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The Trauma of War

For nearly 40 years Afghanistan has been in a constant state of war. How has this affected the mental health of its people? Sahar Zand reports.


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For nearly 40 years,

Afghanistan has been in a constant

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state of war.

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How has this affected the mental

health of its people?

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Afghanistan has been at war

for nearly 40 years.

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A conflict that has claimed over two

million civilian lives.

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They are from 40, 50 years ago,

and it just really shows how long

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war has been going

on in this country.

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And the cost to the nation's mental

health has been enormous.

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It's estimated that three quarters

of Afghan women and more than half

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the men suffer from

mental health problems.

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With rare access to the country's

only secure psychiatric unit and one

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of the largest hospitals,

I meet the medical staff trying

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to deal with the mental

health emergency.

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And the patients traumatised

by decades of conflict.

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Herat, in western Afghanistan,

is the country's third largest city.

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As war continues in much

of the country, the demand

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for mental healthcare

is also skyrocketing.

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This is the psychiatric unit

in the city's main hospital.

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I've come to meet Dr Wahid Noorzad

who, at 33, is the man in charge.

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Azata is 14 years old and has been

brought in by her mother.

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Like many other young Afghans,

traumatic events have been a big

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part of Azata's childhood.

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Dr Noorzad suspects that Azata

is suffering from PTSD -

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Post Traumatic Stress Disorder -

a type of anxiety disorder triggered

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by traumatic events,

often seen in soldiers.

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PTSD is increasingly common

amongst Afghanistan's

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war ravaged population.

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Social taboos around mental health

make it difficult to get patients

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through the door and that's why

Dr Noorzad takes every opportunity

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to reach out to the public.

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At a local Herati TV station,

Dr Noorzad is being interviewed.

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He's a regular guest and gives

mental health advice to people

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who call in.

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Dr Noorzad holds a weekly outreach

programme, an opportunity for more

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people to get help, it's free

and has been running for four years.

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Farhad is a trained

counsellor and a volunteer

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who runs the sessions.

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Farad himself suffers from PTSD

and is also a patient of Dr Noorzad,

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but unlike the majority

of Afghans suffering PTSD,

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he's seeking professional

psychological help.

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A very recent traumatic event led

to Farad getting PTSD.

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On the 1st August 2017,

two men walked into the Jawadia

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mosque and opened fire on 300

worshippers gathered

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for evening prayers.

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They then detonated their suicide

vests, killing 38, including Farad's

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teenager brother, Hossein.

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Dozens of others were injured.

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Jawadia is a Shia mosque and that's

why it was targeted.

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Sunni militants like Isis

and the Taliban regard

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the Shia as heretics.

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Farad comes here every day.

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For him, the trauma

of the attack is still very raw.

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Photographs of the 38 victims,

some as young as two years old.

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All are given the title

'Shaheed', meaning martyr.

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CRYING

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Ghulam Haider Sobhani has been

the Imam of this mosque for the last

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25 years, he was also

here on the day of the attack.

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Speaking to the Imam,

the challenge faced by Dr Noorzad

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and his team becomes clear.

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The taboo around mental health

is rooted deep within the culture.

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For many Afghans, war and violence

have been a constant presence.

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More than 2 million civilians have

been killed since the Soviet Union

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invaded the country in 1979.

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Herat even has its own

museum dedicated to war.

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These are really old,

mostly Russian weapons

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and ammunitions and they are

from 40, 50 years ago,

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and it just really

shows how long war has been

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going on in this country.

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I mean, we hear four decades,

but seeing these really makes

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it more tangible.

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The Soviets' withdrawal in 1989

was the start of a ten

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year-long civil war.

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This led to the rise of the Taliban,

who continue their bloody insurgency

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to this day, funded

by a booming opium trade.

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2017 saw a bumper opium poppy

crop in Afghanistan.

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Perhaps as a form of self medication

for the trauma of war,

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many Afghans use opium.

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An estimated 10% of the population

is now addicted to the opium

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poppy derivative, heroin.

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Some of these addicts end up here,

at the country's only

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secure psychiatric unit.

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It's home to about 250 men and 50

women, many of whom are suffering

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from drug induced

schizophrenia and psychosis.

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Mohammed Essar is a former

member of the Taliban.

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Mohammed Davood is a former

member of the Mujahideen.

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Both men were drug addicts

and suffer from PTSD and were sent

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here by their families.

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Without a resident psychiatrist,

the unit relies on outside help.

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Dr Saljoochi is the

visiting psychiatrist.

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The most dangerous patient, Alli,

is kept isolated from everyone else

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after biting off a staff

member's finger and the ear

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of a fellow patient.

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Many patients' families have left

for neighbouring countries

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because of war and

cannot be contacted.

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Jaffar is here because of

depression and schizophrenia.

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This led to an out of control drug

habit and later to violence.

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He was sent here by his parents.

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Like so many other patients here,

Jaffar is well enough to go home,

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but he's not sure when he can leave.

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Through a locked metal gate

is the female section.

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About 50 women live here,

some with their children.

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Some have been here for years

and look likely to stay.

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A couple of days later,

I've come back to the psychiatric

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unit because I've heard

some news about Jaffar.

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After three years at the psychiatric

unit, Jaffar really is going home.

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Jaffar's dad has made

the 800km journey from Kabul

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to collect his son.

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Back at Herat's main hospital,

Azata, the 14-year-old we met

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earlier who was diagnosed with PTSD,

is back to see Dr Noorzad

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for her first follow-up appointment.

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For Azata, the long journey

to recovery is just beginning

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and she's lucky to have

her family's support.

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For Farad, the volunteer counsellor

who we met working with Dr Noorzad,

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recovery from his PTSD

seems a long way away.

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The trauma that took his brother

away is still too recent and raw.

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Farad's recovery is being aided

by the treatment and friendship

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of Dr Noorzad.

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At the local football stadium,

we've all come to watch

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a game together.

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Seeing these players run around

today, it's easy to forget this

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stadium's dark past -

an execution ground during the reign

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of the Taliban.

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Seeing the scale of the problem,

it's hard to imagine how

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and when the country

will heal, but there is hope.

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The effects of recent decades of war

on people's mental health

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is being recognised and some help

given, and it's clear that many

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Afghans are determined

that they and their country

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will overcome the trauma of war.

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For nearly 40 years Afghanistan has been in a constant state of war. How has this affected the mental health of its people? With unprecedented access to Afghanistan's only secure mental health unit, Sahar Zand meets patients, including a former Taliban fighter, struggling to deal with the trauma of war.