Footprints: Trauma incalculable

Published April 1, 2016
Civil society members light candles for Lahore blast victims on Wednesday.—File photo
Civil society members light candles for Lahore blast victims on Wednesday.—File photo

Khizar lies covered from head to toe in a white sheet. His pale hand is being held by his mother, Zubaida. Hit by shrapnel, Khizar’s liver is injured and his leg fractured.

“He does not want to talk to anyone,” Zubaida says. “He asks everyone to leave. All he wants to do is to hide beneath the sheet and sleep.”

One of the first victims of the Gulshan-i-Iqbal Park bomb blast to come into hospital, Khizar told his mother later that he had seen his own stomach spray fountains of blood; somehow, with a fractured leg, he managed to reach the police who told him that ambulances were coming. But he flung himself on the pile of corpses that were being taken to hospital. He recalls that when his shoes were taken off, blood was pouring out from them.

“How can he forget these memories?” asks his father. “He will be haunted for life.”

Read: Lahore blast death toll soars to 74

“The mental healing process will take time, of course,” says old-timer Abdur Razzak, a guard in a factory who is here for his nephew. “This little girl used to scream when she came in but now she is doing better.” He points to a girl in the bed next to that of his charge. “When even we can’t forget, how can we expect children to forget? My granddaughter at home who saw it all asks me about who did it, why the other children’s bodies were in pieces … can you imagine a six-year-old asking these questions?”

He recounts seeing children playing football; the next second, they were just “flying bits of meat”.

“It was like Judgement Day, we were running around like madmen,” says Razzak.

“Park? We won’t even say a word of entertaining ourselves for the months to come. This was a place where people came after six working days for a bit of relief. But that’s not meant for us anymore.”

Many of the survivors have terrible experiences etched deep in their minds.

Farzana, in her 40s, saw her entrails after her stomach was burst open. Her two-year-old daughter has been discharged, but she still cries and screams, says her father.

The reactions are expected, says Dr Ali Madeeh Hashmi, coordinator of the Punjab Psycho-Trauma Centre which was originally established for helping the victims and survivors of the Army Public School, Peshawar, attack. They have held training workshops for first responders (firefighters, policemen and rescue workers) as well as psychologists, and have also worked with the victims of the child sexual abuse case that surfaced recently in Kasur. But despite the fact that they sent a letter to the provincial health secretary the day after the blast took place last Sunday, permission to begin to work with the recent survivors has not been given.

“We are still waiting for directions,” says Dr Hashmi. “Usually psychological assessment is done after the basic necessities are provided, including medical first aid. After about 72 hours we should be stepping in and assessing how the survivors are doing.”

Survivors show symptoms of post-traumatic stress disorder (PTSD), including anxiety and depression. Crying spells, disorientation and the inability to eat are also common. “At least two-thirds of the survivors will improve but about 15 to 30 per cent go back with problems and find themselves unable to cope with daily life,” says Dr Hashmi.

He puts victims and survivors into four broad categories: the family members of those who have died, the surviving and injured people and their family members, those who were in the vicinity but managed to escape, and also those who were in a completely different area but were affected by insensitive media coverage.

Meanwhile, Sajjad — who almost stopped at the park to get his daughter an ice cream, but decided against it — cannot get over the fact that they managed to escape brutal death. “He has not come to work since the blast,” says a co-worker. “He has been really badly affected.”

In Jinnah Hospital there is a psychiatric department but only a few survivors came for assessment. Duty Doctor Nauman Ahmed says they were suffering from PTSD. “Many of them keep reliving the incident,” he says.

But despite the fact that the health department has not made mental health a priority during the aftermath of this incident, and no evaluation has been made of survivors, relatives and attendants say that the patients are improving.

“They used to scream when they came in, even when they were not in pain,” says the father of Shiza, a seven-year-old. “Now they are responding better.” Shiza’s 12-year-old brother says that he carried his sister to the police.

Another young boy, Awais Butt, is now well enough to talk to the media, says his father Mukhtar. “He is sound. He remembers the whole thing clearly and hasn’t shown fear outside of what was normal for a boy his age. He even gives details of the incident.”

He looks affectionately at his sleeping son, whose jaw has been cut up by shrapnel and now lies bandaged, his eye swollen. “We Pakistanis are very resilient,” he says smiling bitterly. “Nothing can break us.”

Published in Dawn, April 1st, 2016

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