DukeMed Alumni News
Winter 2008

Dyer Leads Major
Psychiatric Confernce to Iraq

by Jim Rogalski

With daily headlines such as “Deadly Blast Hits Baghdad Market,” and “14 Percent of Iraqis Now displaced,” it is little wonder that psychological trauma is rampant throughout war-torn Iraq.

So much so, says Allen Dyer, MD’72, PhD’80, that there likely isn’t a single Iraqi citizen who is not psychologically affected in some way by the war, from lost loved ones, displaced family members, direct trauma, Post Traumatic Stress Disorder (PTSD), or daily fear and anxiety for the future.

A professor of psychiatry and behavioral science at the James H. Quillen College of Medicine at East Tennessee State University (ETSU), Dyer was the lone American invited in June to join three Iraqi-British psychiatrists from the Royal College of Psychiatrists in London to lead a major medical conference at Hawler Medical University in the city of Erbil in Kurdistan, Iraq.

Attendees were psychiatrists and mental health experts from around Iraq. Dyer delivered lectures on child and adult psychiatry, addictions, and medical ethics, and heard of psychological horrors around the country.

“The psychological need is enormous because there is a very small number of psychiatrists in a large country,” he says.

Dyer writes in his blog: “Everyone had a story of terror that was more horrific than one imagines would be possible: stories of murder… and body parts in the garden, kidnappings, threats of death, families separated and driven from their homes… children kidnapped and returned barbequed.”

Yet only the most severe mental health cases currently are being seen by mental health professionals, he says.“We were there to try to help them help themselves by showing them the model we use in this country where physicians work with multidisciplinary teams to extend the care of patients.”

The epidemic degree of long-term mental health problems in Iraq has led Dyer to coin the term Ongoing Traumatic Stress Disorder (OTSD) which he says more accurately describes the unremitting psychological effects of living with ongoing uncertainty.

“PTSD does not quite cover what we are seeing in Iraq,” he says. Many Iraqis
are suffering from physical illnesses manifested from both PTSD and OTSD such as hypertension, heart problems, headaches, dermatologic conditions, sleep disorders, and gastrointestinal disturbances, he says.

He will be sharing his findings on Iraq in May 2008 at an American Psychiatric Association panel discussion in Washington, D.C. titled “Iraq on the Ground: The Real Story Through a Psychiatrist’s Lens.”

“Before there is a proposal for a new (OTSD) designation there needs to be more research and a better understanding of the time sequence of the old nomenclature (PTSD),” he says.

Dyer never ventured out of Kurdistan which he says was “impressively secure” with copious military checkpoints. “At no time did we feel threatened. Kurdistan is a very cosmopolitan part of the Middle East. There is economic development like new skyscrapers being built with oil revenue and a sense of stability that is not seen elsewhere in Iraq.”

He has been invited back to Erbil in April or June 2008 and if security has sufficiently improved in Baghdad he and his British and Iraqi colleagues will deliver lectures there as well. The trip was coordinated by the Medical Alliance of Iraq and funded by the International Medical Corps. ETSU has had a relationship with Kurdistan, Iraq since 2001 when the university was asked to help Kurds develop a medical infrastructure.

“Because we’re a relatively small medical school with a rural population, the things that the Kurds might do are more like what we do rather than a Harvard or a Duke,” Dyer says.

As for the state of Iraq’s future, Dyer says “It’s going to be very hard to reconcile the country as a whole. The metaphor of Humpty Dumpty comes to mind.”

Dyer and his wife Susan, PhD’77, who is on faculty in the English Department at ETSU, and runs a computer consulting/technical writing business called Outsourcery, have two grown children—Will, a software engineer in Philadelphia, and Cliff, who works for UNC-Chapel Hill as a data archivist. The Dyers live in Johnson City, Tenn.

To read more about Dyer’s trip to Iraq, visit his blog at web.mac.com/allendyer.