Thursday, August 10, 2017

Schizophrenic in Marawi and Iligan

Philippine Daily Inquirer/OPINION/by Ma. Ceres P. Doyo

Heartbreaking is the news that of the over 400,000 internally displaced persons (IDPs or evacuees/bakwit) from the bombed out city of Marawi, more than 7,000 are now exhibiting schizophrenic behavior or are on the verge of developing schizophrenia because of the stress they have been going through in the past two months and a half. These IDPs are mostly camped in neighboring Iligan City and waiting to go home—that is, if there is still a place they can call home or a peaceful one where they can feel safe.

But before they can go home — and they have no idea when that would be — the stress they go through is taking a toll not only on their bodies but on their minds as well. Lanao del Sur Crisis Committee spokesperson Zia Alonto Adiong has been quoted as saying that some 2,500 evacuees are showing signs of schizophrenia. His source was the Integrated Provincial Health Office.

Schizophrenia is defined as “a serious mental illness characterized by incoherent or illogical thoughts, bizarre behavior and speech, and delusions or hallucinations, such as hearing voices.” In common parlance it means losing one’s sanity. I do not want to use colloquial terms here which would trivialize the state of mind of the affected IDPs. This is no laughing matter.

I don’t know how the IDPs’ mental and emotional state was assessed. Was there one-to-one examination of the evacuees, or were the conclusions based merely on casual observations of external manifestations? Whatever the case, it must have been easy for observers to see that something alarming was happening to many IDPs and it did not need trained psychiatrists or psychotherapists to conclude that the IDPs were in bad shape mentally, emotionally, physically. How much more can they take?

Most of the IDPs may not be shell-shocked as they were not caught in the crossfire and did not experience up close the fire fight between government troops and the Maute terrorists. If they did, it was only in the beginning. But the IDPs are badly traumatized because they have been forced to flee and leave their homes which, by now, might be rubble. Many of their family members have not been accounted for or are presumed dead.

Right now the IDPs are staying in evacuation centers and wanting in food and amenities. They may not die o f bullets but their lives may be shortened because of the hardship they undergo, the insecurity, uncertainty and fear. Government soldiers are surely undergoing something of their own, like shell shock, war trauma, posttraumatic stress disorder. So, too, are journalists and other media workers in the war zone.

This is the time when the National Mental Health Act should be in full use. Approved last February, Senate Bill No. 1354, which was sponsored by Sen. Risa Hontiveros, seeks to integrate mental services into the health system and for the government to provide mental health services at the community level and professional (psychiatric, psychosocial and neurologic) services in all regional, provincial and tertiary hospitals.

Article IV (on mental health services) lists the ways the services are to be dispensed in all these levels. I wonder how these services are now being implemented in places such as Marawi, Iligan and neighboring places affected by the ongoing fire fight where casualties on both sides are now in the hundreds. While the government is promising billions of pesos for the rehabilitation of Marawi City, what about the rehabilitation of its people? It is so much easier to repair structures that have been destroyed or to build entirely new ones, but restoring individuals’ shattered mind and spirit is no easy task. Traumatized individuals and families with losses to bear, if left on their own, could become like the walking dead, bereft of hope and direction.

The rehabilitation of mind and spirit should start now, even while the fighting goes on. Children are said to be resilient, but you never know. Let us not overestimate them. Neither should we underestimate them. If ignored, their fears and anger can become festering wounds that will be carried to adulthood. The children of war bear ugly scars. Who knows how the sound of guns would one day stir the silent rage in their hearts?