BOGOTA (Thomson Reuters Foundation) - Some children have recurring nightmares and wet their beds, while their parents suffer depression, anxiety and panic disorders.
These are common symptoms of mental illness that medical aid group Doctors without Borders (MSF) found among Colombians living in epicentres of the country’s nearly 50-year-old war, which has left generations of people mentally damaged by the conflict and the poverty it often spawns.
Decades of fighting between the government, leftist guerrillas and right-wing paramilitary groups have killed at least 100,000 people and forced about 5 million Colombians to flee their homes.
In a report released on Tuesday, MSF said the impact of the conflict on people’s mental health is a problem that is largely invisible and unaccounted for.
“Despite the profound impact that violence has on Colombia’s population, mental health continues to be a little known issue. People suffer alone, in silence and are often ignored,” Javier Llorca, head of MSF in Colombia, told a press conference in Bogota.
The report, based on 4,455 patient consultations with MSF psychologists last year in four provinces in southern Colombia, found that nearly 70 percent of those patients surveyed had directly experienced one or more types of violence, making them more vulnerable to mental illness.
The violence the people surveyed experienced includes sexual violence and rape - both at the hands of relatives and by armed groups; they witnessed killings or lost family members who disappeared or were murdered; and they were forcibly displaced, taken hostage and caught in crossfire between warring factions.
A person who has been exposed to such trauma is 4.3 times more likely to develop post-traumatic stress disorder than someone who has not endured such violence, MSF said in its report.
One woman, whose name is not given in the MSF report, witnessed the killing of her neighbours by an armed group, forcing her and her family to leave their home.
“I have dreams where I see the heads of my neighbours. I see them crying, begging for mercy. I wake up crying,” the 50-year-old woman from Colombia’s southwestern Cauca province is quoted as saying in the report.
“I’ve never seen my husband so quiet. I’ve never seen him cry in silence. I have to say that my son is not the boy he once was. Now in his eyes there’s no sweetness but anger and hate. I don’t know what will become of us. Our lives won’t be the same because we’ve been displaced.”
The report also showed a third of those surveyed - 1,410 people - said they had been victims of domestic violence, the most common type of violence cited.
“There is academic research that shows domestic violence increases in the context of armed conflicts,” Cristina Carreno, a psychiatrist and head of MSF’s mental health programme in Colombia, told the press conference.
Under Colombia’s laws and constitution, mental health care is seen as a basic right, which means the government should provide it to all citizens when necessary.
But people living in conflict-ridden regions, concentrated along Colombia’s border areas and southern provinces, have little or no access to mental health services, MSF says.
“There are gaps in Colombia’s mental health laws, a lack of psychologists in rural areas and obstacles in accessing mental health services, particularly in areas where there’s no state presence. The response of health authorities to mental health disorders is in general limited and inadequate,” MSF’s Llorca said.
Furthermore, the concept of mental illness is still alien to many Colombians in rural areas.
“Much work still needs to be done among communities to raise awareness that pain is not just physical but psychological, too, and that psychologists are not just for mad people but that they can help heal trauma and relieve stress,” Llorca told the Thomson Reuters Foundation.
“People often don’t know how to express their pain. They don’t use terms such as post-traumatic stress disorder. Instead they’ll say I feel sadness but I don’t know why and where it’s coming from.”
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