This article is part of AOAV’s report, The Refugee Explosion. The whole report can be found here. Whilst the report introduction and methodology can be seen here. The key findings can be viewed here. The report overview on refugee destinations can be read here, asylum law in Europe, here, and political and economic developments, here. AOAV’s country findings for Germany, the UK, and Greece can be found here, here, and here, respectively. For the report’s overall findings please click here, or for AOAV’s resulting recommendations here. To read some of the interviews from refugees AOAV spoke to please see here..
Between 2011 and 2016, AOAV recorded at least 233,949 deaths and injuries from explosive violence globally, of which 76% were civilians. The six most impacted countries were: Iraq, Syria, Pakistan, Afghanistan, Yemen and Nigeria. Unsurprisingly these countries are also among the countries seeing the most displacement of peoples within these years.
The use of explosive weapons in populated areas is forcing people from their homes, and preventing their return as their neighbourhoods lie in ruins. Repeated bombing and bombardment causes not only death and injury, but also fear and intense psychological distress, increasing the urgency and desire of those affected to flee the area. The extent of this problem is underpinned by the fact that when explosive weapons are used in populated areas, 92% of casualties (between 2011 and 2016) were civilians.
AOAV’s work is supported by other valuable research. In Areas of Harm, a recent report by PAX and Article 36, the researchers concluded that for civilians living in conflict zones, even when force is specifically directed at military targets, explosive weapons used kill and injure civilians, prevent access to basic services and force the displacement of populations.
Even after fleeing the immediate threat, evidence suggests a common pattern of ‘multiple’ or ‘repeated’ displacement of civilians, often due to the widespread threat from explosive weapons across large swathes of territory. In some countries – such as Syria and Iraq – the threat of explosive violence is present in almost every urban area.
AOAV’s report Syria’s Shockwaves (2014) uncovered evidence of this trend, with a quarter of refugees interviewed telling of having been displaced inside Syria on more than one occasion, with one-third of refugees reporting being bombed or shelled as they fled.
Displaced persons are particularly vulnerable to explosive weapons when on the move, often reinforcing their decision to flee across international borders rather than attempting to remain within their country of origin.
Handicap International’s 2016 report, Escaping the Bombing, based on interviews with Syrian refugees in Jordan, found that whilst the causes of displacement were multiple, the sentiment was universal among those interviewed that the threat of explosive weapons was the primary, overriding factor influencing their decision to flee.
The findings of this report – The Refugee Explosion – reiterate Handicap International’s findings. Both reports find that there is a strong correlation between forced displacement and the use of explosive weapons in populated areas, with 53% of those interviewed by AOAV citing war or conflict as their main motivation for fleeing.
Whilst the threat of physical injury from explosive violence is clear, what is often less recognised are the long-term psychological and mental health impacts of explosive weapons on refugee populations – particularly those who have experienced the effects of explosive weapons first-hand, in places such as Syria, Iraq and Yemen.
Beyond their initial impact, explosive weapons can cause long-lasting psychological trauma and a multitude of mental health issues. Clinically speaking, an event is most likely to be traumatic if it happens unexpectedly, repeatedly or involves intentional cruelty.
Explosive violence is virtually always unexpected, such as the sudden detonation of a car bomb, a drone strike or a suicide attack. Other forms, which are more expected, tend to occur repeatedly, such as artillery shelling or the use of hand grenades.
80% of people injured by explosive weapons exhibit symptoms of severe psychological stress, not to mention the psychological trauma inflicted on the wider population who have had to live through the everyday fear of bombardment or IED strike. In addition, 66% of those surveyed were unable to carry out essential daily activities due to persistent feelings of fear, anger, disinterest and hopelessness.
Even for a person only indirectly impacted by the explosion (for instance a witness), the experience can be traumatic. AOAV’s report Anatomy of a Suicide Bomber, which investigated the impacts of the Moon Market bombings in Lahore, Pakistan, found that those that witnessed the horrific attack have gone on to suffer a variety of mental health issues, including many of the symptoms of Post-Traumatic Stress Disorder (PTSD). Many had flashbacks of the events, others were easily distressed or suffered unending headaches. Blood on the Streets of Boston also confirmed these findings, with witnesses also reporting PTSD symptoms.
