In troubled Karachi, the battle that rages inside heads

Karachi
They live in perpetual fear and stress, but the citizens of Karachi are a very resilient people. They somehow manage to carry on with their lives despite the tumultuous circumstances. However, how long can they mentally put up with what is going on around them? Are they gradually recoiling into a shell, losing hope and allowing depression to take over? These were the questions that three psychologists and a civil society activist put their heads together to find answers to at a Karachi Literature Festival session on Sunday.
Titled ‘Mental Health in a Troubled City’, the session was moderated by Murad Moosa Khan, a professor of psychiatry. He started the discussion by mentioning the terrorist attack on a school in Peshawar in December last year in which 150 people, including 132 children, were killed and asking the panellists about the effects of such a horrific event on the mental health of the people.
“Children are the most vulnerable segment of the society when such an event occurs,” said Professor Ayesha Mian who specialises in child psychiatry. “The security steps taken at schools after that attack, the CCTV cameras, the barbed wires, the guards, the instructions not to talk to any suspicious person... children see all that and fear sets in.”
Ayesha said parents needed to ensure that they were not letting their anxieties flow into children. “When you watch blood and gore on TV all the time, there’ll be negative impacts.”
The psychiatrist went on to tell the audience about her experiences with some schoolchildren: “One of them told me that his parents had taught him how to play dead in case of an attack. Another told me that he took ketchup sachets to school every day so that he could pretend that he had been shot if any attacker came.”
She advised parents to communicate with their children and engage them in positive activities. “Children are very smart and resilient. They generally come up with their own ways to deal with such emotions. But reaching out to them is very important.”
Saadia Quraishy, who is also a professor of psychiatry, explained that though resilience was an innate ability that helped in coping with difficult circumstances, there was a limit to how much one could take.
“In such situations, it’s better to speak with others, form social groups where you can discuss these matters,” recommended Saadia, who is also the head of the Aman Foundation’s Mental and Social Health Advocacy and Literacy (Mashal).
“If you keep bottling up these emotions, the frustration keeps increasing. Letting them out definitely helps a person.”
Professor Haroon Ahmed, one of the country’s most senior psychiatrists, spoke about the government’s lack of interest in mental health.
Ahmed, who is the president of the Pakistan Association for Mental Health and assisted in the drafting of a mental health bill, rued that the government was not serious in dealing with such issues.
He also spoke about the time when psychiatry was not taught in any medical college in the country. However, now it is compulsory for them to have a psychiatry department.
“There was a time when mentally-challenged people were treated like animals in the rural areas. They were called lunatics,” he recalled.
Naeem Sadiq, a civil society activist, presented a broader view of the problem. He explained that there were generally two kinds of responses in the wake of an attack like the one in Peshawar: one by the citizens and the other by the government.
“We see that the citizens have responded by taking superficial measures. Walls have been raised higher than those in fortresses. People are buying weapons,” he said. “These steps reflect a shrinking behaviour. By doing all this, people are just giving up their mental space.”
The government’s response, Sadiq observed, could be of three types. The first approach, the sane response, as he called it, was taking pre-emptive measures to avert a problem; the “half-sane approach” would be dealing with a problem after it had developed; and the “insane approach” was the one adopted by the government in Pakistan: first nurturing a problem, allowing it to grow and then doing nothing about it.
Sadiq said the country’s problems could only be sorted out if the citizens, particularly the youth, understood them and engaged in collective efforts to find the solutions.
“Youngsters need to form groups and raise their voice over the issues plaguing the country. It may take years to see the results, but this is the only way it can happen,” he said. “These groups can’t be those like the ones on Facebook. People will have to physically get together.”
The panellists also called for taking a realistic approach to the ongoing problems, not making them bigger than they actually were.