Saturday, April 30, 2016

ප්‍රේමදාසගේ නෙළුම් මල් දෙලක්‍ෂයේ පූජාව


හිටපු ජනාධිපති ලේකම් අමල් වික්‍රමතුංග 

මල්   පරිසරයේ සමතුලිතතාව සමනය කිරීමට . මීමැස්සන් , සමනලයන් වැනි සතුන් ගේ පැවැත්මට උපකාර වේ. පරිසර සමතුලිතතාව පිළිබඳ නොදත් අඳ බාලයන් අසූහාරදාහේ ලක්‍ෂයේ මල් පූජා කියා මීමැස්සන් , සමනලයන් ගේ පැවැත්ම වඳ කර අන්ධ භක්තිය පෙන්වති. මේ හිටපු ජනාධිපති ප්‍රේමදාසගේ වික්‍රමයකි. එය කියන්නේ හිටපු ජනාධිපති ලේකම් අමල් වික්‍රමතුංගය​. 

" 1988 මහ මැතිවරණයට පෙර ප්‍රේමදාස මහත්තයා අනුරාධපුරේ ජයශ්‍රී මහා බෝධියට බාරයක්‌ වෙලා තිබුණා. ජනාධිපතිවරණයේදී ලබාගන්න සෑම වැඩි ඡන්දයකටම නෙළුම් මලක්‌ පූජා කරනවා කියලා. ඒ මැතිවරණය වැඩි ඡන්ද දෙලක්‍ෂ ගාණකින් දින්නා. නෙළුම් මල් දෙලක්‍ෂ ගාණක්‌ හොයන්න මට සිද්ධ වුණා. නෙළුම් පිපෙන හැම තැනකින්ම වගේ නෙළුම් මල් ගන්න වුණා. අන්තිමේ නියම විදිහට බාරේ ඔප්පු කළා. වැඩේ අපූරුයි.... " 

පාළකයා නූගතෙකු වූ විට ඔහු බලයෙන් අන්ධය . ඔහුට මිනිසුන් පමණක් නොව පරිසරයද විනාශ වූවාට කම් නැත​. 

Friday, April 29, 2016

71 කැරැල්ල සහ ඔස්මන්ඩ් ද සිල්වා


මහ නඩුවේ 21 වැනි විත්තිකරු වූ ඔස්මන්ඩ් ද සිල්වා මට හමු වූයේ වනාතමුල්ලේ ඔහුගේ නිවසේදීය. අතීතයේ ගුස්ති ඇල්ලීමට ශ+රයෙකු වු ඔහු අද දිනයේ මහල්ලෙකි. එහෙත් ඔහුගෙ ශක්තිමත් බාහු කියා පාන්නේ අනුරාධපුර යුගයේ ගල් කණු වැනි අතීත ශ්‍රී විභූතියේ ශේෂයන් ය. ශක්තිමත් පුද්ගලයෙකු වූ ඔහුට 71 දි ඉතා දරුණු ලෙස පහර දෙනු ලැබීය. ඔස්මන්ඩ් ගේ කකුලද කඩා දමනු ලැබු අතර අද දිනයේ ඔහු ඇවිදින්නේ නොන්ඩි ගසමිනි. ගෙවත්තෙන් කැඩූ දොඩම් ගෙඩි මිරිකා තැනූ ස්වභාවික ප්‍රණීත පානයකින් මට සංග්‍රහ කළ ඔස්මන්ඩ් ද සිල්වා මහතා මෙසේ පැවසීය.

මගේ දෙමව්පියන් වාමාංශික දේශපාලනයට නැඹුරු වෙච්ච අය. පියා එන්.එම්.ලාගේ දේශපාලන කටයුතුවල ප්‍රබල ආධාරකාරයෝ. මගේ පියාගේ පිටේ දෑකැත්ත මිටිය සහිත ලොකු පච්චයකුත් කොටලා තිබුණා. මව විවියන්ලා සමගත් දේශපාලන උද්ඝෝෂණවල නියැලී සිට කාන්තාවක්. මම සම සමාජ පක්ෂයේ තරුණ සමිතියේ උප සභාපති.
මට විජ්වීර  පළමු වතාවට හමු උනේ 1968 අවුරුද්දේ. ඒ වෙලාවෙ එච්චර හැඟීමක් මට ඇති උනේ නැහැ. විෙජ්වීර සම්බන්ධයෙන්, අපේ දෙවන හමුවීම සිදු වුනේ එඩේරමුල්ලේදී. සතොස ෙජ්ම්ස් ලෝක්කාගේ ගෙදරදී. හවස හතේ සිට පසුදා අලූයම දක්වා විෙජ්වීර හොඳ කථාවක් කළා. මම ටී.ඩී. සිල්වා, ලොකු අතුල, මිල්ටන්, යන අයත් හිටියා. විෙජ්වීර ඉන්දියානු ව්‍යාප්ත වාදය ගැන කථාකළා. ඒක ගැන අද උනත් තියෙන විග්‍රහය වැරදියි. සමහුරු හිතනවා ඉන්දියානු ව්‍යාප්තවාදයෙන් විෙජ්වීර ද්‍රවිඩ වතුකම්කරුවන් ගැන අප්‍රසාදයට කථාකලා කියලා. ඉන්දියාව කියන්නේ ද්‍රවිඩ වතු කම්කරුවෝ නොවෙයි. ඉන්දියාවේ උතුරු ඉන්දියානුවෝ, දකුණු ඉන්දියානුවෝ. ඉන්නවා. ඉන්දියානු ව්‍යාප්ත වාදයෙන් පෙන්නුම් කළේ සමස්ත ඉන්දියානු ධනවාදී බලතන්ත්‍රය මිසක් අහු මුළු වල ඉන්න වතු කම්කරුවන් ගැන නෙවෙයි.

විෙජ්වීර ව්‍යාපාරයට කැපවෙලා හිටියේ. එහෙම කැපවීමක් මම කාගෙන්වත් දැකලා නැහැ. ඔහු රටට ආදරය කළා. ජනතාවට ආදරය කළා. දිගටම අරගලය ගෙන යායුතුයි යන ස්ථාවරයේ හිටියේ. මම හිටියේ වනාතමුල්ලේ. මම ඒ කාලේ බොඩි බිල්ඩිං කලා. රෙස්ලිං කරා. වනාතමුල්ලේ අයොමය පුරුෂයාටත් තේරුණා. මට ජනතා විමුක්ති පෙරමුණේ කොළඹ දිස්ත්‍රික් ලේකම් ලෙස පත් කළා. මම දේශපාලන පන්ති පැවැත්තුවා. වනාතමුල්ලේ, මරදානේ, මහා බෝධි ඉස්කෝලේ, ටෙක්නිකල් කොලේජ් එකේ යනාදි තැන්වල පන්ති පහ පැවැත්තුවා.

මම අවුරුද්දක් විතර විෙජ්වීරගේ බොඩි ගාඩ් විදිහටත් හිටියා. විෙජ්වීර හමුවීමට පාක්ෂිකයන් නිතර අපේ ගෙදර එනවා. අපේ අම්මා කට්ටියට කන්න බොන්න සලස්වලා දෙනවා. විෙජ්වීර දිවුල්කිරි වලට ආසයි. අම්මා විෙජ්වීර ආවාම දිවුල්කිරි එහෙමත් හදනවා. විෙජ්වීර හම්බන්තොටදි පළමුවරට අත් අඩංගුවට ගත්තම අපි ටී.ඩී. සිල්වාගේ එඩේරමුල්ල ගෙදරදි සාකච්ඡාවක් කළා. ලොකු අතුල, පියතිලක, මිල්ටන්, ඉන්කම්ටැක්ස් කරු, සනත් බොරළු කැටිය, රැස්වෙලා හිටියේ. අත්අඩංගුවේදී විෙජ්වීරගේ ජීවිතයට අනතුරක් කිරීම. වලක්වන්න අවශ්‍ය නිසා. විෙජ්වීර ගැන පොදු ජනයාට හඳුන්වා දිය යුතුයි, යන අදහස මම කිව්වා. මගේ යෝජනාවෙන් පස්සේ මෙන්න විජ්වීර  කියන පත්‍රිකාව මුද්‍රණය කරන්න අපි එකඟ උනා.

මම මේ පත්‍රිකාව මුද්‍රණය කරන්න ප්‍රෙස් ගණනාවකට ගියා. කවුරුවත් බාර ගත්තේ නැහැ. අන්තිමේදී දෙමටගොඩ පොඩි ප්‍රෙස් එකක් මේ වැඩේ බාරගත්තා. හැබැයි පත්‍රිකා මුද්‍රණය කරන කන් මට ළඟ ඉන්න කිව්වා. පොලිසියෙන් පැන්නොත් උත්තර දෙන්න. අපි පත්තර 90.000 ක් විතර ගහලා ඛෙදා හැරියා. විෙජ්වීර නිදහස් කරගන්න අපට නීතිඥයෙක් අවශ්‍ය උනා. අහන අහන හැම නීතිඥයාම පස්ස ගහනවා. අන්තිමේදී ආනන්ද ප්‍රේමසිංහ මහතා කැමති උනා. අම්මගේ කීමට. අම්මත් විෙජ්වීරගේ නඩුවට නුවරඑළිය උසාවියට ගියා. අම්මා ඊට පස්සේ පක්ෂ වැඩවලට ක්‍රියාකාරිව සහය දුන්නා.

1971 ට පෙර මාව කිහිප සැරයක් අත් අඩංගුවට පත්වෙලා තියෙනවා. 1970 මම පෝස්ටර් ගහන කොට පොලිසියෙන් අල්ල ගත්තා. මාව පොලිසියේ ගෆුර් මහත්තයා ළඟට ගෙනිච්චා. ගෆුර්ට සිංහල කියවන්න අමාරුයි. එයා ඇහුවා මොනවාද මේ උඹලා ලියලා තියෙන්නේ කියලා. මම අපේ අදහස් ගැන ගෆුර්ට කිව්වා. එතකොට ගෆුර් කියනවා උඹලා පාර්ලිමේන්තුවට ගිහිල්ලා කරන මළදානයක් කරපං. අපිට කරදර නොකර. ඉහළින් අපට ඕඩර් එනවා පෝස්ටර් ගහන එවුන් අල්ලන්න. රිමාන්ඩ් කරන්න කියලා. මළ වදේ. උඹලා අපට කරදර කරන්න එපා කියලා.

තව සැරයක් පක්ෂයට අරමුදල් අවශ්‍යවෙලා මම පක්ෂ සාමාජිකයන් එක්ක මුදල් හොයන්න එක තැනකට ගියා. අපි ගියේ මගුල් හයර් එකක් යන විධියට මොරිස් මයිනර් එකක් කුලියට අරගෙන. අතර මගදී අපි ඩ්‍රයිවර් එළියට ඇදලා දාලා මයිනර් එක පැහැර ගත්තා. අවශ්‍ය තැනට ගියාම ලොකු අතුලත් ඒකට නැග්ගා. අපි සල්ලි ගත යුතු තැනට යන්න හදනකොටම මිනිහෙක් පාරේ යනවා, රේඩියෝ එකක 70 මැතිවරණ ප්‍රතිඵල අසමින්. අපේ ගෝලයා පැනලා මේ රේඩියෝව උදුර ගත්තා. කලබල වේචච මනුෂ්‍යයා කෑ ගහලා අපි කට්ටිය පෙන්නුවා. 

අපි වාහනේට නැගලා එතනින් පිට උනා. අපිට වැඩිදුර යන්න ලැබුනේ නැහැ. ජීප් එකකුයි, ඛෙන්ස් එකකුයි අපිව ෆලෝ කරලා නවත්තා ගත්තා. අපි වාහනයෙන් පැහැලා දුවන්න පටන් ගත්තා. ඒ මිනිස්සු පොලූ අරගෙන අපේ පස්සෙන් පැන්නුවා. කටු පඳුරුවලට කැපිලා අපි
ඔක්කොම තුවාලයි. ඒත් අපි ගෙදර ආවා.

ඊට අවුරුදු දෙක තුනකට පස්සේ ලොකු අතුලගේ කට උත්තරේ මේ මයිනර් එක පැහැර ගැනීම ගැන සටහන් වෙලා තිබිලා පොලිසිය මට නඩු දැම්මා. ඒත් පස්සේ රියැදුරාට මාව හඳුනාගන්න බැරිවෙලා නඩුව අහක ගියා.

පක්ෂය ඇතුලේ මතභේද තිබුණා. ඒවා සමතයකට පත් කරන්න ලොකු අතුල, කුමානායක, රංජිත් කුරුකුලසූරිය, ලක්ෂමන් මාදුවගේ. සිසිල් චන්ද්‍ර, පියතිලක, උයන්ගොඩ, කෙලි සේනානායක, නිමල් මහරගේ. වසන්ත කනගරත්න, මිල්ටන්, ඉන්කම්ටැක්ස් කරු. සනත්, අපේ ගෙදරට රැස් උනා. අපි රැස්වීම පටන් ගත්තේ උදේ 10 ට විතර. පැයක් විතර යනකොට පොලිසියෙන් පැන්නා. කට්ටිය ගෙදර ජනේලයකින් පැනලා දිව්වා. විෙජ්වීරව ළඟ ලන්සි ගෙදරක හැංගුවා.

ගෙදර හිටියේ මමයි, අම්මයි, වසන්ත කනගරත්නයි විතරයි. පොලිසිය ඇහුව්වා කෝ ගෙදර රැස්වෙලා හිටිය කට්ටිය කියලා. මම කිව්වා ඉන්නේ අපි ටික විතරයි කියලා. එතකොට රැස්වීමට ආපු අයගෙ සෙරෙප්පු පෙන්නලා ඇහුව්වා කෝ අයිතිකාරයෝ කියලා. එතන සෙරෙප්පු කූට්ටම් 35 විතර තිබුණා. රැස්වීමට ආපු අය සෙරෙප්පු අපේ ගෙදර දමලා තමයි දුවලා තියෙන්නේ. පොලිස්කාරයා මට එකක් ගැහුවා. එතකොට අම්මා කීවා එයාට ගහන්න එපා කියලා. පොලිස් කාරයෝ අම්මව තල්ලූ කළා. අම්මා ඇදගෙන වැටුනා. 

