In a tiny room where much of the space has been gobbled up by a steel cupboard, a bed and a sewing machine, Ayeshabibi Pathan sits on the floor, reminiscing about the dhamaal of five years ago, and the instant in which her life changed forever. "A bullet killed my husband," she says. "We don't know if the police fired at him, or if the mob did. The mob had all kinds of weapons, and the atmosphere then was such that you didn't know who was doing what."

In the statistics put out by the Gujarat Government, Ayeshabibi's husband is just another number that adds up to what activists say is an understated figure of over 1,000 people killed in the riots of 2002 (a majority of them Muslims). In her household in Faisal Park, Ahmedabad, located in a neighbourhood where riot victims have been rehabilitated by a non-government agency, his death is an immeasurable, palpable loss, and grief a shadow persistently knocking at the door.

Post Traumatic Stress Disorder

Post Traumatic Stress Disorder (PTSD) is a mental health problem that can develop after exposure to stressful events such as natural or manmade disasters.

According to the study on PTSD among riot-affected children and adolescents done by the Psychiatry Department at the Civil Hospital, Ahmedabad, lack of social support can be a factor leading to PTSD and psychiatric disorders.

The disorder manifests itself through a host of symptoms such as irritability, sadness, fear, sleep disturbances, difficulties in concentrating and feelings of guilt (in survivors), among others.

The study says that a manmade traumatic event creates more anger and irritability as compared to a natural disaster because the former is considered "eminently controllable or wilful".

While the children and adolescents interviewed for the study did not have guilt feelings, the traumatic events remained alive in the minds of many.

 •  Orphaned by rioting
 •  Mental health care needs help

Ayeshabibi was a resident of Naroda, where over 80 people were killed in a horrific massacre during the riots. Her own house was looted and burnt. With her children, she sought refuge in the Shah Alam relief camp and eventually moved to her current house. Trying to pick up the threads of an earlier life, she sent her children to a school nearby. But her daughter Tahira wasn't interested in her studies. "She had studied till the seventh standard in a municipal school in Naroda. She was very bright, a good student. But after the dhamaal, she failed in her exams," says Ayeshabibi. Tahira couldn't pass the tests in the new school either, though she attended classes for two years. "She says she doesn't want to study," says the distraught mother, adding as an afterthought, "She keeps remembering her father." Ayeshabibi's 14-year-old son goes to a school in Raigarh. "We didn't want to send him outside," she says. "But he didn't want to study here. Even now, he tells me that he will never come back to Ahmedabad."

Five years have passed after the riots, five years in which saplings have become trees and blueprints have taken the shape of buildings. But time seems to have stopped for many like Ayeshabibi and her children, for whom a monstrous yesterday has become an inextricable part of their today and tomorrow, altering their dreams and hopes in unlikely, distressing ways. Children and adolescents, many of whom suffered or witnessed atrocities during the riots, continue to live in an environment of insecurity and fear that appears to be subtly nurtured by the Gujarat Government, whose complicity in the communal violence is an established fact.

Most of the riot victims live in poverty, and while deprivation is visible, their pain and sorrows seem to have had a more intangible but real impact on their mental health. According to a study on Post-Traumatic Stress Disorder (PTSD; also see box) in children and adolescents affected by the communal violence, conducted in February 2006 by mental health professionals belonging to the Psychiatry Department of B J Medical College and Civil Hospital, Ahmedabad, close to five percent of the 255 interviewed showed signs of the disorder even four years after the riots; 9.4 per cent suffered from depression.

Dr Girish Banwari, co-author of the study and resident doctor at the Civil Hospital, says that most of the children and adolescents interviewed — from Ahmedabad, Mehsana, Vadodara, Anand, Panchmahal and Sabarkantha — had lost their fathers; their mothers did semi-skilled work or were homemakers. Hundred and ninety eight of those interviewed were Muslims; the rest comprised Hindus. Over 65 percent hailed from families whose monthly incomes were less than Rs.1,000.

"We saw most traces of that time in adolescents," says Banwari. "They definitely miss their fathers, they feel their lives would have been different — and better — if their fathers had been there." Many are afraid that something terrible could happen again. "A few children said that even a cracker bursting at Diwali made them afraid. Besides, in Ahmedabad, indeed in all of Gujarat, small issues that take communal overtones keep cropping up all the time," Banwari adds.

The genesis of the study in itself points to a problem that has up till now been more or less ignored. According to Dr G K Vankar, head of the psychiatry department at the Civil Hospital and the principal author of the study, the research was done on the request of the non-government organisation Self Employed Women's Association (SEWA). The organisation's staff, who works with the riot-affected, felt that several children had become "rebellious", says Vankar. "The children were not obeying their mothers, they were not studying," he adds.

Samina Ghotlawala, health coordinator at SEWA, which has been working with riot-affected widows in Gomptipur, Juhapura, Vatva, Bapu Nagar and Danilimda areas in Ahmedabad, says that the organisation has been providing the women with counselling services and making them independent. While there had been a marked improvement amongst those SEWA worked with, a few of the children seemed to have certain problems. "Some were good students earlier but are not studying well now. Some children have started stealing things, some don't want to study at all," she says. The study was an attempt to trace whether the riots had caused the behavioural changes.

The diagnosis of mental health problems, though much neglected, is important because these could affect the quality of life, and studies, says Vankar. In fact, while PTSD itself was identified only in a certain percentage of those interviewed, many exhibited some symptoms of the disorder. Explains Vankar, "To make a psychiatric diagnosis, there are a specified number of symptoms that have to be present for a certain amount of time, there has to be an impairment of functions. We have seen a number a manifestations that fall short of a diagnosis, which means the person hasn't reached the threshold to call it an illness." At the same time, this does not mean that the child or adolescent doesn't have any symptom of a mental-health problem. Of the 255 interviewed, 50 showed some symptoms of the disorder. Though they were not diagnosed with PTSD, they did require the help of mental health professionals, says Banwari.

Dr K Sekar of the National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bangalore, says that a study conducted soon after the riots in 2002 showed that except for three percent, the riots had an impact on all the 100 children interviewed in the relief camps at Shah Alam and Dariya Khan Ghummat. Many girls had been sexually assaulted; the boys didn't want to go back to their homes where they had been manhandled by rioters.

Many children say they don't go back to school because their parents, or they themselves, are afraid and feel unsafe.