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Health Care and Restorative Justice

By Zergabachew Asfaw M.D, FACP

On January 7, 2022, Ethiopian Christmas holiday, several political prisoners were released and following this phenomenon the Ethiopian attorney general, Dr Gedeon spoke about the need for restorative justice in this nation.  This made me think of the absolute necessity for restoring health in communities that were destroyed due to social violence and war, in order to bring restorative justice within affected societies. I would like to examine the scope of the problem and suggest possible remedies. It is a very complex issue that requires complex solutions.

War and violence destroy the basic fabrics of a society. War results in long term physical and psychological harm to children adults and the elderly. It also diminishes the material and human capital. War causes more mortality and disability than any major disease. Ethiopia has witnessed the devastating effects of war and violence over the last few years. Even now, it is an ongoing situation. Wherever it happens violent behavior cannot be justified. I would like to give a few examples of the communities that were affected due to violence.

The extent of the problem cannot be explained by the number of health care facilities damaged alone. However, if we look into the number of health centers destroyed, 453 in Amhara region,19 in Afar,39 in Oromia,5 in Benishangul as of December 2021. The number of hospitals damaged is 40 in Amhara region and one in Afar region. According to Ethiopian Red Cross Association several Ambulances were looted by Tigrayan forces. A total of 214 ambulances were nonfunctional due to the conflict:131 in Amhara, 29 in Afar,9 Oromia,39 in B/Gumuz, 6 in Somalia. This is only structural damage, but mental and psychosocial damage is beyond imagination. We need thousands of mental health care workers to rehabilitate women who were raped, children who lost their parents and adults and the elderly who lost their livelihoods.

Based on the information I gathered from individuals who traveled to Afar and Amhara regions during my stay Addis in January 2022, several women were victims of rape.  Many homes and schools were destroyed. Thousands were killed or injured due to the war. The scope of the problem is beyond material rehabilitation.

A lot has been written on the effect war on mental health of the affected population around the world. Lessons learned from major conflict regions such as Afghanistan, The Balkans, Cambodia, Chechnya, Iraq, Lebanon, Palestine, Rwanda, Somalia and many others should help the world learn the devastation and aftermath of war.    During the second world war, Institute of Mental Health was established in the US to study and alleviate stress among military recruits and military personnel. Mental health organizations and institutes need to be established or expanded in Ethiopia to study and handle the impact of war and violence in the nation. This is not politics, but it should be an action taken to heal the nation.

The scope of restorative justice is very wide. It must address safety of a community and community development and accountability. It takes into consideration the damage inflicted on the victim, and the offender must face legal consequences. The main goal of restorative justice is to bring a community to a balanced and peaceful state of affairs through involvement of all parties based on mutual respect and understanding. It must utilize socioeconomic, spiritual, cultural and other social fabric to bring about justice for all.

Restoring optimum mental health in a community requires cognitive behavioral change that leads to empathy. This action can lead to healing at every level. The damage that has taken place in Ethiopia is very extensive. Everybody must participate in this journey of restoring peace and justice.

 

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