Trauma of Chechnya's ongoing war on internally displaced people.

Despite repeated claims from Russian and pro-Russian Chechen officials that the situation in Chechnya is normalising, the conflict and related human rights abuses continue. 1 The decade of conflict has resulted in an estimated 260 000 internally displaced people. By mid 2004, around 52 000 remained in the neighbouring Republic of Ingushetia. Most live in places unfit for human habitation—tent camps or spontaneous settlements such as train wagons, abandoned farms, factories, and warehouses. Since September, 2003, the Russian and Ingush authorities have been putting considerable pressure on internally displaced people in Ingushetia to return to within Chechnya's border. Health systems and other public services in Chechnya are in a dire state, and a lack of security in the region means that aid agencies are severely restricted in their ability to move around the region to provide additional support. Earlier this year, Médecins Sans Frontières (MSF) undertook quantitative health surveys 2 in the displaced populations both in the spontaneous settlements in Ingushetia and temporary accommodation centres on the Chechen side to obtain information on displacement history, living conditions, and psychosocial and general health status. Results show that insecurity and substandard living conditions prevail in both camps. Most people in the settlements and temporary accommodation centres have been displaced in two waves, either in 1994 or 1999, during periods of severe conflict in Chechnya, and have since been forced to relocate several times. Interviewees said they were prevented from returning home because of security fears or because their property had been destroyed. Almost all people interviewed had been exposed to crossfire, aerial bombardments, and mortar fire. More than one in five had seen killings, and nearly half had seen maltreatment of family. About 90% of people in the Chechen camps and 80% in Ingushetia had had someone close to them die as a result of the war-related violence. Ongoing conflict in Chechnya continues to disrupt people's lives. Over a third of people in Ingushetia felt unsafe, while in Chechnya two-thirds expressed concern about their security. 7% of people in Chechnya and 9% in Ingushetia reported that a family member had died in the 2 months before survey, many as a result of violence. The arrest or disappearance of friends or neighbours was common on both sides of the border. The health effects of these experiences continue to take their toll. However, access to medicines and health services is problematic in both locations. …