මට ගොඩක් තරහ ආවා. අම්මට හිංසා කළාට. පොලිස් රංචුවක් ඇවිල්ලා මාව අල්ලගෙන පොලිසියට ගෙනිච්චා. අම්මා නීතිඥ එඩ්මන්ඩ් සමරක්කොඩි හම්බවෙන්න ගිහිල්ලා මට වේචච දේ ගන කියලා. එඩ්මන්ඩ් සමරක්කොඩි රෑ මාව බලන්න පොලිසියට ඇවිල්ලා මට පහරදීලා තියෙනවා. වහාම වෛද්‍ය පරීක්ෂණයක් කළ යුතුයි කියලා ප්‍රශ්න කළා. ඊට පස්සේ මාව, අධිකරණයට ඉදිරිපත් කරලා දවස් 14 ක් රිමාන්ඩ් කරා.

අපට සන්නද්ධ වෙන්න කියලා දැනුම් දීමක් කෙරී තිබුණු නිසා අපි සාමාජිකයෝ සන්නද්ධ කරා. මා ළඟ ග්‍රෙනේඩ් 3, තුවක්කු දෙකයි, ටින්බෝම්බ 25, ඩයමනයිට් පෙට්ටි 3, විතර තිබුණා. කොළඹට පහර දෙන්න අපේ සැලසුමක් තිබුණා. 1971 අප්‍රේල් 2 දා අපි සංඝාරාමයේ රැස් උනා. ප්‍රහාරය පිළිබඳව අවසන් තීරණය ගන්න. මේ අවස්ථාවේදී එම ප්‍රහාරය ප්‍රායෝගික වෙයිද කියා මම ඇසුවා. මර්දනය උග්‍රයි. තොග පිටින් අපේ සාමාජිකයන් අත්අඩංගුවට ගන්නවා. සමහර අය කිව්වා අපි තනියම හරි ප්‍රහාරයට යනවා. ප්‍රහාරය අරඹන්න අපට පහළින් විශාල පීඩනයක් එනවා. මට තේරුණා දැන් පහරදීමක් වෙන්න යන බව.

අපි පැය 3-4 සාකච්ඡා කළා. භද්දිය, කොටවිල දේවසිරි, රාහුල, යන හාමුදුරුවරු පොළිසිය එයිද කියලා ඔත්තු බැලූවා. අන්තිමේදී ප්‍රහාරය ගැන තීරණයක් ගත්තා. උයන්ගොඩ අප්‍රේල් 4 හැන්දෑවේ ඇවිල්ලා මට කිව්වා කොළඹට පහර දෙන තීරණය අත හරින්න. කොළඹ ආරක්ෂක සංවිධාන තර කරලා. මේක දිවිනසා ගැනීමක් වේවි කියලා.

අප්‍රේල් 5 වෙනිදා මම කට්ටිය එක්ක වනාතමුල්ල ප්‍රජාමණ්ඩල බෝධිය ළඟ හිටියා. පණිවිඩයක් එනකං. මම රෑ 12ට විතර රෑ කෑමට සීවලි පටුමගේ අපේ අම්මගෙ ගෙදර ගියා. පොලිසිය ගෙදර වට කරා. අම්මා මට ගෙදර තිබුණු සැටිය ඇතුලේ හැංගෙන්න කියලා අම්මා සැටිය උඩම ඉඳගන හිටියා. පොලිසිය ඇවිල්ලා මුළු ගේම පරික්ෂා කරා. මෙහෙම ගොඩ වේලාවක් පරික්ෂා කරන කොට එක පොලිස් කාරයෙකුට සැක හිතිලා සැටිය පරික්ෂා කළා. එතකොට මාව අහු උනා. මාව පොලිසියට ගෙනල්ලා පහර දුන්නා. මගේ අතපය කැඩුවා. අද උනත් මගේ ශරීරයේ ඒ පහර දීම් කැලලි තියෙනවා. 

මට පහරදුන්නෙ එස්. අයි. ඩේවිඩ්, ඕ.අයි.සි. පීරිස්, යන අය. මගේ අතපය කඩලා දාලා, මාව මරන්න හිතාගෙන ගැහුවේ. එස්.අයි. සිවරත්න මා ළඟට ඇවිල්ලා වතුර දුන්නා. පොලිසිය මාව මරන්න ට්‍රයිකලාට සී.අයි.ඩී. එකට මගෙන් කට උත්තරයක් ගන්න අවශ්‍ය නිසා මාව මහරෝහලට ගෙනිහිල්ලා ප්‍රතිකාර කළා. ඒත් මාව තියාගැනීම භයානකයි කියලා බන්ධනාගාර රෝහලේ තිබ්බා. විකලංග වාට්ටුවෙ ප්‍රධානියා ඩොක්ටර්. ජයවික්‍රම තමයි මට ප්‍රතිකාර කළේ.

මාව රඳවලා හිටියේ එල්. හෝල් එකේ. වාසු, ෂන්. එස්.ඩී.බණ්ඩාරනායක, නියතපාල, ජයසේන ජයකොඩි, එහෙමත් හිටියා. රවි ජයවර්ධන විතරක් අත් අඩංගුවට අරගෙන එහෙ දවසක් විතර තියාගෙන හිටියා. මගේ අත පය කඩලා නිසා දොට්ට යන්නවත් බැරි තරමට හිටියේ. කෙලී සේනානායක, සිසිල්චන්ද්‍රා, ලක්ෂමන් මාදුවගේ, තමයි මට උපස්ථාන කළේ. මාව නෑව්වා, කැත කුණු පවා ඇද්දා.

මේ වන විට මගේ අම්මාව, අයියාව, මල්ලිව පවා අත් අඩංගුවට අරගන අපේ ගෙදර ගිනි තියලා. නඩුවේදී මට අවුරුදු 3ක සිර ද~ුවමක් ලැබුණා. මම සනීප උනාම කට්ටිය එක්ක ක්‍රිකට් ගැහුව්වා. බන්ධනාගාර
නිළධාරි බතෝලමියුස් මහත්තයා අපි එක්ක ක්‍රිකට් ගහන්න එනවා. විෙජ්වීර මට කිව්වේ ක්‍රිකට් පිස්සා කියලා. අපි සමහරවිට මහින්ද විෙජ්සේකරව කේන්ති කරවනවා විහිළුවට, වරක් මම සෝමවංශ, සිසිල්චන්ද්‍ර, මහින්ද විෙජ්සේකර, කෙලී. දවස් 7 කළුවර කාමරේ හිර කළා තෙත පාන් දීමට උද්ඝෝෂණයක් දියත් කළාට.

අපි ස්වයං විවේචනයක් කළයුතුයි කියන මතයේ මම හිටියේ. ඒත් ඒක සිදු උනේ නැහැ. ඒ නිසා 1974 වන කොට මම ව්‍යාපාරේ එක්ක අයින්වෙලා. 1977 දෙසැම්බර් 30 මම නිදහස් උනා. මම නිදහස් වෙලා ඉන්නකොට මහින්ද විෙජ්සේකර ශ්‍රිලංකා නිදහස් පක්ෂයට බැෙඳන්න යන බව කියලා මටත් ආරාධනා කළා. ඒත් මම ඒ අදහස ප්‍රතික්ෂේප කළා.

අපේ අම්මා ව්‍යාපාරය වෙනුවෙන් කැපවෙලා වැඩ කළා. ධෛර්යමත් කාන්තාවක්. නම සීලවතී සිල්වා. හැඳින්වුයේ ඔස්මන්ගේ අම්මා කියලා. 1971 මාර්තු මාසේදි අම්මා, විෙජ්වීර යාපනයේ හිරගෙදර ඉන්න කොට, විෙජ්වීර බලන්න ගියා. එතකොට පහර දෙන්න එපා. භේද අත්හැරලා කටයුතු කරන්න කියලා විෙජ්විර අම්මා අත පණිවිඩයක් එවා තිබුණා. ඉයන් වික්‍රමනායක ඇතුළු සී.අයි.ඩී. එකේ අය මේ ප්‍රකාශය විකෘති කරලා, විජ්වීර  පහර දෙන්න කිව්වා  යනුවෙන් කට උත්තරය දෙන්න කියලා අම්මට බල කරා. අපේ ගිනි තිබ්බ ගේ හදලා දෙනවා, අයියා, මල්ලී මාව නිදහස් කරනවා. රක්ෂා අරන් දෙනවා කියලා පොරොන්දුවක් උනා. ඒත් අම්මා බොරු කියන්න බැහැ කියලා, ඒ අයගේ මූණටම කිව්වා. 2007 අප්‍රේල් 12 දින අම්මා මිය ගියා. මම සක්‍රීය දේශපාලනයෙන් අයින්වෙලා දැන් ඉන්නේ.

71 කැරැල්ල ආරම්භයේ සිට අවසානය දක්වා පුර්ණ සමාලෝචනයක් කෘතිය​ ඇසුරෙනි - වෛද්‍ය රුවන් එම් ජයතුංග 

Wednesday, April 27, 2016

කාලි මුත්තු

මමත් වෛද්‍ය සුජීව දහනායකත් සිකුරාදා දිනෙක සවස වාට්ටු වල වැඩ කිරීමෙන් පසු  සීමාවාසික නිල නිවාසයට ආවෙමු. අප රාත්‍රී ආහාර ගැනීමට සූදානම්  වූවා පමණි හදිසි රෝගියෙකු ශල්‍ය වාට්ටුවට ඇතුලත් කල බව කියමින් කෝල් බෝයි වාට්ටු පොත ගෙන පැමිනියේය​. මේ නිසා මම ලහි ලහියේ ශල්‍ය වාට්ටුවට ගියෙමි. 

රෝගියා රත්තොට පැත්තේ ලයිමක මිනිසෙකි. වයස අවුරුදු තිහක් පමණ අයෙකි. තේ ගස් කපන පිහියකින් ඔහුගේ ශරීරය කපා දමා තිබුණි. අත් දෙක කටු දක්වා කැපී තිබේ. ඔහුගේ කමිසය  රුධිරයෙන් තෙමිලාය​. වාට්ටුවේ සිටි එකම වෛද්‍යවරයා මාය​. මම වහාම ඔහුගේ රුධිර සාම්පලයක් ගෙන ලේ බැංකුව වෙත දිව්වෙමි. ඉතා ඉක්මනින් ඔහුගේ රුධිර වර්ගය සොයා ගත් මා ඊට අනුකූල රුධිර ෆ්ලැකොන් කීපයක් ගෙනැවිත් රුධිර පාරවිලනය ඇරඹුවෙමි. ඒ අතර ඔහුගේ ශරීරයේ තුවාල මැසුවෙමි. 

මේ මිනිසාගේ මුළු ශරීරය පුරා කැපුම් තුවාලය​. ඔහු කෙරෙන් දාඩිය ගඳ මෙන්ම අමු රුධිර ගඳ හමයි. මා මේ ගන්ධයන් නොතකා ඔහුගේ තුවාල මසා ලේ වහනය නතර කලෙමි. මේ අතර සුජීවද පැමින මට උපකාර කලේය​. අප දෙදෙනා එක්ව මධ්‍යම රාත්‍රිය වෙන තෙක් මේ මිනිසාව මැසුවෙමු. 

ඔහුගේ අත් දෙකේ කැනියුලා දෙකකි ඉන් රුධිර ෆ්ලැකොන් දෙකක රුධිරය එකවර  ඔහුට ලබා දේ. එසේම කකුලේ රුධිර වාහිනියකට සවි කරන ලද සේලයින් බෝතලයකි. එයද ඔහුගේ සංසරන පද්ධතියට එකතු වේ. මගේ ග්ලවුස් සහිත අත් දෙකේ මෙන්ම සුදු වෙද කබායේ ලේ ගෑවී තිබේ. රාත්‍රිය නිසා මදුරුවන් මගේ  වටා කැරකෙති. ඉතා දීර්ඝ වේලාවක් හිටගෙන මැහුම් දැමීම නිසා මගේ කොන්ද රිදුම් දේ. මම සුජීවට නිල නිවසට යන ලෙස කියා රෝගියා සමග සිටියෙමි. 

මිනිසා තවමත් අඩ සිහියෙනි. රුධිරය විශාල ප්‍රමානයක් ගලා යාම නිසා ඔහුගේ හෘධයද ස්පන්දනය​ වන්නේ දුර්වල ලෙසටයි. මේ මිනිසා මිය යයිද ? මම මගෙන්ම ඇසුවෙමි. කෙසේ හෝ මේ මිනිසාගේ ජීවිතය බේරා ගත යුතුය​. මම යළිත් වරක් ලේ බැංකුවට ගොස් තවත් රුධිර ෆ්ලැකොන් කීපයක් ගෙනාවෙමි. හෙදිය ඒවා මඳ උණු වතුරක බහාලූයේ ඉක්මනට පාරවිලනය කිරීම සඳහාය​. 

අධික වෙභෙස සහ නිදිමත නිසා මම රෝගියාගේ ඇඳේ දාරය අල්ලාගෙන සිටියෙමි. නමුත් රෝගියා ලඟින් ඉවත් වීමට මට සිත නොදේ.හෙදිය මට සීනි වැඩිපුර දැමූ ප්ලේන් ටී එකක් දුන්නාය​. ලේ වැකුණු ග්ලවුස් ගැලවූ මම තේ එක පානය කලෙමි. එය අමෘතයක් ලෙස මට දැනුනේය​. තවත් පැයක් පමණ රෝගියා අසල සිටි මම නාඩි වැටීම අඩු වුවහොත් හෝ රුධිර පීඩනය අඩු වුවහොත් මට කතා කරන ලෙස කියා වෛද්‍ය විවේකාගාරයේ පුටුවක ඇලවූයෙමි. 

