Drone attacks and excessive use of force to tackle small challenges has created sympathy for terrorists


Terrorism and political violence

Drone attacks and excessive use of force to tackle
small challenges has created sympathy for terrorists

Some people in the media were also pursuing the terrorist’s agenda
of generating fear and hopelessness - Mowadat H.Rana

Under SABOON project 154 young terrorists have been successfully
re-integrated in the community but they remain vulnerable-Fariha Paracha

LAHORE: One of the sessions during the Asia Pacific Conference on Psychosocial Rehabilitation was devoted to psychiatric and psychosocial understanding of terrorism and political violence. The speakers included Brig. Prof. Mowadat H.Rana, Dr. Fariha Paracha and Dr. Nasar Sayeed Khan. Making his presentation on psychosocial rehabilitation of survivors of war on terror, Brig. Mowadat H. Rana pointed out that excessive use of force to tackle small challenges has created sympathy for the terrorists. It was a major mistake in counter terrorism strategy. Terrorists continue their activities in the name of religion. There is mistrust in social institutions. Added to this is fear, panic, insecurity, helplessness and hopelessness. Terrorists have won the war of mind and we have no effective legislation to take care of these terrorists.

Prof. Brig. Mowadat H. Rana along with Dr. Fariha Paracha replying to
questions during the session devoted to Terrorism and Political Violence
at the Asia Pacific Conference on Psychosocial Rehabilitation held at Lahore recently.

Continuing Prof. Mowadat Rana said that we have many people who are educated and professionals who express sympathy for these terrorists hence ignorance was not the problem. Highly educated people argue in favour of these enemies of Pakistan. They say we are not fighting the just war and there have been reports when those who gave their lives in this war on terror, when their bodies were taken to their native areas, some people even refused to offer their Namaz-e-Janaza which further created doubts in the minds of people about this ongoing war on terror. This is the ambivalence and drone attacks have also created sympathy for the terrorists. Old women, young children were among those killed in these drone attacks. The situation was quite confusing and it has affected the individual and the country both. Terrorism and counter terrorism have come on the same path.
In some of the war affected areas, we have large families. Emotional absence of fathers has made the job of these terrorists easy who can easily recruit these young children to be trained as terrorists. Violence has become a norm. We have limited emotional outlets. There are no sports activities in schools and colleges. There is social approval of time spent away from the family in the name of religion. This has also helped to recruit and train suicide bombers. They were drugged after recruitment and their thinking powers were taken away. We have to recognize terrorists as enemy of Pakistan and Islam. Terrorism is a human catastrophe and we need to have a national disaster policy.

 Prof. Razaur Rehman along with delegates from Iran chairing a scientific session
during Asia Pacific Conference on Psychosocial Rehabilitation held at Lahore.

A national rehabilitation center for psycho trauma with peripheral linkage has been established in Rawalpindi. It has a community based institutional approach. We Pakistanis do much better under stress, we showed this during the earthquake in 2005. We stood together as a Nation. We need to have an organized mother based, family based, school based counter terrorism policy. Vaccine of tolerance can be administered by mothers. To succeed in war on terror, we need people lead counter terrorism movement. We need leaders with foresight and the policy makers should take suggestions from mental health experts, how to bring about a change in psyche and how you govern people. It is the people of Pakistan who have to lead this war and not Pakistan Army.
Brig. Mowadat H. Rana made a passionate appeal to everyone to play their role in saving and strengthening Pakistan. He also emphasized the importance of screening and early detection of clinical consequences besides providing supplies for health, food and shelter to the survivors of this war. Psychological therapy comes much later. We need to form international linkage and do research. We should benefit from our Swat experience of de-radicalization of terrorists. We need to provide psychosocial support to their families and terrorists, potential suicide bombers to rehabilitate them in the community so that they once again become useful citizens. We also need to intelligently handle the media as it was pursuing the terrorist’s agenda to generate fear, hopelessness which was being spread by the media, he added.

SABOON project by Pak Army in Swat

This was followed by yet another excellent presentation by Dr.Fariha Paracha a well known psychologist who is running the SABOON project in Swat. It is a Pakistan Army project and the security is also provided by the Army. She gave details about the issues impacting sustainability in integration after De-radicalization of the terrorists. This project enlisted one hundred ninety two young terrorists out of whom one hundred fifty four have been successfully re-integrated in the community but they remain vulnerable, she remarked.

Group photograph taken during the Asia Pacific Conference on Psychosocial Rehabilitation held at Lahore
recently shows from (L to R) Prof. Farid Minhas, Prof.Norman Sartorius, Dr.Afzal Javed,
Brig. Mowadat H. 
Rana, Dr.Ricardo, Dr. Farrukh Hussain, Mr.Shaukat Ali Jawaid,
Dr. Shujat Ali Naqvi, Dr.Sadaf Rashid and others.

