FREED OYO SCHOOL CHILDREN:Medical checks must include mental evaluation, NMA warns

By Chioma Obinna

The release of the Oyo schoolchildren after more than 50 days in captivity has once again brought to the fore the often-overlooked physical and psychological toll of kidnapping. While the return of victims is widely celebrated, medical experts warn that 

freedom from captivity does not necessarily mark the end of their ordeal. Sunday Vanguard spoke to the President of the Nigerian Medical Association (NMA), Prof. Afekhide Ernest Omoti, on the hidden health consequences of kidnapping, why survivors require urgent medical and psychological care, and what government, families and communities must do to support their recovery.

For him, survivors require immediate and comprehensive medical attention, trauma-informed psychological care and long-term rehabilitation to recover fully from the hidden effects of captivity. 

He warned that untreated physical injuries, infectious diseases, malnutrition and post-traumatic stress disorder (PTSD) are among the health challenges that can persist long after victims regain their freedom.

Omoti further explains why every rescued kidnap victim should undergo thorough medical and mental health assessment, the warning signs families should never ignore, and why Nigeria urgently needs a coordinated rehabilitation programme. Excerpts: 

Freedom is only the beginning

From a medical perspective, the period immediately after release from captivity is critical. Survivors of kidnapping require comprehensive medical and psychological assessment because many of the effects of captivity are not immediately obvious. Even if survivors appear physically well, they should never be assumed to have fully recovered. Psychological symptoms may emerge days or even weeks after release, making continued medical and mental health follow-up an essential part of their recovery. The immediate health concerns include untreated wounds, fractures, bruises, soft tissue injuries and complications resulting from physical assault. Some injuries may have become infected or healed improperly during captivity. Depending on the conditions under which they were held, survivors may also suffer dehydration, malnutrition, electrolyte imbalance, weight loss and nutritional deficiencies due to inadequate food and water. There is also an increased risk of infectious diseases.

Poor hygiene, overcrowding, insect bites and exposure to contaminated food and water may predispose victims to malaria, respiratory infections, gastrointestinal illnesses and skin infections. In addition, individuals living with chronic conditions such as hypertension, diabetes, asthma or epilepsy may have missed their medications, leading to poor disease control and serious complications.

Another important concern is sexual and gender-based violence. Where there is any suspicion or disclosure of sexual assault, survivors should receive prompt, confidential and trauma-informed medical care. This includes treatment of injuries, testing and preventive treatment for sexually transmitted infections where indicated, while respecting the survivor’s dignity, privacy and informed consent. There should also be an assessment for possible substance-related problems, as some captors may administer drugs or alcohol, while survivors with pre-existing substance dependence may experience withdrawal during captivity. The care of released kidnap victims should therefore be multidisciplinary, involving emergency physicians, family physicians, psychiatrists, psychologists, nurses, social workers and other relevant specialists. Recovery extends beyond treating visible injuries and requires coordinated physical, emotional and social support.

Mental wounds

Kidnapping is a profoundly traumatic experience and its psychological impact can persist long after an individual regains freedom. The nature and severity of the trauma vary depending on the duration of captivity, the conditions endured, exposure to violence and the survivor’s previous mental health and coping abilities.

Many survivors experience acute stress reactions in the first hours or days after release. They may appear emotionally numb, confused, withdrawn, tearful, hypervigilant or easily startled, while some may have difficulty concentrating or recalling aspects of their ordeal. Anxiety and persistent fear are also common, with many survivors remaining afraid that they could be abducted again, making them reluctant to leave their homes or resume normal activities.

Sleep disturbances, including insomnia and recurrent nightmares, are frequent. Some survivors develop depression characterised by persistent sadness, hopelessness, loss of interest in normal activities and social withdrawal. Others may experience survivor’s guilt, especially if fellow captives were harmed or remain in captivity.

