Nairobi, Kenya - Cecilia Langat completed the last of her harrowing day’s work at the makeshift trauma counseling centre set up for shell-shocked victims of the Westgate mall attack in Nairobi.
Since the start of her busy shift Wednesday - the first day of a three-day national mourning period for the victims of the deadly siege - Langat reflected on the pain expressed by people who sought out counseling services.
Many victims suffered severe emotional trauma from their terrifying ordeal, after gunmen randomly sprayed civilians with automatic weapon fire and lobbed hand grenades into fleeing crowds. The mall assault killed more than 70 people, but the death toll could go up significantly as authorities clear the burned out shopping centre.
In my examination, I have seen people whose loved ones were trapped or missing. There are those who feel angry and blame themselves for not doing enough to protect their loved ones. There are those who ask ‘why did that happen to them, why not another person?’
As soldiers battled the al-Shabab attackers at the upscale Westgate Mall, a unit of counselors engaged the mental anguish of those who managed to escape with their lives. Staff from the Kenya Red Cross and the Kenya Psychological Association were based at a makeshift location at Uhuru Park, not far from the scene of the urban assault.
"We have cases of people coming for counseling who witnessed very horrific things in the mall," said psychologist Dr Oscar Githua. "People who saw others shot - their friends, relatives and loved ones - during the siege. If you see them they do not have physical wounds, but they have deep psychological wounds."
Githua said there were a range of different reactions from victims of the attack.
"We have seen people who have sleepless nights, others had difficulties talking, others suffered loss of memory and are very angry and agitated," he said.
Psychologist Munira Ahmed has treated patients for the past 30 years. She also told Al Jazeera she witnessed Westgate victims coping with their ordeal in a variety of ways.
"In my examination, I have seen people whose loved ones were trapped or missing," Ahmed said. "There are those who feel angry and blame themselves for not doing enough to protect their loved ones. There are those who ask ‘why did that happen to them, why not another person?’"
Things from the past
In their examinations, several mental health workers also discovered that many mall siege victims were also suffering psychologically from past events, such as the deadly post-election violence that rocked Kenya in 2007-08.
Langat relayed the story of a man who sought counseling services after suffering a breakdown while retrieving bodies from Westgate’s carnage. Because of privacy concerns, he’ll be described as David, 43, for this story.
David lost his 19-year-old son during Kenya’s post-election violence six years ago, in which as many as 1,400 people were killed. A volunteer with the Kenya Red Cross Society - which did most of the rescue and body retrievals from the mall - he suffered a relapse after pulling the body of a 19-year old victim of gunshot wounds out of Westgate. The teenager bore a stunning resemblance to his dead son, David had said.
He broke down after remembering what had happened to his son years ago, a clear indication his emotional scars had yet to heal, said Langat.
|More than 70 people died in the mall siege [EPA]
Several counselors told Al Jazeera those who sought their services suffered mental trauma related to recurrent violence and insecurity in Kenya.
"The country is in a lot of pain starting from 2008 post-election violence, tribal clashes in some parts of the country, insecurity," Githua said. "These things haven’t been addressed, and in the process of counseling people affected with the mall attack, we found ourselves addressing things of the past."
Learning to cope
Ahmed said attacks such as the Westgate siege often lead people to engage in harmful behavior to cope with their experiences. She recommended that victims seek out support and professional treatment early.
"You will find some people taking pills, other drinking alcohol so that the pain can go away. That will help for a short term, but the trauma will haunt you. It is better one goes for counseling," she said.
Ahmed said she counseled at least 10 victims of the Westgate assault over two days at her private clinic.
"There are those who get traumatised immediately after witnessing a horrific accident or attack. But there are those who feel the pain much later," she said.
One female victim, for example, didn’t begin to feel the emotional repercussions for three days after she managed to escape the al-Shabab assault. "The case with the lady I examined, she felt the psychological pain the third night after the attack," said Ahmed.
I thank the doctors, nurses, counselors and other volunteers who thought nothing of their comforts and personal engagements when called upon to be their brother's keepers.
Victims stuck with painful memories for more than a month are suffering from post-traumatic stress disorder, the health professionals said.
Marysnayder Kamau, 21, is a member of local charity group Hakuna Kulia (No Cry), which provides assistance to Nairobi’s impoverished neighbourhoods. She volunteered to help victims anyway she could.
"It makes you feel useful," said Kamau. "During my three days at the park, I learnt first aid and blood handling. This will make me useful in future emergencies."
At the end of their eight-hour shift, several counselors gathered outside the makeshift clinic in Uhuru Park and shared their experiences after treating hundreds of traumatised Kenyans.
President Uhuru Kenyatta, who also lost relatives in the attack, praised those Kenyans who stepped forward to help victims through their ordeal.
"Amid the horror and confusion of the past few days, you have found it in yourselves to be incredibly strong and generous," the president said.
"I thank the doctors, nurses, counselors and other volunteers who thought nothing of their comforts and personal engagements when called upon to be their brother's keepers."