|Aida ALIC: This is why the number 22 or a visit to Gorazde remain so significant for Midheta. â€œWhenever I visit my motherâ€™s grave I feel tense,â€ she says. â€œIf I see a pregnant woman, I remember the horrible scene in Kokino Selo, where they killed a girl who was in the ninth month of her pregnancy.â€|
For Midheta Orelj, the war has never ended. â€œI had nightmares, was afraid of being at home alone, nervous, used to forget things,â€ she says. â€œAt times I constantly checked myself. Even now, when I watch some war trial on TV, I dream about running away from them.â€
Oreljâ€™s story is typical of those suffering from post-traumatic stress disorder, PTSD. The number of victims of this syndrome is not known, as doctors say many victims donâ€™t seek help, though they are aware that they have symptoms.
Some experts believe the number suffering from the syndrome is actually growing because they failed to ask for help on time.
Some research has been undertaken to assess how many people in Bosnia suffer from this form of trauma. It suggests about 15 per cent of the people in the BiH Federation and 16 per cent in the Republika Srpska can be classified as sufferers.
Augustina Rahmanovic, of the NGO Vive Zene, from Tuzla, says it is hard to determine the exact number who suffers from war-related traumas because â€œsociety has stigmatized themâ€.
Alija Muratovic, president of the Stecak association of war veterans, from Tuzla, agrees. â€œThere are many people with PTSD who are afraid of being labeled in some way and who therefore decide not to ask for help.â€ He says. â€œIt also often happens that they commit suicide.â€
The trauma suffered by Midheta Orelj is associated with the number 22, which has a special meaning for her.
This is because on May 22, 1992, when she was 18, she was taken from her village near Gorazde by the Bosnian Serbs and held in detention for months, together with her sister, sick brother and a 13-month-old baby whose mother was killed.
â€œWhen I look back, I see that I have been broken down by the war and my personal tragedy. Before the war I was a very calm person, but now I am somehow mentally burdened,â€ Midheta says.
Doctors researching into PTSD say any persons who survived or witnessed life-threatening events can suffer from the syndrome, which frequently manifests itself as â€œextended or delayed reaction to stressâ€. In addition, persons who experienced â€œa feeling of extreme fear or helplessnessâ€ can also suffer from it.
Indicators that a person is suffering from PTSD include nightmares, fear that some horrifying event is about to happen again, hallucinations, anxiety, depression, suicidal feelings and the avoidance of certain activities that remind the person of the original trauma.
In 2007, a research project, â€œResearch on the influence of war and post-war stress and trauma on veteranâ€™s mental healthâ€, was conducted in Republic Srpska. Involving more than 500 former soldiers, it determined that more than 45 per cent suffered from PTSD.
Such research has not been conducted in the Federation of Bosnia and Herzegovina. However, a short time ago an association of war veterans there decided to undertake a similar survey among its own members.
â€œWe aim to determine the number of patients in each municipality, because 1,480 persons clinically treated for PTSD have been registered in Tuzla Canton alone,â€ Alija Muratovic said.
A Human Rights Watch report on the processing of wartime criminals before cantonal and district courts in Bosnia in 2008 noted that many victims were not willing to speak about their wartime experiences because they felt they needed to get on with their daily lives.
Midheta agrees. â€œThese days, whenever I see the people who were held in the detention camp when I was there, we never speak about what happened to us there,â€ she says.
Those who have been registered as sufferers from PTSD often receive inadequate help. Few of the countryâ€™s 50 social centers – 38 in the Federation and 12 in the RS – provide specific psychological and social support for people who suffered deep traumas or experienced torture in the war.
â€œWe lack the capacities to perform as much work as we ought to,â€ says Edina Mahmutovic, of the Social Work Centre in Sarajevo.
â€œIn some situations we donâ€™t have the space in which to work. On average, we can only conduct up to five interviews with any person who approaches us looking for help, which is not enough.â€
In its 2008 report, Human Rights Watch urged the Federation and the Republika Srpska to fulfill their â€œlegal obligationsâ€ and ensure â€œadequate resources and staffâ€ for Social Work Centers so that they can provide more support for war victims.
