JANUARY is being marked as the month to raise awareness about mental health in Pakistan with the slogan: ‘Raise awareness, erase stigma.’
The initiative has come from the Pakistan Association for Mental Health (PAMH) whose president Prof S. Haroon Ahmed is one of the country’s leading psychiatrists and an indefatigable campaigner for mental health. He raises issues that have a direct impact on mental health.
The extent of the challenge can be ascertained from estimates that put the number of people with mental illness in Pakistan at anywhere between 10 to 20 per cent of the population. Given the size of the population, the actual figures are staggering.
The statistic assumes greater significance when viewed against the backdrop of available expertise and infrastructure in the country to treat mental health patients with just 75 in-patient facilities, under 400 trained psychiatrists and a little over 5,500 hospital beds. To add to this is the social stigma attached to mental illness.
PAMH says the stress-ridden environment is impacting the individual and the community at large, with behavioural changes characterised by violence, sickness and withdrawing into oneself. Targeted killings, street crimes, sex-related offences, including the barbaric act of kidnapping, rape and murder of young children, are playing havoc with the mental health of our people.
This is adding to the incidence of depression and is stressing out people who make use of the easy availability of tranquillisers, without prescription, while illegal narcotic substances is driving many to drugs, extreme religiosity and even suicide, PAMH says.
Asking the state or government to take away ‘avoidable stressors’ represents no more than a forlorn hope as the Sahiwal incident shows.
The association calls for the removal of “at least the avoidable stressors” and says these areas need urgent attention by the state in terms of providing essentials such as clean water, unadulterated food, proper medicine, transport, a hygienic environment, and ensuring crime-free, secure surroundings.
As someone who has seen a close member of the family and some friends suffer from mental illness I am well aware of the challenges such a situation poses, not only for the one directly suffering but also for family and friends. Equally, I have witnessed at close quarters how proper treatment can enable people to lead fulfilling, productive lives.
But the wonderful Prof Haroon, who is someone I have always looked up to, must realise that asking the state or government to take away what he calls “avoidable stressors” represents no more than a forlorn hope. Our collective experience tells us otherwise: the state is incapable of doing so.
One needn’t go far in the search for examples. Just look at what happened on a highway in broad daylight near Sahiwal a week ago. The Counter-Terrorism Department of the Punjab police, which has several anti-terror encounter ‘kills’ to its credit, notched up another ‘success’. The CTD claimed it had killed four terrorists including two women who, the department said, were all committed terrorists of the militant Islamic State group. I will not go into the details of how the CTD version of events unravelled as it is all in the public domain.
What shocked me was not that the police tried to cover up a crime it obviously committed in firing into a vehicle with three adults and four children — one of the two ‘women’ killed was 14 years old and the surviving boy who blew the lid of the police lies and his two sisters are all under 10.
It is not difficult to shred the CTD versions of the event. Yes, there was more than one to my knowledge, including those that claimed that the ‘terrorists’ travelling in the car fired at the police when asked to stop; that guns, ammunition and suicide jackets were recovered from the car, etc etc.
All of this was poppycock as no verifiable evidence emerged to support these contentions. The facts that could be verified were saying the opposite. Interestingly, in the final version and even the so-called JIT report, the mention that it was a joint ISI-CTD operation was dropped with the onus solely on the CTD.
What was even more shocking was Punjab Law Minister Raja Basharat and his cabinet colleagues including luminaries such as Mian Mahmoodur Rasheed and Fayyaz Chohan; Governor Chaudhry Mohammed Sarwar all parroting the CTD version and betraying zero empathy for the wronged. They were joined by Federal Information Minister Fawad Chaudhry.
Just to give you a flavour no matter how distasteful, while Mr Sarwar said all criticism was uncalled for as such “incidents happen all over the world”, Fawad Chaudhry claimed that the terrorists were using the women and children as a “human shield”. Mr Chohan, meanwhile, referred to the presence of children in the car by offering a unique insight: “Dehshatgardon ke bhi bachche hote hain” (terrorists also have children).
Frankly, I will concede I have no evidence to accept or reject the claim of the CTD and Punjab government that the man driving the car was an IS terrorist, but even if he were, how would firing automatic weapons into a car carrying passengers unconnected with any terrorism — ie innocent citizens — be justified, especially since all the occupants were unarmed?
Pakistan, its people and security forces have fought a valiant war against terrorism. That is a huge plus. On the downside, the long, costly fight has often followed the ‘principle’ that extraordinary situations call for extraordinary measures; this has created a culture of impunity for the security forces.
This culture that has seen a string of extrajudicial killings — with an unacceptable number of innocent people killed in the name of the fight against terrorism and many others denied due process — is playing havoc with our mental health and scarring the collective psyche.
Such killings, disappearances and detention without trial are also creating another danger: with continued official contempt for the legitimate concerns of significant chunks of the citizenry we may also be creating a situation where we lose in peacetime what we have won in war.
The writer is a former editor of Dawn.
Published in Dawn, January 26th, 2019