Oct 2, 2020
Mental Health and… Kashmir
Saiba Varma is a medical and psychological anthropologist. She is an Assistant Professor in the Department of Anthropology at the University of California, San Diego. Her book, The Occupied Clinic: Militarism and Care in Kashmir has just been released by Duke University Press in the U.S. and will be released in early 2021 by Yoda Press in India.
She can be reached at @SaibaVarma on Twitter.
I spoke to Saiba about her research in Kashmir, and what mental health there looks like amidst such intense, chronic political and everyday violence that affects so many Kashmiri lives daily:
What brought you to studying mental health and your research background? Can you talk about the “mental health crisis” psychiatrists in Kashmir told you about?
I visited Kashmir in 2008 as a potential site to do my ethnographic research. As an anthropologist, you are desperate for anyone to talk to you, so I was very grateful when a few psychiatrists agreed to meet with me to discuss possible research topics.
They told me about the ongoing mental health crisis in Kashmir since the armed conflict began in 1988 — about how hundreds of thousands of people were experiencing severe symptoms of trauma and PTSD.
More than 100,000 cases per year were being handled by 26 or so psychiatrists at the time, all of whom were working from a single psychiatric hospital serving eight million residents of the Kashmir valley. The doctors were extremely stressed and overburdened, and saw themselves at the frontlines of the conflict. I became really curious about how the effects of violence were being medicalized, how they were made visible through psychiatric diagnoses. That is what I decided to focus on for my research. And most importantly, they agreed to let me to shadow them for the 18 months of my fieldwork!
Mental illness versus mental health. Is it important to make this distinction? What are the experiences and facts that create this distinction?
When I began doing my research in Kashmir with mental health experts, psychological counselors, patients experiencing mental distress, as well as ordinary people living through an unending state of emergency and occupation, I heard the same joke over and over.
When I would tell people that my research was on ‘mental health in Kashmir,’ they would joke and say, “There is no mental health in Kashmir! No one is mentally well here. You should be studying the bemari [illness].”
There was a very clear sense that the conflict had touched every aspect of life, every psyche, every household, family, and neighborhood. This is not an exaggeration. Although of course only a small percentage of the population is diagnosed with a mental illness and seeks psychiatric care, many people experienced trauma and anxiety in their daily lives, simply as a result of living under a never-ending state of emergency and military occupation. For example, people experienced anxiety any time their children left the house, not knowing whether they would return home in one piece. For example, the mass protests in Kashmir in 2010, in which more than 120 unarmed civilians were killed, were triggered by the death of a teenager, Tufail Mattoo, who was killed by a teargas canister while he was walking home from his tuition class.
Because Kashmir is the most densely militarized place on earth, there are soldiers everywhere, on every corner. Walking by them every day, even multiple times a day, these gun toting and unfamiliar presences, is a constant reminder that you are not in a safe place, that anything can happen at any minute. Then there is the regular disruption of life in the form of communication blackouts, curfews, sieges, etc. that are done without people’s consent and are forms of collective punishment. These are mundane experiences for people in Kashmir, but they are extremely psychologically harmful and can easily build up into more serious ailments.
Your book, The Occupied Clinic, which will be out soon, chronicles Kashmir between 2009–2016 and your fieldwork is as recent as last year. What are some things that have changed, or haven’t? And especially after the Internet shutdown and the change from statehood to union territory?
It’s hard not to feel pessimistic about the situation, particularly since August 2019 when Kashmir’s semi-autonomous status was revoked unilaterally and the region was put under the longest communication blackout in history. People were without internet for more than 7 months!
While successive Indian governments have worked to ensure that Kashmiris’ desire for self determination remains an impossible dream and to maintain Indian rule in Kashmir with an iron fist, I think the last few years have been particularly bad.
Far from getting closer to the aspiration of self-determination and taking that seriously as a political claim, it seems to have receded further.
You know, I remember when this government was first elected, one of my Kashmiri journalist friends told me, “Oh, he has come to finish us.” And I remember laughing and thinking, oh that’s so hyperbolic! But now, when you see the changes that have been enacted — not only the revocation of autonomy, but the changes to domicile laws, the changes to official languages, all of which are taking place within a larger climate of anti-Muslim racism and violence, xenophobia, and the suppression of dissent, it is hard not to see that his words were actually very prescient.
On the more positive end, when I look back at when I began working in Kashmir in 2009, I think something that has positively changed for people. Their political demands for self determination have crystallized. For example, many people told me that the devastating floods of 2014 were a critical turning point in revealing the true relationship between the Indian state and Kashmir. While the Indian news channels were full of bombastic images and descriptions of the Indian military’s rescue and relief operations, on the ground, many described how the rescue was largely limited to airlifting the army’s own bases, non-Kashmiri tourists, and the military’s network of collaborators and informers.
