The Depth of a Scar

The growing PTSD crisis in Kashmir

Outside the sun is blazing at its zenith. Little light filters through the small window that illuminates the room. Jameela Banu, 47, is sitting inside her kitchen checking her medicines wrapped in a polythene bag in the dim light. Her five-year-old grandson is playing with his mother after returning from school. On the shelf is a picture of her 15-year-old son Ishtiyaq Ahamad Khanday who was killed in the 2010 Kashmir uprising.

Jameela vividly remembers when Ishtiyaq was killed, unable to speak of him without shedding tears.

From the day she witnessed the killing of her son, Jameela Banu hasn’t been able to sleep alone in her house. She spends the day walking through the house, closing windows, doors, and locking them repeatedly. Her husband, Ghulam Ahmad Khanday took her to many doctors, and finally to a psychiatric hospital in Srinagar, the capital of Indian-administered Kashmir. She was diagnosed with depression and Post Traumatic Stress disorder (PTSD) and is undergoing treatment.

Ishtiyaq’s death left her deeply traumatized. ‘The situation in Anantnag, a district in South Kashmir was tense. A group of youth from Lazbal area of Anantnag, came out to protest against the killing of civilians in Sopore area of North Kashmir, but everything was normal in our village. We were building a new house and my son was with his father, guiding carpenters and electricians. I gave him some money to get bread from the market. He had just reached the gate, when a group of protesters suddenly appeared in our lane. They were being chased by the police and the paramilitary. To disperse the group of protesters police and paramilitary fired indiscriminately and some bullets hit my son’s neck and abdomen, killing him instantly,’ recalls Jameela.

Living with PTSD, Jameela’s life has become a continuous challenge. She still gets flashbacks and nightmares and is totally dependent on anti-depressants and other medicines to cope with the symptoms.

I have lost all ability to concentrate or even complete simple tasks. I am seeing violent images every time I close my eyes. I have stopped visiting relatives or getting involved in gatherings.

‘Eight years have passed; the incident is still fresh in my mind. I cannot close my eyes without seeing the face of my son. I have lost all ability to concentrate or even complete simple tasks. I am seeing violent images every time I close my eyes. I have stopped visiting relatives or getting involved in gatherings. I am also attending counseling sessions, but I’m still unable to cope up or overcome this scar in my memory.’

Her husband Ghulam was forced to sell the cab to pay off the debt he owed for his newly built single-storey house. They are now being taken care of by their son-in-law.

Although the family has lodged a First Information Report (FIR) against the killing of the young boy, their repeated attempts to seek justice have been futile.

“Eight years ago, the government ordered a magisterial inquiry and appointed then Assistant Commissioner Revenue, GM Dar, as the inquiry officer. The inquiry team in its report indicted five state policemen, including two officers, for the killing. The report was submitted to the government, but no action against the culprits was taken and they are still roaming free. I have now completely lost faith in the system and all hopes to get justice have been completely shattered ” said Ghulam.

Where time stands still

Kashmir has been experiencing a prolonged armed conflict for the last two and half decades, which has taken a heavy toll on both the socio-economic and psychological wellbeing of the people. Kashmir has been divided between India and Pakistan since the two gained independence from British rule in 1947. Both the nations claim the territory in full. Several rebel groups have for decades fought Indian soldiers deployed in the territory, demanding independence for the region or its merger with Pakistan. Tens of thousands of people, mostly civilians, have died in the fighting. The insurgency in Kashmir began in 1989 and the ongoing armed conflict has claimed a total of 41,000 lives in the past 27 years, which means an average of 4 deaths per day in the state or 1519 casualties every year, according to the latest available government data, the Hindustan Times reported in 2017.

Abdul Qadeer Bhat, 34, was 12-years-old when he was tortured by the Indian Army in his home. He was returning from school when he saw officers in his home, conducting a search. When he entered the house, he was taken into a separate room and tortured for two hours.

‘An army major took me into the room and I was asked to tell him the whereabouts of the local militants. I honestly told them that I don’t know anything. The army major took out his knife and gave me a deep cut on my palm. That was painful. After that, he continuously slapped me, like a hundred times till my face turned blue. He took me out of [the] room, removed my shirt, hoisted the Light Machine Gun (LMG) on my shoulder as a weight and started firing indiscriminately. That moment was horrific. My entire body started shaking and I fell unconscious.’

Qadeer says the army major along with his subordinates tried to stab him to death and would almost certainly have succeeded, had the commanding officer (CO) not arrived on the scene.

After the event, Qadeer was in a deep shock for a long time. He was unable to keep the memories of the attack out of his mind. At night, he would have terrible dreams of torture, and would wake up screaming. Scenes of torture would run repeatedly through his mind and disrupt his focus. He dropped out of school after he developed difficulties concentrating.

