For my final project and my activity post this week, I am choosing to look at PTSD in Peruvian women.
Levey et al. (2017) studied pregnant women in Peru, specifically to estimate the prevalence of antepartum PTSD symptoms of these women, and to examine the number of traumatic events encountered, and the type of trauma the women experienced. We see from this article and our reading this week that during pregnancy, PTSD’s symptoms are higher during pregnancy, which can lead to negative maternal and infant health outcomes. From their study, they found that out of the 3,372 pregnant women interviewed, 2,920 reported they had experienced one or more traumatic events. 41.8% of these women had met criteria for PTSD, and a quarter of participants had reported experience with four or more traumatic events, and 60.5% of these women had PTSD (Levey et al. 2017). The article mentions that the peak of PTSD related symptoms could be from the hormone imbalance that takes place during pregnancy, or if the women were sexually abused, that the bodily changes, sensations and gynecological/obstetrical care during pregnancy can trigger flashbacks of the abuse (Levey et al. 2017). I think it’s important to point out that while only 3,372 pregnant women were assessed in this study, more than 75% of these women had been through a traumatic event, which is an extremely high amount- and these findings are generalizable to the pregnant Peruvian population, not to all women in general, so I can imagine the overall rate of traumatic events and PTSD symptoms/diagnoses for the entire women population would be very high. The prevalence of PTSD symptomology in this study population was 36.2%- more than four times the lifetime prevalence that has been reported not just in the United States, but globally (Levey et al. 2017).
Another study I found mentioning the PTSD prevalence in Peru was conducted by Cairo et al. (2013), just five months after an 8.0 magnitude earthquake struck Pisco, Peru. In this study, 298 adult earthquake survivors were interviewed and found that 75 of these survivors had PTSD, which is a prevalence of 25.2% (Cairo et al. 2013). In their analysis, they found that female sex, food and water shortages from the earthquake, loss of church, injuries to themselves or loved ones, and low levels of support from loved ones were associated with PTSD, and found that PTSD affected a quarter of Pisco’s population overall (Cairo et al. 2013). While this article doesn’t examine only women, and I cannot seem to find the exact percentage of women of the population of Pisco, I feel it is safe to say that women too are suffering from this type of PTSD, due to the authors’ mention of female sex being one of the reasons for PTSD.
Another source I would like to include is an article by Marta B. Rondon (2009), who discusses the mental health and disorders that we see in Peruvian women. Most women report feelings of unhappiness and pessimism, and that interpersonal violence plays a huge role in the production of psychiatric morbidity (Rondon 2009). It is noted that gender-based violence is widely tolerated, and most of that violence is toward women. According to a study done by the World Health Organization, women in the Andean region of Cusco, Peru are the most physically abused women in the world, with women in Lima, Peru, not too far behind. There are some psychiatric hospitals located in Lima, which make up 75% of psychiatric hospitals, but there are other hospitals with beds for psychological help in Piura, Arequipa and Iquitos (Rondon 2009). There is no mental health care at the primary level. Those needing mental health care have to travel far distances to these countries that have psychiatric hospitals, which stops a lot of people from seeking mental health services. The unavailability and inaccessibility of mental healthcare is the most important human rights and public health issue in Peru, Rondon (2009) argues.
This is an important health issue to address not only culturally, but also from a public health standpoint. For decades, Peru has been a country affected by numerous acts of terrorism and violence by a communist group which is seeking to over through the existing Peruvian government, which led to internal conflict between the country. Between 1980 and 2000, 69,280 victims were killed due to this internal conflict, which only contributes to their culture of violence and trauma (Levey et al. 2017). PTSD is an outcome of all of this trauma and terrorism, which is deeply rooted in their culture. Not only is this a factor, but childhood and sexual abuse in particular were strong predictors of PTSD in the population that Levey et al. 2017 studied- and found that these flashbacks happened more often during pregnancy. With these numbers being so high, it doesn’t surprise me that this may be common in their culture, and with the sexual abuse and violence happening in their society, puts them at higher risk for PTSD. There are other reasons why PTSD is so high in Peru, like natural disaster, that don’t have to do with culture. Aside from culture, we see that PTSD is an important public health issue as well, especially with it being so outrageously high in Peru. We see that PTSD effects the women’s mental health, emotional health, psychological health, and has effects on the infants’ health during pregnancy. In terms of the earthquake, these people were left with food and water shortages too, which can also effect a person’s physical health- only adding more stress to the current PTSD diagnosis or symptomology. They are also regions in Peru with the most abused females in the world, and they have no mental health services available to them, making this a serious public health issue. While some of the sources here don’t discuss PTSD specifically, we know from our lectures and readings in class that the things they are experiencing often cause PTSD, and it all starts with the cause.
Cairo, Javier B., et al. “The Prevalence of Posttraumatic Stress Disorder Among Adult Earthquake Survivors in Peru.” Cambridge University Press, Disaster Medicine and Public Health Preparedness , 1 Apr. 2013, www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/article/prevalence-of-posttraumatic-stress-disorder-among-adult-earthquake-survivors-in-peru/07E3858207AB8B9F596D6DD93CE0DE21.
Levey, Elizabeth J., et al. “Trauma Exposure and Post-Traumatic Stress Disorder in a Cohort of Pregnant Peruvian Women.” The National Center for Biotechnology Information, U.S. National Library of Medicine, 13 Sept. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5849493/.