Wednesday, April 20, 2011
A nine year retrospective of a psychosocial assignment in Ahmedabad, Bhuj, Gujarat
The Gujarat Riots of February 27, 2002 were the results of the burning of the Sabarnati Express carrying Hindu pilgrims returning from the Holy city of Ayodhya that resulted in fifty-eight (58) deaths. The months to come brought about retaliatory actions from the Hindu majority. As a result approximately 1000 people from all religious segments were killed, places of worship burned and many people lost their homes, properties and livelihood. While violence was rampant, and the damages widespread, the most affected community was Muslim.
The American Red Cross was conducting a disaster mental health operation as a result of the Bhuj, Gujarat, India earthquake. The delegates assigned to the operation initially responded as counterparts to the Indian Red Cross Society (IRCS) volunteer efforts and support to the affected people. I invited to go to Ahmadabad for a period of three weeks (April 16, 2002-May 10, 2002) that was extended by four days. During this period I conducted crisis intervention training and supported the volunteers.
The purpose of this paper is to share impressionistic data on Indian Red Cross volunteers that served in the role of psychological first aiders after the riots in Ahmadabad, Gujarat, India in 2002. The information reported herein was gathered from evening defusing meetings, focused groups, and individual interviews. The volunteers report that as time has evolved they are beginning to introject some of the behaviors that are shared with them by the survivors. In some case the empathy of the volunteer changed to sympathy that lead to compassion fatigue. Stressors are the result of; (1) violence inflicted on the Muslim community expressed in different ways, over an extended over a long time; (2) loss of family and friends; and (3) damage or destruction of property; (4) fears of continuation of violence by community members; and (5) segregation in public places are just some of the overt reasons for continued anxiety and stress. Below is a discussion of the areas that most impacted the volunteer.
The anxiety of being hounded
The violence reported by the survivors to the volunteers was symptomatic of their traumatic experience. Every interview or focused group brought depressing news. The communal hatred and prejudices were so deeply rooted that the affected people of the three communities (Hindu, Muslim and Christian) were not ready to talk to each other. Anger and hatred were expressed and acted out. The faith and trust towards others were replaced and replaced by animosity and distrust.
Being a refugee in your own land
Having to take shelter in relief camps, on or near Muslim cemeteries, made the survivors feel as though, this one action, had granted them refugee status. The cramped space, lack of privacy, improper hygiene further deepens the feeling of loss of citizen status in one’s own village, city and state cause helplessness to increase. The volunteers reported a feeling of irritability as a result of having to sign-in upon entry to the camp, daily dependence on outside assistance, and the uncertainty of aid to run the camps.
The constant fear of reprisals led to continual insecurity, hopelessness and anger amongst the affected community. Having been driven from their homes, many of the residents of the camps, felt that the treatment they received from their neighbor and government officials made them feel as though they were no longer citizens of the state. Fear, anger, hopelessness and helplessness were commonly expressed feelings.
Disturbed routine life
The displacement into relief camps is usually sudden and forceful. Therefore people fleeing for their lives have no time to save their assets. When they resettle into new lives they have to start from a scratch. Often they are unable to pick up pieces of their old lives again and the effort to do so only exhausts them emotionally. The day is usually spent in sitting idle. This free time has no value attached to it. The survivors have no work to occupy them, instead they now complain over their conditions which in turn only causes them greater distress.
For the survivors in the relief camps life changes drastically. Overcrowding and weather made conditions very difficult. Their daily routines and lifestyles were disrupted. Survivors reported difficulty in performing even the simple everyday routines that they were an integral part of their lives.
The constant intrusion and questioning of lifestyles had different implications for different people. Women who are in mourning are not emotionally ready to meet others. Thus living in open in the camp distressed and offended them a lot. Women reported difficulty maintaining their personal hygiene especially when they had their menstrual cycles. Several women experienced disturbances in their monthly cycle, the irregularity attributed to the traumatic experience. Pregnant women and women with newly born babies were at risk to infections since pre and post natal care was not being offered.
Men and adolescent males sat idle most of the day since they had not been permitted to case for the management of their camps. Men expressed frustration at having to stay in camps. Living in the open meant an increase in sexual frustrations. The adolescent boys who were now at a stage of sexual awareness, living in the camps gave them plenty of proximity to girls of their age, something they were not accustomed to in their earlier lifestyles.
