In an interview with news.az, Bhava Poudyal, the ICRC’s delegate responsible for a mental health programme, explains the value and achievements of the initiative.
When was the programme to support the families of missing persons initiated?
ICRC has been working in Azerbaijan since the beginning of the conflict and has been in close contact with the family members of those who have gone missing in relation to the Nagorno-Karabakh conflict. As part of its activities towards clarifying the fate of missing people, in 2008 the ICRC started a Detailed Data Collection process, which required the collection of information from the families of the missing with regard to their loved ones.
During the collection process, the ICRC discovered that these families were facing a wide range of psychological and psychosocial difficulties. As a result of further assessments regarding these problems, in August 2011 the ICRC launched an Accompaniment Programme for the families of the missing, which is still being implemented in various districts of Azerbaijan. Thus far, the programme has covered Baku, Sumgait, Mingechevir and 13 districts, reaching out to 57% of the families registered by the ICRC.
What are the specifics of the programme in Azerbaijan?
Before launching the programme the ICRC conducted an assessment in order to learn more about the problems the families had been facing. This showed that in terms of emotional and psychological difficulties, family members had been suffering from a loss that was ambiguous. They lived and live between hope and despair regarding the fate of their loved ones. This perpetual stress of not knowing is very debilitating for many family members.
The assessment also showed that parents of the missing often lack social support and live in isolation, which compounds the emotional stress they already have. Families also face various legal and administrative problems due to the lack of knowledge regarding their rights. One of the widely mentioned issues among the families was the need for recognition of their missing loved ones. Aside from these problems, families also face economic and health issues which are also common among the general population. However, when talking about these problems families connect it with the issue of the missing, as they think if their son or husband were there, he would be taking better care of them.
The ICRC has selected and trained volunteer members from the families of missing people to work as accompaniers (sirdash). By organizing support groups, the programme aims to help the families to better deal with their emotional difficulties. For those who are unable to attend the group meetings, trained volunteers conduct regular home visits to provide emotional support and problem-solving counselling. Through support groups, the programme also helps families to organize events which commemorate the memory of missing loved ones. In such events the families come together, share their memories about the missing and recite poems.
Within the framework of the programme, the ICRC also collaborates with the Clinic of the Iranian Red Crescent Society which provides free medical health-care services to the vulnerable families. In terms of legal administrative problems the families also receive help.
How poignant are the memories of missing relatives?
Families of the missing still suffer from a term referred to as ‘ambiguous loss’. It is a loss that has no verification, thus it is unclear and without closure. Every day, families live between hope (that their loved one is alive) and despair (that he/she is dead, or they will never know). The families have been carrying their memories of missing loved ones throughout these years and they are always interested in sharing these stories with others. The memories are more poignant for mothers, fathers and wives, who are more emotionally attached to the missing. We have come across many mothers who sit in front of a television with the hope that they will hear news about their loved one. Even if the house/apartment where they live is overcrowded with a new generation – grandchilddren from other sons for example – families refuse to move to other places as they fear that if their son returns, he will not be able to find them.
In most cases, the other family members manage to focus on their current lives and do not feel comfortable listening to these stories 20 years later. This further isolates suffering family members, like mothers. As a result of this programme, the families have been able to share stories that they couldn’t share anywhere else ¬– they found listeners!
It is also interesting to note that this ambiguity can also be observed among the general public. During the events regarding missing persons, those who make speeches refer to the missing as ‘shaheeds’, but later on they end their speech with, “I hope that there will be good news about their fates soon”. Thus, it is not hard to imagine the effect of the ambiguous loss on the family members of missing loved ones.
We have also observed that families continue to cherish the memories of their missing relatives in different ways, which is very helpful psychologically. During group meetings, organized as part of our programme, families brought cakes or food that their missing family member liked most and shared it with other families. One mother who loved to bake had not done so for 20 years, after her son went missing. During the support groups, she baked a chocolate cake that her son loved and brought it for the group to share together in his memory. Families also commemorate birthdays of missing relatives or the day they went missing by inviting other family members from their support group.
What are the results achieved by the programme?
To measure the results, we conducted quantitative data analysis before and after the implementation of the programme. Our analysis for 2013 shows that the intervention was effective in reducing symptoms of depression by 41%, anxiety by 42%, psychosomatic pain by 36%, distressing memories of missing relatives by 37%, and that their day-to-day functionality improved by 36%. We also wanted to see if this improvement was retained after the phase-out of the programme. For this we went back to the families that participated in our programme in 2012 and conducted the same survey six months after its closure. The results showed that not only was this improvement retained, but that it continued to improve in the above-mentioned categories. This shows that peer support continues among the families even after the phase out.
During qualitative assessments carried out after implementation of the programme in some districts, the most common response from the families was: “I do not feel alone [in my pain] anymore.” They have met many other families who face the same problems, and this solidarity has helped to construct a ‘psychological family’. People in support groups say: “We have become like a family.” Families feel cared for and appreciate the fact that their missing loved one is not forgotten.
Do the relatives believe their loved ones will be found after so many years?
Families experience ambiguity regarding the fate of their loved ones. Most of the family members, especially old mothers and fathers, still wait for their sons to come back. As a result of this belief, some families refused to apply for shaheed status and thus benefit from governmental provisions for shaheed families. For the elderly, hope is what keeps them going.
At the same time there are also families who have given meaning to their loss in a different way, stating that they are proud that their son died for their country. With ambiguous loss, an end point is not effective – nor is it helpful for us to try to give meaning. Each individual gives meaning in his/her own way. A father can feel proud that his son sacrificed his life for the country, while a mother can reject the idea of death and live with the hope that he will return one day. This can change over time. I talked to two friends, wives of missing persons. One said: “Before I always had hope that he is alive; now I think more that he is dead.” Meanwhile her best friend stated: “I still hope and wait, thinking he will come back one day.”
What feelings has implementation of the programme brought you? And what is the importance of the implementation of the program ?
I feel that this programme has been of considerable value to the families, especially because it has brought them solidarity with other family members, where they feel understanding. Their loss is recognized and they learn how to cope with the perpetual ambiguity they have to live with. Families said that they felt connected to more people, and they never received this kind of attention. The accompaniers/sirdash, who are also from the families of missing persons, mentioned that as a result of the programme they gained respect from families and the community and have found more meaning in their lives. They also said that their psychological well-being improved and they gained more human (interpersonal) skills – how to understand people. "I want to continue my role as a helper/sirdash until the end of my life. As I help the families, I also get help from them," said the wife of a missing person, who herself is also an accompanier/sirdash.
This article was first published on news.az and is reproduced here with the kind permission of the editor.