Opinion: Mental Health Support and Solidarity for Women in Conflict Zones

Content Warning: Sexual Violence, Rape, Suicidal Ideation

This opinion piece is part of a broader, week-long MJPS Online series in collaboration with IRSAM’s delegation to the United Nations. Click here for other components of the series. The views expressed in this piece are solely those of the author and do not reflect the position of the McGill Journal of Political Studies, or the Political Science Students’ Association.

The United Nations Beijing Platform for Action identifies twelve Critical Areas of Concern that serve as guidelines for progress throughout the annual session of the Commission on the Status of Women. Two of these Critical Areas include “Women and Health” and “Women in Armed Conflict”, and overlap to bring attention to the topic of mental health, particularly within volatile zones where women and men are impacted differently.

The World Health Organization defines mental health as “a state of well-being, in which an individual realizes his or her own abilities, [and] can cope with the normal stresses of life…”. Furthermore, the WHO stresses that “violence and persistent socio-economic pressures are recognized risks to mental health. The clearest evidence is associated with sexual violence.” Survivors can incur long-lasting episodes of suicidal ideation, Post-Traumatic Stress Disorder (PTSD), and severe depression.

Women and men will face different vulnerabilities, trauma, and coping mechanisms in times of war, and thus it is critical to examine this issue through a gendered lens.

Specific Mental Health Challenges for Women in Conflict Zones

There are a variety of factors that are conducive to female-specific vulnerabilities during times of armed conflict. From colonial histories to modern warfare, “rape, forced impregnation… and the spread of Sexually Transmitted Infections (STIs) are elements of contemporary conflict”.

In a report cited by the 2002 United Nations Security Council Report entitled “Women, Peace, and Security”, there was a study performed on women’s mental health in Afghanistan under the Taliban-controlled regime. Women attributed their depression to Taliban militants who restricted their various freedoms and frequently used rape as a weapon of war. 65 percent of the women in the study had considered committing suicide, while 16 percent had reported attempting.

Furthermore, in 2014, Raiza Sultana -a Rohingya human rights lawyer and advocate, received a report entitled “License to Rape”, which detailed the use of sexual violence by the Burmese army to coerce and control predominantly female populations. Currently, there are an estimated 40,000 pregnant women within the Rohingya conflict zone, where a significant proportion of these pregnancies come from rape. However, in areas where natal care is scarce and medical resources are allocated by male decision-makers, the lives of predominantly very young girls are at risk. This issue stands as one of the most under-reported war crimes, as a culture of shame inhibits a woman’s ability to access and seek help.

There is a fear of tarnishing their family’s reputation and seeking help from medical professionals, as well as a common practice of family ostracisation after the rape has occurred. These feminized vulnerabilities are conducive to consistent hyper anxiety and ingrained trauma, where an Oxfam survey reported that 29 percent of Rohingya women (in comparison to 5 percent of men) felt unsafe being alone in their camps. Furthermore, over a third of women reported being unable to have safe access to water, bathing facilities, and latrines, as the prospect of violence increases within closed spaces.

Women are often socially perceived as caretakers of the family, indicating that they not only carry the stress of fending for themselves, but also the stress of protecting and sustaining their children. Frequently, when men are in the midst of the war, women or young adolescents are left to act as the head of the household, experiencing extreme levels of anxiety.

Their ability to take care of their families becomes even more challenging when considering the existing socio-economic stigmas placed on women. During wartime food shortages, women and their children are more susceptible to malnutrition due to the inequitable distribution of food at the community level.

Increased vulnerability to sexual violence, a culture of stigma, and the pressure of taking care of families are factors that exacerbate the mental stress and trauma of women in armed conflict.

Proposed Solutions and Limitations

One proposed solution to combat a host of vulnerabilities would be that of group therapy. The logistics of this process will look different in various contexts, considering local cultural realities. However, the general structure of these group therapy sessions would build on existing networks, such as the Rohingya Women’s Welfare Society established by Raiza Sultana, and others that are further instigated by organizations such as Oxfam.

This proposition motions to add another layer of support to these effective structures, thereby encouraging local mental health specialists to lead group therapy sessions, in a way that is culturally sensitive to local practices. These sessions need to be led by a local and trained professional, because if these group sessions are not held in a productive and healing manner, this may lead to unintentional cases of Vicarious Trauma (VT).

These therapy networks aim to mitigate several of the aforementioned risks. For one, if survivors wish, it gives them professional access to mental health support, with a community of empathetic survivors. It allows survivors to foster a sense of solidarity, to overcome fears of being alone and accessing toilet facilities. These groups can form more effective family supports, in taking shifts between resource collection and child care. Furthermore, as medical resources are scarce, it acts as a means of widely accessible health care.

By congregating, a women-led platform for discussion and decision making is created, finding solidarity in coping with mental health struggles.

However, this proposition does not come without limitations. For many survivors of sexual violence, it is very difficult to recount their experiences, particularly to a large group. Many women may be more comfortable coping by doing their best to forget the encounter, as opposed to reliving it through group therapy. Furthermore, the culture of stigma serves as an obstacle in the organization of these group therapy sessions.

As of now, there is no clear answer as to how to work around these challenges and foster effective mental health support networks. In the pre-emptive stages of implementation, more work needs to be done to understand local realities, pre-existing mental health supports, and cultural alternatives to an effective mental health support system.

Image by Sabrina Gill