The mental health and psychosocial impact of the Bougainville Crisis: a synthesis of available information

Abstract

BackgroundThe Bougainville Crisis (1988–1997) was the largest armed conflict in the Pacific since WW-II. Despite this, there has been no assessment of the Mental Health and Psychosocial (MHPS) impact of the war. The aim of this paper is to summarize the available data regarding the longer-term MHPS impact of the Bougainville Crisis.MethodsA literature review and a sequence of consultations in Bougainville were conducted to identify the MHPS impact of the Bougainville Crisis and the capacity within Bougainville to address these issues.ResultsThe Bougainville Crisis resulted in violence-related deaths; the displacement of more than half of the population; widespread human rights abuses; far-reaching societal impacts including undermining of the traditional authority of elders and women and damage to cultural values and relationships; property damage; and significant impacts on education and the economy. Conflict-related experiences continue to impact on mental health in the form of trauma-related symptoms, anger, complicated grief, alcohol and substance abuse, domestic violence including sexual assault, excessive alcohol use and a lack of engagement in purposeful activities. Other impacts include an increase in other forms of gender-based violence (including sexual assault), population displacement, and adverse trans-generational effects on children exposed to disturbed parental behaviours attributable to conflict exposure. In spite of the evident needs, there is limited capacity within Bougainville to address these pressing MHPS issues.ConclusionsThe Bougainville Crisis has had a significant MHPS impact at multiple levels in the society. There is a strong interest within Bougainville to draw on external expertise to build local capacity to address MHPS issues. Preliminary recommendations are made to assist the process of building the capacity in Bougainville to address MHPS needs.

Estimating Adult Mortality in Papua New Guinea, 2011

“…The northern region (Morobe, Madang, East Sepik) and Bougainville reported moderately high levels of male 45q15. Bougainville was affected by a 10-year-long civil war between 1989 and 1998 which resulted in 15,000-20,000 deaths, mostly men [43]. Central province, despite surrounding the National Capital District, includes Goilala and Rigo, two of the most remote and least developed districts in districts in the country [15, 38].…”

“…Particularly, large differences in male versus female adult mortality were found in Western, Southern Highlands/Hela and Bougainville. While the civil war on Bougainville could have resulted in high male than female adult mortality, high rates of violence and tribal conflicts in Hela and Southern Highlands could be the reason for the comparatively high excess male mortality compared with females [43, 44].

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The Bougainville referendum through the eyes of the ‘lost generation’: Observations from Siwai

“…Although those born during the conflict did not participate in fighting, they likely possess a substantial living memory of the events that unfolded (Kent and Barnett, 2012: 38), including human rights abuses and displacement into care centres (Tierney et al, 2016: 5). Additional to personal trauma, Tierney et al (2016: 1) highlight the transgenerational effects of exposure to problematic parental behaviours attributable to conflictrelated suffering. This is thought to have contributed to the 'weakening of family and community structures, absence of customary guidance and role models previously provided by traditional authority structures' (Tierney et al, 2016: 5).…”

“…Government [ABG], 2018[ABG], -2022Joint Technical Team, 2018: 71); fiscal self-reliance has not been reached (Chand, 2018); safety services for women and children are inadequate (ABG, 2018(ABG, -2022; and individuals and communities continue to experience the lingering impacts of conflict-related trauma (Tierney et al, 2016). Particular concerns have been raised about the social and economic security of Bougainville's large youth population (ABG, 2018(ABG, -2022.…”

“…Particular concerns have been raised about the social and economic security of Bougainville's large youth population (ABG, 2018(ABG, -2022. Those born during the conflict are referred to disparagingly as the 'lost generation' (Tierney et al, 2016), 'crisis generation' (Kent and Barnett, 2012) and 'confused generation' (Roka-Matbob and Hill, 2018: 104), many of whom grew up with limited or no formal education nor basic health care (Chand, 2013: 1). Calls have been made for increased participation of young Bougainvilleans in 'all aspects of Bougainville life' (ABG, 2018(ABG, -2022, to promote both individual and community well-being.…”