උදේ පහන් විය​. රෝගියාගේ තත්වය මඳක් යහපත් ය​. කෙසේ නමුත් වතු කම්කරුවා මරණය පරාද කලේය​. සතියකට පමණ පසු අප ඔහුව යළිත් ශල්‍යාගාරයට ගෙන ඔහුගේ කැපී තිබෙන පේශී, විලම්බක (ligaments )  හැකි පමණ එකට පුරුද්දා මැසුවෙමු. ඔහුගේ දෑත් වල ක්‍රියාකාරිත්වය යලි ලබා දීම අපගේ අභිප්‍රාය විය​. 

 තරමක සුවය ලැබූ පසු ඔහු අප සමග කථා කලේය​. නමින් ඔහු කාලි මුත්තු වේ. වත්තේ ගැහැණියක සමග යහළු වීම නිසා ඉන් උරණ වූ ගැහැණියගේ මල්ලී තේ පඳුරක් තුල සැඟවී කාලි මුත්තු  ලයිමට  එන විට ඉතා තියුණු තේ ගස් කපන පිහියකින් ඔහුට කෙටුවේය​. ගෙලට එල්ල කල පහරවල් වැලැක්වීම සඳහා ඔහු අත් දෙක පිහියට පෑවේය​. එයින් ඔහුගේ අතේ අස්ථීන් පවා ගැඹුරට කැපී ගියේය​. කාලිමුත්තු පහර පිට පහරකා අවසානයේදී බිම ඇද වැටුනේය​. ප්‍රහාරකයා දිව ගොස් සැඟවුනේය​. ලේ විලක වැටී සිටි කාලිමුත්තුව රෝහලට ගෙන එන්නේ ඥාතියෙකි. 

ඔහු  සිංහල කතා කලේය​. ඔහුගේ දිවි බේරා දීමට අප කරන ලද කර්තව්‍ය ඇගයූයේ සිනහවකිනි.  කාලි මුත්තු කෑලි මුත්තු උනා නේද කියා හෙද නිලධාරියෙකු ඇසූ විට  ඔහු දසන් පෙන්වා සිනාසුනේය​. ඒ අතරවාරයේ ඔහුගේ පෙම්වතියද  කාලි මුත්තු බලන්නට වරින් වර ආවාය​. තුවාල සුව වූවද ඔහුට අත් දෙක  එසවීමට නොහැකි විය​. වැසිකිලියට ගිය විට අන් රෝගීන් කාලි මුත්තුට උදව් කලහ​. ඔහුට යටත් පිරිසෙන් කමිසයක් ඇඳ ගැනීමට පවා අසීරු විය​. 

මෙසේ මාසයක් පමණ අප කාලි මුත්තුව වාට්ටුවේ තබාගෙන ප්‍රතිකාර කලෙමු. ඉන් පසු ශල්‍ය සායනයට එන ලෙස දන්වා ඔහුගේ ටිකට් කැපුවෙමු. මාස දෙකකට පමණ පසු මට කාලි මුත්තුව සායනයේදී හමු විය​. ඔහුගේ තත්වය එලෙසමය​. දෑත් ක්‍රියා නොකරයි. අප ඔහුව නුවර වැඩිදුර ප්‍රතිකාර සඳහා යොමු කලෙමු. එහෙත් ඔහු දිගු මගක් ගෙවා මහ නුවර යයිද කියා සැකය මට මතු විය​.  

කාලි මුත්තුට පිහියෙන් කොටපු මිනිහාට මොකද උනේ කියා මම ඇසුවෙමි : " ඌ මාතියා මට රුපියල් අටදාහක් දුන්නා ඒ නිසා අපි ෂමාදාන උනා"  ඔහු කීවේය​.

ඉන්ටන්වරයෙකු ලෙස ඒ කාලයේ මගේ මාසික වේතනය රුපියල් හත් දහසකි.  රුපියල් අටදාහක් යනු කාලි මුත්තුට ලොකු මුදලක් වූවද දෑත් පණ නැති ඔහු ජීවිකාව ගැට ගසාගන්නේ කෙසේද කියා මා කම්පිතව සිතුවෙමි. කාලි මුත්තු මේ වියසනය ඉදිරියේ ප්‍රත්‍යාවර්තය. ඔහු මට සිනහවකින් සංග්‍රහ කොට යන්නට ගියේය​. 

මා කාලි මුත්තුගේ ජීවිතය බේරාගත් නමුත් මට ඔහුගේ දෑත් බේරනු නොහැකි විය​. ජේෂ්ඨ ශල්‍ය වෛද්‍ය නිලධාරී ෆාහීම් ද , විශේෂඥ ශල්‍ය වෛද්‍ය නිලධාරීද කාලි මුත්තුගේ හානියට පත් වූ දෑත් යථා තත්වයට ගෙන ඒමට උත්සහ කල මුත් එය සාර්ථක වූයේ නැත​.  

 මේ සිදුවීම වී මේ වන විට වසර විසි දෙකක් ගතවී තිබේ. කාලි මුත්තු තවමත් ජීවතුන් අතර සිටින බව මගේ සිත කියයි. රත්තොට ප්‍රදේශයේ වතු පීරා කාලි මුත්තුව සොයා ගත හැකි නම් ? ඔහුගේ අත් දෙක යන්තමින් හෝ වැඩ කරනවා නම් හොඳය​. නැතහොත් ඔහු මිය යන තුරු අනුන්ට අතපා ජීවත් වනු ඇත​.  

වෛද්‍ය රුවන් එම් ජයතුංග 

Wednesday, April 20, 2016

ලෙනින්ග්‍රෑඩ් හෙවත් සෙන් පීටස්බර්ග් නගරය


සෙන් පීටස්බර්ග් නගරය ගොඩනැගුවේ මහා පීටර් රජුය​. ඔහුට ස්වීඩ්න් ජාතිකයන් ගේ ආක්‍රමණ වලට මුහුණ දීම සඳහා නගර දොරටුවක් අවශ්‍ය විය​. මේ භූමිය නගරයක් තැනීමට සුදුසු භූමි භාගයක් නොවූවද  මහා පීටර් රජුගේ දැඩි අධිෂ්ඨානය මත මහා නගරයක් ලෙයින් සහ යකඩින් ඉදි විය​. එය යුරෝපයේ මහා නගර වලට දෙවෙනි නොවන අන්දමින් ඉදි කිරීමට මහා පීටර් රජු වග බලාගත්තේය​. සෙනෆෝබියාව හෙවත් විදේශිකයන්ට බිය වීම නිසා මුළු ගැන්වී සිටි රැවුල් වවාගත් රුසියන් ඔර්තඩොක්ස් ජනයා යුරෝපය වෙත ලඟා කලේ ඔහුය​. මහා පීටර් රජු යුරෝපයේ සංචාරය කොට යුරෝපයේ නවතාවයන් රුසියාවේ ඇතිකලේය​. එසේම රුසියානු නාවික හමුදාවේ නිර්මාතෘද ඔහු වේ. සෙන් පීටස්බර්ග් නගරය විශ්ව නගරයක් කිරීම ඔහුගේ අභිලාශය විය​. 

1917 දී බොල්ශවික් විප්ලවයෙන් පසු ලෙනින් සෝවියට් දේශය ස්ථාපිත කලේය​. ඔහුගේ මරණින් පසු ස්ටාලින් සෙන් පීටස්බර්ග් නගරය ලෙනින් ග්‍රෑඩ්  ලෙස නම් කල අතර වොල්ගෝ ග්‍රාද් නගරය ඔහුගේ නමින් ස්ටැලින්ග්‍රෑඩ්  ලෙස හැඳින්වීය​. සෝවියට් දේශය බිඳ වැටීමෙන් පසු  ලෙනින්ග්‍රෑඩ් යලි සෙන් පීටස්බර්ග් ලෙස නම් කරන ලදි. 

මා ලෙනින්ග්‍රෑඩ් හෙවත් සෙන් පීටස්බර්ග් නගරයට ගියේ 1989 දීය​. සෙන් පීටස්බර්ග් නගරය ඉතිහාස පොතකි. එහි රජ මාලිගා , සාර් රජුගේ සුප්‍රකට හිම මාලිගාව​, එර්මිටාජ් කලාභවන ලෝක ප්‍රකටය​.  මෙවැනි කලාත්මක නගරයක් නිර්මාණය කලේ කෙසේද යන්න විමතියකි. මෙම ගමනේදී මම අව්‍රෝරා නෞකාව , මහා පීටර් රජුගේ ප්‍රතිමාව , පුෂ්කින් ගේ නිවස දැකබලාගතිමි. මට දොස්තයෙව්ස්කිගේ නිවස බැලීමට අවශ්‍ය වූවද එයට කාලවේලා මදි වූයේ යුද කෞතුකාගාර වල බොහෝ කාලයක් ගත කිරීම නිසාවෙනි. 

දෙවන ලෝක යුද සමයේ සිද්ධීන් වලට දෙස් දෙන යුද කෞතුකාගාර මෙම නගරයේ තිබේ. ඒ අතර ජර්මන් හමුදාව විසින් දින 900 නගරය වටලා තිබූ අවස්ථාවේදී මිනිසුන් නිරාහාරව මිය ගිය අයුරු සාක්‍ෂි සහිතව දක් නට තිබේ.  එක කෞතුකාගාරයක යුද සමයේ ජීවත් වූ කුඩා දැරියකගේ දිනපොතක් තිබේ. එහි හාමත්වීම නිසා මියගිය පවුලේ උදවියගේ නම් සඳහන් වේ. අවසානයේදී දැරිය සියළුදෙනා මිය ගිය බවත් අවසානයේදී ඇය පමණක් ඉතුරු වූ බවත් සඳහන් කරන්නීය​. 

2013 වසරේදී මට සෙන් පීටස්බර්ග් නගරයට ගිය කැනේඩියානුවෙකු වන පෝල් මැක්ග්‍රෝරි මුණ ගැසුනි. පෝල් ලෝකයේ බොහෝ රට වල සංචාරය කොට තිබේ. 

" ඉතින් කොහොමද සෙන් පීටස්බර්ග් නගරය ? මම ඔහුගෙන් ඇසුවෙමි 

ඔහු මෙසේ කීවේය​. සෙන් පීටස්බර්ග් නගරය ටොරොන්ටෝ ,නිව්‍ යෝක් නගර සමග සසඳන ටොරොන්ටෝ ,නිව්‍ යෝක් යනු කොන්ක්‍රීට් ජංගල්‍ වෙති. සෙන් පීටස්බර්ග් නගරය සමග සැසඳීමට නගරයක් තවමත් ඉදිකොට නොමැත​. එය ඉතිහාසය , සංස්කෘතිය සමග ශ්‍රී විභූතිය මිශ්‍ර වූ  මහා නගරයකි.   

මම පෝල් සමග සියයට සියයක් එකඟ වෙමි. 

වෛද්‍ය රුවන් එම් ජයතුංග 

Tuesday, April 19, 2016

War Trauma in the military, their families and Communities


Ruwan M Jayatunge  M.D.  

Combatants Affected by the Prolonged War

The 30 year armed conflict in Sri Lanka has produced a new generation of veterans at risk for the chronic mental health problems that resulted following prolonged exposure to the war. Over 200,000 members of the Sri Lanka armed forces and police had been directly or indirectly exposed to combat situations during these years. There had been nearly 20 major military operations conducted by the Armed Forces from 1987 to 2009. A large number of combatants from the Sri Lanka armed forces were exposed to hostile battle conditions and many soldiers underwent traumatic battle events outside the range of usual human experience. These experiences include seeing fellow soldiers being killed or wounded and sight of unburied decomposing bodies, of hearing screams for help from the wounded, and of helplessly watching the wounded die without the possibility of being rescued. Following the combat trauma in Sri Lanka, a significant number of combatants were diagnosed with Post Traumatic Stress Disorder (PTSD). The combat operations in the North and East had involved military personnel in major ground combat and hazardous security duty. A significant number of combatants had posttraumatic reactions soon after the traumatic combat events. Majority of these reactions were undetected and untreated. The deaths include 27,639 LTTE carders, 23,327 Sri Lankan soldiers and police officers, 1,155 Indian soldiers, and tens of thousands of civilians. The last phase of the war resulted 280,000 internally displaced persons.

Combat Trauma Experienced by the Soldiers

War is particularly traumatic for soldiers because it often involves close violence, including witnessing death through direct combat, viewing the enemy before or after killing them, and watching friends and comrades die (Hendin & Haas, 1984). After exposing to combat trauma soldiers are more likely to have psychological ailments predominantly stress related symptoms, problems with social relationships and various other problems. The wounds that they received from war are not confined to the battlefield it frequently transformed to their domestic environment as well. Although studies are needed to systematically assess the mental health of members of the armed services, a very few studies were conducted during the last 30 years. The most common mental health issue for soldiers is post-traumatic stress disorder and related symptoms of depression, anxiety, inattention, sleeping difficulties, nightmares, and survival guilt.

The psychological casualty of the operation liberation
The Operation Liberation or Wadamarachi Operation was conducted in 1987. It was the first major military operation in Sri Lanka. Nearly 8,000 soldiers participated in this campaign.  The most popular and the famous officer of the Sri Lanka Army the late Gen Denzyl Kobekaduwa commanded this military offensive against the LTTE. Corporal Ax36 is one of the psychological casualties of Operation Liberation. During this battle, he faced many battle stresses. He was physically and mentally exhausted. After serving, a number of years in the Army Cpl Ax36 witnessed many traumatic events.  He suffered nightmares, intrusions, hyperarousal, and flashbacks. He was avoiding people and places related to his traumatic experiences and became emotionally numbed. In 2003, Cpl Ax36 was diagnosed with PTSD. 

Corporal Ax36 describes his present emotional and physical ailments as follows.


