The psychological impact of genocide on the Yazidis

The psychological impact of genocide on the Yazidis

Background: The genocide against the Yazidis by the Islamic State of Iraq and Al-Sham in the Sinjar area of Northern Iraq has costed many lives and has also caused a psychological long-term impact in this minority. This impact can be seen among individual survivors. Additionally, there is a large number of direct and indirect victims and for this reason, the impact can also be observed on the level of the group and society in this region at large.

Methodology: The research examines three different population groups (Yazidis members who had been exposed to violence by terrorist group actions, those not exposed to this experience as they were living in an area not directly exposed to Islamic State violence, and a control group of non-Yazidi general population members). In total, four hundred twenty-five participants (age range fifteen to seventy-eight) took part in the study and participated in interviews using standard scales to measure general physical and mental health.

Results: The results demonstrate that psychological stress and suicidality are higher among the Yazidis survivors of violence than in the other Yazidi participants.

Conclusion: Psychological disorders after a genocide and war in post-conflict populations should receive more attention in the planning of mental health care and prevention and should be seen as a major problem, especially in camp settings and displaced persons besides the usual increased prevalence of posttraumatic stress and other disorders covered by research so far in this context.

Introduction

The Yazidis are a small ethnic-religious minority group which is spread over several Middle Eastern countries including Iraq, Syria, Armenia, Georgia and Turkey. They speak Kurdish and most of them consider themselves ethnic Kurds, although some communities prefer identifying themselves as Yazidis with their own ethnic and religious identity. There are about eight hundred thousand to one million Yazidis worldwide, the largest group of about four hundred thousand Yazidis lives in Northern Iraq in the area of Mount Sinjar in Nineveh governorate. They practice one of the oldest religions, notably Yazidism, which contains elements of Islam, Christianity, Judaism and Zoroastrianism and is passed on orally. Many derogative prejudices exist against the Yazidi community, one of them being the wrong accusation of engaging in "devil-worshipping". For this reason, they are considered as "Devil

Worshippers" and not regarded as "Followers of the Book" by radical Muslims. Yazidis have been victims of persecution, forcible conversion to Islam and systematic murder for many centuries. In the last eight hundred years, seventy-four genocides against this minority group have been perpetrated. The Yazidis have been particularly affected by massacres due to their religion and their secluded settlement areas in the Sinjar Mountains and the lack of protection. For these reasons, it can be argued that the group as a whole has been exposed to a "genocidal environment" with far-reaching, also trans-generational impact, while other groups in the region were not exposed to transgenerational, multiple genocides.

In August twenty fourteen, Islamic State attacked the Sinjar region of Northern Iraq. The Yazidis were forced to seek refuge on Mount Sinjar. More than three thousand of them were killed and almost seven thousand kidnapped. Thousands of Yazidis were tortured, suffered inhuman and degrading treatment, were held hostage, or were forced to convert to Islam. Young boys were separated from their families and placed with Islamic State fighters and women and young girls were raped and sold on Arab markets. Many of those who managed to flee remained trapped in tremendous circumstances without water, food, shelter, and enduring extreme temperatures and were killed or kidnapped if they could not flee in time. They were evacuated between the ninth and thirteenth of August and finally managed to flee through Syria into the Kurdistan Region of Iraq. The majority was displaced in camps in the Kurdistan Region, others settled in camps in Syria or Turkey. While some Yazidis returned to their home villages, many of them found asylum in foreign countries including Germany or Turkey. But the biggest part still lives as internally displaced people in so-called internally displaced persons camps or informal settlements. Most of the severely traumatized Yazidi women live in one of the twenty-four refugee camps near Dohuk and Zakho in the Kurdistan Region. Each camp consists of up to twenty-eight thousand internally displaced persons. There are an estimated three hundred sixty thousand Yazidis who have lived in camps for internally displaced persons in the Kurdistan Region. Not only did the Yazidis experience their own individual trauma, but they also experienced a collective and transgenerational trauma which is passed on to the next generations.

The situation in these internally displaced persons camps in Iraq and also, in general, the situation in refugee camps is often extremely precarious. A systematic review of psychiatric disorders among forcibly displaced people in conflict settings demonstrated prevalence rates mental disorders much higher even than in more general post-conflict and war-zone populations, for post-traumatic stress disorder up to almost ninety percent as well as for depression and anxiety disorders of up to eighty percent. Surveys show that remoteness, poor connection and poverty in the camps lead to a lack of supply and care.