Mental health assessment should begin as soon as possible after release, ideally within the first 24 to 72 hours once the survivor is medically stable. The initial assessment should identify acute psychological distress, assess immediate emotional needs, screen for severe anxiety, depression, suicidal thoughts or other psychiatric symptoms, and determine whether specialist mental healthcare is required. However, this assessment must be trauma-informed and compassionate. Survivors should never be pressured to recount their experiences in detail immediately after release, as doing so may increase emotional distress. The immediate priority should be ensuring safety, meeting basic needs, providing reassurance and identifying those who require specialist intervention.

Importantly, psychological follow-up should not end after the initial evaluation. Some survivors appear emotionally stable in the immediate aftermath but develop post-traumatic stress disorder, depression or other trauma-related conditions weeks or even months later. Early recognition and timely intervention significantly improve recovery and reduce the risk of long-term psychological complications.

PTSD is a real danger

 Post-traumatic stress disorder (PTSD) is one of the most common long-term mental health consequences of kidnapping. Although the exact prevalence varies depending on the circumstances of captivity and the populations studied, research suggests that between 30 and 70 per cent of kidnapping survivors may develop PTSD. The risk is particularly high among those who experienced prolonged captivity, physical or sexual assault, repeated threats to life, or witnessed the abuse or death of others.

Families are often the first to notice that something is wrong. Warning signs include recurrent nightmares, disturbing dreams, flashbacks, avoidance of people, places or situations that remind survivors of the kidnapping, persistent fear, hypervigilance, sleep disturbances, irritability, anxiety, depression, emotional numbness and loss of interest in activities they once enjoyed. Some survivors may withdraw from family and friends, have difficulty concentrating or complain of headaches, body pains, palpitations or other physical symptoms that have no obvious medical cause.

Thoughts of self-harm, hopelessness or suicide require immediate psychiatric evaluation and treatment.

Comprehensive screening

 Every kidnap victim should undergo a comprehensive medical evaluation before or immediately after reuniting with family, even if they appear physically well. Many of the physical and psychological consequences of captivity are not immediately obvious, and early assessment can prevent complications while documenting important medical findings. The evaluation should include a thorough physical and neurological examination, supported by appropriate laboratory investigations such as a full blood count, blood glucose, urinalysis and, where indicated, kidney, liver and electrolyte tests. Survivors should also be screened for malaria and other infections based on their symptoms and exposure history, while existing medical conditions should be reassessed because treatment may have been interrupted during captivity. Where there is suspicion or disclosure of sexual assault, survivors should receive confidential, trauma-informed care with their informed consent. This may include treatment of injuries, testing and preventive treatment for sexually transmitted infections, HIV post-exposure prophylaxis and other appropriate medical interventions, as well as psychological support. Mental health assessment should form part of the routine evaluation, including screening for acute stress reactions, anxiety, depression, PTSD and suicidal thoughts. Psychological first aid should begin early, with arrangements for continued follow-up where necessary. Nutritional assessment is equally important, particularly for survivors who have endured prolonged deprivation.

While these assessments should be carried out as early as possible, they should not unnecessarily delay family reunion where the survivor is medically stable. Medical care and emotional support should continue alongside reintegration into family life.

Recovery

Recovery from kidnapping is rarely immediate. Prolonged captivity can leave lasting effects on both physical and mental health. Some survivors continue to experience chronic pain, malnutrition, untreated injuries, infections or worsening of pre-existing illnesses long after they have returned home. The psychological consequences may be even more enduring. PTSD, depression, anxiety, sleep disorders, persistent fear, poor concentration and social withdrawal can continue for months or even years. Some survivors may develop Complex PTSD following prolonged or repeated exposure to trauma. Although many people recover with appropriate treatment and support, some symptoms do not become apparent until weeks or months after release. This is why long-term medical follow-up, mental healthcare and strong family and community support remain essential components of recovery.

No rush

Families play a crucial role in helping survivors’ recover, but they must recognise that healing takes time. They should provide a safe, supportive and non-judgmental environment while allowing survivors to recover at their own pace. Relatives should avoid pressuring survivors to repeatedly recount their experiences. Instead, they should listen with empathy whenever survivors choose to talk, encourage healthy daily routines and watch for persistent nightmares, anxiety, depression or social withdrawal. Where these symptoms continue or worsen, professional medical and mental health support should be sought promptly. Patience, understanding and consistent support are fundamental to successful recovery.

