood-affected people. She spoke of 45-year-old Roshmeena who complained of having body aches, but after clinical examination and psychosocial counseling was found not to be physically ill. A resident of Akora Khattak village, Rashmeena has 10 children and an unemployed husband. Already struggling financially, the floods washed away the family’s home and all of their belongings, leaving them without even the most basic resources. “Mental stress and anxiety can convert to psychosomatic disorder,” Dr. Rahim explained. “We want to see Roshmeena for regular follow-up visits and advised her to do muscle relaxant exercises.”

Like Roshmeena, others in Pakistan also complain of body aches and other illnesses, which are actually symptoms of psychological distress, according to specialists. Dr. Rahim recalled seeing a 10-year-old boy complaining of severe hiccups. His mother explained that he had feigned hiccups since the floods struck their village.

“Such psychological illnesses are growing among the flood victims,” Dr. Rahim said, noting that counseling of the child revealed that children in the area had lost all recreational facilities to the floods. “The schools are closed and the lack of recreational activities often leads to mental complications among the children.”

Comparing the displacement of people from Buner district to the devastation and displacement caused by the recent floods, Dr. Rahim notes that a natural disaster often leaves deeper after-effects on local populations because it is so unexpected and sudden that victims have no chance to prepare emotionally. “In Buner and Swat, people knew beforehand that a conflict was brewing in the area. In a sense, they were mentally prepared to leave their houses. But, with the floods, there was no warning. People were caught unaware and they could not even find time to rescue their most valuable items.”

Through International Medical Corps’ mobile clinics in Pakistan, patients suffering from emotional stress are identified during clinical check-ups and referred for further psychosocial counseling.

“When stress converts to depression, it becomes a long-term process to cure,” Dr. Rahim says. “Early psychosocial counseling helps lower the stress and prevent the conversion into acute post-traumatic stress disorders.”

To date, International Medical Corps’ psychosocial support staff has conducted individual and group sessions for approximately 920 individuals, including young children.