An IS attack in October has triggered a crescendo of acts of violence against and displacement of Sunnis in a province in Iraq, bordering Iran, which has long suffered from cells operating in its dense orchards and Hamrin mountains. At least eleven people from the village of al-Rashad in the eastern Diyala province were killed. The attack was followed by retaliatory violence against local Sunnis, sparking fears of a return to the years of massive sectarian bloodshed. An operation conducted on 3 November by Iraqi security forces as well as additional security forces sent to the area has failed to quell widespread concerns and indignation. Reportedly several men were abducted and killed, followed by more of their relatives after they had been called to collect the bodies. Armed men subsequently attacked the Sunni-majority village, killing people, burning and destroying homes and farms, in retaliation for assumed ‘collusion’ by the entire local Sunni community with IS.

Since hostilities began last November, there have been rapes and massacres of civilians on a large scale. As far back as January, aid agencies were sounding alarms about how much worse the situation could get. Continued fighting, bureaucratic hurdles, and aid blockades have since led to a continuing famine affecting hundreds of thousands of people. More than two million people have been displaced from their homes, and tens of thousands have died. The declaration of a nationwide state of emergency by the federal government on Tuesday has triggered fears of more instability. The war has degenerated into a brutal conflict to crush and erode Tigray, and talk of elimination of entire ethnic groups has been normalised. The USA has sent a special envoy to Ethiopia for talks, and on 16 November there will be a meeting of the East African bloc Intergovernmental Authority on Development to discuss the worsening conflict.

Now in its seventh year, the crisis in Yemen is no longer headline news. But the conflict continues to have a devastating impact on people’s wellbeing, and on their mental health in particular. In Hajjah, Doctors Without Borders teams have found a high need for mental health services. The range of conditions that they treat is very large; there are people suffering from anxiety and insomnia, psychosis, depression, bipolar disorder and post-traumatic stress disorder. They regularly see patients following suicide attempts: such an attempt might be provoked by a variety of circumstances. Severe symptoms of psychosis can manifest as auditory hallucinations which tell the patient to hurt him or herself, or a patient might be suffering from severe depression. Lack of awareness leads to stigma, discrimination, and segregation, and this leads to people hiding their conditions. Yemen’s conflict has also reduced access to healthcare, education, and food, as well as restricting freedom of movement.