Psychosocial Consequences of War: Northern Sri Lankan Experience
A community-based approach to address psychosocial problems was used, and the interventions were aimed to include:
• Training community health workers in identification and intervention for psychosocial problems, thereby
• Develop their knowledge and skills to use a variety of psychosocial interventions
• Develop practical structures in the community for promotion of psychosocial well-being, and
• Develop referral and treatment possibilities for those suffering from severe mental illness at the local hospital
• Identify and help the most vulnerable such as women, widows, children, the displaced and the poor.
OBJECTIVES OF THE PUBLIC MENTAL HEALTH PROGRAMME As outlined above, the psychosocial sequealae to the ongoing war have been immense (Somasundaram, 1998) and a program to start systematically addressing the increasing trauma was needed. It is significant that the Health Reach Program at McMaster University (Perera, 1996) did a detailed study of children in the Eastern Province of Sri Lanka, in addition to their studies in Yugoslavia, Palestine and Iraq, and found considerable more war trauma and psychological problems in Tamil (including Muslim) children compared to Sinhalese children. One was an in-depth one year observational study of 76 children in the Kokuvil and Kondavil area ( just north of Jaffna town) identified as having been exposed to war trauma, out of whom 18 were 3–6 years old (Lakshman & Sivashankar, 1994). The mental health programme trains a target group of people such as teachers, health-workers, healers and welfare workers to be able to help people in local communities to identify their emotional and social difficulties and to feel empowered to find their own solutions to these problems.