Thousands of Displaced Iraqis Living with Psychological Toll of Conflict
Mosul – Weeks after the retaking of Mosul city, many internally displaced persons (IDPs) are exhibiting signs of stress and anxiety. As the psychological toll of what many had endured over the last three years kicks in, children in particular have been scarred by the violence of life under ISIL. They will need long-term psychological support.
IOM, the UN Migration Agency, has been offering support to IDPs since November 2016 – virtually since the start of the Mosul crisis – by providing integrated psychosocial services to 24,399 internally displaced Iraqis. IOM’s outreach ranges from individual counselling to structured play. Emotional support comes in the form of sporting activities, as well as from guided group discussions and specialized consultations.
With support from the Office of US Foreign Disaster Assistance (OFDA) and the Government of Canada, IOM’s Mental Health and Psychosocial Support programme (MHPSS) now has seven centres catering to IDPs from Mosul and its surrounding areas, between the Qayarah Airstrip and Haj Ali emergency sites, and the Hasansham U3, Nergizilya 1 and Chamakor camps.
IOM’s MHPSS began operating in Iraq in October 2014, when the Organization first established its Psychosocial and Recreational Centre in Erbil. This was followed by the addition of five centers in IDP camps in Dohuk, and the deployment of four mobile teams in the Baghdad, Karbala, Najaf, and Babylon Governorates. Those teams provide services to IDPs camps and host communities.
During nearly three years of operations, IOM MHPSS in Iraq has reached over 50,000 beneficiaries and provided roughly 150,000 different psychosocial support activities. In fact, the average beneficiary can engage in three different types of activities, such as individual counselling, a language course and an arts and crafts workshop, over a period of up to 12 months.
Some months ago, Yunis came to IOM’s MHPSS Center at the Haj Ali emergency site. He was at a critical point in his life: he felt his world was falling apart and his marriage was on the verge of breaking down. Not only had he been displaced twice prior to arriving at IOM’s emergency site, but he had also lost all his possessions. His home was destroyed shortly after ISIL took over the area in 2014 and his small juice shop went out of business – it was the family’s sole source of income.
Unable to lactate due to stress, Yunis’ wife, Umm Ibrahim was unable to breastfeed her baby, Doha. With no money coming in, Yunis was unable to afford the formula milk needed to feed the little baby.
As a last resort, he borrowed money and bought a cow, believing it would provide Doha with essential fresh milk. But the milk was not pasteurized and little Doha soon became very sick with severe diarrhoea and dehydration.
In an act of desperation, he and his wife sought help from an ISIL-run hospital. But, as Yunis recounts, they refused to help the infant. With the baby in his arms, Yunis begged various pharmacies for an IV to rehydrate his baby.
Yunis carried the little one in his arms while praying. “I felt her die in my arms,” he said. “Her eyes went white as her soul left her and she stopped breathing and her little arm slumped to her side.”
Yunis’ breakdown began there and then. He felt useless, as if he had failed his family and he was riddled with guilt about the death of his four-month-old baby.
When he finally arrived at IOM’s Haj Ali emergency site in Qayara, the toll of events caught up with him and for three days he sat crying and howling in the tent, unable to sleep. Then one morning he went to the medical centre seeking drugs. He was immediately referred to IOM’s MHPSS centre on the site and was taken in charge by one of the psychosocial staff.
The Iraqi father of four, who originally comes from Tal-Afar, told aid workers he was feeling suicidal. Counselling sessions and an integrated psychosocial support were provided to Yunis. He was also hired as a labourer in the camp and began to earn some money.
“I felt better… IOM helped, they restored my confidence and self-esteem and allowed me healing time and provided the necessary support,” he said.
“I now engage with my children, I am no longer angry at them… we play, laugh and joke around,” he continued.
For Yunis, much has changed since he first visited IOM’s MHPSS Center at Haj Ali emergency site. Today he sells sweets at the camp, which helps him provide for his family.
With Mosul finally retaken by the Iraqi forces, Yunis is now more confident that Tal-Afar will follow suit and that he will eventually return to his home where he dreams of reopening his juice shop and rebuilding his house.
Doha’s death is no longer a source of guilt, but now both he and his wife say they feel her presence around them, “like an angel flying between us all.”
IOM staff at MHPSS centres note that many of the IDPs seeking help display symptoms of acute stress such as hyper vigilance, anxiety, depression, anger, memory loss, psychosomatic symptoms and a lack of appetite.
Amongst the many children IOM works with, those from Mosul tend to display symptoms of developmental regression, exhibited by episodes of bed-wetting, severe anxiety, apathy and quickness to get angry or cry.
In cases such as those of Yunis’, IOM concentrates on containment and preventative measures to help the IDPs establish a sense of safety and normalcy. The goal is to empower individuals to see themselves as survivors rather than victims, facilitating acceptance of the new conditions, and to activate resilient strategies to cope with past, present and future challenges.
IOM Iraq Chief of Mission, Thomas Lothar Weiss, said: “Psychosocial services are an essential aspect of assistance to displaced Iraqis, who have experienced unimaginable horrors and pain. Now that Mosul has been retaken, and many IDPs have reached safety, part of the healing process involves assisting individuals to process their grief and loss, and empowering them to take steps to recovery.”
Weiss added, “IOM MHPSS services have assisted thousands of Iraqis affected by the current conflict in the healing process. Hence, IOM will continue to provide these vital services in the immediate stabilization efforts in Mosul, as we consider mental health wellbeing a critical component of the peace building process.”
IOM Iraq has been leading the Mosul MHPSS sub-cluster working group since its inception in November 2016, ensuring coordination among the various humanitarian organizations and institutional counterparts in Ninewa Governorate.