The mental health crisis in Afghanistan is extreme as a new BBC Our World documentary, The Trauma of War, shows with rare access to the country’s only secure psychiatric facility – and the situation will likely only grow. This past week, President Donald Trump reiterated his administration’s plans to continue the war in Afghanistan – the longest in US history. After a draw-down of NATO troops in 2014, now 1,000 US troops are set to join the 14,000 already in the country. This year it will be 17 years since the US, Britain and allies invaded Afghanistan following the September 11th 2001 attacks.
In the first half of 2017, civilian deaths reached a sixteen-year high, according to the UN’s figures, with 1,662 civilians killed and more than 3,500 injured. Child casualties rose by 9% to 436, compared with the same period last year, and female deaths were up by 23%, with 174 women killed. Two-thirds of the deaths were attributed to the Taliban by the UN and the rest to Islamic State and unidentified anti-government forces.
Violence continues to surge in Afghanistan this year; recently the self-proclaimed Islamic State attacked a military outpost in Kabul killing soldiers. A few days previously, over 100 died in an ambulance bomb explosion in Kabul claimed by the Afghan Taliban. The same group claimed the deaths of some 20 people in another recent attack on a hotel, also in Kabul.
In the The Trauma of War, broadcaster, Sahar Zand, meets some of the sufferers of Afghanistan’s war-driven mental health crisis and the psychiatrists and counsellors trying to staunch the suffering. In Herat, the third largest city in Afghanistan, Zand is confronted with some of the human cost of some 40 years of conflict, going back to the Soviet invasion in 1979.
An estimated three-quarters of women and over half of men suffer mental health problems in Afghanistan. In Herat, Sahar Zand meets 33 year-old senior psychiatrist, Dr Wahid Noorzad, who heads the psychiatry unit of the city hospital. Dr Noorzad counts amongst his patients a 14 year-old girl who suffers from PTSD after witnessing a bomb explosion outside her house. Zand also meets a counsellor, Fahard Karimi, who himself is coming to terms with PTSD after his younger brother was killed by a suicide bomber who struck a Shia mosque.
The mental health toll of ‘endless war’ in Afghanistan is compounded by an opium addiction that affects an estimated 10% of the population. 2017 saw a record harvest of poppies from which opium is derived. Helmand alone saw a 79% increase, accounting for nearly half the growth across the country. The Afghan Taliban now control or contest 40% of the territory in the country and has expanded its role in the opium industry.
In Herat, BBC Out World’s Sahar Zand meets inmates of Afghanistan’s only secure psychiatric facility, including a former Taliban and mujahidin fighter – former deadly enemies – shackled together. Both are said to have been drug-addicts and suffering mental illness. The facility is home to around 250 men and 50 women. A visiting psychiatrist to the facility reveals that some of the inmates are considered safe to release but with no family or friends to hand them on to, they continue to languish.
Whilst the Taliban regime no longer perform public executions and amputations in the Herat football stadium, violence, murder and associated mental illness are rife in the country. Afghanis are also impacted by the actions of the US-led military coalition in Afghanistan, such as the night raids in which homes are broken into and inhabitants dragged away or, sometimes, killed or the aerial bombardment, including drone warfare which not only kills but terrorises civilians with the ever present threat of attack.
With 2 million Afghani civilians said to have died in 40 years of conflict, it is hard to see much hope for the country’s mental health crisis without an end to the warfare. This makes all the more remarkable and important the work of people like Dr Noorzad who, despite the incredible odds he faces, continues to treat patients, hold weekly free outreach sessions and goes on local TV to provide mental health advice to Afghanistan’s war-damaged people.
Further information
‘Scars Visible & Invisible: Afghanistan’s Mental Illness Epidemic’ by Sahar Zand – The Quint – Article by the journalist/film-maker about her experiences making the BBC Our World Documentary, The Trauma of War.
‘What Remains of War’ by Sucheta Chakraborty – The Hindu – Review of the The Trauma of War, including a brief conversation with the presenter, British-Iranian journalist and film-maker, Sahar Zand.
“The idea of this film came to me when I was looking for an alternative to stories about war and suppression, and seeking a way to talk about the less tangible effects that war and conflict have on a population. I didn’t want to tell a story about destroyed cities and corpses – this does not seem to overly bother people any longer. I wanted to show the human side of it. I wanted my viewers to see the pain of war from another angle.”
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