I have no strength in my body now. My joints are aching. I cannot even walk a mile.  Prematurely I have grown old. My mind is full of melancholic feelings. I am unable to feel happiness. For many years, I never experienced cheerfulness.

Private K and Survival Guilt
“Survivor guilt” is the term used to describe the feelings of those who, fortunately, emerge from a disaster, which mortally engulfs others. On an irrational level, these individuals wince at their privileged escape from death’s clutches(Harvery, 2007).



Did I bury him alive?

My Sergeant died in my arms: says Private RS



After his death, my conscience blamed me for not saving him. I felt guilty. I wish I could have taken him to the Medical Point on time. If I had done that, it could have saved his life. But I was late and Sergeant L died. I was troubled by this guilty feeling and combat related nightmares and various intrusions. My life became to a standstill. I was filled with sorrow and repulsion of combat events. I was disgusted with all these issues and once I wanted to shoot myself and end the suffering. Somebody or some power saved me from self-harm and showed the way towards life. Again, I saw light.
(Private RS was found with PTSD comorbid with depression.  Following intensive treatment, he was able to recover. He became free of survival guilt that had troubled him for a long time. Now he is serving in his unit without firearms and doing light duty. )

Rifleman Sn34 and Baptism of Fire
I became a psychological casualty at the Yal Devi operation says Rifleman Sn34 revealing his story thus.
Operation Yal Devi was my first combat experience. We faced the enemy with courage. I witnessed a lot of traumatic incidents there. Our fellow soldiers died in front of my eyes leaving us in sorrow. On one occasion, the enemy gave us a surprised attack and we were scattered. I jumped in to a pit and waited all night long. It was a dark night. I saw the enemy collecting weapons from our bunkers. I was alone and feared for my life because I knew, the enemy had no mercy. I had seen dead bodies mutilated by the enemy. I thought they would do the same thing to me if they could capture me. It was an awful idea. I had vivid mental pictures of my funeral and I saw my parents were crying. I did not want to be captured by the enemy and let them mutilate my body.


I went home as a completely changed person. The innocence of youth and affection towards the family members had gone away. They saw me as a frightened cold soul. My parents thought that some evil spirit had got in to my body and they did Thovilaya, the ancient ritual to chase dark spirits to heal me. But it did not help. My memory was fading and I couldn’t sleep. Nightmares ruined me to the end.


I went home after several months serving in the North. I had no happy feelings that I got a vacation after so many months fighting in the jungle. My emotions became numbed and I was no longer interested in marital life. I became more and more hostile and physically abused my wife. Since I couldn’t have a sound sleep, I started indulging in alcohol.  Practically day and night, I was drinking secretly. But it made me worse. It made me a monster. My wife was afraid of me. When I came home, she was shivering in fear. When I was angry, I destroyed the house property. Nothing gave me relief.

The soldier who did not like to attend military funerals
I hate to participate in Military Funerals says Lance Corporal S who described his military life in the following account.
In 1987, I was posted to Kurumbasevadi camp near the Palali Base Camp. There I faced the baptism of fire. In that camp, I served nearly one and half years and was then sent to Welioya camp. I was at the forward defense line. At the Welioya camp, I witnessed many horrendous combat events. The enemy attacked us with heavy weapons killing my fellow soldiers. I saw how they were lying on the ground with bullet or shrapnel wounds. I collected the dead bodies and put them in to body bags. I was utterly devastated when collecting human remains.

In 1991, I served in a non-operational area but my official duty was to participate in funerals of our soldiers who died in action. When I was at these military funerals, I had various intrusions about the battlefield and my dead buddies. My heart was broken when I heard the mourning and wailing of the relatives. At one funeral, I saw a mother was crying for her dead son. He was a good soldier whom I knew. Her weeping reverberated in my ear. I recalled the dead soldiers at Welioya, how they were lying on the sand. Some with opened eyes.  Many weeks I could not sleep. I hated to participate in these depressing military funerals. However, my duty required such participations. In each funeral, I had flashbacks and deep sensation of sadness.


My body became a source of pain. Every joint in my body started aching. When I experienced an unbearable headache, I could not stand noises.  After the land mine explosion, I was again posted to the former camp in the non-operational area to fulfill funeral duties, which I hated. Regrettably, the senior officers gave no ear to my grievances. I was there for another one and a half years. During that time my illness progressed rapidly and once I decided to commit suicide inside the camp. My unsuccessful   suicide attempt alarmed the platoon officer and I was sent to the hospital. At the hospital, I was treated and given medication and psychological support. After months of treatment, my condition improved. Today I am doing light military duty in a non-operational area. But still I cannot see the dead and war memorials.
(Lance Corporal S was diagnosed with PTSD treated with SSRI and EMDR. After intense therapy, his anxiety based symptoms were reduced to a significant level)



We fired at them without giving any break. Suddenly they attacked my bunker with a RPG and the bunker collapsed. A large Palmyra log fell on to my head and I was semi-conscious.  My ears became blocked and I felt bleeding from my head. I knew if we stayed there, we would be killed. Therefore, we came out from the wreck and crawled towards the center of the camp. While we were moving several LTTE carders came to capture us alive and I threw a grenade to escape.

When two of us went further, we met a group of our soldiers. We regrouped and attacked the enemy.  The assault went for a long time, by dawn the enemy withdrew from the camp leaving many casualties. Although I was injured and tired, I fought with my guys without dropping my weapon.  In the morning, I was sent to the hospital for treatment.


Sometimes I see battle events in my dreams. Often when the enemy attacks I am unable to return fire, my gun is jammed. Since I am unable to shoot the enemies, they are approaching me little by little. I can hear their voices scolding us in Tamil Punde Army, Punde Army.  I become helpless. I hear someone throw a grenade. My fear increases and I shout. Then I realize that it was another nightmare.


The Story of Private UG
Private UG met with a blast injury in 1997 near the Thaladi camp. He was wounded and psychologically shattered by the blast. After several months of the injury he complained of severe headache, insomnia and fear feelings. Gradually he developed PTSD symptoms. Private UG found it difficult to sleep and experienced nightmares related to the blast injury. He had fright feelings and always wanted to avoid the places and conversations related to the blast injury. Any slightest sound made him jumpy. He became irritated and could not control his anger. Often he experienced sexual dysfunctions and as a result of family turmoil, his wife left him. Following family problems and overwhelming anxiety, he tried to commit suicide.


I was hiding in a hole in the ground: Rifleman Mx38
The night of the 27th of September 1998 was the most terrible hours of darkness of my life.  I was at the FDL in the Paranthan area. The LTTE attacked my bunker and they managed to come very close. My friends had thought that I was dead and the enemy had captured my bunker. Then they too attacked the bunker with their weapons. I was trapped facing enemy fire as well as friendly fire. Without many options, I decided to abandon the bunker. I crawled and moved away from the FDL.  Then I found a pit and I was hiding in there. I heard the enemy’s movements and lot of gunfire. I thought this would be the end. Within a few moments, they would discover me and they would not think twice to kill me. I saw child soldiers moving towards the FDL with heavy weapons, then the LTTE female carders with AK 47 in their hands. Luckily, no one saw me or not expected me to be in a hole in the ground.  I could hear heavy fighting and I decided to stay inside the pit. I was trapped there for several days. I had no food   and my water bottle finished by the second day.  On the third day, I was thirsty and I was compelled to dink my urine. By the fourth day, I had no alternative. I decided to move towards the FDL. I noticed the defeated enemy retreating group by group. I took cover and avoided them. It was a dark night and I made no noise. I was without food and water with severe exhaustion. I moved slowly.

When I came near the FDL I had to be vigilant not to attract friendly fire. I shouted at our soldiers. I told them my name, unit and my serial number. Then they recognized me with a surprise. They had thought that I was killed or captured by the enemy. I was taken to the C/O and he admired my courage. I evaded death like a miracle. I was lucky to come alive. But this happiness lasted for few days. Often the fear and isolation that I experienced inside the ditch bothered me. I could not rest, every time I had to be on guard anticipating an invisible enemy.   Days went by, I was still feeling fear. When I went to an ambush I became restless, I was looking at the front, then my inner feeling said the enemy is behind you, I looked back, and no one was there. I could not concentrate my mind. It was a terrible mess and became an obsessive ritual to watch every direction for the enemy.

(Rifleman Mx38 was diagnosed with PTSD treated with SSRI and Psychotherapy –CBT& EMDR. According to the 12th April 2005 follow up he experienced no major PTSD symptoms. His sleep became normal and the startle reactions became minimal. No intrusions or flashbacks troubled him)

The story of Lance Corporal AS – The soldier who was living in isolation
I was happily married but things changed when I became wounded. In 1990, I was at the Thaladi Camp, Mannar. There I saw fierce battles.  The LTTE attacked us with heavy weapons killing nearly 40 soldiers. With utmost difficulty, we were able to defeat the enemy. My heart cried when I saw the dead bodies of our fellow soldiers. We were like one large family. Prior to the attack we had meals together and made jokes about odd things. They have gone forever. When I put their bloodstained bodies in to the body bags, I cursed the enemy.




When I came home these battle events started roaming around my mind. I wanted to be left alone. But my wife wanted to know what’s wrong with me. I was not interested in sex life. I was avoiding my wife. She thought I was having an illegal affair. I could not stand her accusations. I became depressed and could not tolerate noise. When my children played and shouted I became extremely angry. I punished them severely. When my wife protested, I used to beat her too. One day I smashed the TV and chased everybody out of the house.



My wife refused to come back then I became more depressed. I wanted to end suffering by shooting myself. Once when I was on duty at the Army camp, I took a weapon to take my life. A senior NCO jumped and grabbed the weapon. Then I was produced before my Officer in Command. I thought I had to face charges violating military discipline. Instead of punishing me, they sent me to the Military Hospital. There I was treated and the doctors were kind enough to arrange an open interview with my family. The doctors convinced my wife to come back and finally she agreed. With   treatment, I was able to control my anger. My intrusions and nightmares diminished and gradually I became a productive person. Now for over two years, I live with my family and I do not abuse them.

I lost my voice in the height of the battle – Lance Corporal W

I joined the military in 1995 and faced many battle events. In 2000, I went to serve in the Pallai camp where the LTTE attacked us with mortars. I was shattered by the sound of this mortar fire. I felt a profound breakdown inside my body. Every time I took cover to incoming mortars. I could feel the shockwave.  I saw how our soldiers sustained injuries. I still recall one event in which a soldier succumbed to a mortar blast. His bowels came out and blood splashed  all over. It was a cruel and painful death. I was always on guard for incoming mortars. When that ‘zooooo’…..noise comes I always took cover. I knew what was going to happen in the next moment.  Mortar come with that sound and gives a terrible blast. If you don’t go down you would be hit by shrapnels. Although I was extra careful, I was not lucky. Once I sustained minor injuries as a result of a mortar attack. Shrapnel pierced my thigh.   I was hospitalized and treated for a few days.

Pallai experience was a horrendous experience for me. I was not sure of my life and often lived in uncertain situations. However, I was lucky to be alive and returned from Pallai. Then I served in a relatively favorable environment. In 2003, I re-experienced Pallai events and I frequently had nightmares. My fellow soldiers did not like me because I used to scream at midnight with fear. Some thought that I was smoking ganga. One night when I was sleeping, I saw an incoming mortar. I cried for help but there was no sound. I became speechless. . Ever since, I could not speak and I lost my voice.
(Lance Corporal W was aphonic for several weeks and underwent psychotherapy. He was treated with hypnotherapy and was able to regain his voice. His PTSD condition lasted for a long time. Medication and CBT helped him to minimize the condition)

I had walked to the enemy lines: Private SK
“I was confused and did not know what I was doing. I had walked to the enemy lines. Luckily, a team of Special Forces saved me. When they found me, I had dropped my weapon and was wondering towards the enemy lines. I don’t remember how I left my defense point or where I dropped my T56. I was taken to the camp and produced before Col ….. I was heavily questioned.  Later they blamed me for abandoning my post and losing the weapon. I was severely punished for that offence”.

(Private SK had gone into a psychogenic fugue state following overwhelming battle stress. He could not recall what really took place on that day. He served at Nedunkurni and witnessed the death of four soldiers as a result of an artillery fire. He saw how their bodies had been blown into pieces and instantly he was shocked. After this incident, he gradually became a victim of combat related PTSD which was undiagnosed and untreated. He had dissociative features as well. Several times, he went into fugue states and in the final event, he had walked to the enemy lines.   After he was rescued Private SK was referred to the Psychological Treatment Center at the Military Hospital, Colombo. At the center, he underwent a series of psychological assessments and cyber testing method to elicit autonomic arousal. He was diagnosed as having PTSD. Private SK was treated with SSRI and SPDT (Short Term Psychodynamic Therapy). With the treatment, his mental state improved)

POW s with PTSD
There are a number of POWs of the Eelam War who still carry the psychological scars. Most of them suffer from DDD Syndrome which was delineated by Farber Harlow in 1956. The DDD Syndrome consists of Debility, Dependency and Dread.  POWs often show depression, apathy, suspicion and fear. Some have large memory gaps and still feel guilty about their POW days.

Lance Corporal U has served 17 years in the Sri Lanka Army. During the Balawegaya operation, he sustained a gun short injury to his leg and became immobile. When the enemy advanced, he could not move and hence he became a prisoner. When he was captured, he was severely beaten and threatened with death. But one of the LTTE regional leaders stopped the beatings and sent him for medical treatment.



Although Lance Corporal U became a free man, he often suffered from an unexplainable fear. The POW days memories hounded him severely. Some nights he used to wake up with fear thinking that he is still in the LTTE prison cell. He was depressed and surrounded by guilty feelings. In order to avoid nightmares, he was indulging in alcohol. More he used alcohol more he became depressed. He often physically abused his spouse. Lance Corporal U began to avoid everything related to his traumatic experiences.


