In Kashmir, Conflict's Psychological Legacy

Mental Health Cases Swell in Two Decades

SRINAGAR, India

Suraya Qadeem's brother was one of the Kashmir Valley's brightest students. Handsome and disciplined, he had been accepted into a prestigious medical school in Mumbai. But just weeks before Tahir Hussain was to pack his bags, the 20-year-old was shot dead by Indian forces as he participated in a peaceful demonstration calling for Kashmir's independence.

At his funeral, Suraya Qadeem, also a medical student, wept so hard she thought she might stop breathing. Seventeen years later, she spends her days counseling patients in Indian-controlled Kashmir who have painfully similar stories.

In the sunny therapy rooms of a private mental hospital here in Kashmir's summer capital, Qadeem listens to young patients, nearly all of them children scarred by the region's two-decade-old conflict. Most suffer from depression, chronic post-traumatic stress disorder, drug addiction and suicidal tendencies in numbers that are shockingly high, especially compared with Western countries.

Srinagar, a scenic lakeside city nestled in the foothills of the Himalayas, once had among the lowest mental illness rates in the world. But in 1989, leaders of the region's Muslim majority launched an armed separatist movement, one of several said to have been backed by predominantly Muslim Pakistan, which has fought two wars with Hindu-majority India over Kashmir since India's partition in 1947. Srinagar became a battleground as hundreds of thousands of Indian troops quelled the uprising. The fighting has left a powerful psychological legacy.

The number of patients seeking mental health services surged at the state psychiatric hospital, from 1,700 when the unrest began to more than 100,000 now. Last year, they were treated at the hospital or the recently opened Advanced Institute of Stress and Life Style Problems, where Qadeem works.

"Every home in Kashmir has a heartbreaking history," said Qadeem, who admits she sometimes becomes emotional during sessions. "There is terrible ache when you lose a sibling. Pills can't help. I share that agony of loss with my clients. In Kashmiri society, this pain is everywhere."

India's push to keep Kashmir is taking a toll on Kashmiris as well as Indian soldiers, in ways that are harder to measure than deaths or injuries. Experts say that mental health is an invisible casualty of war and that generations will bear the scars, imperiling Kashmir's prospects for a bright future with or without India.

The patients have insomnia, learning disabilities, anxiety disorders and what Kashmiri therapists call the "midnight-knock syndrome," a fear stemming from the many pre-dawn raids by Indian security forces aimed at rooting out suspected insurgents.

Mental health groups estimate that 60,000 Kashmiris committed suicide last year, a record number, said Mushtaq Margoob, head of the Government Psychiatric Diseases Hospital in Srinagar.

More than 15 percent of Kashmiris are afflicted with post-traumatic stress disorder, according to a recent study by Margoob. Indian troops also are suffering, undertaking long tours without their families in a place where residents are often hostile. In January, the Indian army recruited 400 psychiatrists after more than 100 soldiers, including officers, killed themselves.