Introduction
Events of terror and violence are not instantaneous, meaning that their effects stretch for prolonged periods of time. There have been many cases in human history when victims of terror, after surviving violent events, struggled with consequences for many years. This paper provides an overview of scientific evidence on the issue and discusses the case of a woman who survived the Japanese comfort station. A comparison between theory and the actual case is made in order to promote the claim that terror leads to mental health issues that will pursue the victims for the whole life, but such consequences can be moderated by external support and emotional intelligence.
Theory
Overview
The number of extreme events and health-threatening situations has been growing continuously for many years. This constant increase requires that the scientific community studies the health impacts of these terror-causing cases as a separate field of health sciences. When inspected in general, terrorist acts and other violations have both long-term and short-term health influences on victims (Mohanti, 2017). These health outcomes are comprised of both physical injuries and psychosocial complications. Furthermore, impacts can be considered at an individual and a societal level (“Effects of Terrorism,” 2018). In most cases, current scientific evidence emphasizes the magnitude of stress-related conditions, while physical injuries are common during accidents (“Effects of Terrorism,” 2018). However, it is important not to dismiss the fact terror is often accompanied by physical distress. Trauma can be obtained not only from witnessing a frustrating scenery but also from receiving continuous physical abuse.
Individual Level
In terms of physical health, victims of terror may have issues in sensory organs, may develop a disability, chronic conditions related to pain, including problems with the back and tissue. Disturbances in the cardiovascular system and respiratory organs are also common (“Effects of Terrorism,” 2018). Sexual violence introduces another layer of physical health outcomes. Urological, gynecological, and genital conditions are among the typical results of rape and other forms of sexual disturbance. In most cases, victims are forced to engage in unprotected sex, which may cause a plethora of sexually-transmitted diseases, including HIV (“Effects of Terrorism,” 2018). Pregnancy and miscarriage are also among the possible results of rape, which may, in turn, lead to issues in the reproductive system (“Effects of Terrorism,” 2018). It is evident that the range of possible physical health outcomes is extensive. However, most scholars stress the importance of studying impacts in terms of mental health because they often bring long-term complications that affect both an individual, a society, and subsequent generations.
People that have experienced terror often develop psychiatric conditions, such as acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). Both ASD and PTSD are transient reactions to external events – in other words, these conditions do not last for prolonged periods, and their effects decline over time (Bryant, 2017). However, it is incorrect to consider them as light consequences because of their symptoms. ASD is a range of unpleasant reactions that may occur shortly after an offensive event. Symptoms include respiratory issues, such as difficulty breathing, cardiovascular responses, such as palpitations, and pain in various areas, including chest, head, and stomach (Bryant, 2017). The disorder is classified as PTSD if these symptoms are present for more than one month (Bryant, 2017). A person with ASD is dysfunctional, meaning that they cannot maintain focus, have issues with sleep, and may often be angry and irritated. Therefore, it is challenging for a person with such conditions to work and commit themselves to a purpose.
In some instances, ASD and PTSD do not fade away but develop into depression and bereavement. The latter is grief associated with the loss of someone or something a victim was emotionally connected with (Collyer, 2015). Depression is a source of continuous stress that may have long-term impacts on well-being (Asad Ali Shah et al., 2018). It causes a behavioral change that may influence the daily lives of victims and deteriorate relationships with their family members and friends (Asad Ali Shah et al., 2018). In some cases, depression causes physical pain that is challenging to locate and treat with medication. Only qualified medical provider support may help alleviate such outcomes.
Depressed individuals may fall into a state of self-abjection when they are unable to accept themselves and continuously try to reject themselves and cast themselves off culture, society, or group they are part of. Abjection may lead to a loss of self-identity, which impacts the role of a person in the community and deteriorates their ability to work and live fulfilled lives (Collyer, 2015). Researchers have noted that ASD and PTSD are often challenging to assess because of avoidance expressed on behalf of victims (Soomro et al., 2020). Individuals that were affected by violence may be unwilling to share their stories and describe what they feel, which complicates the research and treatment process. Fear to be rejected by society is a common reason behind this unwillingness. Therefore, it is important to support such individuals and show empathy and support.