The Cook of the Poonari Camp
Mr. N -a civilian worked as a cook in the Poonareen Camp. When the LTTE attacked the Poonari camp in 1993, many lost their lives. To evade the enemy he was hiding inside the building complex and was later found by LTTE carders. He was beaten and threatened to be killed on the spot. He was mistakenly identified as an officer in disguise. He was subjected to numerous physical and mental tortures. Eventually the Red Cross intervened and established his correct identity.

For nearly nine and half years, he lived his life as a prisoner under the LTTE. He was homesick and practically every day prayed for his freedom. For long time he lived with uncertainty without knowing what his future would be. When the Air Force attacked the LTTE camps, their guards used to ill-treat them severely. His condition significantly improved when he met another POW – Capt Boyagoda from the Sri Lanka Navy. Captain Ajith Boyagoda became a POW when his naval ship   “Sagarawardene,” was attacked by the Sea Tigers in 1994. Capt Boyagoda gave him courage and strength to face the callous conditions. Along with the other POWs, he spent the time discussing their release and writing letters home via ICRC.



Combatants with Partial PTSD

Cpl Tx3 was a member of the Army Special Forces engaged in a number of military operations. He often worked with the long-range reconnaissance patrols (LRPP). Cpl Tx3 met with numerous hostile enemy conditions, which affected him psychologically. On one occasion, they had deeply penetrated the enemy area. He was with a five-man team and they operated silently. Suddenly he met with two LTTE female carders face to face and none of them fired. Cpl Tx3 was in a dilemma situation, if he had fired at the two LTTE female carders his team would have been in a great danger. Unbelievably, the two women disppeared into the jungle. He was confused and dazed for a while but was able to return safely.

For many years, this incident stuck in his mind. He always questioned himself “why didn’t they shoot? With these intrusive thoughts, he re-experienced combat events that occurred in the North. He would have a startle reaction to any loud noise and became vigilant all the time. Despite the posttraumatic features, he was not avoiding combat situations. Therefore, the avoidance feature was not seen in Cpl Tx3.

Lance Corporal Ax4
“In 1992 I was posted to Kaytes Island. My own brother served with me in the same unit and I was not comfortable with it. Therefore I requested for a transfer and I was asked to serve in Kajuwatta, Mannar. While I was serving in Kajuwatta camp, one day I got a message saying that my brother was killed in action at Keerimalei. Although I was given leave to attend my brother’s funeral, when I went home the funeral was over. But I attended  the religious ceremonies after his funeral.

When my leave was over, I had to report back to the camp. My mother was devastated over my brother’s death. When I went to say goodbye to her she asked me to stay with her. But I had to report to duty. So I left home. While I was traveling to the camp, again I got a message near Puttalam stating that I should report home immediately. My inner mind told me that some bad thing had occurred. When I went home, I met with another disaster. My mother had committed suicide. I was relentlessly shattered. I lost my brother and now my mother. This time after her funeral, I did not report to work and became AWOL. After several months,   I decided to report for duty and this time I was posted to a rescue mission at Poonary. In this mission I sustained a mortar blast injury and was taken to the hospital.

“After I was discharged from the hospital I participated in Rivirasa operation. We walked up to Killinochchi facing hostile enemy attacks. A lot of buddies died in front of my eyes. At Killinochchi the enemy attacked us with mortars. I sustained injuries and I was bleeding. I asked others to help me. No one came to help me and I felt fear. Then I saw a sergeant passing near me and I asked him to help me. But he left me just giving a glance. I was helpless and in pain. I gathered my entire energy and strolled   towards Elephant Pass. Half way, a group of soldiers helped me. They put me in a cab and took me to the nearest Med Aid Point. There I lost my consciousness and when I opened my eyes, I was at Anuradapura hospital.”

“I was treated several weeks at the Anuradapura hospital and then discharged. I realized that I was experiencing some distressing past events and these intrusive memories troubled me. I could not tolerate sudden noises. My mind was full of traumatic events that I had experienced in the recent past. Some nights I could not sleep and I was having a severe headache. When I am with physical and emotional pain, I become restless. I am not afraid of the battle. As a soldier, I can go to the warfront at any time. The war does not scare me anymore”



So they went to rescue him. I went further. I could not crawl anymore. I lost my energy. The world was trembling in front of my eyes. I could hear the gunfire, artillery explosions and the incoming mortar sounds. My eyes were covered with a dark strip. I lost consciousness. When I opened my eyes, I was at the Palali Hospital.


Finally, I told my fears to one of my unit leaders. He listened to me for a long time and said “you need medical treatment”. So I went to the military hospital seeking salvage. I was referred to the psychiatric unit and treated for nearly three months. I received drug therapy and psychotherapy. My symptoms reduced little by little. Then I felt much easier. Today I am doing light duty. But I have not been completely freed from the Malakam events. Occasionally I see the face of my commanding officer.

The Johny Batta that changed a young life
Private Hx26 became a victim of an anti-personnel mine in the North and underwent B/K[1] amputation. He became shocked when his foot had blown off from the ankle and for a long period, he relived this traumatic incident. After he met with the injury, his life fell apart. The girl who promised to marry Private Hx26 left him.  He could not adjust to the life with a prosthetic foot. He became more and more alienated and stopped associating with people. His life was limited to a wheel chair.

Although he was recommended rehab therapy, Private Hx26 did not actively participate in the rehabilitation program. Once he made an unsuccessful attempt to jump into the pool at the rehab center with his wheel chair. After his attempted suicide, Private Hx26 was referred for psychological therapies and he was diagnosed with PTSD.


The EPS debacle was my worst experience

On the 21 of April 2000, I was at the FDL of the Elephant Pass Camp. We were told that the evacuation order would be given at any moment. The following day at about 10.30 am, the enemy attacked the Elephant Pass camp with heavy artillery. While the enemy was attacking, our soldiers withdrew towards Kilalli lagoon. There we met Brigadier Percy Fernando who was a brave officer. He tried to reorganize and launch an attack’ then to go for a safe withdrawal. We assaulted the enemy and moved toward Pallai. The LTTE attacked us with mortars and their snipers targeted our officers and signalmen. I saw Brigadier Percy Fernando sustain a gunshot injury. It was a disastrous moment. Brigadier Percy did not abandon us. Some cowardly senior officers saved their skin and got away leaving us to the enemy. But Brigadier Percy Fernando stayed with us and gave us leadership until the end. When he fell down, I knew that we were doomed.
We were tired and exhausted. Many of our soldiers could not walk. Hot sun and dry wind sapped our energy. I felt thirsty but my water bottle was empty. Many of us did not have sufficient water. We were walking like zombies in the hot sand. Some drank salty water from the lagoon. Some began to sing songs as they lost their minds.  Many fell down with exhaustion and never got up.


My energy was ending. I could not carry the ammunition pack. I had to throw my belongings.  Finally, I threw my weapon which was my savior for a long time. I walked in the hot son with other soldiers. All I needed was water. My head was dizzy and I fell down. I saw the hot sun. There were no clouds in the sky.  Many soldiers passed me by but no one helped me. I knew if I stayed there, I would be dead soon.  I gathered my energy and again started to crawl avoiding enemy attacks. Panicked solders trampled me and ran towards Pallai. On my way, I saw many dead bodies.

One soldier grasped my boots. He was wounded and bleeding. He pleaded with me and those very words still echoes in my mind. He said I am dying and I don’t want you to carry me, then he gave his name and address and asked me to convey his death to his parents. I still cannot forget this incident. I didn’t know who he was and by the time I came to Pallai I was unconscious. I too suffered a heat stroke and later recovered. I have forgotten his name and the address. I could not convey the message to his relatives up-to-date. But I still remember his face filled with utter despair. “

The acute PTSD victim of 2005 ceasefire
Signalman Px54 met with a claymore mine explosion in Jaffna in December 2005. He sustained minor injuries to the left hand as a result of this explosion. But 13 other soldiers died in this incident. Signalman Px54 witnessed the terrible deaths of two privates and a sergeant. These events changed the psychological equilibrium in Signalman Px54 and he was diagnosed with acute PTSD. This is how he describes the event that drastically changed his psyche.

“That was a horrible event indeed. We went to Jaffna town by a truck.  I was in the middle holding my weapon. Suddenly I heard a large noise. The soldiers in front of me fell down. Then I realized that, it was an enemy attack. Despite the ceasefire agreement they attacked us with claymore mines and then with small arms. When the enemy attacked, our driver sustained injuries.  But he was able to keep the vehicle stable and we kept on going further. There was a large tyre inside the truck beside which I took cover. While I was lying down two wounded soldiers asked for water from me. But there was no water. We had to travel a few more kilometers to the nearest camp. Another wounded sergeant crawled near me and said something. His mouth was full of blood.  Within a minute or two, he became motionless. His eyes were open and he was dead. When the truck entered the nearest camp, I rushed to help the wounded men. Most of them were dead, including the two soldiers who had asked for water. I felt really sorry for them. I could not help these soldiers even to give a cup of water.

The soldier who became overwhelmed after killing the enemy
Sergeant Sx78 served nearly ten years in the operational areas exposed to heavy combat. He faced fierce battle events defending the Jaffna Fort. The Jaffna Fort was under siege and the enemy attacked them with heavy weapons. The operation “Midnight Express” was launched to rescue troops that were trapped inside the Fort. During the confrontation, he killed five of the enemy carders. After some years, he became preoccupied with the thoughts that were related to these killings. Although they came to kill us, they too human beings says Sergeant Sx78.

They were poor village boys like us who had no many options in lifeThey were indoctrinated, poisoned with hatred and directed to attack us. We had no alternative except firing at them. In a war things are intense, either you or the enemy. If you don’t kill him, he will kill you. Anyhow, these Tamil youths had parents like us, they too had expectations. All ended sadly. Someone, somewhere may be still missing them. I know killing is bad. It is a violation of the first Buddhist precept. I was compelled to do that act”.


The final days of the War
However, in a war civilian casualties are inevitable. For instance, how many civilians died in Iraq and in Afghanistan when the US forces retaliated? But I remember several events, when the enemy attacked, our soldiers did not attack back due to the civilian factor. The outside world would never know about these facts.

In another event, I saw soldiers carrying little Tamil children when the civilians broke the sand wall and came towards us. These humane stories were never told and only negative points were highlighted.

I agree, in a war atrocities are often committed and in every army you see people like William Calley who did the My Lai Massacre. I personally think that the media should comment on atrocities as well as humane stories of the war. Otherwise, there will be no reconciliation at any point. After all, man is not pure evil.


I felt sorry for the Tamil civilians who followed a mirage. When I first came to the North as a schoolboy at the age of 16, I was touched by the kindness of the Tamil people. The Jaffna people were cultured and educated. They had a great civilization that cherished non-violence. When the conflict erupted in early seventies, things changed drastically. Then I had to come to the North in a combat fatigue.

Tamil people in the North paid an immense price for the war. Their property were destroyed, children were forcibly recruited. They faced deaths and destruction. They lived under poverty. What happened to the millions of dollars that was pumped by the NGOs and by the Tamil Diaspora to the North? The people of Wanni had no infrastructure, people were malnourished. If this money was used to develop the North, they could have built a little Singapore.

Functional Impairment Following Combat Trauma
Warfare has placed great stress on combatants. Death, grief and social disorganization have been inevitable accompaniments of war. Violent conflict is part of social experience and memory (Davis, 1992).  Combat can produce distant reactions involving

Affective (anxiety, depression, irritability), Motivational (low productivity), Cognitive (confusions, poor attention and memory), Interpersonal (conflicts and withdrawal), and Biological (associated with somatic complaints) dimensions causing maladaptive behavior.

Difficulties in parenting
Many of the skills children acquire are fundamentally dependent on their interactions with their parents. Parent-child interactions are crucial in child development especially self-esteem, academic achievement, cognitive development and behavior.  PTSD patients find difficulties in parenting. Many PTSD patients are unable to express love since there are troubled by emotional anesthesia.

Sergeant KP8 a known PTSD patient described his inability to enjoy his role as a father in following manner…..
Since I became ill, my 8-year-old daughter is detached from me. She is highly frightened when I went in to tantrums and had quarrels with my wife.   Once I got very angry and dashed plates and cups, which were on the table. She started crying and hid under the bed. In the past years, she used to sleep with us, but I wake up for a slightest sound with terror and overwhelming reaction. I have fears that I might harm her when I experience flashbacks of the battlefield. I am unable to express my love for her and my feelings may be dead. I have become a cold father.

Domestic Violence
Family violence is a widespread problem that occurs among the combatants with PTSD. They use force to inflict injury, either emotional or physical, upon their spouses. Many combatants sublimate their rage. Domestic violence is a form of sublimation and transformation of anger. Based on our study, out of 56 Sri Lankan soldiers with PTSD, 13 of them frequently physically abused their spouses. Beatings and house property damage were common among them. Their anger and rage were focused towards their wives. They were irritable and hostile in family affairs.

There are many types of abuse that take place as part of domestic violence. These are emotional abuse, physical abuse and verbal abuse. They have gradual withdrawal from day to day activities. There are marked personality changes which affect their function as an active member in society as well as in family circles. Often they break family commitments, both major and minor. They become impulsive, numbed and inhibited. These features destroy a successful family life and positive parenting.

Men with PTSD commonly have sexual dysfunctions. This may be due to the anxiety and depression that they suffer. Long term use of antidepressants for their PTSD and Depression also can cause erectile dysfunctions. Some males become suspicious and have sexual jealousies. This factor too escalates family violence.

Many combatants with PTSD admit that when they go in to tantrums they over punish their children. Children often live in fear and despair. The physical abuse takes place inside the family system and rarely mothers admit that the beatings were done by their husbands. When the children are hospitalized for physical abuse, mothers always conceal the physical beatings in order to evade child protection laws.

Once a soldier with PTSD went in to flashbacks and strangulated his little daughter. The girl was choking and luckily neighbours came and rescued her. In another incident, a PTSD father became annoyed when his eight year old son could not solve mathematical sums and he beat his son with a cricket bat. Later the child was admitted to the hospital and treated for three weeks.

