Ian Timberlake, Banda Aceh – Civilians in Indonesia's Aceh province show levels of combat-related stress, depression and anxiety comparable with those in Afghanistan and Bosnia, researchers say.
The International Organisation for Migration (IOM) conducted the study with Harvard Medical School's Department of Social Medicine and Aceh's University of Syiah Kuala.
IOM spokesman Paul Dillon said Aceh faced a "mental health crisis" that could jeopardize reconstruction after the December 2004 tsunami.
The university said it was the first systematic survey of communities severely affected during 29 years of conflict between Indonesian forces and separatist rebels of the Free Aceh Movement (GAM), which left nearly 15,000 people dead.
"Psychological symptoms in this population are extraordinarily high, ranking with post-conflict populations in settings such as Bosnia or Afghanistan," the 58-page report said.
Both sides reached a peace deal in August last year, which led to local elections Monday. A former rebel is expected to be confirmed as the Indonesian province's new governor.
Researchers surveyed 596 people last February in 30 villages selected randomly in Pidie, Bireuen and North Aceh districts, which were heavily affected by the violence.
They found 78 percent of respondents reported experiences of combat including bombings and firefights, while 47 percent were forced to flee danger and 38 percent fled burning buildings.
"The first and most overwhelming finding of the survey is that members of the three districts experienced remarkably high levels of traumatic events," the report said. It found 41 percent reported a family member or friend killed, and another 33 percent reported friends or family had disappeared.
Thirty-nine percent reported beatings to the body, 26 percent were attacked with a gun or knife and 54 percent witnessed physical punishment, it said. A separate finding said 48 percent of young men between 17 and 29 received beatings to the head.
"Rates of head trauma and potential brain injury... are extraordinarily high and deserve clinical interventions and further research," the report said.
Eighty-two percent said they had lacked food and water because of the conflict. "These statistics provide clear evidence of the magnitude of suffering and terror experienced in these communities," the report said.
Respondents reported abuses including "suffocation with plastic bags, public displays of sexual humiliation, drownings in septic tanks and sewage canals, and being forced to injure or humiliate friends and loved ones".
The survey did not ask who might have been responsible for the violence, but rights groups have previously blamed most of it on government forces, which heavily outnumbered the rebels.
The report said 65 percent of the sample ranked high for depression symptoms, according to accepted international protocols, while 69 percent ranked high on anxiety symptoms, and 34 percent for post-traumatic stress disorder. Many respondents suffered from complex trauma resulting from years of violence and insecurity, the report said.
Despite the findings, it said the affected communities "remain strong and highly resilient". But it recommended the international community recognize the urgency to provide mental health services to communities most affected by the conflict.
The study aimed to gather data which could be used to develop treatment programmes.
More than 168,000 people died when the Indian Ocean tsunami hit Aceh, sparking a massive international aid and reconstruction effort, and providing the impetus for last year's peace accord.