Rehabilitation programme

Given the increasing incidence of kidnapping and its profound physical and psychological consequences, Nigeria should establish a standard medical and psychological rehabilitation programme for all rescued kidnap victims. Recovery should not end with a victim’s release from captivity. Such a programme should provide immediate medical evaluation, comprehensive psychological assessment, trauma counselling, treatment of injuries and illnesses, and long-term follow-up to identify and manage conditions such as post-traumatic stress disorder (PTSD), depression and anxiety. It should also include social and vocational rehabilitation to help survivors reintegrate into their families, workplaces, schools and communities.

A standardised, multidisciplinary approach would ensure that every survivor receives comprehensive care, improve recovery, reduce long-term disability and enhance overall quality of life. Mental health services must improve Nigeria’s hospitals can generally manage the immediate physical injuries sustained by kidnap victims. However, mental health services remain inadequate to meet the growing demand for trauma care. There are shortages of psychiatrists, clinical psychologists and other mental health professionals, while specialised trauma services are limited and access to care remains poor in many parts of the country. Strengthening trauma-informed services, expanding mental health infrastructure and investing in specialist training should become national priorities if survivors of kidnapping and other forms of violence are to receive the care they need. Psychological care is just as important as treating physical injuries because the emotional consequences of kidnapping are often invisible but can be equally disabling. Survivors may develop anxiety, depression, PTSD, persistent fear and sleep disturbances that affect their ability to return to work, school, family life and normal social relationships.

Early psychological assessment and timely intervention help identify these conditions, promote healthy coping, reduce the risk of long-term mental health complications and improve overall recovery. Treating both the physical and emotional consequences of trauma offers survivors the best opportunity to rebuild their lives.

Role

Recovery does not depend on healthcare professionals alone. Employers, schools, religious institutions, traditional leaders, communities and the media all have important roles in helping survivors reintegrate into society. Employers and schools should provide a supportive environment and, where necessary, make temporary adjustments that allow survivors to gradually resume their normal activities. Religious and community leaders should promote acceptance, reduce stigma and encourage those affected to seek professional help when needed.

The public should also treat recently released kidnap victims with empathy, dignity and respect. While curiosity is understandable, survivors should never be pressured to repeatedly recount their ordeal, as this may retraumatise them and delay recovery. The media equally has a responsibility to report such stories ethically by respecting survivors’ privacy, obtaining informed consent before interviews and avoiding sensationalising their experiences. Survivors should be allowed to tell their stories only if, and when, they feel emotionally ready.

National policy

With kidnapping and other forms of violent crime becoming increasingly common in parts of Nigeria, trauma care should become a stronger component of the country’s emergency healthcare system. Trauma care should extend beyond treating physical injuries to include routine psychological assessment, counselling and long-term mental health follow-up. Strengthening trauma-informed services, training healthcare workers and integrating mental health into emergency care will improve recovery, reduce long-term psychological complications and help survivors return to productive lives.

Recovery from kidnapping is not simply about regaining freedom. It is about restoring health, rebuilding confidence, recovering dignity and helping survivors regain a sense of safety, trust and hope. That should be the goal of every intervention for victims of kidnapping in Nigeria. The release of a kidnap victim should never be seen as the end of the story. It is only the beginning of what is often a long journey to physical, psychological, and social recovery.

As a nation, we must move beyond celebrating freedom alone. Every survivor deserves comprehensive medical care, mental health support and the opportunity to rebuild their lives with dignity. That is the hallmark of a compassionate and responsive healthcare system. If we strengthen trauma care, invest in mental health services and establish a national rehabilitation programme for survivors of kidnapping, we will not only improve individual outcomes but also strengthen our collective response to the growing burden of violence and insecurity in the country.

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