Despite these troubling concerns regarding the mental well-being of individuals affected by terror and violence, there are ways of mitigating unfavorable consequences. Emotional intelligence (EI) and community support have been mentioned by researchers as moderators in psychosocial well-being (Asad Ali Shah et al., 2018). Emotional intelligence is an appropriate differentiation between various emotions a person may have (Asad Ali Shah et al., 2018). Although EI is the responsibility of each person, the concepts and practical tools should be taught by a qualified professional. Therefore, EI and community support are strongly intertwined with each other. Along with psychological assistance, health providers may need to provide resources relevant to becoming emotionally intelligent. Community support may help alleviate fear and help a victim overcome depression and self-abjection. In a supportive environment, individuals are more likely to regain self-identity and return to healthy and orderly lives without anxiety and worry.
Societal Level
The collection of individual responses comprise the societal reaction to terror. Depression and other mental disorders often lead to behavioral changes that impact the consumption patterns of an individual (Mohanti, 2017). When consumption patterns of the whole population changes, there is a shift in economic activities. Therefore, it can be considered that terror has an impact on the micro and macroeconomic context. Change in habits and behavior is only one part of terror’s influence. Regions that rely on tourism as their main source of income may face more significant struggles due to decreased tourist flow (Bacon & Buzinde, 2019). Health outcomes can be viewed on a societal level as well. Research suggests that constant stress on behalf of a pregnant woman leads to a significantly lower birth weight than usual. For instance, children that were born after the 2001 attacks in New York had birth weights less than 2500 grams, and in some cases, even lower than 1500 grams (Brown, 2020). This evidence shows that terror can have an intergenerational impact within a victim society.
Argument
Terror leads to unfavorable outcomes both in terms of individual health and societal response. When considering the issue on a personal level, the impact of terror can be divided into short-term and long-term effects. Physical injuries and stress are expected during times when violence is experienced. In the long-term context, victims often develop chronic mental conditions that will persist for the rest of their lives. These issues pose a hindrance to living a happy life and may deteriorate personal relationships. However, psychological assistance and support from family members can help regain self-identity and get rid of the fear of sharing the experiences. It is important that victims do not engage in self-abjection; otherwise, their condition will worsen over time.
Case of Jan Ruff-O’Herne
Historical Background
At the beginning of World War II, Indonesia was the colonial territory of the Netherlands and was called the Dutch East Indies. Soon the Netherlands was occupied by Germany, and Indonesia, squeezed by the British colonies of Malaysia and Australia, fell under the control of the British (Evans, 2017). Singapore played a strategic role in the region, where a large formation of British troops was concentrated (Evans, 2017). However, the defeat of Great Britain and the rapid advance of the Japanese demoralized the defenders of the city. On the night of February 9, 1942, after a massive shelling, General Yamashita’s Japanese army began a landing in Singapore (Evans, 2017). Several days later, the British garrison surrendered and the Japanese continued their expansion.
After overcoming the resistance of the Allies, the Japanese landed in Bali. The Japanese took control of the island of Timor and advanced their positions in the region. In the battle in the Java Sea, the Allied naval forces suffered a crushing defeat from the Japanese squadron of admiral Takagi (Evans, 2017). On March 1, the Japanese troops landed in Java, and a week later, the Dutch general Hein ter Poorten surrendered (Evans, 2017). After the fall of Java, the occupation of the remaining parts of the Dutch East Indies was carried out by the Japanese practically without clashes. Military confrontations were not the only violence that took place in the region. Japanese practiced other kinds of terror, which impacted women for many years after the war.
Ruff-O’Herne Story
Comfort stations were military brothels that existed in Japan and the territories it occupied from 1932-1945. In the beginning, these stations were run by volunteer women from Japan (Soh, 2008). However, with the rise of demand, Japanese soldiers began forcing women from local populations to work in the brothels (Soh, 2008). During their short period of existence, approximately 400 thousand women and girls of all ages from China, Korea, Taiwan struggled in the comfort stations (Soh, 2008). In some places, there were women from Europe and Australia that lived in Dutch and British colonies (Soh, 2008). By the end of the war, three-fourths of these “comfort women” died while the rest received a trauma that would pursue them for the rest of their lives.
