Home Health Delhi riots: The violence has left a mental health crisis that will last generations

Delhi riots: The violence has left a mental health crisis that will last generations

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Delhi riots: The violence has left a mental health crisis that will last generations

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This is the fourth part of a series on a civil society report about the Delhi riots in February put together by a team of about 30 young people who answered the Karwan e Mohabbat’s call for volunteers to run a rescue helpline.

The three days of violence in North East Delhi had left entire neighbourhoods like Shiv Vihar razed to the ground and deserted, thousands displaced, at least 53 killed and an entire community irrevocably shaken. When the violence halted on the February 27, the Citizens Collective for Peace had begun following up on our rescue efforts through legal, medical and psychosocial support, and relief distribution.

We mapped over 3,000 people who were displaced from Shiv Vihar by the violence and were temporarily staying in the safety of locals’ homes in Babunagar, just a few minutes away. This is when we met Ruksana (name changed) and her family huddled in one of the houses.

“What did I do to deserve this?” cried Ruksana, with a toddler in her hand. She had to flee from her home in Shiv Vihar, the epicenter of the violence between Hindus and Muslims in North East Delhi on the night of February 24. She was with her two children and her elderly in-laws and had no place to go.

In these homes of Babunagar, we met more than 80 families like Ruksana’s, displaced by the violence, who were identified to be in need of immediate psychosocial care. We spent many hours and sometimes several days with them. The more families we met, the clearer it became that the Delhi carnage has left North East Delhi with a mental health crisis that is going to exist over generations. It has irrevocably compounded social exclusion – families are facing severe poverty, double displacement, grief, betrayal, and trauma. Their trauma is further experienced through feelings of apathy, loss of control, excessive rumination and hopelessness.

Given the scale of this mental health crisis, it was important the psychosocial support began hand-in-hand with all other relief efforts. There was no scope for it to just be an afterthought.

Trauma caused by such violence takes years, if not more, to heal from. Mental health care in a situation like this looks different from conventional ideas of therapy – it is an entire community that needs care, and not just individuals. It is therefore also crucial to provide community-based holistic emotional support by complementing psychosocial care with entitlements.

A textbook on the floor of a room in DRP School in Shiv Vihar. Credit: Sandeep Yadav, Karwan e Mohabb

Managing collective trauma

In a bid to ensure basic mental health support as soon as possible, we identified four areas where our presence was most needed: addressing mental health issues that came up at our medical camp in Babunagar, conducting house visits, setting up a children’s centre and staying alert for emergency care needs.

The medical camp saw nearly 10,000 patients over the course a month. We immediately recognised that the many of the survivors’ symptoms were a result of severe trauma and were often psychosomatic. For anyone experiencing mental health turmoil, the first act of acknowledgment of the distress occurs through physical manifestations – back aches, stomach aches, panic attacks and body pain. We stationed trained psychologists at the camp who could take care of mental health concerns and ease the patients through the medical process. This process also helped in flagging those who needed immediate psychiatric care.

Heena (name changed), a 16-year-old resident of Mustafabad, fainted every time she heard a loud noise post the violence. When we met her ten days after the incident, she said that she could not sleep or eat anything. On February 24, she hurt her back while jumping from her home to flee the site of a fire set off by an angry mob in their locality. Every day, she fears that someone will chase her. She is scared that she will never be “normal” again.

This fear gets hardwired into the minds of those living in distress. They get further characterised by feelings of apathy, loss of control, excessive rumination and hopelessness.

Treating vulnerable families

The mapping exercise laid out a clear picture of the number of families that were displaced and flagged families that were more vulnerable. A team of over 30 mental health volunteers was trained and prepared to visit these vulnerable families at their residences. Three volunteers were assigned to each family with whom they established a consistent relationship. This process gave families a hand to hold and an opportunity to voice out their distress, paving the path for relational healing through trust and sustained relationships. These home visits made it more encouraging for the community to believe that there was care for them.

Survivors and witnesses of riots experience trauma of varied types and intensities. To many, the violence of the riots was perhaps only one in a series of traumatic experiences. Poverty, sexual violence, severe mental illness and disability, all stand to compound the impact of the riot on people’s mental health. People with mental illnesses see their mental health deteriorating further when faced with traumatic experiences such as this.

DRP School in Shiv Vihar. Credit: Sandeep Yadav, Karwan e Mohabbat

We met Arif (name changed) near our camp in Babu Nagar. He lived on the streets and used a wheelchair to get around. He had an amputated leg and needed assistance to walk. On February 24, he was severely beaten up during the violence. He had fallen from his wheelchair and had broken his arm.

