Dealing with distress caused by armed conflicts: The case of Marawi

WAR and violence destroy communities and countries all over the world and have a devastating impact on the mental health of millions of people. They lead to the breakdown of local systems and infrastructure. As a result, adequate assistance is often unavailable when people need it the most.

People affected by armed conflict and violence are at risk of death, displacement, loss of loved ones and weapon wounds - among others - need care for both physical and psychological conditions.

Not all wounds are visible. It has been estimated that the prevalence of mental disorders (depression, anxiety, post-traumatic stress disorder, bipolar disorder, and schizophrenia) was 22.1% at any point in time in the conflict-affected populations assessed in settings that had experienced conflict in the preceding 10 years, according to the World Health Organization (WHO).

Indeed, mental health is just as important as physical health. When not addressed, mental health and psychosocial needs have a far-reaching and long-term impact on people, their families, their communities, and on the whole society.

The incidence of psychosocial needs also significantly increases during armed conflict, other situations of violence and emergencies. Exposure to violence, the disruption of social networks, the loss of and/or separation from relatives and friends, deteriorating living conditions, poverty and limited access to support can have both a short- and a long-term impact on the psychological well-being of individuals, families and communities.

In Marawi City, southern Philippines, the devastation wreaked by the five-month conflict continues to affect many Filipinos, particularly those who lived through its horrors–people who were trapped for weeks, some held against their will or subjected to violence; and those whose loved ones went missing.

Though not in the Philippines at that time, I came across news about Marawi that made me wonder about the conflict’s devastating physical and psychological impact. Nine months on, when I met those who had been severely affected by the fighting, my worst fears came true—there were many in need of psychosocial support, but some of them also in need of specialized psychological care. For people who never had experienced such type of traumatic event, it is difficult to fully understand their suffering.

Take the case of 34-year-old Mel (not his real name), who was among those held hostage for 148 nights in Marawi. Because of his experience, he had a lot of unanswered questions and avoided seeing people.

Mel is one of the 52 severely distressed people receiving individual advanced psychological care sessions through the International Committee of the Red Cross (ICRC). As an independent humanitarian organization that protects and assists victims of armed conflict, the ICRC started its mental health and psychosocial support (MHPSS) program in Mindanao in October 2018 after assessing gaps in providing specialized psychological care for victims of armed conflict.

MHPSS services play a particularly important role during armed conflicts. Violence, fear and uncertainty can create chaos and deplete community resources. As a result, people experience psychological distress that usually impairs their daily functioning and social interaction.

Our MHPSS program in the Philippines caters to victims of the armed conflict experiencing severe psychological distress, many of them linked to the Marawi siege. In the individual sessions, we provide a safe and trustworthy space, helping beneficiaries to process their traumatic experience. So far, they have expressed relief and felt comfortable, safe and understood during the sessions.

They also said that they have since become more functional in their daily lives because their psychological burdens were reduced.

According to Mel, he learned a lot about himself and his frailties during these sessions. He said: “There is considerably a big change in me, because of that great help, because of that program.”

The ICRC also engages with the families of beneficiaries and their communities to sensitize them on the needs of distressed people and to encourage social support. It’s important to build awareness and mobilize the community because there may be someone struggling, not being the same as they were before, having difficulty in relationships, in the community or at work, but people don’t always put it together. Recognizing the body and mind reactions due to a traumatic event is key.

Approaching the first year of this program, we have reached 1,097 people including the beneficiaries receiving individual MHPSS care, their families and community members, with various MHPSS activities in six Mindanao provinces. Thanks to the open communication and trust gained, our teams are warmly welcomed in every session.

We are constantly inspired by the strength and resilience of these people, who were in really challenging situations but continued to take care of their families the best they could.

With the full support of Philippine authorities, it is our hope that the MHPSS program for victims of violence due to armed conflict becomes sustainable, with local providers rendering this valuable service in the years to come. Together, we can bring the much-needed message of hope and encouragement to Mel and other people severely affected by the armed conflict, so they know that they are not alone.

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* Jesus Miguel Perez Cazorla is a mental health and psychological support (MHPSS) delegate of the International Committee of the Red Cross (ICRC) in the Philippines.

*** The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the position of Astro AWANI.