“We are disturbed mentally. I have a son. I can’t even sleep at night. He says he will go and fight,” Laila Ibrahim of Pakistan’s Kurram tribal district tells VOA by phone.
Surrounded by Afghanistan on three sides, the district in Pakistan’s northwestern Khyber Pakhtunkhwa province has been largely cut off from the country, the highway connecting it to the rest of Pakistan closed to traffic since a deadly wave of sectarian violence between Shiite and Sunni tribes erupted in mid-October.
Medical staff tell VOA that Kurram’s besieged residents, facing severe shortages of food and medicine, are showing signs of malnutrition and deep mental distress.
“We saw that most of the population has gone toward malnutrition,” district health officer Dr. Qaiser Bangash, who led a survey of health conditions in the region’s hard-to-reach villages, told VOA by phone from Parachinar.
“They don’t have vegetables, fruits, lentils, clarified butter,” he said. “They cannot find milk. There is no formula milk for children. Because of this, the situation is quite bad.”
In the absence of regular food deliveries, he said, people mostly get by on boiled rice, plain wheat bread, tea without milk and sugar, and locally grown seasonal produce.
Wave of violence
Nearly 250 people were killed in Kurram’s sectarian violence between July and December of last year. After scores were killed over the summer and fall, Nov. 21 marked a sharp escalation, when a convoy of Shiite passengers was targeted, killing 52. No group claimed responsibility for the massacre, but retaliatory attacks saw nearly another 80 killed within a matter of days.
Kurram’s violence is rooted in historic land disputes between Shiite and Sunni tribes but often takes a sectarian bent. More than a century of competing security interests coupled with militancy spilling over from wars in Afghanistan have pushed each side to heavily arm itself.
The targeting of the Shiite convoy in November followed an Oct. 12 attack on Sunni residents.
Supply shortages
Since the deadly October attack, few trucks carrying essential supplies have entered the region from the major entry point in the south.
A convoy carrying mostly fruits, vegetables, and poultry arrived Wednesday after being delayed for days over threats of violence. What arrived was expensive and partly spoiled because of the hold up.
Few got their hands on the limited supplies.
“We could not buy anything. It was so busy, people were pushing each other,” Mehwish Shazad, a Parachinar-based mother of three told VOA on the phone.
Villagers traveling to the city for supplies didn’t have much luck either.
“The vehicles arrived in the evening. There’s no diesel or petrol that could enable people from villages to come to the city to purchase the goods,” local journalist Hidayat Pasdar told VOA.
“By the time people arrived from the villages, locals living in the suburbs had bought everything,” said Pasdar. “There was nothing left.”
A 25-vehicle convoy carrying food supplies arrived Tuesday. Pasdar said that’s half the number of vehicles that were expected.
Pharmacy shelves are almost empty.
With smaller clinics unable to provide medicine, patients are increasingly turning to the district headquarters hospital in Parachinar. Bangash says the patient load has more than doubled.
Although government and aid groups have delivered tranches of medicine via helicopter, the quantities, Bangash said, aren’t sufficient.
“Even with hundreds of trucks, it will be hard to cover the gap that has occurred,” said the physician.
Psychological scars
The violence is also causing deep psychological pain.
“Mostly there were cases of depression — anxiety, too — and phobia,” said psychologist Kalsoom Bangash. “Children have become phobic. Those who have been displaced were worried about how they will set up everything again when they go back.”
The psychologist was part of the team of medical professionals that surveyed the medical needs of local communities, providing mental health support to women and children displaced by violence.
Even those not displaced by the violence are living in constant fear.
“I have noticed that when children play, they worry a bullet may come flying from somewhere,” psychologist Bangash told VOA. “If they hear a sound, they say it’s the sound of a bullet.”
Delicate peace
On Jan. 1, warring Sunni and Shiite tribes reached a 14-point peace deal, after weeks of government-led negotiations.
Despite a January 5 gun attack on a government convoy that injured the Kurram deputy commissioner, a tenuous peace has remained.
On Monday, security forces began destroying bunkers that armed fighters from both sides have erected across the region. Rivals have also agreed to disarm.
Prime Minister Shahbaz Sharif expressed hope Tuesday the peace would hold. Successful implementation of the deal would mean people and goods will once again move across the district, likely under heavy security.
For Ibrahim, peace means her 15-year-old son may have a future other than as a fighter.
“I want him to get a good education, but he can’t get it because the school is shut down again and again,” the mother said. “His lessons get disturbed. I get disturbed.”