The Kashmiri people were largely left to fend for themselves. But instead of feeling helpless, communities mobilized — people built rafts out of water tanks and rescued people on their own. They created community kitchens, they really took care of one another. These collective experiences of oppression — what Kashmiris call zulm — have unified the community like never before. There is a sense of immense unity and understanding that is borne out of oppression and violence.
And even though the revocation of autonomy might seem like a setback, no one has abandoned their goals for self-determination. The horizon is still extremely clear, though it might be a little more stretched out.
You mentioned that making mental health a crisis also obscures how people cope. People often cope through dark humour. Can you tell us more?
Yes! While it’s uncontestable that the entire population of Kashmir has been negatively affected by more than 30 years of military occupation — and more than 450 years of foreign rule — it is worth asking the question of, how have people survived? How do they craft meaningful lives in these conditions?
If you go to Kashmir, you’ll instantly find a deep well of dark humor that people dip into whenever things get particularly bleak, as they often do.
There is a tradition of satire and Koshur (Kashmiri language) joke-telling here that runs deep — similar to other places which have experienced similar forms of oppression and violence.
So, for example, I was in Kashmir last August during the lockdown. In the days before Eid, which is of course the year’s biggest celebration, the government had suggested that they would open the mosques so people could congregate and pray. But when the day of Eid came, none of the largest mosques were opened. It was an extremely desolate and depressing day. I was complaining about it to a Kashmiri friend, thinking that he would commiserate with me.
But instead, he laughed and said, “It’s not so bad! We’ve been through so much worse. During Sikh rule (in the 19th century), all the mosques were turned into horse’s stables.” We actually laughed about the long history of oppression that Kashmiris have had to bear!
It was such a powerful reminder of how people find ways of coping with these impossible situations — here I was, a foreigner, moaning about things but he was able to draw on this deep historical consciousness and humor to make sense of it all!
And that Eid, people greeted each other, not with “Eid Mubarak” but with “Qaid Mubarak”!
It was just amazing to see how they flipped the situation into something light and humorous.
I highly recommend checking out the Instagram @JajeerTalkies. It’s fantastic.
What are some works of art that have inspired you in how you think about your research?
I love this question! Oooh there are so many. I’m a TV junkie, especially after lockdown! I recently watched the show The Leftovers, which was very resonant with quarantine time. It offers a really interesting way to think about grief and loss and I connected with it deeply, particularly thinking about people in Kashmir — more than 8000 have been disappeared since the conflict began — and what it means to not have any kind of resolution or finality.
On that show you see people struggling with grief, struggling to cope, and the kinds of strange effects that it has, how it ripples through an entire community and transforms people.
It’s a wild ride, I highly recommend it!
I also read a lot of fiction because, at my very core, I think of myself as a writer. Writing is how I think and communicate; it is very grounding for me, although it can be painful, slow and difficult. For my book, I was inspired by the work of Ruth Ozeki, who is a novelist, filmmaker and also a Zen Buddhist nun — her novels, including A Tale for the Time Being and My Year of Meats operate on many different registers, affective, political, and spiritual.
I wanted to produce an academic work that also traversed those different registers and wasn’t just about presenting information to a public in a neutral way but captured the affective experiences of doing this research, the struggles, hopes and fears that I had.
For example, in My Year of Meats, the narrator says, “You cannot make a better world unless you imagine it so, and the first step toward change depends on the imagination’s ability to perform this radical act of faith. I see writing as a similar endeavor.”
Telling these stories about survival and endurance is for me an act of hope as well as a political act of being in solidarity with the aspirations of people in Kashmir, their desires for justice and liberation. On a lighter note, when I need a good laugh, I love Hasan Minhaj’s Patriot Act (really sad Netflix canceled it). I also think Schitt’s Creek is hilarious.
There are so many amazing Kashmiri poets, artists, musicians, writers who are working now — from MC Kash, a rapper, to Malik Sajad and Suhail Mir who are fantastic cartoonists, to writers like Mirza Waheed, Feroz Rather, and many others, filmmakers like Iffat Fatima and Aamir Bashir, and Uzma Falak is a poet whose work I love too. Malik Sajad had a really powerful piece in the New York Times on the effects of the curfew on everyday life.
It’s a really beautiful thing to see these voices and perspectives out there in the world, because for so long they have been drowned out by much more powerful Indian or Pakistani voices. As a non Kashmiri, my work is to be in solidarity with people there and help amplify their voices and aspirations for self determination, but it is an entirely different thing to represent yourself and your community.
