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HEALTH: Healing the Invisible Wounds of Violence
By María Vega
ROME, Dec 5 (IPS) - One billion people in the world today are psychologically scarred by violence and armed conflicts, a problem that brought together health ministers from around the planet in the search for ways to help heal these invisible wounds.
Richard Mollica, director of the Harvard University Programme in Refugee Trauma, told IPS that one-sixth of the world's population suffers the psychological consequences of such traumatic phenomena as war, ethnic conflicts, natural disasters, social upheavals, torture, terrorism and landmines, which kill over 15,000 people every year and mutilate many thousands more.
The problem, he noted, is that victims of post-conflict trauma, especially in developing countries, rarely have access to the help they need, and are thus doomed to lives of depression, anxiety, nightmares and relentless fear, which seriously handicap their social and family relations.
Nevertheless, Mollica added, it has been scientifically proven that there is hope for recovery for these victims if a mental health action plan were put into effect in the societies where they live.
This was the objective behind the International Congress of Ministers of Health for Mental Health and Post-Conflict Recovery, held in Rome Dec. 3 and 4.
The health ministers of 49 countries joined together here to establish a plan of action based on the One Billion Project, an initiative developed by the Harvard University programme in conjunction with the Fulbright New Century Scholars Programme, the humanitarian organisation Caritas-Rome, and the Rome Higher Institute of Health.
The One Billion Project, used as a guideline for the health ministers at the congress, has scientifically demonstrated that a mental health action plan can be effective in helping the victims of violent situations if it is adapted to the specific realities and cultures of each country.
For Mollica, the health ministers play a key role in this endeavour, and are in the best position to coordinate these kinds of activities.
The project, initiated three years ago, has explored the effects of violence on mental health and shown that there is a direct correlation between mental health, economic development and human rights.
It has also succeeded in disproving two long-held myths: that survivors cannot overcome post-conflict trauma, and that there is no connection between individual and collective recovery.
According to Mollica, however, health care initiatives alone will not suffice. A much more comprehensive approach is needed, integrating such elements as government policies, legislation, financing, international cooperation, economic development, human rights, and scientific research on mental health.
The task ahead is not an easy one. "Those of us from countries that have lived through conflict know that it will be impossible to solve all of the mental health-related problems, because our resources are limited," said José Maza, the minister of public health and social assistance in El Salvador.
"But we can at least work towards alleviating these problems, instead of sitting back and doing nothing," he added.
Between 1980 and 1992, El Salvador was engulfed in a violent civil war as government security forces and paramilitary death squads sought to crush the leftist guerrilla insurgents and their civilian support base. The war left roughly 75,000 dead and 7,000 "disappeared", and according to Maza, most of the survivors continue to suffer the psychological effects.
The situation is especially serious in countries that face extreme poverty and constant upheaval, such as Haiti, where it is estimated that 70 percent of women suffer the consequences of some form of violence, six out of ten are physically or psychologically abused, more than 10,000 children are living on the streets, and 600,000 people have no access to health care and medicines.
To make matters worse, natural disasters left over 100,000 Haitians homeless in 2004 alone.
Nevertheless, the Haitian government representatives attending the congress in Rome stressed that there is a marked political will to solve these problems.
They pledged that every effort would be made to implement the action plan and adapt it to their own realities by involving all relevant social actors and making use of all available resources.
In Peru, the population continues to suffer such psychological effects as depression, fear and anxiety as a consequence of the wave of guerrilla and counterinsurgent violence that swept the country between 1980 and 2000, leaving 69,000 dead, 6,000 "disappeared", 40,000 orphans and 20,000 widows, according to the 2003 report from the Truth and Reconciliation Commission.
"In most developing countries that have suffered conflicts and violence, existing mental health policies are insufficient, because they have traditionally been ignored in national health care plans," Peruvian Health Ministry official Ricardo Bustamante told IPS.
"In Lima, the capital, there is one psychiatrist for every 55,000 inhabitants, and in the rest of the country, the ratio is estimated at one for every 200,000, which is clearly not nearly enough to satisfy the country's needs," he noted.
In an attempt to remedy this situation, the ministry has established mental health as one of the 10 national priorities for health-care policy making, said Bustamante, and budgetary resources are already being specifically earmarked for related activities.
The health ministers gathered in Rome committed themselves to promoting the implementation of the mental health action plan in their own countries as an official state policy.
The congress participants concurred that mental health encompasses such factors as access to employment, education and health care, as well as respect for human rights. Consequently, any mental health care initiatives should be linked to fighting poverty.
For his part, Mollica stressed that the best treatment for children suffering post-conflict trauma is school, and for adults, it is work. Some victims need psychiatric treatment, and others require medication, but all of them need to work and get back to a normal life, or at least attempt to rebuild their lives, he said. (END)
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