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Book Review

The Continuing, Vivid Cost of Freedom

Khademul Islam
The Mind of War-Injured Freedom Fighters of Bangladesh by Dr. M. A. Mohit Kamal, Dhaka: BidyaProkash, 2001.
First the bad news. Which is that-even by the standards of English publications in Bangladesh, even after allowing for the fact that the above is a landscape spectacularly littered with linguistically-challenged products-Dr. Mohit's book has to be one of the worst produced books I have ever read. For example, the first foreword, among quite a few, by one Dr. Md. Tauhedul Islam ("Member of the Foreign Service Programme, University of Oxford, U.K." no less) begins: "Forgone are the nine months of 1971--the Liberation War of Bangladesh. True, very a few do memorise the memoirs of those agony. But what about the tethered warriors-the war-injured Freedom Fighters (WWIF)? Neither can they bloat the impact of war, nor they can lout it."
Right then you know that this is a Dhaka-to-Sylhet road trip on a ‘coaster’ with no seat cushions, guaranteed to jar loose your teeth.
The introduction, for example, where it says "On March 25, 1971 the Pakistan army swooped down on the unarmed Bengalis in a frenzied bid into total submission to the West Pakistanis." Or page 32, "During period of conduction of above study, PTSD was not known into full form." And so on.
And I'lll nawt eben talk about mis-pellings an tipos.
Now the good news: the view is worth the bone-rattle. The book is a solid contribution to the existing literature on our war of liberation, the hard-cover publication of the findings of a study conducted to as-
sess the psychological after-effects of war on our 1971 freedom fighters. It was a study that was carried out from January to December 1998 in fulfillment of a master's degree in the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University.
We as a nation have just celebrated March 26, our Independence Day. A day in which we usually recount, in great detail and full living colour, the glory of our war of independence, a day on which we pay ritual tribute to our freedom fighters, the ex-Mukti Bahini, but for whose valour and courage the Pakistani boot would still be on our necks. As adults, as Bangladeshis, we understand that freedom has its costs, that some must die that others can live, that the dead cannot be brought back and given medals and share in the common victory. But what about those that have survived the war with hidden traumas, scarred for life, but invisibly, their minds forever an inch away from the horrors of war, some part of it forever in the shadows? This book is about these men (enough women freedom fighters could not be located for purposes of the study, but one hopes that it may be possible in the near future), the comparison of "psychomorbidity" among war-injured freedom fighters (a sample population of 192 WIFF) versus non-war-injured freedom fighters (99 NIFF) and I have to commend the author, Dr. Kamal, for going ahead and publishing his research findings. As Michael Radford ("Chair, Bangladeshi Mental Health Association, UK"), in another foreword of the book, puts it: "This book is about the suffering of men...Almost thirty years later, a high proportion of both war-injuries (sic) and noninjured fighters were suffeing (sic) form (sic) psychiatric point of view. Unlike the major physical injuries, the effects of the mind are less easily seen. People suffer in silence or their behaviour is affected. Loss of confidence and hopelessness in the face of future prospects are greater disabilities at times than loss of limb or an eye."
Indeed! It is not a subject that has been studied, or written about, much by us—just one previous study, in 1973 of 200 wounded freedom fighters, which had then revealed that of them "29.5 percent suffered from irritation, 12.2 percent from depression, 8.5 percent from anxiety, a full 22 percent had hysteria, 9.8 percent had obsessional neurosis." These are terms that are not to be taken lightly. These are clinical terms, and these war heroes showed clinical symptoms of really debilitating, and sometimes quite horrifying, mental conditions.
After great pain, a formal feeling comes%
The Nerves sit ceremonious, like Tombs%
The stiff Heart questions was it He, that bore, And Yesterday, or Centuries before?
The Feet, mechanical, go round%
Of Ground, or Air, or Ought%
A Wooden way
Regardless grown,
A Quartz contentment, like a stone%
This is the Hour of Lead%
Remembered, if outlived,
As Freezing persons, recollect the Snow%
First—Chill—then Stupor%then the letting go%
With rare exceptions, in PTSD there is no "if outlived," as in Emily Dickinson's poem. It is forever the "hour of lead."
