Boko Haram victims fight psychological trauma

MAIDUGURI, Nigeria — In a vacant room, silent and blurred, 40-year-old Sule Hauwa faced a lay counsellor.  She tried to explain the cycles of attacks she faced from the Boko Haram insurgents, her voice falling low and her eyes welling up with tears. 

“Since this happened, I have not been sleeping. I’ve always been crying because of this pain and things that happened to my family,” she said, while Kaye Cletus, the counsellor who works at Neem Foundation, listened. 

 “Mama, everything is fine. Together we can get over everything because you need to be well," Cletus responded  in a calm tone. But “what happened?” he asked after allowing a good, absorbing silence to brew.

“I was happily married with  four children,” she said. “And on one  fateful day my husband was attacked in the family farm. He tried to escape but Boko Haram fighters ran over him with their truck.”

“The same day Boko Haram visited our community and killed three of my children,” she continued. What she described as children were actually grown up sons, all killed in a day.  

No one could call Hauwa’s situation by its real name: trauma. There is a culturally-driven perception against mental illnesses in Nigeria. They are considered spiritual problems that can be fixed with rituals such as fasting and prayers. Advanced mental illnesses are largely perceived as an act of witchcraft. 

So people with psychological trauma either hide from the world and make prayers for God's help, or commit suicide. They rarely consult a psychologist. 

In such difficult circumstances, there’s the three-year-old Neem Foundation, dedicated to healing traumatised war survivors. In partnership with the Federal Neuropsychiatric Hospital in Maiduguri — the only psychiatric facility in all of northeast Nigeria, Neem has treated at least 15,000 patients since 2016. 

The foundation started visiting the hard-to-reach communities, using lay counsellors such as Cletus who are especially trained  to work with victims of conflicts. Hauwa who is from Saba Maari – a small village tucked 250 kilometres away from the Nigerian war torn city of Maiduguri – is among those who have received the treatment. 

“Don’t stay idle. Idleness encourages negative thoughts and flashbacks and you must interact with others; our teacher would tell us. So I started sharing my stories with many people and made new friends,” says Hauwa.

The World Health Organisation (WHO) estimates that one in five people in IDP camps may need mental health care in northeastern Nigeria. Despite this huge and urgent demand for care, there is only one specialised mental health facility in the whole region.

In Saba Maari or even far flung rural communities, as well as neighbouring Chad, Cameroun and Niger – all affected by the insurgency, Hauwa’s stories and suffering is matched and exceeded.

In many small community settlements, people have devastating  stories to share. But there is a shortage of listening ears; for its part, Neem gets the affected women to meet and share their stories on a mutually agreed date. 

Has this helped? 

Bem Tivkaa, a clinical psychologist, says it has. The women come to hear stories to overcome isolation. “It helps to hear a fellow woman when she talks about surviving something you feel is impossible to deal with.”

“When I shared my stories with many people, I discovered I am not alone and some people have similar problems,” she says. “Even far worse than mine. Some people lost their entire family. I even realised my loss is smaller compared to theirs.”

Partly because the insurgents targeted men, there is an unusually high number of widows. What is left  for these traumatised women are young or old dependents like Hauwa’s four grandchildren and a single surviving son. Under Neem’s tutelage Hauwa has gone into the business of making of  bean cakes – something that scarcely fills the financial void left by her “hardworking” late husband. 

Unlike Hauwa, Umaru Yessa – another survivor, says she doesn't know if her husband is alive or killed in the war. And the doctors at Bama hospital in Maiduguri says her thinking about the situation has made her “sick in the head.”  

The need for psychological ease is massive among these women, Tivkaa says. “We personally feel the burden. Last year we served about 8,000 people, and we hope to see as many this year.”

In 2014, less than a year after Umaru Yessa got married to her husband, Boko Haram – responsible for over 20,000 deaths, invaded Budumrin – a small village known for smallholder farming of corn, beans, onions, tomatoes and carrots, in Bama, Borno state. The insurgent group established its rule there, but they couldn't sustain it for long. 

But when Boko Haram came in 2014, “they said our village was now an Islamic state and that things have changed. They said women should not go to the grinding machine, farm or market or fetch water. They flogged defaulters and they killed some depending on the offence.” 

With a farm to harvest and ripe pregnancy, Yessa found life under Boko Haram unbearable and she and her husband decided to escape but “Boko Haram security stayed up all night and day – watching who is going and who is returning.” 

Ten days after delivering a male child, she attempted an escape with her husband Umaru Yusuf and their infant, Mohammed, who is now four years old.

On a dark rainy night in 2014, the family of three left their home. At the Boko Haram fence, Yusuf scaled his wife over and let the baby reach her at the other side with a roped basket. 

Though they escaped the slavery of Boko Haram that night, life wasn't easy along the way. 

They spent the night in the forest under a flooded bridge where Yessa and baby shivered all night.

They eventually reached a Nigerian military unit, where a soldier wrote their names, ripped pieces of cloth from their shirts to blindfold them. He then shepherded them away to Bama, a dusty town in the northeastern part of Nigeria.

In Bama, the family faced separation since the army placed them in separate cells. 

“The next morning, I saw him for the last time,” she said, adding that her husband was still blindfolded. “They [the Nigerian military] took him away.”

Now it's just her son Mohammed that's left in her life. She is fighting against hunger, starvation and malnutrition to keep him alive. Mohammed has suffered from severe bouts of illnesses because of lack of water and food. 

Most mornings, Yessa would follow other women to get water from the city or scavenge for food. Once the military offered to accompany them to the suburbs to fetch water and they allegedly raped them in return for that favour. 

After her husband was abducted by the military, she was raped by the members of the same military. She was carrying her two-month-old baby while her body was being violated. The injuries in her genitals from childbirth were still fresh. She bled profusely until she got to the military hospital in Bama. 

A couple of months later, she was raped again. The cycle continued for several months, whenever she stepped out in search of food or on those long trips to fetch water in the suburbs. 

Bama became a place where rape was inevitable because there was no other way to find food. She had to step out in order to survive. 

“The women could not behold their child dying. We took the offer of food in exchange for sex," she said.

In Nigeria, only 3.3 percent of Nigeria's health budget goes towards mental health, a 2016 study published in BioMed Central points out. With its population of 180 million, there are less than 200 psychiatrists — or just one for every one million people, the same study states. And in the entire northeast, there are less than 10 clinical psychologists serving over 18,000 persons. 

“Some tell me my husband is dead. Others would say they saw him alive in the prison. I will fight till I see my husband again,” Yessa said, shedding tears of longing and sorrow.