Lance Corporal P has served seven years in the combat zone. He sustained a gunshot injury to the right leg. After he came home he could not get a sound sleep. He had nightmares with startle reactions. To avoid his sleep difficulties and intrusions, he consumed alcohol practically every night. He became depressed and aggressive. Lance Corporal P used to physically abuse his children and the spouse. Several times he became AWOL. For nearly 3 years he went undiagnosed and untreated. Subsequently, he was referred to the Psychological Unit Military Hospital Colombo and diagnosed with combat related PTSD.  After 6 months of successful medication and psychotherapy program, Lance Corporal P was free of his PTSD symptoms. Today he is having a productive family life.

Occupational Problems
Soldiers who suffer from PTSD have occupational problems. Their productivity is weakened. They are detached from co-workers. Soldiers with combat stress have dysfunctional interactions at work places. Traumatized soldiers develop their own peculiar defenses to cope with intrusions and increased psychological arousal. One officer who was diagnosed with PTSD felt uneasy and often manifested startle reactions when soldiers come and halted with a salute. The noise made him frightened. Therefore, he used to stay away from others. Another soldier who had trepidation of uniforms felt uneasy when he comes to the camp. The irritability and spontaneous rage make them more socially isolated. They deliberately keep away from people in order to avoid confrontations. They easily get provoked. Some have homicidal tendencies.

Private WX6, who sustained a gun short injury to the face in  Operation Ranagosa in 1999, became more and more dysfunctional. He had intense rage, suspicion and homicidal ideas. He frequently had conflicts with the soldiers and officers in his unit. In 2002, following a work related dispute, Private WX6 planned to kill six of his platoon members including the platoon sergeant. His movements became suspicious and he was not issued firearms. Later, Private WX6 was referred for psychological counseling and work related disputes were resolved avoiding a major disaster.

Compulsive Exposure
Some traumatized individuals have a compulsive urge to expose to situations reminiscent of trauma. Professor Bessel Van der Kolk (1996) gives numerous examples. This is a common feature among the Sri Lankan combatants too. Many combatants believed to be suffering from combat trauma have joined the private security firms, working with politicians and engage in violence during election periods, or working with the mob. Repetition cause further suffering for the victim and for the people around them (Kolk, et al., 1996).

Cpl FC8 was psychologically devastated when he witnessed the deaths of three of his platoon members in Silavathura and later developed PTSD symptoms. He left the military prematurely and joined with a local politician. During the 1999 infamous Wayamba PC election, Cpl FC8 engaged in many election related violence that was instigated by his political master.

Private AX4 experienced numerous traumatic combat events from 1996 to 2001. He became AWOL and joined with an underground criminal gang that committed several bank robberies. For several years he was evading the police and the CCMP. In 2005 when the criminal gang attempt to rob a bank in Mathara district, they were arrested by the Police. Today Private AX4 is serving a prison term.
Capt KF9 lost his leg in the Northern territory as a result of an anti-personal land mine which was called Johnny Batta. He underwent below knee amputation and was transferred to a non-combat unit. After serving several years in a non-combat environment, he became distressed and wanted to go to the war front. He had marked posttraumatic features with intense rage. He was affected by severe hyper arousal and traumatic reminiscences. After leaving the Army, he joined a private security firm and worked for several years. His occupational difficulties were intensifying. Once he had a severe conflict with the Police and was arrested for assaulting a Police Officer.

Suicide and Deliberate Self-Harm
Studies estimate that patients suffering from PTSD have up to a seven-fold increased incidence of suicide, and four-fold increased risk of death from all external sources (Bullman & Kang, 1994). A significant number of soldiers have committed suicide in the battlefield during the Eelam War. In addition, considerable number of attempted suicides has been recorded. Suicide is a complex event. There are biological, psychological and sociological causes of suicide and suicidal behavior. Among the 824 combatants referred to the Psychiatric Unit, Military Hospital Colombo during 2002 Aug – 2005 March, 22 of them had suicidal attempts. These combatants had used various methods such as self-poisoning, shooting, hanging and in one case a planned road traffic accident.

Private HX67 was deployed in Kokkuthuduwai in the height of the Eelam war and he felt that his life was in danger. His platoon was in the jungle, they had minimal facilities and continuous heavy rain made things worse. Private HX67 shot his leg with his weapon and forced an evacuation. He was immediately taken to the hospital and treated. After his recovery Private HX67 had to face disciplinary charges.

Sergeant LX54 witnessed a number of traumatic events in the North. He witnessed the death of his platoon members and handled human remains. By 2002, Sergeant LX54 had no life interests. He had an intense death wish. Once he went to the armory, took a T-56, and placed it under his chin. The soldiers who were on duty grabbed the weapon. Subsequently he was referred for psychological therapies. Sergeant LX54 was treated with SSRI and CBT. After the treatment, he became free of suicidal ideas.

Alcohol and Substance Abuse
Alcohol and substance abuse is an observable condition among the combatants especially those who suffer from combat stress. These negative stress coping methods are often used to displace the intrusions and negative thoughts. Alcohol and other substances give a temporary sedation but in long term, it causes an enormous damage to the soldier both in physically and psychologically.

Alcohol abuse, as described in the DSM-IV, is a psychiatric diagnosis describing the recurring use of alcoholic beverages despite negative consequences. It is differentiated from alcohol dependence by the lack of symptoms such as tolerance and withdrawal. Traditionally alcohol has become a part of the military culture. Alcoholic beverages are offered in the Officers Mess and sometimes the officers are indirectly encouraged to have alcohol.

Rise in alcohol and Substance Abuse among the Sri Lankan combat veterans suffering from PTSD have been observed. The veterans consume alcohol and other substances to suppress traumatic war-related memories, escape flashbacks and to achieve a combat nightmareless sleep.

A number of reports indicate that individuals meeting diagnostic criteria for Post Traumatic Stress Disorder (PTSD) are likely to also meet DSM-3 R criteria for alcoholism and /or drug abuse. Among Vietnam Veterans seeking treatment for PTSD 60-80% exhibit concurrent diagnoses of drug or alcohol abuse or dependence (Kofoed, Friedman, & Peck, 1993).
Alcohol dependence, as described in the DSM -4, is a psychiatric diagnosis describing an entity in which an individual uses alcohol despite significant areas of dysfunction, evidence of physical dependence, and/or related hardship. Chronic Alcoholism has serious consequences on a person’s health and personal life, on family and friends, and on society.

Combatants suffering from combat stress easily go into negative stress coping methods like alcohol abuse. Alcohol and substance abuse is evident among the combatants suffering from war trauma. Those veterans who experienced prolonged exposure to heavy combat are especially vulnerable. Soldiers abuse substances such as drugs, alcohol, and tobacco for varied and complicated reasons. When we interviewed 56 Sri Lankan combatants with full blown symptoms of PTSD we found 8.9% of them were severely addicted to alcohol. They were found to have alcohol related symptoms and their liver function were seriously affected following the misuse of alcohol. They consumed a large amount of alcohol in order to avoid sleep disturbances and eliminate scary nightmares. The heavy drinking may also seem to relieve anxiety and block out intrusive memories associated with combat events. But the truth is excessive drinking can disturb the natural sleep process, interrupting REM dream patterns; the veteran may become more vulnerable to the symptoms of PTSD.

Capt NX453 served in the Army for over 16 years and exposed to heavy combat situations. In an incident near Paranthan, his team was ambushed by the enemy. He saw the death of fellow soldiers and their final outcry. Another member was shot in the abdomen and his bowels came out. After they made an unsuccessful attempt to resuscitate him, the soldier died in Capt N’s arms. For number of years he blamed himself for taking his men to the enemy’s jaws.

He was disturbed over the incident and he increased his alcohol intake in order to get a better sleep and disassociate from the horrific combat event. Hence, he could not sleep without alcohol. Gradually Capt NX453 had   long periods of being drunk, he started drinking alone. He was neglecting his official duties and the senior officers could not trust his capabilities anymore. Several times, he was reprimanded for being drunk on working hours. In 2004, he was diagnosed with Harmful Use of Alcohol.

Tobacco addiction is another unseen factor, which has serious health related consequences.  Nicotine dependence is an addiction to tobacco products caused by the drug nicotine.  Nicotine can produces physical and mood-altering effects and frequent usage can increase risk of numerous health problems. The common symptoms of nicotine dependence are inability to stop smoking, experiencing strong withdrawal symptoms such as anxiety, irritability, restlessness, difficulty concentrating and sometimes headaches.

Veld and  colleagues (2002)found that cigarette smoking was more prevalent in those with current PTSD. The researchers hypothesized that, in trauma survivors, current substance use is associated with peri-traumatic patterns of psychological tension–reduction modes.

Lance Cpl RXC143 met with traumatic combat events at Mandathivu. He was troubled by the war trauma that he experienced there. He became more and more isolated and took to smoking. He became a chain smoker and couldn’t be without a cigarette. According to his wife, Lance Cpl RXC143 smokes 30 -40 cigarettes per day.

Warrant Officer AXE86 joined the Military in 1973 and participated in all the combat operations until 1999. During these times, he witnessed numerous traumatic events especially in 1988 -89. He was diagnosed with Adjustment Disorder and Nicotine Addiction. Warrant Officer AXE86 smoked over 30 cigarettes per day which caused serious vascular obstruction in his lower extremities. In 2003, he underwent below knee amputation.

Substance abuse is another issue that has to be dealt effectively. Substance abuse refers to the overindulgence in and dependence on a stimulant, depressant, chemical substance, or herb leading to effects that are detrimental to the individual’s physical health or mental health, or the welfare of others.

Our 2005 study revealed that cannabis was the most frequent substance that was often used by the Sri Lankan combatants.

Cpl  WXC45 who was an experienced combatant diagnosed with Cannabis intoxication described how he became addicted to cannabis. The narration below is based on his testimonial.

I was first posted to Nadenkerni. Our team consisted of young fearless soldiers. We knew our days were numbered; death was several inches ahead of us. To evade the nostalgic feelings and homesickness we smoked ganga. When you take the puff inside, you feel that you are disconnected with the reality. No enemy, no bullets, no mortar attacks make you frightened. In an attack, you can advance like a wind. You don’t feel the heaviness of your backpack, you don’t  feel pain even when you sustain a gunshot injury.

The supply was a problem. We used to buy the stuff in Colombo. There were many joints where you could buy it. There were a number of places in Boralla, Maradana, Slave Island etc.  Only problem was to bring it to the Northern war front. If we travel by air through Ratmalana, the Air force guys used to search us. If you get caught you are in a real trouble. We used several methods to traffic it. The popular method was to put the stuff in to a condom and then insert it inside the anal cavity.

Although there were many restrictions, our guys used to bring it and we smoked it. When we did bunker duties ganga cigars kept us awake. Thus, we were on guard all night long.

We often used Madana Modaka (Aurvedic cannabinoid product) as well. It’s like a toffee. When some of our group mates went for the operations, they kept it in the wallet. Madana Modaka gave a sensational feeling. You can run, jump and move your body like a rubber when the effect comes. We feel no pain even we sustain injuries. Some said it prolongs your ejaculation and we used to take it home when we got duty leave.

After long usage of cannabis, Cpl WXC45 had low motivation, aimlessness, apathy and sluggishness in mental and physical responses. He presented with poor self-care and transient disorientation, as well as impaired memory. Today he knows the negative effects of cannabis.

Heroin usage was not in abundance among the Sri Lankan combatants according to our experience. From 2002 to 2005, we systematically interviewed 824 soldiers and we found only three heroin users. Heroin is a highly addictive opiate, which is processed from morphine. Although it’s illegal in Sri Lanka, the addicts know the places where it can be bought. Sri Lankan heroin addicts usually sniffed or smoke it and intravenous injection of heroin is not popular among them. Why we had very minimal number of heroin addicts among the soldiers that we interviewed? When strict rules and regulations are applied to the soldiers in the Army camps, heroin uses find it extremely difficult to obtain and use it. Often they become AWOL and continue their addiction with heroin.

The effective measures have to be taken to prevent alcohol and substance abuse among the combatants. In the post war era, there is a possible risk that is prevailing and we have to take urgent measures.There are many examples from other countries that indicate the excessive use of alcohol and other substances among the combatants. According to the 2000 and 2001 NHSDUH reports[2] on illicit drug use among the US Veterans, an estimated 6 percent of all veterans living in the United States used an illicit drug in the past year. Of the 256,000 veterans in need of treatment for illicit drug use in the past year, 20 % had received treatment during the past year. These studies show that we too are at risk.

Untreated and undiagnosed PTSD
As pointed out by Lipkin, Blank, Parson and Smith (1982) many cases of PTSD go underreported because many Psychiatrists and Psychologists fail to ask about military experience or what happened to the person while in the military. We have found a number of combatants who had manifested dissociative reactions; symptoms of acute PTSD in the height of the battle who were not treated or referred to psychological therapies. When the symptoms aggravated with malignant PTSD they were referred to the Psychiatric Unit, Military Hospital Colombo.

Hence we can give a case example. Corporal T had nightmares, intrusions and disorientation during the operation Jayasikuru or the Victory Assured in 1997. He became distressed and asked for medical attention. He was taken to the nearest MSD and treated with analgesics. With the difficulty that he experienced he was sent back to the battle front. After two weeks he lost his voice or in other words he had a dissociative reaction of psychogenic aphonia. Still he was not sent for any kind of treatment. After many months, he became depressed and threatened to commit suicide. Then he was posted to Anuradhapura where there was no active combat, but had to handle dead bodies and human remains. Only in 2002, he was referred to the Psychological therapies. By this time, Corporal T had developed chronic PTSD with severe functional impairments.

Kessler’s Phenomena
According to Kessler 16% of PTSD patients can have psychotic features. When the PTSD sufferers are affected by the psychosis, they seem to loose of contact with reality. They are affected by hallucinations, delusions and thought disorders.

