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Seminar on Conflict and Mental Health in Northeast India

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Root cause of armed conflict in Manipur is due to the dehumanising condition of the Manipuri people – MC Arun

A National Seminar on “Conflict and Mental Health In Northeast India” was held on January 23, 2016 at the Conference Hall, Tribal Research Institute, Imphal. The seminar was organised by the Department of Social Work, Indira Gandhi National Tribal University (IGNTU), Regional Campus, Manipur and sponsored by ICSSR, New Delhi.
Prof. Akshaykumar, Clinical Psychologist, formerly with Department of Clinical Psychology, Regional Institute of Medical Sciences, Imphal and Prof. MC Arun, Director, Centre for Manipur Studies, Manipur University were the Presidium Members of the Inauguration Session of the seminar.
Prof. Akshyakumar delivering the keynote address stated that when the armed struggle started in Manipur or Assam, many people have lost their lives. It is the people who are related to the deceased who suffers. It is them who acquire the problem of mental health. The prevalence of mental health such PTS, anxiety, depression, etc. on account of armed conflict in Manipur is high. He stressed that what is important is to identify whether people are maintaining mental health. In order to find these out, one has to be aware of the early signs and symptoms such as sleeping hours, allergy, physical pain, feeling of unusually confused, upset, worried and other forms of behavioural changes (including mood fluctuations and persistent thinking about an incident), etc. The person who is suffering from mental health problem may not be able to recognise these early signs. Thus, persons who are close to these people must be of help. He added that mental health problem can develop at any time in the life of a person. Then he spoke about the characteristics of a sound mind. A person with a sound mind can have quality time with his surrounding with a sense of happiness, purpose and security. The opposite are the characteristics of a person with unsound mind and often live under hallucination.
Prof. MC Arun stated that the root cause of armed conflict in Manipur is due to the dehumanising condition of the Manipuri people. There was contradiction between the minority superiors and the majority inferiors in the state and this gave birth to the phenomenon of insurgency. Initial targets of the insurgents included rapists and corrupted officials including doctors so as to remove the dehumanising condition. At this initial phase, the people gave tacit support. But after the 80s, the insurgents have been perceived by the commoners as another oppressor who imposes what to wear and what to speak, etc. Since then, the people are caught in between two oppressors, the State and insurgents, thereby increasing the incidences of mental health. There is a decrease in the intensity of armed conflict but the intensity and incidences of mental health are ever increasing. Prof. MC Arun cautioned that these understandings largely remain hypothetical. Therefore, proper study to document the prevalence of mental health is a must, a task to be undertaken with professionals such as doctors.
The study would be useful to empirically establish the link between armed-conflict and mental health.
Dr. Hanjabam Shukhdeba Sharma proposed the vote of thanks.
In the first technical session titled, “Conflict, Militarization and Mental Health”, Chaired by Dr. Aheibam Koireng, Asst. Prof., Centre for Manipur Studies, Manipur University, 4(four) resource persons presented papers.
Dr. Malem Ningthouja from the Indian Institute of Advance Studies, Shimla presented a paper titled, “Torture and Mental Health”. He said that torture can be understood as pain caused to human life that last and remain for longer period of time. When torture is shifted from individuals to society it becomes a social issue. There are many term uses round the globe. India was declared as a disturbed area so AFSPA 1956 was passed by the Government of India. The Act was amended in conflict area like J&K and also in states that wanted to get independence. According to him, there are two factors of torture. First one is military & political or institutionalised form of torture. The second form of torture which challenges the human rights which are somewhat related with the constitutional laws. The system of the society causes torture to the society and individuals. Self intended torture by accepting torture to face the torture or for the cost the society. Law enforcing agencies uses law as tools for torture and form an informed kind of torture. Capitalist superstructure imposts torture to the individuals to asquint their desire.
Dr. Homen Thagjam, MB College, Government of Manipur presented a paper on “Theorising Violence and Mental Health”. He noted that violence is being used in the paper to connote the political form. The birth of modern states (nation-states) was through a tumultus and violent struggle of the people. It was forged through blood and war. And embedded in this violent product was a violent nature which holds the monopoly over violence in te Weberian sense. Modern state is in pursuit of homogenization and stands for the same. In order to achieve this goal, it uses violence in the name of security and development. Those who oppose it simply because they have a memory which so different from the one the nation-state holds are termed as the internal enemy or the objective enemy who needs to be terminated. He cited examples from Manipur and Algeria to illustrate his opinion. Citing Franz Fanon, Dr. Homen stressed that the first symptoms of mental health begins with the question, “Who am I or who are we?”.
Dr. Nelson Loitongbam from the Department of Psychiatry, Jawaharlal Nehru Institute of Medical Science, Imphal presented a paper on “Post Traumatic Stress Disorder following ethnic clashes in Manipur”. He observed that mental health is gradually recognized as an important development issue, especially in the case of conflict-affected zones. Traumatic events and the way people cope with them have a crucial role in development of Post Traumatic Stress Disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), somatization, and dissociative disorder. He added that although conflict is associated with an increase in the prevalence of mental disorders, there are few population based studies carried out in conflict-affected areas and low income countries. Mental health is more than the absence of disease or disorder. It is defined as a state of complete mental well-being including social, spiritual, cognitive and emotional aspects. And Posttraumatic stress disorder (PTSD) is an anxiety disorder that a person may develop after experiencing or witnessing an extreme, overwhelming traumatic event during which they felt intense fear, helplessness, or horror. For the study, victims included all the persons who had experienced, witnessed or were confronted with an event or events that involved actual or threatened death or serious injury or a threat to physical integrity of self or others as a result of the ethnic violence. He remarked that out of the total 100 cases taken up for study 97 percent had some form of psychiatric morbidity. Further, the hospital sample had 100 percent morbidity which was expected as the individuals have attended the psychiatric OPD for treatment. The field sample which was ‘at risk’ population showed 94 percent morbidity. In the case of PTSD in the total sample was found to be 25 percent, PTSD in Hospital Sample was only one case (2 percent) and PTSD in the field sample was 24 cases (48 percent). As way forward he stressed on the need for recognition of the importance of the linkage between poverty, conflicts, social capital, mental and psychosocial well-being and dysfunction.