Qadeer’s parents started worrying seeing his condition. They took him to a general physician in their village but nothing improved. He, too, was referred to a psychiatric hospital in Srinagar, and diagnosed with PTSD and severe depression.

‘It’s been 22 years now, I am still dependent on anti depressants, as it’s helping to decrease the levels of anxiety and depression. My life has become totally meaningless as I am unable to do anything. I am confined to my room.’

Whenever Qadeer hears loud noises, such as a gun firing, loud music, people shouting or huge gatherings, he starts to panic. At night he still has difficulty relaxing and falling asleep.

‘My aim was to become a scholar but that dream has been shattered. I couldn’t continue my studies after this incident. I remain tense at all times and I’m easily startled. I feel “dirty” and somehow shamed by this traumatic event and feel rejected.’

Kashmir remains one of the world’s most heavily militarized zones. According to the Jammu and Kashmir Coalition of Civil Society (JKCCS) 2015 report, Structures of Violence, the number of soldiers, paramilitary, police and other agencies deployed by India in Jammu and Kashmir is estimated between 650,000 -750,000, giving it an extremely high (70: 1200) force to population ratio. According to the 2011 census, the state of Jammu and Kashmir has a population of more than 12 million. So India has deployed 1 soldier to 12 Kashmiri civilians. The Indian armed forces in Kashmir operate with impunity provided by law – the Armed Forces Special Powers Act (AFSPA) – under which they can shoot anybody on mere suspicion and can enter and search any premises without a warrant.

The prevalence of mental health issues in Kashmir has significantly increased since the insurgency began in 1989. Also, the mental health services are inadequate, and accessibility to the people of Kashmir remains a hurdle. Kashmir’s only psychiatric hospital — Institute of Mental Health and Neurosciences (IMHANS), in Srinagar, the summer capital of Indian Administered Kashmir is facing a manpower shortage and inadequate facilities, which is taking a heavy toll on mental health care.

“Every day, the hospital is seeing a huge influx of patients from across the Kashmir valley, who suffer from mental health issues. But it becomes difficult for us to manage that with limited resources and manpower. There are only six doctors, who run both IMHANS and the psychiatry unit at the Shri Maharaja Hari Singh Hospital (SMHS) in Srinagar on rotational basis. We don’t have trained clinical psychologists, counsellors and no recreational facilities are available for mental health patients,” said a hospital official on condition of anonymity.

My aim was to become a scholar but that dream has been shattered. I couldn’t continue my studies after this incident.

Médecins Sans Frontières/Doctors Without Borders (MSF) released a comprehensive report on mental health in Kashmir and concluded that half of all residents of the valley have ‘mental health problems’. The report found that nearly 1.8 million adults – 45 percent of Kashmir’s adult population – suffer from some form of mental distress. A majority of people have experienced conflict-related trauma. According to the report, 37% of adult males and 50% of females are suffering from probable depression; 21% of males and 36% of females have a probable anxiety-related disorder; and 18% men and 22% women have been diagnosed with probable PTSD.

“Trauma in Kashmir is a reality and is very prevalent. Due to the ongoing conflict, there has been sharp rise in mental health issues in Kashmir, which has resulted in chronic post-traumatic stress disorder, depression, and drug abuse. The prevalence of mental health disorders is greater in women than in men. Apart from PTSD, the other mental disorders that we found among the Kashmiri people are schizophrenia, bipolar disorders, OCD, dysthymia and general anxiety disorder. “said Dr. Arshad Hussain, an associate professor of psychiatry at the Government Medical College in Srinagar, the summer capital of Indian administered Kashmir.

Collateral damage

One morning in January last year, in a small village in southern Kashmir, Sarah Banu, 45, was busy doing her household chores, while her 18-year-old son Amir was playing an inter-village cricket match, away from home.

When the match was over, her son came back, had a bath and told his mother he was going for prayers and would be back soon. That was the last time Sarah saw her son.

Two hours later, Sarah Banu called her son Amir, but his phone was switched off. She started worrying and went to nearby relatives to look for him.

‘I became restless and went to neighboring villages to ask people about him, everyone was clueless. I couldn’t sleep that night, I was thinking about him. I hoped that he would return.’

The next day, a photograph of the 18-year-old Amir carrying an AK-47 rifle was doing rounds on social media. The militant group, which Amir had joined posted his picture on social media announcing he had joined them.

When Sarah Banu heard the news, she collapsed and slipped into a deep shock. Sarah says, whenever she sees the bedroom and belongings of her son, she becomes restless. To overcome the trauma, she left her home and went to her father’s place to live, because the memories of her 18-year-old son were haunting her.

Trauma in Kashmir is a reality and is very prevalent. Due to the ongoing conflict, there has been sharp rise in mental health issues in Kashmir.

