Iraq War Mortality Estimates: A Systematic Review

Background:India and Pakistan have disputed ownership of the Kashmir Valley region for manyyears, resulting in several conflicts since the end of partition in 1947. Very little is known about theprevalence of violence and insecurity in this population.Methods:We undertook a two-stage cluster household survey in two districts (30 villages) of theIndian part of Kashmir to assess experiences with violence and mental health status among theconflict-affected Kashmiri population. The article presents our findings for confrontations withviolence. Data were collected for recent events (last 3 months) and those occurring since the startof the conflict. Informed consent was obtained for all interviews.Results:510 interviews were completed. Respondents reported frequent direct confrontationswith violence since the start of conflict, including exposure to crossfire (85.7%), round up raids(82.7%), the witnessing of torture (66.9%), rape (13.3%), and self-experience of forced labour(33.7%), arrests/kidnapping (16.9%), torture (12.9%), and sexual violence (11.6%). Males reportedmore confrontations with violence than females, and had an increased likelihood of having directlyexperienced physical/mental maltreatment (OR 3.9, CI: 2.7–5.7), violation of their modesty (OR3.6, CI: 1.9–6.8) and injury (OR 3.5, CI: 1.4–8.7). Males also had high odds of self-being arrested/kidnapped (OR 8.0, CI: 4.1–15.5).Conclusion:The civilian population in Kashmir is exposed to high levels of violence, asdemonstrated by the high frequency of deliberate events as detention, hostage, and torture. Thereported violence may result in substantial health, including mental health problems. Malesreported significantly more confrontations with almost all violent events; this can be explained byhigher participation in outdoor activities.