Damaged buildings in Diyala, Iraq
Iraq

Isolated, angry, anxious and stressed - mental health in Iraq

The psychological and emotional scars of war in Iraq are immense and thousands of people need mental health assistance. Mental health is a key component of many Médecins Sans Frontières (MSF) projects in Iraq. We have teams of qualified medical doctors, psychologists and counsellors who provide vital care and support for moderate and severe cases, including post-traumatic stress syndrome (PTSD), depression, schizophrenia and severe anxiety.

Jasim Hammed, 32, fled his home in Muqdadiyah in 2014 and eventually settled in Alwand 1 Camp, Diyala governorate, where he now works for MSF as counsellor. 

Why did you leave your home and come to Alwand 1 Camp?

In July 2014, there was a lot of shooting and bombing near my home in Muqdadiyah and a lot of people were dying. My mother said it wasn't safe and we should go. I left with my family.

As we were fleeing, we saw fighting and bombing happening in the area, and we saw families get killed. A whole family in the two cars behind us got killed by an airstrike.

My youngest child, Othman, was only 10 days old at the time and I didn't think he was going to live. But thankfully he is here and still alive – he’s three years old now. My younger brother was kidnapped when he went back to our home town to try and complete his studies. He was taken from my mother’s house. We still don't know where he is.

We went from camp to camp until we reached here, to Alwand 1 Camp. Some of the camps where we stayed didn’t have water or electricity. I worked for some other NGOs in the camp and then applied for a job with MSF in Alwand 1 Camp.

What is the situation in Alwand 1 Camp and what are the challenges facing people in the camp?

There are more than 3,000 internally displaced people living in Alwand 1 Camp. Most people in the camp come the from the surrounding area, from towns such as Sadiyah, Jalawla and Muqdadiyah. Most people fled the conflict with the Islamic State (IS) group. People in the camp live in caravans with shared bathrooms. There is a school in the camp, as well as a health centre, run by MSF. 

People living in the camp face many challenges. The main challenge is their financial situation, and this often impacts on their psychology. Some of them have given up and say: “My life is finished. I’m done”.

In additional to financial concerns, there is the additional fear of an unknown future. There has been some renewed conflict in the region and people’s fear has increased. There are people who cannot communicate with family members, and others have ruined houses from the conflict and they cannot return home. Some of the families say they don't feel comfortable living in the containers and that it doesn’t feel like a house to them, it feels like a prison. We have seen people become isolated, angry, anxious and stressed. Some of the children show signs of aggressive behaviour, incontinence and anxiety. 

I was managing the case of a man who was very isolated and wouldn’t leave his container. I started going to see him and eventually he told me his story. His son was taken by an armed group. He managed to get his son back, but as they were passing through the last check point before reaching their house, the armed group took his son again and shot him in the head and threw him in a ditch. He says he misses his son every day.

When people experience these traumatic situations, it is extremely difficult for them to cope. But when they are also living in a camp and cannot continue their normal life and cannot see a future, it can have a severe impact on their mental health.

What does your job with MSF involve?

As part of my role with MSF, I identify people who need mental health support, I try to increase people’s awareness about mental health and the services MSF provides and I run group counselling sessions with my colleagues. If we identify a very severe case, we refer them to the MSF psychologist.

The group sessions are generally a good way to identify people who need further support. We usually follow up with people in the group who are very quiet, withdrawn and cannot focus. After the group sessions, we also get parents coming to us and saying they have concerns about their children – such as bedwetting or anxiety – and ask for help.

In February 2018, in Alwand 1 Camp, MSF provided 213 individual and 287 group mental health consultations. MSF also provides treatment for non-communicable diseases (NCD), sexual reproductive health services and health educational sessions in the camp. In the towns of Jalawla and Sadiya where people are returning to their homes, MSF provides NCD, mental health and sexual reproductive health services in collaboration with the Directorate of Health.

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Voices from the Field 18 January 2018