Recently, a new set of problems arose due to the current COVID-nineteen pandemic which has exacerbated the prior psychological stress. Social distancing is almost impossible in the overcrowded internally displaced persons camps and hygiene practices are difficult to apply. A study compared the prevalence rates of mental disorders before COVID-nineteen and shortly after COVID-nineteen outbreak of Yazidis living in internally displaced persons camps in the Kurdistan Region. It was found that post-traumatic stress disorder rates increased significantly to up to fifty-eight percent among women and up to forty-seven percent among men. Also depression, anxiety, dissociation, somatoform disorders and suicidal ideas increased.

Prevalence rates of mental disorders are estimated to be even higher in survivors of rape, military action, captivity, internment for ethnic or political reasons, or genocide. For example, research conducted in Rwanda and Bosnia shows that genocidal atrocities have severe long-term effects on the people concerned. Forty-four percent of Rwandan adolescents suffered from PTSD ten years after genocide, but the percentage of the adolescents presenting some of the PTSD-related symptoms is even higher. Among the Bosnian refugees, up to sixty-five percent suffered from PTSD and thirty-five percent from depressive disorders a few months after their resettlement in the United States.

During genocide, sexual violence against women is a serious problem and rape is used frequently as a war tactic because of its devastating physical and psychosocial consequences on the individuals and also on the whole community. When rape is committed on a mass scale, consequences are even more serious. This reality was illustrated by different studies conducted in Bosnia-Herzegovina, Rwanda, Sudan, Uganda, and Congo where rape and extreme sexual violence were carried out against women.

Whether people develop a mental disorder after a potential traumatic event depends on various risk factors. First and foremost, higher exposure to traumatic experiences and post-migration stress seem to play a particularly important role. Other risk factors include the severity and type of potential traumatic events, pre-existing mental disorders such as depression and PTSD, and individual characteristics, feeling of guilt, and the time interval since the potential traumatic event. In war-affected populations, torture, captivity, sexual attacks, experiencing violent attacks, and the death of a significant, close person were correlated with PTSD and depression. In a sample of Yazidi women, it was found that the number of potential traumatic events experienced and the duration as well as the frequency of captivity predicted comorbid PTSD and depression.

Consequently, the psychosocial stress in these IDP camps is extremely high and many Yazidis suffer from serious mental health problems. It was found that forty-two point nine percent of Yazidi refugees in Turkish refugee camps suffer from PTSD and thirty-nine point five percent of major depression. In a study with four hundred sixteen Yazidi women and girls, sixty-five of whom had survived sexual enslavement, in IDP camps in the KRI, more than eighty percent and almost all survivors who had experienced enslavement fulfilled criteria for PTSD. It has been shown that formerly enslaved Yazidi females suffer from higher prevalence of mental stress, ninety-seven point one percent, PTSD, ninety point six percent, suicidal ideation, thirty-eight point one percent, depression, thirty-six point seven percent, and general anxiety symptoms, thirty-seven point four percent. Among those who had been sexually abused, very high prevalence rates of mental stress of fifty point nine percent for complex PTSD and twenty percent for PTSD were found

These high rates, particularly for complex PTSD, emphasize the unique nature of trauma caused by the combination of captivity and sexual slavery. An alternative explanation for the occurrence of complex PTSD might be the stress and poor conditions in the refugee camps after the captivity by ISIS.

Subsequent life events, physical and psychological support, and the role of religion and culture have been shown as important protective factors. Furthermore, daily stressors, such as material deprivation and loss, interparental conflict, abuse, concerns about perceived safety and basic needs, can mediate the relationship between war exposure and mental health.

Suicidal behavior is also an important issue in post-conflict settings. Years after a war ended, suicide rates seem to have risen in post-conflict settings. For example, surveys conducted in Kosovo eight years after the war and in Rwanda fourteen years after the genocide show that eleven percent of the Kosovo participants and almost seventy percent of the Rwanda sample reported that they had already felt suicidal ideation or considered hurting themselves. Additionally, suicidal ideation was reported to be associated with unemployment, and with high depression and PTSD scores. In post-conflict Northern Uganda, twelve point one percent stated suicidal ideation and six point two percent suicidal attempts. Suicidality was found to be higher in this Ugandan population when the people suffered from depression and PTSD. In Southern Iraq, high attempted-suicide rates of five to seven percent were found and even higher rates of suicidal ideations of over twenty percent.

This study investigated the relationship between psychological stress, particularly among Yazidi members living in refugee camps in Iraq and Yazidi members and Non-Yazidi who lived in a more or less secure Kurdistan Region of Iraq during the crimes perpetrated by ISIS.

We excluded those community members with a reported clinical diagnosis of severe mental illness such as a psychosis, which might interfere with informed consent or understanding of the questions in the study instruments. Furthermore, two participants were excluded from the data analysis because they could not be assigned to one of the three groups in terms of their living situation or religion.