The session also had a short discussion hour after the resource persons had spresented their respective papers. During the discussion hour, resource persons were asked different questions by delegates. Queries about the law related with conflicts, insurgency problems and mental health were clarified by resource persons. With this the session was concluded with the words of appreciation from Dr. Aheibam Koireng Singh.
Babloo Loitongbam presented a paper titled, “Culture of Impunity and Mental Health”, Human Rights Alerts. As a part of the presentation there was a screening of a documentary film, “claiming justice: Women Confronting Impunity in India’s Northeast”, a Human Rights Alert production, which was followed by discussion.
The post lunch session titled, “Conflict and Resilience Mechanism” was chaired by Dr. Sashi Mangang, State Epidemiologist, Manipur Health Services and 3(three) resource persons presented papers. Kangujam Ranjit representing Families of Involuntarily Disappeared Association (FIDAM) presented a paper titled, “FIDAM’s Experience”. He narrated the agony of the family members of the “disappeared” persons after the imposition of the Armed Forces Special Powers Act in the hill areas in 1958 and in the valley areas of Manipur in 1980. He stressed that what had and is happening to Manipur is as good as wiping out the people from the State after the imposition of the draconian law. After a husband disappeared, the onus of caring the family goes to the wife. It is heart wrenching to observe how the wife struggles. Equally questionable is if the victims receive the deserved legal rights. He added that FIDAM submitted a PIL to provide the same to the High Court of Manipur. “However, no positive response is forthcoming. It has become a habit of the State as well as the Union Government to put everything under the carpet and cover up its misdeeds”, he remarked. He also pleaded to the medical fraternity to organise awareness programmes on mental health especially for the families of the “disappeared” persons so that they can be rehabilitated and bring back into normal life.
Sobita Mangsatabam from the Women Action for Development, Imphal shared “Resilience Mechanism (Experience from Eco Project)”, a project that covered Kashmir and Manipur. In the case of Manipur (May 2014 to December 2015) as a part of the project, 25 villages in Thoubal district were covered. According to her Thoubal district has the record of having the highest number of fake encounters, arbitrary killings and enforced disappearances. She said that Awareness Generation Programme (AGP) on mental health, health camp and community based psychosocial care and support were organised. Plus, Resilience Building Program (RBP) targeting community leaders, alliance building with apex civil society organisation such as the United Committee Manipur, All Manipur United Club Organisation and Extra-judicial Executions Victims Families Association, Manipur, etc., Need Based Skill Training Program and Capacity Building Program for the victims (direct and indirect) of armed conflict were conducted. She added that Screening, Clinical Assessment (mental disorder) and Referral Service for the needy were provided in the year 2014-15. Further she mentioned that Livelihood Support (overall 154) were provided to needy such as conflict widow (26), torture victim (108), family who lost bread earner (13), victim who sustained either projectile/bullet/splinter injury (5) and family who lost bread earner due to enforced disappearance (2). According to her some of the major challenges faced during the tenure of the project were included trust deficit between implementing staffs and villages due to false promise made by other NGOs in the past and refusal of local elected representatives to involve in the project as awareness on MNREGA, PDS and governmental schemes were included during the implementation. Otherwise, local representatives tried to discredit the project in order to avoid their self interest from governmental welfare schemes. Moreover, care-givers were seen as informers.
Alung Kamei from Rural Education & Action for Change, Manipur (REACH-M), Pallel shared his experience on “Resilience Mechanism (Experience from Eco Project)”. He stated that objective of the project was to improve the quality of life of people affected by the prolonged conflicts in Manipur and to improve the resilience of the most vulnerable people in coping with and recovering from the affects of conflict. The project covered 15 villages in the Chandel district. He shared that Awareness Generation Programme (AGP) on mental health, health camp and community based psychosocial care and support were organised. Plus, Resilience Building Program (RBP) targeting community leaders, alliance building with apex civil society organisations, need based skill training program and capacity building program for the victims (direct and indirect) of armed conflict were conducted. He added that screening, clinical assessment (mental disorder) and referral service for the needy were provided. Further he mentioned that livelihood support were provided to needy such as conflict widow, torture victim, family who lost bread earner, victim who sustained either projectile/bullet/splinter injury and family who lost bread earner due to enforced disappearance. According to him the psycho social functioning of people are affected by various consequences of conflict situation. People are living in stressful environment due to traumatic events. Limited livelihood opportunities are available to the victims and costs for treatment for the affected people (psycho-social problem) are extremely high. Finally he shared that people suffering from psycho social issues are stigmatized due to lack of community awareness.

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