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PTSD Goes Largely Untreated In Iraq's Kurdish Region


The Kurdish region of Iraq has lived with violence for decades, from Saddam Hussein's chemical weapons attacks in the late 1980s to the Kurdish civil war in the mid-90s to the current threat from Isis. The violence has produced generations of Kurds who suffer the same PTSD and depression symptoms of American veterans, but with a tiny fraction of the treatment. Dr. Ahmed Amin started one of the regions few psychiatric centers in 2007. And in a recent piece in Harper's magazine, he said, before his center opened, there were 30 psychiatrists in all of Iraq. Reporter Jenna Krajeski wrote that story. We reached her in Erbil. She says the Kurdish civil war, in particular, had a profound effect.

JENNA KRAJESKI: Because the Kurdish struggle against central Iraq is based largely on this national pride, And that pride binds people together. And the idea that eventually there will be an independent Kurdistan is something that Kurds thought they were fighting for and struggling for. So when the two major political parties begin fighting each other, not only was it a vicious fight, families fought families. Dr. Amin has this quote in my piece where he says, neighbors fighting neighbors, families fighting families. And he also says, we've always wanted to erase this from our minds.

RATH: You spoke with people who are dealing with the PTSD problem directly there - the people working at one of very few mental health clinics in Kurdistan. This is the trauma rehabilitation and training center. What are the kind of stories that doctors are hearing there that they have to deal with?

KRAJESKI: Well, there's a lot. The doctors see a lot of people who were detained. And in those prisons - particularly under Saddam - they really underwent systematic torture. There's also the chemical weapons attacks, which really concentrated in a town called Halabja, which is quite an isolated town. Thousands of people died in one day. There are people who suffer extreme mental distress. They're still waiting for their family members to come back. You know, they have certain sensory associations with those days that traumatize them.

Dr. Amin me something that I think is really interesting. They encountered a kind of language that even he, as an Iraqi, didn't really know how to identify and diagnose. Women would tell them that their souls were hurting. And he would just say, you know, I've been trained in Europe and in Iraq. I don't know how what to do when someone tells me my soul is hurting. I've never read any literature that says, this is the treatment for someone who says, my soul is hurt.

RATH: I have to imagine that having an active war going on - that must complicate treating people for posttraumatic stress, when there's still, you know, stress in the air.

KRAJESKI: Yeah. I think that that's a very good point. There's a really high need for treatment. People who have suffered through decades of wars and occupations and invasions and - that project almost necessitates that there be an optimism about the future because you're seeing people who you've convinced that by revisiting this very traumatic past, they can have a better future.

And so with the threat of Isis, you have hundreds of thousands of internally displaced people coming from areas that have been besieged by Isis into Kurdistan. Not to mention Syrian refugees - 250,000 of them in Kurdistan. And you have Kurds living in Kurdistan who are scared or had to leave their own towns. So, of course, this means more trauma, more patients. And yet, when I spoke to this Dr. Amin last, he told me that they were seeing fewer patients. And he thought it was because people were too frightened to come to the clinic. And to me, that says, maybe that optimism was gone if people weren't going to the clinic. That, to me, was a disappointing thing to hear, and I hope it doesn't last.

RATH: That's reporter Jenna Krajeski. She's been writing for Harper's magazine about treating PTSD in Kurdistan. Jenna, thank you.

KRAJESKI: Thank you. Transcript provided by NPR, Copyright NPR.