What is different about Dr. Kamal’s study is that it incorporates later advances in the understanding of trauma-related psychosis, be it war, or other traumatic events such as earthquake or fires, or the permanent siege condition such as the one which Palestinians suffer, which induces psychiatric morbidity. The chief of which is PTSD, or post-traumatic stress disorder. And what this book does is outline fairly exactly, in dry, even arid, social science language, the continuing costs of our war of liberation, and which makes reading of it such a different experience than the usual run of highly-wrought articles on our independence and after. The trick to reading the book is to translate its language into everyday reality. The "diagnostic criteria" for clinical PTSD, reproduced at the back of the book, consist of "recurrent distressing dreams of the event," "sudden acting of feeling as the traumatic event were recurring ... hallucinations and disassociative (flashback) episodes," "restricted range of affect," "irritability or outbursts of anger," "exaggerated startle response," et cetera, et cetera. It means that victims suffer repeated nightmares, wake up in the middle of the night shouting, drenched in night sweat, the sounds of gunfire in their ears, and then don't fall asleep again. It means they can't love their wife or children, or other near ones. It means periodic violent outbursts, or withdrawal and alienation. It means suicide can be a constant companion. That they constantly look over their shoulders for an invisible enemy, may hate their neighbours, don't want to cross a street because a loud car horn can set their hearts pumping. In fact, any loud noise can set their hearts pumping. And seeing something associated with inflicted torture, something innocuous to most people, like boots, or a particular uniform, can plunge them into moments of pure terror. A British friend, Ian Maxwell, the son of Neville Maxwell the Sinologist, once told me that an Oxford don who had been in a Japanese prisoner-of-war camp in the Second World War would in later life go absolutely white in the face, tremble violently and start to stutter whenever he met a Japanese. No matter how much he tried to control it, PTSD would assert itself. A shaking, quivering insomnia in a Bosnian Muslim father forced at gunpoint to choose between his son's life or that of his community (he chose to give up his son, who was shot in front of him). Raped Rwandan women found clinging to their children. A group of Algerian children rendered mute by witnessing slaughter. The list is long.
A part of daily life exists on a different plane, where no consolation, no prayer, no healing reaches it, where it is cold as deep space twenty-four hours a day.
Chart 2(ii) in the book reveals PTSD and concurrent psychiatric illness among the group studied. "Total PTSD were sixty (31.3 percent) and twenty-three (23.2 percent)" among war-injured FF and non-war-injured FF respectively. "Out of these number, thirty one WIFF with PTSD (51.6 percent) met operationally defined criteria for one additional diagnosis, two (3.4 percent) met for two additional diagnosis. Regarding NIFF four of them (17.4 percent) met operationally defined criteria for additional one diagnosis." And what are those "additional diagnosis" for? Major depressive disorder, dysthymia, somatoform disorder, obsessive-compulsive disorder, panic disorder,
phobic disorder, bipolar disorder-currently hypomanic, psychoactive substance use disorder, and drug abuse. If this is a representative sampling-- and the research methodology seems okay to my untrained eyes-- then there are a lot of ex-freedom fighters suffering silently out there. In their urban slums, which is where they have been given housing. Because, as one sentence in the book's "Recommendation" section puts it: "The Freedom Fighters with Post-Traumatic Stress Disorder (PTSD) were reluctant to, even not aware of the need of the treatment." That 44 percent of FF who "witnessed brutal death or injury developed PTSD" and 56 percent of them developed "other psychiatric disorders." While those "who did not witness brutal death or injury, only 2.8 percent developed PTSD" (p. 98). Meaning that the ones most in the thick of it are the ones suffering the most.
The book is revealing in other ways too. The study reveals that the majority of FF at the entry point of the war, (51.6 percent), were aged between 14-20 years, and 36.5 percent in the age range of 21-25 years. In terms of occupation during entry in liberation war, the largest group were students (59.4 percent), business (14.6 percent), farmer (10.4 percent), service (9.4 percent), unemployed (3.1 percent) and day labourer (2.1 percent).
In other words, it confirms what we have always known: The revolution came on the backs of the young and the impressionable, the predominantly urban, lower middle class. The ones whose luck, by the look of things, continues to run low in independent Bangladesh. There are photos of some of the freedom fighters who were part of the survey, the faces of our triumphant nationalism: ordinary-looking, some bearded, some clean-shaven, in shirts and kurta pajamas. Very much your average Bangladeshi man, bumping into whom on the street you would never suspect the raw courage they were capable of. Or the troubles they are undergoing at present.
As I said before, this is a book about the costs of war. The continuing, vivid, untreated costs of war and liberation. It is also a book where some of the truest annals of our liberation war history has been recorded.
Khademul Islam is literary editor, The Daily Star.