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Mental effects of the earthquake will linger longest

With millions likely suffering mental trauma and thousands disfigured or disabled, the aftershocks of the earthquake in Pakistan and India will be felt for decades to come, doctors and psychologists warn.

Those who survived the quake and manage to find shelter, warmth and food before the onset of winter in the mountains of Kashmir are still a long way off leading anything resembling normal lives, they say.

The short-term prognosis makes bleak enough reading: at least 53,000 people were killed, half a million are still trapped in mountainous villages and hamlets with little more than plastic sheets to keep out the icy cold, millions are homeless, and at least 80,000 are injured.

Jan Egeland, the UN's emergency relief coordinator, has described the immediate fallout from the quake as "worse than the tsunami."

But looking further down the road, the future for Kashmiris in the Pakistani zone of the divided Himalayan territory looks not much better.

Kashif Ikram, a Karachi surgeon working at a field hospital in the Pakistan Kashmiri capital Muzaffarabad, feared the impact of the 7.6-magnitude quake would be felt for a long, long time.

"Kashmir will change dramatically. It will not be the same again," Ikram said. "It will take years for [Muzafarrabad] to be rebuilt, and by then many people will have found new homes.

"This place holds too many bad memories. Most survivors are suffering some form of mental trauma. It will take ages for things to normalize," he said.

Experts in both countries warn that the mental scars may take years to heal and that many families will remain dysfunctional unless long-term rehabilitation programs are launched.

The Times of India newspaper yesterday quoted the case of Kashmiri engineer Saneep Gigoo, 25, who despite taking sleeping pills sleeps fitfully, and who during the day believes the furniture in his room is rattling, that the ceiling is falling and the floor is slipping beneath his feet.

Psychologists say there are hundreds of thousands, if not millions, like Gigoo who are suffering trauma and are gripped by fear.

"The anxiety will continue, and only with time -- and in the case of chronic patients, psychiatric and medical help -- will it wane," neurologist Sushil Razdan said.
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