Mental Health Challenges of Public Protests – The Case of Bangladesh – Asrar Qureshi’s Blog Post #1009

Mental Health Challenges of Public Protests – The Case of Bangladesh – Asrar Qureshi’s Blog Post #1009

Dear Colleagues! This is Asrar Qureshi’s Blog Post #1009 for Pharma Veterans. Pharma Veterans Blogs are published by Asrar Qureshi on its dedicated site https://pharmaveterans.com. Please email to aq.pharmaveterans@gmail.com for publishing your contributions here.

Photos Taken from Various Sources

This post has been inspired by an article by Md Omar Faruk from Bangladesh, published in The Lancet, October 2024 issue just published. Link at the end. Other references also mentioned.

Preamble

Public protests are a part of daily life in Pakistan. People come out on the streets due to dissatisfaction, anger, disagreement, and to voice their position on key issues. Some public protests are staged by parties to get into/stay in the news; some are staged to get some material benefit from the government. Public protests organized by the public against injustice are relatively uncommon in Pakistan, which is an indicator of the noncommittal behavior of public. As a result, so called public protests have no energy and achieve nothing. 

The role of law enforcing agencies is similar in countries like us. Police, rangers, even army try to quell protests with force, from low intensity to high intensity. Videos circulate on the social media showing use of brutal force here and there. 

No one reports about what happens to the protesters later. Some may be taken up by the law enforcement agencies and subjected to the kind of stress which they cannot even tell when they are released, if they are released. Many get injured but no one reports about their health status later. The media has very short attention span, and so has the public. Events are forgotten in hours, not even in days.

Over the years, the trend of applying more and more force has sharply increased, leading to physical and mental health injuries. It is easy to understand that a normal civilian after having been imprisoned for several days on any pretext will suffer from serious mental health damage. And he or she may not suffer alone; their family also undergoes severe stress.

Bangladesh, during June, July, August 2024, went through bloody protests. Three papers have been published in The Lancet, a journal of high repute. Let us go through the events through these reports. I may quote liberally from the reports. 

Students’ Protests in Bangladesh

Graduate students and job seekers in Bangladesh had long been demanding fair access to government jobs through reform of the ‘quota system’ that disproportionately benefitted the descendants of freedom fighters of the 1971 war of liberation. In 2018, the government issued a gazette notification cancelling the quota provision following a nationwide student protest. However, in June 2024, the High Court of Bangladesh reinstated the quota, and a massive student protest erupted that resulted in at least 210 confirmed deaths. Among the deaths, 75% were of children and young people, primarily university students. Many of the protesters were shot by law enforcement agencies using lethal weapons. Amid the nationwide protest, the government cut off internet services and enforced a strict curfew with only 2 hours of ease across Bangladesh to curb the protests. The curfew was imposed to ban public gatherings and law enforcement agencies, including the Army, were authorized to “shoot at sight”. Law enforcement personnel have been widely alleged to have used unlawful forces and arbitrarily arrested protesting students from their homes.

On 15 July 2024, students at Dhaka University were sitting with placards and flags in a peaceful protest calling for reforms on the quota allocation.  Suddenly, they were attacked by individuals armed with rods, sticks and clubs with a few even brandishing revolvers. Within hours, a pattern emerged across the country with similar attacks coordinated by people believed to be members of the Bangladesh Chatra League (BCL), a group affiliated with the ruling Awami League (AL), against student protesters.

By the afternoon of16 July, police fired tear gas and charged with batons drawn at protesters in front of Begum Rokeya University in the north-western city of Rangpur where students had gathered, led by the protest coordinator Abu Sayed among others.

Abu Sayed, a student of English at the Rangpur’s Begum Rokeya University, stood his ground. As the police closed in, he spread his arms wide open, in a moment of defiance.

Abu Sayed

In a seemingly intentional and unjustifiable attack, the police fired directly at his chest. At least two police officers discharged 12-gauge shotguns directly towards him from across the street – a distance of merely 15 meters.

Sayed clutched his chest on impact as officers fired at least two more times using birdshot, ammunition that is designed for hunting, which is extremely dangerous, inherently inaccurate and thus unlawful for use in the policing of protests.

Sayed posed no apparent physical threat to the police. Sayed’s death certificate states he was ‘brought dead’ to the hospital. He was just 25 years old.

The video of Sayed’s brutal killing sparked outrage and became a symbol of the violence directed at protesters in Bangladesh since 15 July 2024.

Prothom Alo received information of the deaths of 210 people in the clashes from various sources including hospitals, relatives and the people who brought the dead bodies. Of these, detailed information on age, occupation and type of injury and the area where they sustained injuries or killed was found for 150 people.

An analysis of the deaths reveals most of the bodies had marks of live bullet injuries while marks of pellet, rubber bullet or other type of injuries were little. 

The analysis shows 19 of the deceased are children and adolescents including a 4-year-old child. Ninety-four are 18-29 years old, 21 are 30-39 years old and 16 are about 40 years of age.

Sum Up

Currently, the number of mental health professionals in Bangladesh is insufficient, with 0·073 psychiatrists, 0·196 psychiatric nurses, 0·007 psychologists, and 0·002 social workers per 100 000 population. The treatment gap for both children and adults is more than 90%. Addressing potential mental ill health in Bangladesh is therefore crucial, particularly for protesting students and family members of students who were injured or killed, as they might experience anxiety, depression, prolonged grief, and post-traumatic stress disorder.

Pakistan has an even lower ratio of healthcare professionals in psychiatry, and the mental health institutions run by the government are worse than the prisons. 

I have yet to see a medical paper coming out on the topic of mental health damage/ challenges faced by the public protesters. It is an important topic and needs attention from psychiatrists and other healthcare professionals.

Concluded.

Disclaimers: Pictures in these blogs are taken from free resources at Pexels, Pixabay, Unsplash, and Google. Credit is given where available. If a copyright claim is lodged, we shall remove the picture with appropriate regrets.

For most blogs, I research from several sources which are open to public. Their links are mentioned under references. There is no intent to infringe upon anyone’s copyrights. If, however, it happens unintentionally, I offer my sincere regrets. 

References:

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00281-5/fulltext 

https://www.amnesty.org/en/latest/news/2024/07/what-is-happening-at-the-quota-reform-protests-in-bangladesh/

https://en.prothomalo.com/bangladesh/1hmcovbabm