Life is a great
risk and the psychological challenge of contending with forces that threaten
our existence is enormous. The reality is that the world we are living in is
essentially unsafe stretching from America down to Africa and to the Kalahari Desert.
The much progress man has made is paradoxically the bane of his insecurity. Nuclear
reactors were primarily designed for the promotion of healthy living but have
become lethal weapons of warfare capable of destroying humankind. There are
natural catastrophic occurrences such as the hurricanes, floods and the tsunami
that have overstretched the coping mechanisms of human populations whenever
they occur. In Nigeria, cases of rape occur although largely unreported because
of our cultural and religious sentiments and it is capable of frustrating a
future marital life because of the attendant psychological trauma. Recent but
common cases of kidnapping and in the last few years, suicide bomb attacks have
been on the increase in our country. In the last decade, we have experienced
many air disasters and on a yearly basis there is increasing incidence of road
traffic accidents as a result of our bad roads. Other traumatic events
associated with grave psychological consequences include child neglect and
physical abuse; sexual molestations of minors, women especially when physical
attacked and threatened with a weapon, witnessing the death of a relative or
injury, tortured victims as well as those held hostage. The focus of this discourse is that the human
mind with its limited coping facilities is at the center of all these
challenges. In Africa we mourn the dead and even mount big ceremonies in their
memories but no care is instituted for the mental health challenges of
survivors of road and air accidents as well as suicide bomb attacks. Nigeria
has one of the largest and gallant army of soldiers who have fought to keep our
nation together but with no adequate care for the attendant mental distress
they live with consequent of combat experiences. Survivors of armed robbery attacks have
considerable mental distress which has made some families to abandon their new
building for rented apartments.
There is a whole family of psychiatric disorders traceable to exceptionally stressful
life events and depending on the duration and peculiarity of symptom; there is the acute stress disorder and post traumatic
stress disorder. Basic symptoms include disturbed concentration, disorientation,
emotional numbness, anger, panic anxiety and despair among others. Post traumatic stress disorder has the listed symptoms
but in addition has emotional numbness and blunting, detachment from others,
re-experiencing symptoms when such persons involuntarily experience aspects of
the traumatic experience in a very vivid and distressing way as flash backs in
which the person acts or feels as if the events were reoccurring, night mares
and intrusive images from the traumatic event just as some actually avoid
activities and situations reminiscent of the event. Men experience more
traumatic events than women but the women experience higher impact events. The critical
challenge in recognizing this disorder is that the clinical picture is often
marked by substance abuse and depressive illness. The view of a layman is that
traumatic events cannot fully explain this abnormal mental state but literature
and clinical practice have established a spatial relationship between these events
and the occurrence of these disorders.
The experience for those directly involved or witnesses carry a
possibility of actual or threatening death or serious injury or threats to the
physical integrity of the self and others. We should realize that survivors of
traumatic events require mental health management and should be appropriately
referred. Our culture and religious orientation encourage suppression of the
emotional experience thereby militating against a speedy recovery. Untrained
counselors get them to deny the
reality of their feelings that impairs the principle of “working through” the
trauma. The Federal Government needs to urgently incorporate mental health
program in the rehabilitation of the survivors of suicide bomb attacks in
addition to economic empowerment and social repositioning for those who have
suffered significant handicaps because of the crisis. This is important because
economic deprivation and loss of social role functioning are potent factors of
poor recovery. The amnesty program being proposed cannot be successfully
implemented unless a preliminary rehabilitation of survivors of the attacks is
undertaken. The Ministry of Defense needs to have a strong mental
health program to cater for soldiers both serving and those retiring. Cases of
rape should be promptly reported not just for prosecution but for timely
rehabilitation. Our state ministries of health should be at the center of
public health campaigns in managing survivors of disasters as they have input
in disaster management effort. In conclusion, the relevance of the mental health
care professionals in primary care is indisputable especially for public
enlightenment.
Dr. Adeoye Oyewole
adeoyewole2000@yahoo.com
+234 803 490 5808 (WhatsApp Only)
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