Trauma for Arif now, is not just the experience of brutal violence. He is further faced with the additional challenges of overcoming physical and mental distress while dealing with apathy from the society.

Timely intervention is key

A scary consequence of a trauma of this kind is that survivors may begin to internalise their aggressor. They may start to identify with the violence and sometimes become self-destructive. This is why timely intervention is key. Specialised mental health care was assigned to those who may have experienced sexual violence, who had pre-existing mental illness, and to pregnant women. It was difficult for us to state whether sexual violence was one of the weapons of the riot, owing to a strong apprehension among the community to discuss this.

However, there were a few indicators of its possibility – some women asked for female doctors in angst, a few broke down when the question sexual violence came up, and others who first wanted to file complaints later withdrew it. Regardless, this is not enough to establish a clear conclusion or pattern.

Even under regular circumstances, children are more susceptible to face stronger consequences of trauma, let alone during violence of this kind. They are more tender and can absorb the impact of the violence more heavily than adults, altering their view of the world permanently. Witnessing and surviving the riots have significantly and irreversibly scarred the children in and around Shiv Vihar, regardless of their religion. Children as young as three exhibited large amounts of passive display of trauma. When asked to draw, they would compulsively draw images of burning houses.

During our home visits, we met four-year-old Fatima (name changed) from Mustafabad. When we gave her some colours to draw, she only drew houses. “All I want is to go back to my house. It’s burnt now and I can never go back home, so this is what I want to draw.” she said while continuing to draw more pictures of her home.

Fatima witnessed her home getting burnt down in Shiv Vihar. She now has no sense of home, and is confused and lost about what is to come next. Many children like Fatima have become more vulnerable as they began fearing the loss of all sense of familiarity including family and home, hope, and friendship. Unfortunately, this environment of violence gives many families reasons to discontinue the children’s education, further jeopardising their future.

Space for children

Recognising an immediate need for a safe space for children, we opened up one floor of a local masjid on March 4. With the help of a theatre group, and a creche, we were able to foster this into a space of comfort for children of the aged 3-15. The space grew to accommodate over 50 children from the area. They would learn, play, and engage in therapeutic activities.

As we spent the first few weeks offering support through a voluntary network, we will now move into a more sustained form of care. Sustainability here would mean working with a system that builds a long-term relationship with the community, strengthening their agency over their own mental health care. We will therefore be training a cadre of community care workers for paramedical, paralegal and psychosocial support. Each care worker will be mentored by a senior expert in the field of psychosocial care.

A scene of devastation from Shiv Vihar. Credit: Sandeep Yadav, Karwan e Mohabbat

Sustaining care

The memory of this violence and the apathy of the state will eventually get embedded not only in the minds of every survivor but also in that of their children and grandchildren. When people experience a trauma of this intensity, they share a collective memory of the fear, loss, and betrayal it caused, and this becomes the community’s heirloom. We saw the significant impact of such transgenerational trauma during the partition of 1947 and the Holocaust.

The brutality of the carnage is not the only source of this transgenerational trauma, for the riots did not happen in isolation – but were a direct result of an environment of empowered hate. Under these circumstances, both central and state government’s, lack of acknowledgment, let alone remorse, is the very antithesis of the care and justice that the survivors deserve.

The state often equates reparation, an essential part of healing, to financial compensation alone. However, in the context of the North East Delhi violence, or any situation marked by such a sense of collective fear and betrayal, it hardly covers the due. While it provides families with the crucial support required to build their lives back up, they are by no means enough to help victims reconcile with the trauma of communal violence.

Ironically, even though the Delhi Government announced compensations, the majority of the survivors are still awaiting their claims, From our legal camp, only 10% have received their compensation.

In the course of our work with the community, it was clear that every aspect of our relief work was an essential part of psychosocial care – from answering distress calls, to addressing legal cases, distributing relief, running the medical camp and mapping. Every person involved with the relief efforts was therefore providing mental health support in one way or the other. This is a crucial aspect to community based mental health care: support to rebuild lives hold as much value as a therapeutic circle.

When transferred to the state, this implies that official efforts to support survivors should include due financial compensation, livelihood rehabilitation and legal justice, alongside mental health care. The state’s effort should be superseded by a public acknowledgement of the injustices and an expression of remorse as part of their reconciliation efforts.

This is the last part of a four-part series on the Delhi riots. Read the other parts here.

Harsh Mander is a human rights and peace worker, writer, columnist, researcher and teacher who works with survivors of mass violence, hunger, homeless persons and street children. His Twitter handle is @harsh_mander.

The full version of the report ‘Chronicling Truth, Countering Hate’ by Karwan E Mohabbat can be accessed here.

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