January Issue 2015

“We were in class, attending the third period, when a teacher came and told us that a first aid training session had been arranged for students in the auditorium. Shortly after we moved to the auditorium, the door suddenly broke open and there was a torrent of gunfire. I saw a man in white shalwar-kameez holding an AK-47. Instinctively, I hid in a gap between the chairs and lay there as the firing continued. I saw two of my classmates die and one of my juniors get shot in the leg. As I helped him up, I saw bodies drenched in blood littered all around and some children trying to escape toward the school section. I took the injured boy with me to the school section where we took refuge in a classroom along with several others. After half an hour, army personnel came and rescued us.”

Zahid Ayub looked shaken as he recounted the story of the attack on the Army Public School in Peshawar on December 16, 2014. His eyes glazed over as if they had not been able to process what they had seen. And yet, the brilliant 10th grade student is determined to return to school when it reopens on January 5, 2015. While only days ago his aspirations were purely academic, the word ‘revenge’ has now become part of his vocabulary.

“My father, Mohammad Ayub, an airforce official, had witnessed and survived the bombardment of Indian planes in Bangladesh on December 16,  1971. On the same date, I was lucky enough to come out of the school massacre alive,” Zahid says.

Mohammad Ayub looks on at his son with concern. “Their mother died in June this year. We had hardly overcome that loss when this incident occurred,” he laments.

Mohammad and his family are trying to cope with the situation as best as they can. He, along with Zahid’s elder brother and cousin, plays table tennis with him to keep him distracted. Zahid, however, still gets flashbacks of the attack.

Zahid’s schoolfellow and 9th grade student, Ahmed Nawaz, is still in Lady Reading Hospital (LRH) and has undergone three surgeries after being shot in the arm. Doctors are concerned that he might lose his arm, but his father Mohammad Nawaz is determined to do whatever he can to help him. He lost his youngest son, Haris, in the attack.

Visibly traumatised, Ahmed explains how he jumped to the ground when the attack began. He says the attackers came and fired two to three bullets at every student lying on the floor, and that he was shot in the arm. As he lay there bleeding, he heard one of the attackers say, “Leave him. He is dead.” Ahmed still does not know about the death of his younger brother.

Mohammad Nawaz chokes on his words as he recounts the story of how Haris was killed. An 8th grade student, Haris was with six friends when they started running for shelter. But he refused to leave, saying he wanted to rescue his injured elder brother, Ahmed.

“The demons hit him in the back,” he recounted chillingly. “One bullet entered his head and exited through his mouth.”

Mohammad Nawaz draws strength from his son’s resilience as Ahmed says he wants to go home as soon as possible and prepare for his exams in March. But he is also concerned about Ahmed’s reaction when he learns of his brother’s death. For now, he’s been told that Haris is also undergoing treatment at LRH and cannot speak due to doctor’s orders.

Psychiatrist Dr Noor Mohammad, who has served at the Central Jail and  the psychiatric ward in LRH, says the incident is a catastrophe of unimaginable proportions and has impacted every segment of  society. He says that one of his psychiatry students told him that after spending the day treating children and families affected by the incident, she often weeps when she goes home.

In terms of treatment, Dr Mohammed says that the initial process will involve classifying the victims, based on their level of trauma, before devising a treatment plan. Those who have lost limbs or have been physically injured will require different kinds of therapy, as opposed to those who witnessed the incident or were affected by the death of a friend or family member.

Dr Mohammed says that the therapy will involve gradually recalling memories of the incident and exposing the students to the school campus over time, which will help them overcome fear. He says that the days right after the incident are immensely important and any delay in proper therapy may lead to victims developing Post Traumatic Stress Disorder (PTSD).

Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms, which may manifest differently as compared to adults. Children between the ages of five and 12 may not have flashbacks or problems remembering parts of the trauma, the way adults with PTSD often do, but they may put the events of the trauma in the wrong order.

They might also think there were signs that the trauma was going to happen. As a result, they think that they will see these signs again before another trauma happens. They think that if they pay attention, they can avoid future traumas.

They might also show signs of PTSD in their play and keep repeating a part of the trauma. These games do not make their worry and distress go away. For example, a child might always want to play shooting games after he sees a school shooting.

Among teens, some PTSD symptoms begin to resemble those of adults, although they are more likely to display impulsive and aggressive behaviour, compared to younger children or adults.

Dr Mohammed says it is essential that trained social workers step forward and help the families cope with the trauma. Within days of the attack, the minister of state for National Health Services, Regulation and Coordination (NHSRC), Saira Afzal Tarar, directed the ministry to prepare a plan in coordination with key stakeholders in support of provincial and military efforts, for the provision of counselling sessions on PTSD on an immediate basis for the victims: students, their families and teachers. The Ministry notified a six- member committee comprising members from the Mental Health and Non Communicable Disease Coordination Cell of the NHSRC, the Army Medical Corps, expert psychiatrists from Islamabad and Peshawar, the WHO collaborating centre, UNICEF and the Department for International Development (DFID).

It remains to be seen how those affected by this heinous attack will cope with its aftermath in the weeks, months and years to come. It is imperative for the people of Pakistan as a whole to come together to help those affected, in every possible capacity.

This article was originally published in Newsline’s Annual 2015 issue.