THE AFTERMATH OF THE SHELLING OF THE FIJIBATT, QANA

‘The Israeli Grapes of Wrath operation into South Lebanon began on the second week of April (1996). As the conflict started to escalate the UNIFIL AO situation became tense as the status of the alert changed from Yellow to Red with every Kytusha attack by the Hizbollah, and retaliatory fire from Air, Artillery Tanks and Gunship by the Israeli Defence Forces (IDF). Refugees began to filter into FijiBatt UN positions fleeing for their lives. About 2500 civilians took refuge in FijiBatt with more than 800 sheltered at the HQ compound in Qana.

Since most refugees came with what little they could gather, the soldiers had to make provision for shelter; bedding and food which was barely enough for a crowd five times their own number. As the days passed by, continuous shelling by the IDF began to take its toll. An ambulance carrying women and children was blown off the road at CP1-23 (Sarafui), killing its occupants and injuring others. Rescue work and body handling were done by FijiBatt soldiers. 0n the eighth day of the conflict, FijiBatt HQ in Qana came under heavy shelling. Three of the shells scored direct hits into the refugee concentration shelters. More than seventy deaths were account for, many, burned beyond recognition. Four Fijian soldiers suffered severe injuries. There were about 150 military personnel in the HQ compound at the time of the shelling. Most if not all were exposed to various stressors which resulted in the development of many stress reactions.’

This report covers the assessment of these stress reactions, the initial coping strategies, the psychoanalysis and screening by a Stress Management Expert, the counseling and follow-up management protocol.

Stressors

Traumatic stress is the result of a single sudden and violent assault which harms or threatens an individual or someone close to him, either physically or psychologically. These stressor dimensions were observed and experienced by the Fijian peacekeepers at the FijiBatt HQ in Qana on that fateful April afternoon:

A. Being a powerless spectator of a massacre where about 100 refugees were killed in front of their very eyes.
B. The destructive shelling of buildings only a few metres from where they stand.
C. The shock wave of nearby exploding shells.
D. The mass casualty situation.
E. The seriousness of their comrades' injuries.
F. The mutilated bodies of the dead and body handling.
G. The intrusive smells of blood, burnt flesh and spewed gut.
H. The unbelievable, unprecedented shelling of FijiBatt HQ by the IDF.

Some of these stressors had taken toll during the time of the shelling, resulting in reaction of the "shell shock" type. The most severe stressors were found to be danger, loss and exposure to the grotesque. It was only a matter of time before the full impact of the stressors were felt.

Active Stress Reactions

Although the range of emotional reactions to trauma is limited, such reactions may vary from one individual to another. The time it takes for these reactions to appear, and their severity, depends on the character and vulnerability at the time. Those observed with the affected Fijian soldiers developed gradually but persistently for the first few days and subsided just as gradually.

Numerous reactions indicating stress disorders which the complainants volunteered are as follows:

A. PHYSICAL
i. Nausea
ii. Fatigue
iii. Muscle tremors and jumpiness
iv. sleepiness / nightmares

B. COGNITIVE
i. Confusion
ii. Difficult concentration
iii. Decision making difficulties
iv. Memory problems
v. Accelerated thought processes
vi. Slowing of thought processes

C. EMOTIONAL
i. Fear, anxiety
ii. Anger, irritability
iii. Feelings of guilt, grief, hopelessness
iv. Numbness
v. Depression
vi. Flashbacks

BEHAVIOURAL DISORDERS which often accompany the physical, emotional and mental reaction above were also observed in some subjects which included the following:
i. Hyperactivity
ii. Overwork
iii. Angry outbursts
iv. Dangerous driving
v. Senseless arguments etc.

Coping Strategies

I must say that we were lost the first few days after the disaster. No one was willing to admit boldly that there was an existing acute stress reaction amongst our men. More importantly we had no prior training on how to deal with a situation like this. Our only tool was our initiative.

Fijians have big egos. They have a reputation of being "macho". They are also very sociable and they live simply. They can be very open and also very protective. They value their traditions and culture and are proud of their confessional system.

To deal with such individuals, one must obtain a good historical background and must understand his culture and traditional values. After the first few days, stress symptoms became too obvious to ignore. Those that did seek help at the Regimental Medical centre were counseled and advised on the do's and don’ts.

The following strategies were implemented in the hope of reducing the psychological impact of the stressors on the soldiers.

• Daily work routines were re-established as soon as possible.
• Daily church services were encouraged to boost the level of faith and to enhance group support.
• The traditional "Kava" sessions in the evenings were stimulated by relaxing the rules. This is an exceptional occasion where officers and soldiers can sit together, share the "Kava" bowl and join in the serenades. These sessions remind the men of good comradeship and elevate morale.
• Participation in sporting activities after working hours were encouraged.
• Soldiers were also advised to have a good rest whenever possible. Leave was also recommended to those who had leave due and pending.
• Command elements were advised to increase contact with their men and to increase extra caring.
  

PTSD Screening

Two weeks after the Qana disaster, a group of psychologists was sent by the UN following our request to do an assessment of our soldiers. This was the Norwegian Stress Management Team who had previously done a UNIFIL study on the subject. On their three days of screening of FijiBatt, a total of 39 soldiers were seen. Their report showed a prevalence of 30% suffering from a Traumatic Stress Syndrome.

(The detailed screening report is not included in this article)