Afghanistan Nurses Psychological Scars of War
Saturday, December 29, 2001
Jeremy Page

KABUL (Reuters) - Bilal was a normal, healthy boy until a midnight rocket attack near his home in Kabul four years ago. He is now 11, but doctors say he has a mental age of about three. Nervous and distracted, he spends his days at home in silence, a victim of the psychological trauma which doctors say affects up to 70 percent of the population in the Afghan capital in some way.

``If he doesn't take his medicine, he falls over and blacks out the whole time,'' said his mother Mommana, surrounded by her three other children. ``If the war continues, I worry that all the others will be the same.''

As Afghanistan starts to repair the physical damage from more than two decades of war, mental health experts say they are only just beginning to understand the depth of the psychological scars the conflict has inflicted on the nation.

``After 23 years of war, and five years of cruelty under the Taliban, almost all our people have some psychological problems, but especially our children,'' said psychologist Abdul Mannan Haqyar, head of the Kabul Mental Health Hospital. The most common symptoms among children are distrust of adults, a lack of hope in the future and an obsession with traumatic experiences.

``When children witness a traumatic event like a rocket or bomb attack, their minds can become obsessed with that incident, especially when they are alone or asleep,'' said Haqyar. ``If it happened at school, they will avoid going to school. They feel human life has no value, they lose hope and they become depressed.''

BAD DREAMS

Five years of the Taliban's public executions and beatings of those who violated its extreme interpretation of Islamic law have compounded the psychological damage. Haqyar cited one case of a young boy who witnessed a man being hanged by the Taliban from a tank in the city center.

``He was always dreaming about that man,'' he said. ``He couldn't sleep, he became depressed and he didn't want to go out.'' Women bear perhaps the deepest scars from the Taliban, which banned them from work and school, allowed them out of the house only in the company of a close male relative and forced them to wear the head-to-toe robe, the burqa.

``Those who were taken out of school can face anxiety and depression,'' said Said Abdul Ahad Awara, a psychiatrist and deputy head of the hospital.``But school is not the only problem. Hiding under the burqa, staying in the house all day like a prison, you see no hope in the future and you have no social relationships.''

UNHEALTHY RELATIONS

Afghan men have suffered from the lack of contact with women other than their mothers and close relatives under Taliban rule, Awara said. ``They cannot make a healthy relationship with the opposite sex because they had no contact with female teachers or colleagues,'' he said. ``When a man faces a woman for the first time, some of them suffer from a lack of basic knowledge. This can create sexual problems in the future.''

Many Afghan men are unable to have a sexual relationship with a woman until after the age of 30 because they spend most of their time fighting with male comrades away from home, he said. And with no education and few skills other than those of warfare, finding a role in a peaceful society can be as traumatic for men as the violence they leave behind, he said. Ironically, it is only during peacetime that many of these problems come to the surface, said Awara, whose hospital treats about 80 new patients every day.

``When people face a lot of hardship, they do not take these personal problems seriously,'' he said. ``But once their lives are secure and stable, they will start to think more about their abnormalities and psychological problems. ``Then we expect to see 10 times as many patients at the hospital.''