There were doctors who were responsible for monitoring the health of women in comfort stations, but these health providers lacked professional capacities. Many doctors raped the healthiest of their patients and deteriorated their psychological well-being (Soh, 2008). Mortality rates remained at high levels due to the absence of trained psychologists (Soh, 2008). Suicide had become a daily occurrence and did not surprise military officials (Soh, 2008). Although other women attempted to convince those on the brink of suicide, they knew that such efforts are worthless because of their inefficacy. Some women stole opium from soldiers, while others used medicines from doctors or hung themselves using their clothes. Everyone who contemplated suicide would eventually find the desired death.
It was not only the depressed mood among the comfort women that contributed to the high mortality rates. Having gained experience from the German Nazis, the Japanese began to use some medical techniques to control the birth rate within the stations (Soh, 2008). The so-called No. 606, which contains high amounts of arsenic, came into use, and although contraception was closely monitored in military brothels, drugs were used to terminate unwanted pregnancies among station workers (Soh, 2008). Among the effects of this drug were increased risk of miscarriages, the possibility of developing infertility or mutations in future children, and in some cases, the death of victims.
Among the victims was Jan Ruff-O’Herne, an Australian woman that lived in the Dutch Indies during World War II. She was unlucky to be captured by the Japanese military and forced to work in a comfort station (Williams, 2016). Jan remembers her first day with horror and says that she felt as if the nightmare would never stop (Williams, 2016). The situation worsened after she realized that she was pregnant (Williams, 2016). The Japanese forced her to take birth control pills, and the woman miscarried. After the end of the war, she and her husband wanted to start a new life and moved to Australia (Williams, 2016). However, Jan could not forget what happened during the war, and the nightmares and terror pursued her for many years (Williams, 2016). She had not shared her story until other victims started demanding an apology from the Japanese government (Williams, 2016). She believes that rape is not permitted even during times of war and is willing to make the Japanese apologize and pay compensation for all injuries conceived.
Links with Theory
As discussed in the Theory section of this paper, terror and violence often cause adverse health-related issues both in terms of physical and mental well-being. Comfort women, including Jan Ruff-O’Herne, were forced to providing sexual services against their will. Victims developed short-term mental disorders like ASD, which caused anxiety and led to many suicide cases (Soh, 2008). It was mentioned that rape in a war period inevitably leads to unwanted pregnancies. Correspondingly, most women in comfort stations were forced to use birth control pills. Absorption of such drugs results in miscarriages and issues in women’s reproductive systems (Soh, 2008). No. 606, for instance, may lead to vaginal blood discharge and an inability to have children in the future. Pregnancies were a result of unprotected sex, which suggests that HIV and other sexually-transmitted diseases were common in comfort stations (Soh, 2008). Health-related results of terror on comfort women correspond to the currently available theoretical knowledge.
The influence of war-time experiences did not fade away for Jan with the end of World War II. It is known that violence often has long-term consequences for victims. Ruff-O’Herne could not forget what happened and has lived with it for the rest of her life. Although she moved to Australia to start a new life, she could not settle because she had developed depression. Jan could not accept her history and has lived in fear of revealing it to others. This situation corresponds to the discussion of avoidance in the Theory section. Individuals with mental disorders are often unwilling to speak about what items are causing anxiety and how it can be remedied. Jan, too, kept silent for many years and hid her story. She did not speak partly because of self-abjection – Jan was frustrated with her background and probably believed that other people will only mock.
Jan only spoke after other victims started sharing their stories and demanding apologies and compensation from the Japanese. The courage of other women served as moral support for Ruff-O’Herne and empowered her to take action. Jan was able to break out of her depression because of external influence, which confirms the suggestions made in the Theory section. Psychological support helps victims of terror cope with their issues and empowers them to confront self-abjection and to restore their self-identities. In the case of Jan, her family members and children have supported her for all these years (Williams, 2016). They are even ready to continue Ruff-O’Herne’s mission of restoring justice and making the Japanese apologize for all crimes conducted during World War II (Williams, 2016). This particular case of terror supports the suggestions made by scholars and professional health providers. Violence has short-term and long-term consequences, which often affect the health and well-being of a victim. The damage can be alleviated by continuous support on behalf of family members and psychologists, and courage from fellow victims has the capacity to motivate and release from the burden of fear and depression.