The repeated use of explosive weapons in heavily populated areas leaves residents having to deal with heightened levels of fear, distress, anxiety and uncertainty on a daily basis; feelings which manifest themselves in various ways in different individuals. Some may experience difficulty sleeping or carrying-out daily tasks, whilst others may fall into a state of depression and social withdrawal. These feelings often remain present long after a person has fled the conflict zone, and may have a lasting impact far into their lives.
A disproportionately high number of refugees are known to suffer from PTSD, in comparison to those who have not experienced life in war-torn areas. In the first study of its kind, Save the Children examined the psychological impact of explosive violence on children in Syria. The study, Invisible Wounds, published in March 2017, found that almost all children and 84% of adults reported that bombing and shelling was the number one cause of psychological stress for children. 71% of interviewees said children were increasingly suffering from symptoms of toxic stress and PTSD.
Refugees may also face additional stresses as a result of physical injuries obtained from explosive weapons, with many facing a range of temporary or permanent impairments. Some have undergone dramatic changes in appearance or experienced the traumatic amputation of a limb, whilst many others have life-changing injuries such as loss of hearing or sight. As a result, affected persons may feel that their independence has been taken away, and that they no longer could play a useful part in family or community life, leading to feelings of detachment, withdrawal and hopelessness.
In Syria’s Shockwaves, AOAV stated that ‘lost in the endless news-cycle of deaths are the people who survived.’ In this sense, the long-term suffering of refugee populations who have lived through the effects of explosive violence, often goes unreported and unrecognised.
UNHCR, along with the International Organization for Migration (IOM) and the Mental Health and Psychological Support Network (MHPSS), have recently issued a multi-agency guidance note to humanitarian organisations working with refugees in Europe, providing details on best practice for ensuring adequate, appropriate and culturally sensitive mental health support. It is the hope of this report that AOAV’s recommendations help highlight the urgent need for these best practises to be put into action.
DATA TRENDS FOR EXPLOSIVE VIOLENCE AND DISPLACEMENT
As expected, AOAV found a clear trend in the levels of explosive violence and the levels of IDPs and refugees fleeing from the most impacted countries. We acknowledged, however, that there are other factors that can influence the level of refugees and IDPs – such as ethnic violence or the state response – but explosive violence is consistently shown to be a significant cause of refugees. To the right, you can see the figures of casualties, refugees and IDPs from five of the six most impacted countries from explosive violence between 2011-2015.
Syria: Overall it can be said that as levels of explosive violence in Syria have increased from 2011-2015, so too have the number of Syrians living outside of the country’s borders. The widespread threat of explosive violence has also led to large numbers of people being internally displaced, some of them on multiple occasions.
Iraq: the direct correlation between explosive violence levels and the number of refugees from Iraq is not as strong. A correlation, though, between explosive violence and displacement does still seem to be the case, although not as clear as in other affected countries.
This is perhaps due to the fact that Iraq has been in a state of insecurity and conflict for many years, meaning that population displacement is sadly well entrenched and current displacement is driven by a variety of factors that are often related to changing dynamics within the country.
Pakistan: a comparison between explosive violence and population displacement in Pakistan shows a convincing pattern of correlation. This correlation was notably apparent between 2011-2012, when explosive violence levels went unchanged, something matched by an almost unchanged number of displaced persons.
Afghanistan: in Afghanistan, from 2011-2015, a persistently high level of explosive violence has been matched by a consistently high number of Afghan refugees, with Afghanistan maintaining its status as being historically one of the largest producers of refugees.
Nigeria: In Nigeria, there appears to be a clear link between the level of explosive violence and the number of people fleeing the country. There are also huge numbers of internally displaced persons in Nigeria, with 2.1 million IDPs in 2015. However, data on IDPs in Nigeria was not available prior to 2013, making it difficult to establish a long-term trend.
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