â€œWe need specialized institutions dealing with this issue but such institutions donâ€™t exist in this country, despite the fact that society is obliged to deal with these cases,â€ says Salih Rasavac from the NGO, Corridor.
However, Saliha Djuderija, a legal expert, says lack of institutions supporting traumatized people is not the main issue â€“ but victimsâ€™ refusal to seek help. â€œThey are afraid of what their communities might say,â€ Djuderija says.
Some, however, are speaking out. Indeed, the need to offer war victims better psychological and legal aid was one of the main conclusions of speakers at a conference on â€œProtection of Victims and Witnessesâ€, held in Sarajevo in early October, 2008.
At the conference, organized by three NGOs whose members include victims, Narcisa Sarajlic, a professor from Zagreb, said society needed to find new ways to provide help and determine who needed help. â€œToo many traumatic things have happened in this country but itâ€™s good that victims are starting to talk about their experiences,â€ she added.
Reliving the nightmare of war:
The worst traumas are often suffered by victims of rape or by those who lost their children in the war.
Psychiatrists and psychologists who have testified as court experts at war-crime trials often describe rape as the experience with â€œthe strongest potential to create stressâ€, adding that many rape victims only talk about their experiences after a long delay.
â€œLoss of a child and rape has the most damaging consequences on peopleâ€™s personalities,â€ Senadin Ljubovic, a psychiatrist, told one trial before the State Court in July this year. â€œSuch memories do not easily fade. Whether they want it or not, the scenes keep coming back.â€
Other court experts have told the courts that victims often re-live traumas that they suffered earlier; indeed, testifying before the court is sometimes the cause of this.
According to Sabina Suljankovic, of the Snaga Zena womenâ€™s association in Tuzla, anniversaries of certain dates, visits to former places of residence, or visits to sites where they survived traumas are some of the known â€œtriggersâ€, prompting recollection of terrifying events and inducing trauma.
This is why the number 22 or a visit to Gorazde remain so significant for Midheta. â€œWhenever I visit my motherâ€™s grave I feel tense,â€ she says. â€œIf I see a pregnant woman, I remember the horrible scene in Kokino Selo, where they killed a girl who was in the ninth month of her pregnancy.â€
Edina Mahmutovic, of the Centre for Social Work in Sarajevo, says after having received professional therapy, trauma victims can become â€œfunctionalâ€, although many of them give up on the treatment when they â€œget close to painful issuesâ€.
â€œMore persons are coming to us with problems associated with the war than before, and if we do not treat them we will face long-term problems,â€ says Augustina Rahmanovic, of the Vive Zene association in Tuzla.
Most (Bridge), an association from Visegrad, is one NGO that tries to provide support for victims of PTSD. Their clients are mainly women returnees. In this eastern Bosnian municipality, no centre specifically offers help for traumatized persons.
â€œAll we can do, as we canâ€™t provide specific psychological and social support, is talk to them,â€ says Bosa Miletic. â€œThey were often afraid of visiting the town for a long time.â€
A few NGOs from Tuzla have been offering psychological â€“and social support to former residents of Srebrenica for many years.
The town is notorious as the site of the single worst massacre in postwar European history in 1995, when Bosnian Serbs killed up to 7,000 Bosniak men and boys, following a long and brutal siege.
â€œEven today, itâ€™s not easy to work with those people, as their families are incomplete and they show fear, insecurity and distrust,â€ Sabina Suljankovic says. â€œWe have to work with them for a long time before to seeing any results.â€
Midheta attended some group therapy sessions run by an NGO in Sarajevo in 2001 but did not visit a psychiatrist.
However, she says her condition has improved thanks to the group therapy. â€œIt helped me when I heard stories told by other people who suffered even worse things than I did,â€ she explains.
Aida Alic is a BIRN â€“ Justice Report journalist. [email protected] Justice Report is a weekly online BIRN publication.