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Pay attention to terror victims' mental health

By Rachel Kimani | Jan 30th 2020 | 3 min read

"I cannot go back to Dusit. Just driving past the hotel gives me anxiety," said a survivor in a recent article commemorating the first anniversary of the Dusit D2 attack.

These emotions are echoed by survivors of the 1998 US Embassy bombing, Westgate and Garissa University siege and many other terror attacks Kenyans have had to endure.

The latest terrorist incidents in Kenya are a constant reminder that we must be suspicious of strangers, vigilant and always guard against the infringement of our civil liberties. Terrorism is not unique to Kenya or Africa. It is a global concern.

Still, these threats have a significant impact on our politics, economy, socialisation and also have a complex mental health effect.

Beyond the visible attack on lives and property, terror is a form of psychological warfare. Contemporary use of the word "terrorism" is rarely neutral.

Terrorism is a multifaceted phenomenon that generally involves the judgment of the perpetrators' motivations and origin. In the dictionary, terror is synonymous with fear and this can be extrapolated to mean terrorism is something that causes fear and sustains it.

Terrorism disrupts our way of life and punches holes in our mental defences. When a bomb goes off in a military base in Lamu or gunmen target teachers in Garissa, people everywhere are hyper vigilant and uneasy.

The fear of impending attacks has shopping malls increasing their security checks by posting guards with dogs at entrances, searching cars for explosives and even subjecting shoppers to personal pat-downs.

The survivors, families and the public are confronted continuously with narratives of the event provided they contain enough shock and terror.

Whether we realise it or not, the dread of terrorism is embedded in our collective consciousness and every successive terrorist attack seems to leave a lingering negative effect which could transform us into fearful, hostile and ethnocentric people.

Social scientists studying the impact of terrorism agree that terrorism is not only actual destruction and injury, but the threat of violence and ensuing psychological effects. Some research studies have associated terrorism trauma with post-traumatic stress disorder (PTSD), depression, mood disorders, alcohol abuse and risky behaviours.

However, exposure to terrorism does not equal mental illness. In fact not every Kenyan exposed to terrorism has developed psychiatric illness.

Although only a minority develop a severe mental illness, and as terrorism incidents persists, there is need for a comprehensive strategy to address resulting psychological trauma.

In a resource-constrained country like Kenya, it may be tempting to put psychological first-aid in the back-burner as we deal with injuries and compensation of victims. However, the few studies conducted in Africa show that victims of terrorism have similar mental health risk as western populations.

Consequently, medical and psychological support is needed. A reasonable strategy could be victim follow-up, where mental health professionals would screen and treat persisting psychological trauma.

Aside from identifying and treating those with severe trauma-related illness, it may be useful to encourage an analysis of terrorist incidents that highlight our will to survive and endure. Perhaps, this era of terrorism doesn't have to be a cultural apocalypse.

As we search for meaning to make sense of the traumatic experiences, we can make an effort to reframe the experience, restore a sense of community and explore the opportunities to actively promote post-terrorism adaptation and resilience.

These can include governments implementing community preparedness plans that include command systems, emergency alert mobile apps and tactical first-aid training.

At first, to talk of resilience may appear to negate the adverse effects and suffering that people experience following terrorist attacks. This instead, can be viewed as another aspect of the overall experience of coping and adjustment.

For so many involved, the immediate aftermath of a terrorist attack is devastating and needs urgent medical support. The terror attacks may subside, but this will not be the end of their effects. What happens to the individual and collective mentality ought to be addressed by mental health professionals and policy makers.

And possibly this will help us construct a stable future and regain our sanity.

Dr Kimani is a lecturer at Aga Khan University’s School of Nursing and Midwifery, East Africa

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