Increasing tensions in Kashmir worsen an already severe mental health situation

Recent developments in the tensions between India and Pakistan regarding the disputed territory of Kashmir has brought some changes to MSF operations in the area. The current threat of nuclear confrontations has only served to increase tensions and fear amongst the population. The military tension between the countries regarding the disputed Kashmir territory has been longstanding. Although shelling across the line of control (the line that divides Kashmir between India and Pakistan) has been going on for years, the recent escalation in exchanges is likely to cause some displacement within the civilian population. People are already moving away from the line of control . MSF has been working in Kashmir since 2000, running a mental health programme in and around Srinigar. Currently, the four-person MSF team (two psychologists, one project co-ordinator and one logistician) has moved to Delhi to discuss likely scenarios for MSF involvement and the future role of the MSF staff. The team is being increased with two new expats (one nurse and one watsan) to increase its emergency response capacity. From the Pakistan side of Kashmir, a two person team is travelling into the area to assess the displacement situation. MSF activities in Kashmir Since 2000 MSF has been running a mental health programme in the areas north and south of Srinigar. These communities have suffered enormous mental trauma as a result of the years of violence. The confrontations between militant and Indian government forces and have also brought about direct attacks upon civilians suspected of favouring either side. As a consequence of both repression and human rights abuse, the area population is suffering from traumatic stress, depression and psychosocial problems, such as substance abuse and domestic violence. MSF staff have found that people have great difficulty in coming forward to discuss their experiences due to the fear of being marked as informants or generally drawing attention to themselves. The poverty and despair at the apparent hopelessness of the future situation, are amongst the indirect traumas. Local counsellors, trained by MSF, support the population and help them cope with their problems and traumas. The team also supports the psychiatric hospital in Srinigar where the caseload of patients has risen astronomically since the surge in violence that started in the late 80s.