Generalizability
One may claim that Jan Ruff-O’Herne’s case is too specific and cannot be used as a general reference for considering the impact of terror. However, numerous other pieces of historical evidence suggest the opposite. For instance, Leon Cohen, who was a member of the Sonderkommando at Auschwitz-Birkenau, lived with fear and horror until the end of his days. Cohen collected gold from the mouths of Jewish corpses in the concentration camp (Greif, 2005). His task was horrific as he had to spend his days among hundreds of dead bodies of his fellow Jews (Greif, 2005). While in the camp, he developed anxiety and could not sleep and eat well (Greif, 2005). The fact that Leon could not forget his experience can be derived from his detailed descriptions of the camp and his work. The stress turned into depression when he lost the beloved person – Cohen’s wife left him and returned to her home country (Greif, 2005). This combination of mental conditions deteriorated his health, and life was spent living in reminiscence of days at Auschwitz-Birkenau.
Leon’s story is similar to Jan’s, except the former never recovered because of loneliness and lack of support. It is difficult to say what would have happened had his wife not left for Greece, but it is safe to suggest that Cohen would have lived a more fulfilled life. A similar experience was suffered by Rithy Pan and many Cambodian citizens, victims of Khmer Rouge, the regime that ruled Cambodia between 1975 and 1979 (Nong, 2016). Many people were tortured to death in detention centers, but Pan was able to survive the terror (Nong, 2016). His documentary film about the incidents depicts two of the other survivors. They describe their experiences in full detail, which indicates that they could not forget what they lived through (Nong, 2016). Pan says that, although trauma will pursue the victims for the rest of their lives, it is important to share stories and support each other (Nong, 2016). Retaining the collective memory of the events is significant for empowering the individuals who suffered from the regime (Nong, 2016). This case is also similar to Jan’s story, which suggests that consequences experienced by Ruff-O’Herne can be generalized to victims of other instances of terror and injustice. Mental trauma is almost inevitable after experiencing horrific events, but there are strategies for mitigating the long-term impact and helping victims.
Conclusion
Terror and violence are omnipresent, which necessitates research of their long-term health impacts and mitigation strategies. This paper discussed the case of Jan Ruff-O’Herne, a woman who was forced to work in a comfort station during World War II and experienced the war-time terrors of rape and enslavement. She was able to confront her fears and horrors because of the support she received from others. Her case supports the argument that long-term impacts can be mitigated by psychological support and public acceptance.
References
Asad Ali Shah, S., Yezhuang, T., Muhammad Shah, A., Khan Durrani, D., & Jamal Shah, S. (2018). Fear of terror and psychological well-being: The moderating role of emotional intelligence. International Journal of Environmental Research and Public Health, 15(11), 2554.
Bacon, L. E., & Buzinde, C. N. (2019). Perceptions of terror stricken tourism destinations. Journal of Tourism and Cultural Change, 17(5), 594–608.
Brown, R. (2020). The intergenerational impact of terror: Did the 9/11 tragedy impact the initial human capital of the next generation? Demography, 57, 1459–1481.
Bryant, R. A. (2017). Acute stress disorder. Current Opinion in Psychology, 14, 127–131.
Collyer, F. (Ed.). (2015). The Palgrave handbook of social theory in health, illness and medicine. Springer.
Evans, D. C. (2017). The Japanese navy in World War II (2nd ed.). Naval Institute Press.
Greif, G. (2005). We wept without tears: Interviews with Jewish Survivors of the Auschwitz Sonderkommando. Yale University Press.
Mohanti, B. K. (2017). Health impact is the invisible side of terrorism. The National Medical Journal of India, 30(5), 285–286.
Nong, R. (2016). S21 Khmer Rouge killing machine [Video]. YouTube. Web.
Soh, C. S. (2008). The comfort women: Sexual violence and postcolonial memory in Korea and Japan. University of Chicago Press.
Soomro, S. A., Roques, O., & Ali, A. (2020). Fear of terror and employees’ behaviour in terrorist-ridden areas. Journal of Aggression, Conflict and Peace Research, 12(3), 125–137.
Effects of terrorism: A trauma and victimological perspective. (2018).. UNODC. Web.
Williams, P. (2016). Jan Ruff-O’Herne, 93-year-old Australian former ‘comfort woman’, still waiting for apology from Japan. ABC News. Web.