Soon after, she started getting panic attacks and was soon diagnosed with PTSD.

‘I struggle with sleeping. I am on different types of medication. Often, I have panic attacks and my dreams are nightmares. My dreams are about my son getting killed. There is nothing “happy” about the things that race through my mind during the night. When [the] sun sets and everything becomes dark and quiet, the dreams about my son start recurring, which re-triggers the trauma, making me restless,’ Sarah explains.

Amir was adored by his family, relatives and friends. When Sarah hears news of any gunfight in Kashmir, her hands start trembling and the color of her face turns pale. She starts crying and screaming for her son.

“Amir never participated in any protest demonstration, he was normal. I never thought that one day he will leave us and join militants. I don’t know what compelled him to join militants. I am completely lost and have no interest in doing things. I always pray for his survival. When I wake up, I am already anxious, tired and short of breath. For the last three months, I am suffering from memory loss too.’

The Jammu and Kashmir police and army are frequently asking Sarah Banu and her 47-year-old husband to appear at the police station and army camp for questioning.

‘It’s very traumatic for me to face the security forces. We haven’t seen our son since the day he left, and neither has he reached out to us. We don’t have any contact with him, but we are still being pushed by the authorities to ask our son to surrender. It’s adding more distress to our lives,’says Sarah.

Trauma and healing

In the afternoon of 29 July 2016, Naseer Ahmad, 27, was busy at his salon in the northern district of Baramulla, giving a scalp massage to a customer, when he heard loud voices outside and saw a group of protesters being chased by the police and paramilitary troops. He quickly shut his shop and ran towards the narrow alley leading to a neighbor’s house which he considered a safer spot.

‘I went inside the house and was sitting in a room on the second story. Outside, police started firing tear gas shells and pellets indiscriminately. The window of the room was open and some of the pellets hit me. I fell to the ground and blood started oozing out from my right eye.’

Naseer’s family and friends rushed him to Srinagar’s SMHS Hospital, the main state-run facility. He underwent three operations and doctors say he has lost all vision in his right eye. His father even took him to Amritsar for specialized treatment, but doctors there said the damage was permanent.

‘The loss of vision in my right eye was a psychological trauma for me. People can see my scar outside, but on the inside, nobody can see how I am really feeling. My life has entirely changed and I am struggling to cope. I haven’t earned a single penny since this incident. I am totally dependent on my family. I have become a liability for them,’ he says.

Naseer’s family depends on the earnings of his father, a farmer, and his elder brother, who runs a small business. ‘I got married in 2015. I have two young daughters; I can’t do anything for my own family. I have no control over anything and I am feeling I lack confidence and am constantly over-thinking. Sometimes I don’t want to leave the house fearing that someone would come and kill my daughters.’

In many cases, families aren’t familiar with PTSD as a mental illness, and are lost as to how to help their loved ones. “It’s very hard for family members to understand the person suffering from PTSD. Its symptoms influence the behavior of a person and can cause him to appear angry, strange and upset. PTSD victims often take a long time to recover and family support plays an important role in it. “said Saima Khan, a Clinical psychologist.

A small room with a huge front window is eerily silent. Each day, Ayesha Begum, 58, spends the entire day peering outside. She says her life came to a standstill after her son Javed, 25, joined militants.

Javed, 25, was mature-minded, polite in nature and the oldest among his siblings. He was 10-years-old when his father died of a heart attack. To support his family, he gave up his studies and started working in a local bakery. But one day in 2007, he went missing.

The loss of vision in my right eye was a psychological trauma for me. People can see my scar outside, but on the inside, nobody can see how I am really feeling. My life has entirely changed and I am struggling to cope.”

When he didn’t return, Ayesha called his friends and went to nearby villages to search for him. The family then filed a missing persons report at the local police Station. After several days, Javed’s family came to know that he had joined the militants.

Many years have passed, and Ayesha Banu no longer remembers the date when her son was killed, but she remembers the last meeting with her son.

‘That day he came home to see me and had lunch with us. When he was about to leave, he hugged me tightly and left. Next morning when I woke up, I learned from neighbors that my son had been arrested by the army in a nearby village and later killed. Afterwards, the army raided my house and told me to collect the dead body from the local police station.’

‘I ignored the symptoms of mental illness for a long time. But my condition detoriated day by day. One day, my nephew, who is also a paramedic, took me to a psychiatric Hospital in Srinagar city, where I was diagnosed with PTSD. Since then I am on medication, but still I have moments of hyperventilation, palpitations, flashbacks and little interest in doing things.’

Some sources’ names have been changed by request.

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Faisal Magray

Faisal Magray is a photojournalist based in India. His work revolves around documenting global and local issues—primarily focusing on human rights, health, conflict aftermath and socioeconomics.

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