They are being provided monitored education at Mingora in Swat. Most of them are between 8-18 years of age. Most of them were school drop outs, coming from low socioeconomic class. Many had not gone to schools. Their activities had nothing to do with the religion. The factors which prompted them to join these terrorist activities included extreme poverty; drop out from schools or no education at all. These are some of the issues which needs to be tackled effectively she added.
During the discussion it was pointed out that Dr. Farooq from Mardan who himself was a religious scholar was killed because he was preaching tolerance. We need to eliminate injustice in institutions, frustration, anger and corruption to end militancy.
Prof. Khalid Mufti from Khyber PK spoke on conflict and mental health and pointed out that now resistance has reduced in certain areas and peace has returned to Swat. However, the terrorists carry on with suicide bombers from time to time. These terrorists are very motivated. We saw these suicide bombers in Palestine and again in Sri Lanka by the Tamil Tigers. He then discussed the causes of rebellion and revenge and other related factors. He was of the view that we need to introduce psycho politics in our training programmes. History gives us some answers. There are corporate interests of various countries who do not want to seen an end to such wars. Americans came up with the New World Order. Western media blames Islam. These terrorists, Prof. Khalid Mufti opined, were misguided arrows. Religion usually plays a positive role and we see people going to mosques and churches in grief. USA and USSR both have suffered a great deal. For some reasons Pakistan has remained a fertile ground for terrorists. Pakistan Army and the Nation have suffered a great deal during this war on terror. We need to look at who sponsored these terrorist activities. Doctors have done a commendable job and we may be seeing more complex emergencies in future. W should plan how to offer help to people immediately after such terrorist activities and we have to plan for the long term rehabilitation of the victims.
Dr. Zeb Taintor from USA opined that we should forget why the terrorists are doing it but what they are doing is a crime. Speaking on psychiatric neuroscience and treatment of consequences of terrorism, he said that over the years violence has decreased. Most of the 9/11 victims in USA are suffering from mental disorders like anxiety, depression and PTSD. There are 7.5 million people in USA who are suffering from PTSD. There are many cases of domestic violence. Tension adds to anxiety because of ongoing trauma and threat. Exposure to violence can be through media as well. Now neuroscience is tooling up. We have MRI, FMRI, qualitative EEGs, CAT and all these sophisticated tests available. He also talked about stress response, treatment, evaluation and monitoring, cognitive behaviour therapy and conditioning. Neuro feedback, he stated, was more effective. Use of effective drugs, hypnosis, support groups and avoiding avoidable behaviours were also discussed in detail. Fear extinction requires multipronged interventions. Prazocin can be used to treat nightmares, for dream control and feelings of helplessness. Stem cells help in repair of traumatic brain injury by building bio bridges of science. There is also possibility of selectively erasing unwanted memories from the brain, he added.
In another session Dr. Shujat Naqvi, consultant child psychiatrist from USA made a presentation on catatonia which is classified as mild, moderate to severe. He discussed in detail the effectiveness of ECT and adverse effects of ECT. He suggested that one should avoid trial with drugs as some of these medications make catatonia worse.

Reception at Governor House

Governor of Punjab, Mohammad Sarwar Chaudhry also hosted a reception for the international delegates of the conference at the Governor House during the conference. Those who expressed their views at the reception included Dr. Michael President-elect of World Association of Psychosocial Rehabilitation, representative from the Royal College of Psychiatrists UK who said that they were taking back happy memories of our visit to Pakistan. This is the place to come and work together. We see great hope and atmosphere of change and keenness how to improve mental health services. The rehabilitation faculty in RCP, she said, can help in this regard. Prof. Norman Sartorius representing Council of World Psychiatrists Association said that the delegates had good exchange of ideas during the conference and it will help us in overcoming domestic, internal and external crisis. Dr. Amjad Saqib thanked the foreign delegates visiting Pakistan and said that it has provided them an opportunity to see the real Pakistan. We have people with love and passion and the political leadership is also keen to learn. He hoped that these delegates will come to Pakistan again and again in the days to come.
Governor Punjab Chaudhry Mohammad Sarwar said that we have to improve our mental health services. I highly value the volunteers who work in this field. We have many unsung heroes who work behind the scene who help to improve the quality of life of others, he added.
Prof. Razaur Rahman from DUHS Karachi chaired the session wherein Prof.Ricardo from Spain talked about psychiatric reforms in Spain. He pointed out that there were three attempts to introduce these reforms in 1820-1823, 1931-36 and then in 1986. Economic development and internet connections played an important role in this effort. Political will coupled with healthcare laws introduced in 1986, sector policy, decentralization and gradual increase in resources helped in the success of these reforms. He emphasized on low cost high quality interventions. Discussions with the industry, getting their support, empowering the consumers and working with media were all quite helpful, he added.
Dr. Ibrahim Murad from Palestine was the next speaker. He pointed out that there are twenty two qualified psychiatrists in Palestine and most hospitals are understaffed. Hospital staff is involved in advisory positions. At present a group of doctors are being trained in mental health in France and sixty five NGOs have developed mental health programmes. Some of these NGOs are operating independent of health authority. A survey showed that house hold violence was about 11.3%. Prisoners are tried in Military Courts in Military Camps. Mental Health Authority was asked to train mental healthcare personnel. Politically active psychiatrists were repatriated from Palestine. About sixteen hundred Palestinians are kept in administrative detention every month and the total number of Palestinian prisoners under administrative detention at present was thirty eight thousand. About 30% of the patients are treated by traditional healers before any drug treatment. The common diseases include increasing PTSD, eating disorders and emotional disorders in children.
Summing up the session Prof.Razaur Rahman remarked that there are about seven hundred Pakistani psychiatrists in UK and about eight hundred in United States while only five hundred were practicing psychiatry in Pakistan and some of them were not qualified psychiatrists, he added.
In the next session the need for community mental health rehabilitation services was emphasized. Dr.Helen Killapsy from UK in her presentation on deinstitutionalization of rehabilitation services discussed the closure of asylums. She also referred to shifting of resources from large hospitals to community services. She called for creating a balance between community health services and indoor mental health services. About 10% of health budget is spent on mental health services.
Primary healthcare services in UK, she said, are very well developed and patients with common mental disorders like anxiety and depression are treated there. But what happens when mental health services are not in place in complex disease, they remain in ward and occupy bed. Then they are moved to public hospitals which are known as re-institutionalization of mental health services. She was of the view that there is a need for specialized rehabilitation services even in developed countries with good mental health care services.