Private SK67 was actively involved in combat and on one occasion, he and a small team of soldiers were trapped behind enemy lines for over 3 days. By 2003, his mental condition was failing and he experienced passivity feelings, ideas of reference, thought broadcasting, thought insertion and disorganized thinking pattern. He was diagnosed with Schizophrenia at the North Colombo Teaching Hospital, but on re-assessment he was found to have key symptoms of PTSD such as hypervigilance , avoidance,  nightmare etc in  Private SK67.

Recruit SD45 developed an abnormal reaction after being wounded by a MBI (Mortar Blast Injury) to the left shoulder. His flashbacks were wrongly interpreted as visual hallucinations and distress reaction was misinterpreted as manic features. After a detail assessment, this soldier was diagnosed as having PTSD.

Delayed Reactions of PTSD
Currently the definition of delayed-onset PTSD encompasses symptoms that surface only up to 6 months following an event. Sometimes PTSD can emerge many years after the original trauma. According to Robertson and colleagues (Ruzich, Looi, & Robertson, 2005), large numbers of older veterans are present with nightmares and intrusive memories of the war. Some are experiencing these features for the first time in their lives. For some World War II veterans, memories of the war can still be upsetting more than 50 years later.

Late onset trauma plagues war veterans in a devastating manner. Those who are in their old age are now troubled by disturbing war memories. The delayed reaction, could be triggered by a subsequent stressful event
In a study of 147 Dutch veterans who had fought in the Resistance against the Nazis in WW2, it was found that forty years after the end of the war over half of these people are still suffering from PTSD and  only 4% showed no symptoms at all (Hovens et al., 1992).

A new study (Boscarino & Adams, 2009) that assessed New Yorkers exposed to the events of September 11, 2001 provides additional evidence that posttraumatic stress disorder (PTSD) can surface up to 2 years after the event in individuals with preexisting emotional or social problems.

Some of the Sri Lankan veterans too have shown delayed-onset PTSD reactions. They have manifested posttraumatic features many years after original trauma.  Combat trauma experienced by them may result in long-term sequelae.
Sergeant TH7 was an experienced combatant who participated in numerous combat operations in the North. During 1988 / 89 insurgency period, his platoon was deployed in the Southern part of Sri Lanka to fight the left wing Sinhala rebels who launched attacks against the Government. In the height of the conflict, the rebels attacked the Army killing several soldiers. This incident escalated to fathomless atrocities.

In 1989, Sergeant TX7 and his group arrested some of the suspects and eliminated them.  Sergeant TX7 tortured one of the suspects who was believed to have masterminded the attack on soldiers. He shot the suspect, poured petrol while the victim was alive. Then set fire. When the victim was on fire, he made an unsuccessful attempt to grab Sergeant TX7.  Sergeant TX7 narrowly escaped the fire and he became shocked and utterly frightened. Then he aimed his firearm towards the blazing man and fired several shots. Then the suspect died instantly. After a few weeks, he completely forgot the incident.

In 2002, thirteen years after this incident one night Sergeant TX7 s wife tried to light the Kerosene lamp while they were having dinner. Then she accidentally dropped it and the lamp exploded. His wife s clothes caught the fire. She was on flames. Immediately Sergeant TX7 poured water onto his wife and extinguished the fire. She went unharmed. But Sergeant TX7 was utterly devastated.

When his wife was on fire, the 1989 incident came into his mind immediately. Instead of his wife, he saw the JVP suspect who tried to grab him a moment before death. From that night, he had nightmares of the original incident and continuous intrusive memories. Sergeant TX7 startled easily and he was gradually turned in to different person. He became depressed and started abusing alcohol. He lost his life interests. Once he planned to commit suicide. He went to the railway station and walked along the railway tract. When the train was a few meters away, he changed his mind and jumped off.

Sergeant TX7 was diagnosed with PTSD in late 2002 and treated with medication and psychotherapy. (EMDR and CBT). By 2003, he was free of most of the PTSD symptoms.

Lt Col XXD participated in the Operation Balawegaya in 1991 and faced heavy fire by the enemy. In front of his eyes, several soldiers died following sniper fire. He took a key effort to prevent the enemy advance and sustained a gun short injury to the leg. He thought that he would be dead as his fallen soldiers. While lying on the battlefield his thoughts, were about his home, parents, wife and the children.

He was bleeding profusely and the other combatants took a great effort to evacuate him immediately. He was transferred to Palaly hospital and then air lifted to Colombo.

The doctors took massive effort to save his leg and eventually the operation became successful. He recovered his physical injuries soon and went back to his unit. His physical and mental health was stable.
In 2003, he suffered DVT or Deep Vein thrombosis and experienced unbearable pain. While he was in physical pain he had flashbacks of the 1991 Operation Balawegaya events, how he sustained a gunshot injury, how he was lying on the ground etc. he even saw the late General Denzel Kobbekaduwa in his flashbacks. He became restless and had a PTSD attack.
After he was treated for the Deep Vein Thrombosis his pain subsided, but he was hounded by the battle events. He experienced intrusive memories, flashbacks and startling reactions. His sleeping pattern changed and in order to avoid nightmares he started to work until late nights. Lt Col XXD adopted a workaholic attitude to evade disturbing ruminations. After sometime, he was physically and mentally exhausted. His system could not cope any more. Then he had a second attack, which manifested as an aggressive fearful reaction.  Lt Col XXD was treated with SSRI and relaxation therapies for a long time and gradually his posttraumatic symptoms subsided.

Eelam War and the War Widows
One harsh reality of the war is that the every soldier killed in war leaves behind grieving family and relatives. It has been a reality since the Trojan War.

The women who were left widows as a result of the Sri Lankan conflict are facing radically altered circumstances. There are estimated thousands of war widows and war-affected family members from the Tri Forces who still experience grief reactions. Many widows are in the 22 to 35 age group; and with the death of their husbands these women have become a psychologically and socially vulnerable group. Most of the women who underwent severe emotional pain still have not completely recovered. Many have become the victims of pathological grief. They are unable to work through their grief despite the passage of time. With the widowhood, they experience identity change, role adjustment and change in social status.

Many researches concur that the mental trauma of the war widows can last for long years. Depressive reactions are common among the Sri Lanka war widows. In 2005, 86 Sri Lankan war widows were clinically interviewed based on Beck’s depression scale and depression was diagnosed in 23 (27%). Ten war widows said that they had contemplated suicide after they lost their husbands (12%). (Jayatunge, 2005)

The war widows of the other conflictive areas in the globe are facing similar consequences. The conflict in Iraq had recorded high numbers of war widows.  According to Olga Ghazaryan, Oxfam’s regional director for the Middle East, the Iraqi war has made widows of an estimated 740,000 women and left many others fatherless (Rubin, 2009).  After 1991, many Iraqi war widows became sole wage earners, often going hungry to feed their children; possibly 60% suffered from psychological problems, with physical manifestations such as weight loss and difficulty breast-feeding (Hoskins, 1997 quoted in (Salvage, 2002).

In the conservative Asian societies, widows face social, economic and legal handicaps. Widow as its name denotes is associated with some form of socio-cultural stigma and humiliation. They are considered as bad omen in many Sri Lankan rural areas. They are marginalized by their own communities. These factors affect their self-esteem. In some events, the accusations were made by the in laws stating that the husband’s death occurred because of the unluckiness of the wife and they are partially answerable for the husband’s death. They experience lack of social support and loss of their social possession in their own family circles.

The war widows face a number of mental health problems. They have suffered bereavement as a result of the violent deaths of their husbands and these traumatic memories hound them for long years. They are often subjected to extreme forms of discrimination and physical, sexual, and mental abuse. Therefore, widowhood represents a form of “social death” for these women.  Their plight and vulnerability lead to numerous psychological ailments.
Many of the widows carry the memories of their late husbands. They are emotionally troubled by the loss and grief.  In the overall view the large percentage of women are having following psychological features.

Common symptoms included intrusive memories about their dead husbands, fear and uncertainty about the future, self-pity, low self-esteem, sleep disturbances, irritability, displacement of anger, emotional numbing, feelings of guilt, and psychosomatic complaints like persistent headaches and backaches which do not have any medical basis and do not respond to painkillers.

Many Sri Lankan widows have a tendency to experience and communicate psychological distress in the form of physical symptoms. Some have multiple unexplained somatic symptoms. Most often, the complaints involve chronic pain and problems with the digestive system, nervous system, and reproductive system. These young war widows, who have suppressed their biological needs following the cultural pressure and family honor, often manifest conversion reactions.
In a study by Gabriel Silverman and colleagues (2000), traumatic grief, PTSD, and major depressive episode were found to overlap with each other to similar degrees. Of those with traumatic grief, 47 percent also received a diagnosis of major depressive episode, 33 percent met criteria for PTSD, and 40 percent had traumatic grief.

Individuals who meet the diagnostic criteria for prolonged grief disorder have been shown to be at an increased risk of developing clinically distinct posttraumatic stress disorder, generalized anxiety disorder, major depressive disorder as well as suicidal ideation (Grey, Prigerson, & Litz, 2004). The violence of war does not end with the return to peace for those living closest to former combatants. Following is the experience of a war widow whose husband died in the operation Jayasikuru in 1997.

When I heard of the death of my husband, my entire world collapsed. He was a Lance Cpl in the Army and we were living in his house with his mother and two unmarried sisters. I still have a fragmented memory of the funeral. Some events I cannot remember. My three-year daughter who had no clue about father’s death asked various questions. I did not know what would happen to my daughter and me after my husband’s death.

After several months, my mother in law and husband’s two sisters started passing negative comments. They blamed me for his death. They implied that I was unlucky and since I came to their house, the things changed negatively. Even the neighbors avoided me.

I had to go to Panagoda Army pension branch to get my dead husbands’ pension. They said he was a volunteer and it would take some time and gave me papers to fill up. I had no idea how to do the paper work. I asked my cousin brother to help me. The day I went to his house with the daughter to get the paper work done my mother in law came up with false accusations and blamed me for seeing men soon after the husband’s death. She humiliated me and demanded the full pension of my husband saying that I have no financial rights.

I had no place to go and my parents died when I was small. My relative had no financial ability to look after me and my daughter. Therefore, I had no other option but to live with the husband’s relatives, facing humiliations every day. When I received my husband’s pension, my mother in law took it. We were given only food.

Every month I had to go to the Grama Niladari to confirm that I am still a widow and not remarried. When I went to get his signature on the document he used to pass inappropriate jokes and once tried to touch my hand. I scolded him and left the office. Ever since, he delayed signing my papers.

I became depressed and when my daughter goes to sleep, I cry alone. If not for her, I would have committed suicide, ending this suffering. My mind is preoccupied with the events of my husband’s funeral. I had the mental pictures of the coffin, his dead body, ceremonial uniform, and many more things. I had mental pictures of these miserable events. Constantly I had feelings of fear and uncertainty about the future. My memory started fading and I could not concentrate. Gradually I have become a living dead………….

Mrs AT87 had been married only for seven months when her husband became MIA (missing in action). This is her story.
……..When my husband went missing in action, I was 30 years old. We had been married for seven months. As a young wife, I had to face the challenges of life. I waited for him many years but he did not return. Every day was a painful anticipatory day for me. I went to many army camps, to the ICRC and even went to the North during the ceasefire era in search of my husband. There was no news about him. My relatives urged me to marry again but I refused.  I still cannot believe that he is dead. I hope one day he would come back…..

Mrs. HK34 faced severe hardships with the death of her husband who was a full corporal in the Army. She was driven out from the husband’s family which accused her of being unlucky. She was living in a small house with her four years old son. Her neighbor – a middle-aged man tried to help her with different motives in his mind.  When his intentions were revealed, Mrs. HK34 did not speak to him and avoided him. Then he started spreading malicious rumors about her in the village. The villagers, especially the women, humiliated her publicly.  Some nights, stones were thrown to her house. As Mrs. HK34 believed, her neighbor was behind all these mock incidents. When the troubles intensified, she decided to leave the village but she had no place to go.

The conflict in Sri Lanka has generated a large number of war widows in the North and East.  Widows in the North and East province totaled some 89,000 in 2010 (Mohamed Hizbullah, 2010). Many women are living in abject poverty and despair.

Many women in war are faced with the main responsibility for care giving in the family, with the destiny of their husbands unknown and new and unfamiliar duties placed on them. If the household is facing hardships, this may overload women’s capacity to cope; as preoccupation with the needs of the family may lead to neglecting their own needs, especially if they become widows.

The late Air Chief Marshall Harry Goonetilleke conducted a valuable psychosocial assisting project for the war widows of Sri Lanka under the Ranaviru Family Counselling Association. This project helped the war widows to reconstruct their lives and gain confidence. He believed that there should be a permanent rehabilitation policy for the war widows at the national-level. Until his death in 2008, Air Chief Marshall Harry Goonetilleke actively engaged in the rehabilitation work of the Sri Lankan war widows.

Mrs. KL342 was able to face her destiny with courage and determination after her husband’s premature death that occurred in the Eelam war.

…………. When I heard the terrible news of my husband’s death in the war front, I was utterly devastated. For many months, I was in a denial stage and could not believe that he would never come back.  Somehow, I had to gather strength for the sake of my two little children. I knew that being a widow in a deeply conservative society is not easy. But I had no alternative and with courage I faced the consequences.

