Abstract
BackgroundIndia and Pakistan have disputed ownership of the Kashmir Valley region for many years, resulting in several conflicts since the end of partition in 1947. Very little is known about the prevalence of violence and insecurity in this population.MethodsWe undertook a two-stage cluster household survey in two districts (30 villages) of the Indian part of Kashmir to assess experiences with violence and mental health status among the conflict-affected Kashmiri population. The article presents our findings for confrontations with violence. Data were collected for recent events (last 3 months) and those occurring since the start of the conflict. Informed consent was obtained for all interviews.Results510 interviews were completed. Respondents reported frequent direct confrontations with violence since the start of conflict, including exposure to crossfire (85.7%), round up raids (82.7%), the witnessing of torture (66.9%), rape (13.3%), and self-experience of forced labour (33.7%), arrests/kidnapping (16.9%), torture (12.9%), and sexual violence (11.6%). Males reported more confrontations with violence than females, and had an increased likelihood of having directly experienced physical/mental maltreatment (OR 3.9, CI: 2.7–5.7), violation of their modesty (OR 3.6, CI: 1.9–6.8) and injury (OR 3.5, CI: 1.4–8.7). Males also had high odds of self-being arrested/kidnapped (OR 8.0, CI: 4.1–15.5).ConclusionThe civilian population in Kashmir is exposed to high levels of violence, as demonstrated by the high frequency of deliberate events as detention, hostage, and torture. The reported violence may result in substantial health, including mental health problems. Males reported significantly more confrontations with almost all violent events; this can be explained by higher participation in outdoor activities.
Highlights
India and Pakistan have disputed ownership of the Kashmir Valley region for many years, resulting in several conflicts since the end of partition in 1947
A two-stage cluster design was executed in two districts in the Indian part of Kashmir (Kupwara and Badgam). These districts were chosen because Médecins Sans Frontières (MSF) intended to start working there, an operational decision based on anecdotal evidence of mental health problems among populations living in these areas
Proximity to violence was defined as either exposure ('Being in the vicinity of a violent event but not witnessing or self-experiencing'), witnessing ('Witnessing an event so close it could have happened to you or you were forced to see it'), or self-experience ('The event happened to you')
Summary
India and Pakistan have disputed ownership of the Kashmir Valley region for many years, resulting in several conflicts since the end of partition in 1947. The Kashmiri population – the majority of whom is Muslim – was promised a choice of joining either India or Pakistan through a popular vote but this plebiscite never took place. Conflict and Health 2008, 2:10 http://www.conflictandhealth.com/content/2/1/10 the start of a long history of conflict affecting the roughly 8 million inhabitants of Kashmir [1]. Both India and Pakistan have made control of a unified Kashmir an essential cornerstone of their national identities and have fought several wars between 1947 and 2002 on this issue. India controls the largest part, with the rest governed by Pakistan and China [1]
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