The writer is a PhD scholar at the University of New Mexico, USA. He can be reached @mianfawadshah
The government of Pakistan claims that Operation Zarb-e-Azb is almost complete. It has been reported that almost all parts of Shawal Valley, which was the last major hub of militants in North Waziristan, have been cleared from militants. The return of the IDPs to some areas of North Waziristan has started. According to media reports, IDPs repatriated to North Waziristan in the first phase were given Rs25,000 as cash assistance and Rs10,000 as transportation expenses. They were also provided with food rations for six months and a kit containing non-food items. Government officials claim that they are trying to make sure that the IDPs are treated with “respect and dignity”. They also claim that the government is trying to bring about legal and administrative reforms in Fata.
What is often missed is that the debate around IDPs is limited to political and administrative reforms only. We need a wider discourse on the subject. Is the government doing anything to meet the health and education needs of the IDPs once they are repatriated? Improving the health and education system in Fata is as important as introducing legal reforms.
The subjugation of IDPs to the brutal force of militants resulted in their segregation and displacement. They experienced physical and psychological violence, economic destruction and cultural dispossession. If ignored, the current plight of these people can turn into a trauma of historical proportions. Public health literature says that historical trauma results in depression, substance abuse and mistrust in the state. Research has shown that historical trauma is cumulative, intergenerational and the cause of multiple negative health outcomes. The responses prompted by historical trauma are physical, social and psychological, and are transmitted through generations. The residents of Fata, directly affected by the unfortunate events in the past decade, will tell their stories to their children and grandchildren. They will tell their younger generation how militants subjugated them for more than a decade. They will also tell their grandchildren how they had to stand in line to get meals for their kids. The coming generations of these IDPs will also want to know why they weren’t sent to schools. These questions and their answers will haunt the upcoming generations of IDPs for decades and cause resentment. This resentment will result in negative health and psychological outcomes. The trauma they have been through will lead to depression, anxiety and chronic bereavement, not only among the people directly affected but also in the generations to come.
The government needs to be ready to deal with these consequences. Political reforms and financial support will play a role in decreasing the depression caused by the massive cataclysmic events. However, we will also have to strengthen health systems in Fata and come up with health campaigns and projects that could directly deal with the negative health outcomes caused by displacement due to the war on terror. We will have to work with these communities to make sure they redeem their confidence. We will have to provide them avenues where they could share their grievances.
This is the right time to reduce the amount of damage done to the physical and mental health of the IDPs. We will have to start the physical and psychological rehabilitation of the people of Fata at this stage. The government needs to initiate rehabilitation efforts as soon as the repatriation process ends. The IDPs feel discriminated against. Their feelings will get stronger with every mismanagement and failure on the part of the government in dealing with their problems. We owe a lot to the coming generations of IDPs. Our failure as a nation can result in crippled and mentally handicapped generations. We may see generations of these IDPs with increased rates of substance abuse, hypertension, anti-social personality disorders, and type-two diabetes. We cannot afford to neglect their health at this critical stage. Currently, it is about prevention; if that is not done, we will have to treat them. Prevention is always more cost-effective than treatment.
Published in The Express Tribune, February 17th, 2016.
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