Children got little safe space to play. They are no longer able to attend their old schools or appear for their exams as a result one academic year has been lost. The relief camps do not provide an ideal environment for studying. Thus there are constant worries especially amongst the older children about their education. Several children reported witnessing rapes and killings of family members and friends. Some had even fought the mobs alongside the other family members. Nightmares and sleeplessness were common amongst them. They would cry at the very mention of their lost near and dear ones. Some were unable to yet comprehend the tragedy that had struck them and were numb and silent.
As the children have been displaced from their old localities and schools they miss their old life and they are unhappy. The sudden displacement from their homes perplexes many younger children initially. Their parents simply ran with them away to relief camps leaving behind their houses and all their possessions. The terrifying experience of witnessing violent crimes devastates the children emotionally, as they not yet developed the emotional maturity to deal with their feelings. This is manifested in behavior such as constant weeping or clinging to their mothers and other elders in the family. Some had become silent and were terrified to be alone or in the company of strangers. Many develop feelings of vengeance towards the other community to which the perpetrators of violence belong. Certain incidents might trigger off hidden fears and expressions of violent behavior.
The effect of the riots differs depending upon the degree of vulnerability. The under-represented group is composed of children, single women, women who lost their husbands and are now the sole bread winners of their family, women subjected to sexual violence, older women and men especially those who have none left to care for them and those disabled in the violence all have reacted differently depending upon the age and the type of violence and suffering inflicted on them. Several individuals were predisposed to emotional instability and they have suffered further.
For women who have to now shoulder all economic responsibilities, the trauma is severe. They have had to cope with loss of their husbands and other earning members of their family and also make efforts to keep themselves strong for maintaining their family. Therefore, while they perform their new roles, inside they remain emotionally fragile. They have developed somatic symptoms such as loss of appetite and disturbed sleeping patterns, pain or loss of movement in limbs, paralysis, and blurred vision have been reported to the volunteers.
The survivors felt helpless to control their lives and also a very high sense of hopelessness. Many have lost interest in life. Those who were inclined to praying and fasting feel a great sense injustice and betrayal. Many report suicidal ideation. For the survivors the violence and displacement caused by the riots was a first ever occurrence, they had to develop new coping mechanisms. They did not know how to cope with the anger and fears generated by this experience.
The survivors want to resettle in places that bring about a sense of psychological safety. Some shift to their old places or begin looking for newer localities, which are perceived as ‘safe’. Others have moved in with friends and relatives or stay in rented houses.
The shift to new localities has brought back old cultural, psychological, social and economic ties of the affected people. Their old friends from the other community are no longer perceived as friends. As families get displaced they lose contact with their extended family or get distanced from them. In several instances wedding engagements are broken due to deaths of the people to be married or lack of finances to arrange the weddings. This has been the cause of anxiety amongst the parents of such children.
With the earning members of the family out of work it is difficult to make ends meet. The avenues of employment have been reducing. The survivors have begun to lose hope of finding regular employment. Those who were gainfully employed before the violence now sit idle. Men and youth who have been unemployed for long may display unusual anger and aggression towards family, friends and the wider society. A feeling of helplessness exists amongst the survivors as they feel that they are unable to control their lives and their future.
Living this experience was like being inside of a bubble. Due to security reasons there was not community visits and limited times outside of the hotel for the American Red Cross delegate. I was only able to meet with the volunteers twice a day and attend meetings with Project Harmony, the coordinating group for the psychosocial support response. The work with four volunteers was very rewarding; we shifted from teaching crisis interventions strategies to the simple principles of psychological first aid. This tool became successful for the community outreach. Attempts at individual counseling were substituted with some community activities with children and adolescent. Nine years to the day have elapsed since I experienced that assignment in India. Over the years I have had occasion to visit Ahmadabad, the town has evolved the burned building that stood as a memory of the riots have been renovated, and the people have moved on.
 Dr. Prewitt Diaz is a Humanitarian Psychologist affiliated with the University of Puerto Rico School of Law. He was the recipient of the 2008 APA International Humanitarian Award.
 Trip report submitted nine (9) years after the assignment.
 Slaikeu, K. (1990). Crisis Intervention: A handbook for practice and research (2nd Ed.). Boston, MA: Allyn and Bacon, Inc.
 Figley, C. (200). Compassion fatigue as a secondary traumatic disorder. London, Eng: Brunnel-Rotledge