The elderly Kashmiri farmer had never enjoyed the best of health. But when his teenage son was shot dead by troops who suspected him of being a militant, things took a sharp turn for the worse. Mohammed Parray's epilepsy attacks became more frequent and his moods turned increasingly aggressive. Even now, seven years later, he still snarls whenever soldiers pass.
"He has no reason, no insight," sighed his wife, Taja, as Mr Parray sat quietly, brushing tears from his mottled face. "I do not speak up, I do not blame him. I know this is something that he has internalised. If I don't understand him, who will?"
Across Kashmir, it sometimes feels as if everyone is on the brink of tears. A two-decade-old separatist insurgency combined with an overwhelming response from the government that has transformed the valley into one of the most militarised locations on earth, has also left it one of the most traumatised. In 1989, when the insurgency started to gather pace, around 1,500 people annually sought help for mental health issues. Today the figure is closer to 75,000.
"Everybody here is affected. Either they have witnessed something or else they know someone who has suffered," said Dr Henna Hejazi, a mental health expert with the charity ActionAid. "Depression has become a common malady. Elsewhere in the world, the level of post-traumatic stress disorder stands at three per cent, but in Kashmir it is eight."
This trauma manifests itself in different ways. Suicide attempts are common, while the level of anxiety and phobia is high. In rural areas, experts say there are many instances of obsessive behaviour, such as the repeated washing of hands. And in a society dominated by men, it is very often women who suffer the most; the 20 years of fighting that has left at least 80,000 people dead has also created up to 35,000 widows or "half-widows", those whose husbands disappeared but whose bodies have never been found. Worse of all, nobody likes to talk about the problem, to admit to their fears.
Slowly, organisations such as ActionAid, which is one of the charities featured in this year's appeal by The Independent, are addressing the issue of mental health, funding and training specialists and setting up workshops and outreach sessions in some of Kashmir's most remote areas.
And engagement can make a difference. Mr Parray, from the village of Chowan and whose son's bleeding body was brought back to his house by neighbours, said that since attending hospital sessions set up by ActionAid and agreeing to a course of drugs, his situation had improved. "It has given some relief to me," he said.
A trip into rural Kashmir is a journey through a land of shadows. Though the levels of militant violence has fallen off in the past couple of years, everywhere there are reminders of the area's troubled past and its uncertain future. Paramilitary forces ride around in the rear of open trucks, automatic weapons pointing in every direction; barbed wire and sentry posts surround police and army camps; and foot patrols of soldiers move through the thin winter light like a phalanx of ghosts. To a newcomer it is instantly disconcerting; for those who have had no option but to endure it for years it must grate at the soul.
At a house in Asham, between Srinagar and Baramulla, where the women of the village were meeting with ActionAid staff for assessments, a grey-haired, 75-year-old woman called Mugli revealed how, 16 years earlier, she had lost her three sons within seven months. One was a militant and was killed after he returned from training camp inside Pakistan; the other two were also apparently killed by former militants, or renegades, who claimed they were also linked to the insurgency. They were killed, mutilated and their bodies hanged, one in a mustard field, the other in a rice paddy. The youngest was aged 16.
"I did not know that my first son had gone to Pakistan," said the woman, who could not stop crying. "He returned after nine months with severe frostbite. The moment he came back he was killed by the renegades." "After my first son was killed," she added, chillingly, "I went to the renegades and pleaded with them not to kill the others."
A member of the ActionAid staff said that in addition to constantly crying, Mugli was suffering from restlessness and sleeplessness. She was also unable to stop unsettling flashbacks. "We have to resolve her grief. It has not gone, it is overwhelming her," said Dr Hejazi. "We must make her relive the experience. The more she ventilates, the better. She needs to blurt out, she needs to cry."
It soon became apparent that Mugli's experience, while perhaps extreme, was not unique. A woman called Merha Gaffardar who wore a bright orange headscarf, was also weeping. She told how her son, a one-time militant, was killed six years ago. Her husband was dead and her daughter was married and had left home. The old woman said she was asking the charity for a cow, something it occasionally offers as part of a parallel project designed to help boost people's livelihoods. "A cow will also be my friend," said Mrs Gaffardar. "I'm alone. I get scared at night."
One of the most remarkable stories came from the lips of Zareetha Ahmed Shah. Her husband, also a militant, was killed 15 years ago and she had gone to live with her in-laws. One night, unidentified men stormed into their home and started shooting. Her father-in-law, brother-in-law and sister-in-law were all killed but, remarkably, Mrs Shah and her two children survived. Now she was having to care for her in-laws' children as well.
Mrs Shah's case notes said she was suffering was flashbacks, depression, suicidal thoughts and general helplessness. "After the shootings, I felt like roaming from village to village and cutting off all my clothes," she said. "[Now], I speak with friends and I feel some relief by sharing my thoughts. Also it helps when I am praying."
Everyone in the frigid, unheated building had a story to tell, a tale of anguish. The women said the worst years of the militancy played out during the 1990s when their village was turned into a war zone and there was a lot of pressure on local people to take up arms against the government forces. "It used to catch us unawares," said one woman, describing how sons and husbands would disappear for up to six months training in Pakistan. "They would leave without saying anything."
Another woman, Taja, said that it was still hard to let go of the fear and uncertainty. "The militancy has died down, now it has washed off," she said. "But even now if we hear a bang or door slam, then we jump."
It is probably the most traumatised place in the world. But with the help of organisations like ActionAid, something can be done to assuage the pain.Reuse content