Jakarta, 15th June 2007. Almost two years after the Helsinki peace accord was signed, Acehnese civilians continue to suffer a high rate of combat trauma, the International Organization for Migration and Harvard researchers have found in the first Aceh-wide study of conflict related trauma and depression.
The assessment which evaluates the mental health needs of people affected by the 29-year conflict between Indonesian security forces and the Free Aceh Movement (GAM), was conducted with assistance from Syiah Kuala University, the Indonesian Health Department and funded by the World Bank, the Decentralization Support Facility, Harvard University and IOM.
The assessment conducted in high-conflict communities across 14 districts of Aceh, found that 35 percent ranked high on symptoms for depression, 10 percent for Post-Traumatic Stress Disorder (PTSD) and 39 percent for anxiety.
Nearly three quarters (74 percent) of the randomly selected sample of the 1,972 civilians from 105 villages report living through combat, 28 percent have experienced beatings, and 38 percent had a family member or friend killed during the conflict.
Civilians in South Aceh and along Aceh's East coast experienced even higher rates of traumatic events, and as a consequence display high levels of symptoms for mental illnesses. For example, 41% of villagers surveyed from the south and west coast suffered high rates of depression symptoms, 43% anxiety symptoms and 14% PTSD symptoms.
A Psychosocial Needs Assessment of Conflict-Affected Communities in 14 Districts of Aceh was not designed to catalogue or identify groups or individuals allegedly responsible for causing trauma.
But the reports authors say that this traumatized portion of Aceh's population could be possible triggers for further violence, if left untreated.
"These memories are alive in the community, and they have the tremendous power to reproduce that violence. These traumatized individuals can become stressors for the rest of their community," said Professor Byron Good, one of the reports authors, from the Harvard's School of Social Medicine.
The report calls on the Indonesian government to fund desperately needed mental health services, as well as on the international community involved in Aceh's post-tsunami reconstruction to incorporate psychosocial care as part of their programmes.
"This report shows that many civilians in Aceh, where one of South-East Asia's long running conflicts has raged until recently, are in urgent need of specialized mental health care," said Professor Good.
"Developing a mental health system that reaches these traumatized individuals, who are often located in remote, widely dispersed villages, is essential for Aceh's future," added Professor Good.
In response to results from this study, the World Bank, with funding from the British government's foreign aid agency, DIFID, has agreed to fund IOM's outreach mental health programme in Bireuen and North Aceh which will target 3,000 individuals, in ten sub-districts, over 12 months.
"This unique mobile programme, which provides both basic health care and psychosocial care, will provide an important service to remote villages in two of Aceh's most conflict-affected districts," said Steve Cook, IOM's Indonesian mission chief.
In response to the results of a 2006 assessment of Aceh's mental health needs, which revealed that civilians in three districts displayed levels of combat-related trauma comparable to the Bosnians in the Balkan war, and Afghanistan, IOM launched a six-month outreach health programme in Bireuen. Since January 2007, the mobile clinics, which work together with the government community health centres or puskesmas, have targeted 14,000 civilians, and treated 581 patients suffering mental illnesses.
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