Ranaviru Family Counselling Association offered me strength and guidance. At the meetings, I saw women like me who were struggling to survive. I learned new skills and started to work in an income-generating project. While working and attending to my children’s needs, my emotional trauma was reduced. But the deep sorrow was always with me. I had to be the sole breadwinner of the family; I had to be responsible for my children.  I was determined to live a life with dignity.
During the cease-fire in 2002, a group of war widows from the North visited us. Their husbands were LTTE carders who died in the battle. When I saw them, I had angry feelings. I thought for a while probably one of the husbands of these women had killed my husband. My heart stated beating rapidly. I saw they were looking at us. Simultaneously I thought they would be having the same feelings about us. That moment I realized that anger and hatred offer nothing but destruction. My anger dropped to the zero level. We welcomed them, the women from the opposite side but who share the same grief as us. We all are victims of the war no matter the racial differences. After all our tears and suffering had no ethnic difference. We spoke with these women and exchanged ideas. Soon we became friends. We cried together for the memories of our dead husbands who left us so unexpectedly. At the end of the day, we parted like sisters. Some of these women still write to me and we are good friends…….

Mrs. GF54 lost her sense of purpose in life when she underwent a pathological grief reaction following her husband’s death in 2001 during the Operation ‘Agni Kheela’. She was extremely focused on the loss and reminders of her husband. She had problems accepting the death, preoccupied with sorrow, inability to enjoy and move on with life, trouble carrying out normal routines and was withdrawn from social activities. She was treated with medication and EMDR, which gave optimum results. Today Mrs. GF54 is rationally facing her life. She is self-employed and building a house for herself and her children.

Rachel Tribe and Padmal De Silva (1999) highlight the importance of integrating coping strategies, self-help principles changing perceptions, attitudes and stereotyped beliefs when improving mental health issues of the Sri Lankan women who were widowed following extreme traumatic events. As they recommend the cultural and socio-political issues should be taken in to consideration.

As a matter of fact, very few governments and non-government organizations view widows as a special category with individual problems and special status. Therefore, war widows are marginalized in many communities around the world. The higher levels of stress and mental illness among women, common in many post conflict societies, are even higher in Sri Lanka due to the prolonged war(Somasundaram, 1998). The war widows carry extra burden than the average women in the Sri Lankan society. Apart from their traumatic experience, daily stressors such as poverty, family conflict, health problems, unemployment, social isolation and harassments exert a significant effect on their stress levels. Some widows take care not only of their children but often of their extended family as well.

The mental health interventions of the war widows should be followed with the specific cultural contexts and not contradicting religious beliefs of the victims. The war widows need strength-based psychosocial interventions. Welfare and rehabilitation of widows are essential with teaching of coping strategies, facilitating education and job training for the socially shunned widows. The measures are needed to help women transform their new skills into financial independence and sustainability. At the same time as strengthening women’s existing skills, new skills should be introduced in traditional and non-traditional fields.

There must be a permanent rehabilitation policy for the war widows at the national-level that helps widows to build a new life, regain confidence and gently adjust to a new life. The children of these war widows should have a secure and dignified future as their fathers always expected.  It is the duty of the nation to repay their dues to these families who have become the invisible victims of the Eelam war.

Children Affected by the Eelam War
UNICEF recently estimated that over 90% of the victims of today’s warfare is women and children. Children who are a vulnerable group have suffered severe traumatic events during the Eelam War.

Worldwide studies indicate children of the war zones undergo severe psychological trauma. The research in Gaza, Rwanda, Mozambique and Cambodia reveal children who were exposed to war and atrocities are at a high risk of developing PTSD. Thabet (2000) did a study to estimate the rate of Posttraumatic stress reactions in Palestinian children who experienced war traumas. The sample consisted of 239 children of 6 to 11 years of age. 174 children (72.8%) reported PTSD reactions of at least mild intensity, while 98 (41%) reported moderate/severe PTSD reactions.


Little K was nine years old when she became a victim of a cross fire between the armed forces and Tamil militants in the North. She sustained a gunshot injury to her left arm. She underwent a traumatic amputation of the left hand. The doctors were compelled to perform this operation in order to save her life. After the operation she was taken to an orphanage in Mulangavil in the Killinochi district. She has feelings of fear, night terror, bed wetting, hyperarousal and alienation. Traumatized war- zone children like little K carry the psychological scars throughout their lives.

Children who have experienced or been exposed to war trauma often have anxieties and insecurities that can cause them to perceive every aspect of the world as being unsafe and frightening. They grow up with a generalized fear and hostility which affects their future lives. Trauma is often associated with intense feelings of humiliation, self-blame, shame and guilt, which result from the sense of powerlessness and may lead to a sense of alienation and avoidance. Therefore the initial trauma could become a vicious cycle.

The following case study gives the longitudinal effects of psychological trauma on children, which can affect their later lives.

Master S was 12 years old when the 1983 communal riots erupted. His family was hiding in a neighbour’s house to evade the mob attack. The attackers burnt their house while Master S and his kid sister were hiding under a bed in their Sinhalese neighbour’s house. He could hear the shouting of the mob and the screaming of the victims. Master S had feelings of fear and he thought that the mob would kill him. These fears lasted for many years as he grew older.

The following day, their kind neighbour with the help of the Police took them to the refugee camp at Bambalapitiya Kadirashan Kovil. Before going to the camp Master S had a quick glance at their house which was completely destroyed by the fire. He felt sorry for losing his books and toys.

After spending several months in the refugee camp, his father was managed to get asylum in West Germany. For many years S had nostalgic feelings for his lost books and toys and also feared that a group of people would come and attack him unexpectedly.

After coming to West Germany S underwent a prolonged cultural shock and frequently felt a misfit in Western society. He became more isolated and neglected his studies. As a teenager he became more and more hostile and frequently had conflicts with his parents. After spending 12 years in West Germany S moved to Canada and got married. But he always felt the empty space and became emotionally numbed. On some occasions, he could not control his temper and engaged in domestic violence. His violent outburst resulted in an injury to his wife and S was charged by the Canadian authorities. Today he is serving a prison term.

Children who had witnessed the war trauma and atrocities can have diminished cognitive abilities. They frequently have learning difficulties at school. Some have behavioral disorders. Most of them do not receive proper psychological therapies and rehabilitation. As Osofsky (1995) indicates the differential response to trauma depends, in part, on the child’s age and level of psychological maturity. Children vary in their reactions to traumatic events. Some suffer from fears and terrifying memories immediately after the event, which dissolve with time and emotional support. Other children are more severely affected by trauma and experience long-term problems. Children of the war zone may exhibit regressive behaviors such as bed-wetting, thumb-sucking or fear of the dark. They may have increased difficulties separating from their parents. Also they can have attention problems and learning difficulties at school. Many of these affected children can have somatic complaints, irrational fears, sleep problems, nightmares, irritability and angry outbursts. They may appear to be depressed and more withdrawn.

Adolescent (ages 12 to 18) responses are more similar to adults and they are at increased risk for problems with substance abuse, peer problems and depression. Child soldiers have been exposed to events beyond the normal boundaries of human experiences. This is a story of a child solder whose pseudonym is SE .



Exposure to war situations cause children to lose predictability in their lives. They become withdrawn from daily routines and daily habits which provide security for them. It affects their psychosocial development negatively.

Master P was terrified when air attacks took place in Jaffna. During this attack his neighbor’s house was destroyed and some were critically injured. They were taken to the Jaffna hospital. Master P becomes anxious when he hears aircraft sounds. He has startle reactions, intrusive memories of the air attacks and sometimes nightmares.



Master D (10 Y) was a bright student who suddenly showed learning difficulties and behavioral problems when his father died in the Rivirasa operation. He became aggressive and started bed wetting. He lost interest in social activities and showed positive features of Paternal Deprivation Syndrome. He was not a happy child after his father’s death.

Living with a father who is affected by the combat trauma is another predicament faced by some children. Little B was an eight year old boy who was beaten by his PTSD father an ex-combatant with sudden rage. The boy was hospitalized and received treatment for his physical injuries.

Miss M (15Y) and master L (12Y) are sister and brother of the same family. Many days they had to spend the nights at neighbor’s house when their father became aggressive and went into tantrums. He is a combatant suffering from PTSD. When he experienced combat related flashbacks, he became extremely violent. Their mother left the house following continuous physical aggression by the father.

In recent years, since 1990, nearly 49 wars have been waged, and 46 have been fought with small weapons. Over 40 million men, women, and children have been forced into refugee status due to war violence. A situation of war, frequently experienced by refugees, has a disorganizing and traumatizing effect on the entire family. The Eelam war caused displacements of civilians at large. Many are still living in refugee camps.

Master M (9Y) and his family had to flee from his village with the other neighbors when the LTTE ordered the Muslim people to leave the North. Their family came to Puttalam and lived in a small hut without basic facilities in Alankuda, Kalpitiya. Master M became more isolated and showed positive features of anxiety and depression. He was nostalgic for his native village in Mannar. His education was disrupted and today M works as a three wheel driver in Puttalam town. M feels himself as an alien in Kalpitiya .He is addicted to cannabis and has no long term life plans.

During the Eelam War, the LTTE launched a number of suicide bombings sometimes targeting civilians. Master N (15Y) was a psychological victim of the dreaded Central Bank Bombing by the LTTE. When the blast occurred they were in a motor car. They sustained minor injuries, but master L was psychologically shattered. He had feelings of fear, startle reactions, intrusive memories and nightmares for nearly a year.

How to heal the wounds that occurred due to the armed conflict ? These children need medication, psychotherapy, psychosocial rehabilitation and long term monitoring. In Sri Lanka there is a big scarcity of experts in this area. Very often traumatized children grow up without psychosocial support. Unhealed traumas affect their cognitive and personality development.

Time does not heal the trauma. Therefore active measures are needed. Social support should be given to the children who were exposed to war trauma. Children’s resiliency to traumatic events is influenced by the degree of social support and positive community influences (Garbarino & Kostelny, 1996).



War trauma in Sri Lanka has created a critical situation. A large number of children have been affected by the prolonged armed conflict in Sri Lanka. This has become one of the crucial problems that would affect our future. Consider that a significant numbers of our next generation are traumatized and unhealed.

American Psychiatric Association (APA) (1994). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association

Boscarino, J., & Adams, R. (2009). PTSD onset and course following the World Trade Center disaster: findings and implications for future research. Social Psychiatry and Psychiatric Epidemiology 44(10), 887-898.

Bullman, T. A., & Kang, H. K. (1994). Posttraumatic Stress Disorder and the Risk of Traumatic Deaths Among Vietnam Veterans. Journal of Nervous & Mental Disease, 182(1), 604-610.

Davis, J. (1992). The Anthropology of Suffering. Journal of Refugee Studies, 5, 149-161.
Garbarino, J., & Kostelny, K. (1996). The Effects of Political Violence on Palestinian Children’s Behavior Problems: A Risk Accumulation Model. Child Development, 67(1), 33-45. doi: 10.1111/j.1467-8624.1996.tb01717.x
Grey, M., Prigerson, H., & Litz, B. (2004). Conceptual and Definitial Issues in Complicated Grief. In B. Litz (Ed.), Early Intervention forTrauma and Traumatic Loss (pp. 65-111). New York: The Guilford Press.
Harvery, D. (2007). Intergenerational Transmission of Trauma from Holocaust Survivors to their Children.Baycrest, 7. Retrieved from
Hendin, H., & Haas, A. (1984). Posttraumatic Stress Disorders in veterans of early American wars.Psychohistory Review, 12(4), 25–30.
Hovens, J., Op den Velde, W., Falger, P., Schouten, E., De Groen, J., & Van Duijn, H. (1992). Anxiety, depression and anger in Dutch Resistance veterans from World War II. Psychotherapy and Psychosomatics, 57(4), 172-179.
Jayatunge R (2004) PTSD Sri Lankan Experience , ANL Publishers Colombo
Kofoed, L., Friedman, M. J., & Peck, R. (1993). Alcoholism and Drug Abuse in patients with PTSD. PSYCHIATRIC QUARTERLY, 64(2), 151-171. doi: 10.1007/BF01065867
Kolk, B. v. d., McFarlane, A., & Weisaeth, L. (Eds.). (1996). Traumatic Stress: the effects of overwhelming experience on mind, body, and society. New York: Guilford Press.

Lipkin, J., Blank A. Parson E, and Smith .J (1982) Vietnam Veterans and Posttraumatic Stress
Disorder (retrieved from
Mohamed Hizbullah, D. M. f. C. D. a. W. s. A. (2010). Sri Lanka: Conflict over, but not for widows. Alertnet, 26 Oct 2010. Retrieved from
Osofsky, J. D. (1995). The Effects of Exposure to Violence in Young Children. Amercian Psychologist, 50, 782-788.
Rubin, A. (2009). Iraqi Surveys Start to Unveil the Mental Scars of War, Especially Among Women. New York Times. Retrieved from
Ruzich, M., Looi, J., & Robertson, M. (2005). Delayed onset of posttraumatic stress disorder among male combat veterans. American Journal of  Geriatric Psychiatry, 13, 13:424-427.
Salvage, J. (2002). collateral damage- the health and environmental costs of war on Iraq. London: Medact.
Silverman, G. K., Jacobs, S. C., Kasl, S. V., Shear, M. K., Maciejewski, P. K., Noaghiul, F. S., & G., P. H. (2000). Quality of life impairments associated with diagnostic criteria for traumatic grief. Psychological Medicine, 30, 857-862.
Somasundaram, D. (1998). Scarred Minds. New Delhi: Sage Publications.
Thabet, A. A., & Vostanis P. (2000). POST TRAUMATIC STRESS DISORDER REACTIONS IN CHILDREN OF WAR: A LONGITUDINAL STUDY. Child Abuse & Neglect, 24(2), 291–298.
Tribe, R., & Silva, P. D. (1999). Psychological intervention with displaced widows in Sri Lanka. International Review of Psychiatry, 11, 184-190. doi: 10.1080/09540269974366
Velde, W. o. d., Aarts, P. G. H., Falger, P. R. J., Hovens, J. E., Duijn, H. v., Groen, J. H. M. d., & Duijn, M. A. J. v. (2002). ALCOHOL USE, CIGARETTE CONSUMPTION AND CHRONIC POST-TRAUMATIC STRESS DISORDER.Alcohol and Alcoholism, 37(4), 355-336. doi: 10.1093/alcalc/37.4.355

Find Us On Facebook