The Trauma of War Our World

For nearly 40 years,

Afghanistan has been in a constant

state of war.

How has this affected the mental

health of its people?

Afghanistan has been at war

for nearly 40 years.

A conflict that has claimed over two

million civilian lives.

They are from 40, 50 years ago,

and it just really shows how long

war has been going

on in this country.

And the cost to the nation's mental

health has been enormous.

It's estimated that three quarters

of Afghan women and more than half

the men suffer from

mental health problems.

With rare access to the country's

only secure psychiatric unit and one

of the largest hospitals,

I meet the medical staff trying

to deal with the mental

health emergency.

And the patients traumatised

by decades of conflict.

Herat, in western Afghanistan,

is the country's third largest city.

As war continues in much

of the country, the demand

for mental healthcare

is also skyrocketing.

This is the psychiatric unit

in the city's main hospital.

I've come to meet Dr Wahid Noorzad

who, at 33, is the man in charge.

Azata is 14 years old and has been

brought in by her mother.

Like many other young Afghans,

traumatic events have been a big

part of Azata's childhood.

Dr Noorzad suspects that Azata

is suffering from PTSD -

Post Traumatic Stress Disorder -

a type of anxiety disorder triggered

by traumatic events,

often seen in soldiers.

PTSD is increasingly common

amongst Afghanistan's

war ravaged population.

Social taboos around mental health

make it difficult to get patients

through the door and that's why

Dr Noorzad takes every opportunity

to reach out to the public.

At a local Herati TV station,

Dr Noorzad is being interviewed.

He's a regular guest and gives

mental health advice to people

who call in.

Dr Noorzad holds a weekly outreach

programme, an opportunity for more

people to get help, it's free

and has been running for four years.

Farhad is a trained

counsellor and a volunteer

who runs the sessions.

Farad himself suffers from PTSD

and is also a patient of Dr Noorzad,

but unlike the majority

of Afghans suffering PTSD,

he's seeking professional

psychological help.

A very recent traumatic event led

to Farad getting PTSD.

On the 1st August 2017,

two men walked into the Jawadia

mosque and opened fire on 300

worshippers gathered

for evening prayers.

They then detonated their suicide

vests, killing 38, including Farad's

teenager brother, Hossein.

Dozens of others were injured.

Jawadia is a Shia mosque and that's

why it was targeted.

Sunni militants like Isis

and the Taliban regard

the Shia as heretics.

Farad comes here every day.

For him, the trauma

of the attack is still very raw.

Photographs of the 38 victims,

some as young as two years old.

All are given the title

'Shaheed', meaning martyr.

CRYING

Ghulam Haider Sobhani has been

the Imam of this mosque for the last

25 years, he was also

here on the day of the attack.

Speaking to the Imam,

the challenge faced by Dr Noorzad

and his team becomes clear.

The taboo around mental health

is rooted deep within the culture.

For many Afghans, war and violence

have been a constant presence.

More than 2 million civilians have

been killed since the Soviet Union

invaded the country in 1979.

Herat even has its own

museum dedicated to war.

These are really old,

mostly Russian weapons

and ammunitions and they are

from 40, 50 years ago,

and it just really

shows how long war has been

going on in this country.

I mean, we hear four decades,

but seeing these really makes

it more tangible.

The Soviets' withdrawal in 1989

was the start of a ten

year-long civil war.

This led to the rise of the Taliban,

who continue their bloody insurgency

to this day, funded

by a booming opium trade.

2017 saw a bumper opium poppy

crop in Afghanistan.

Perhaps as a form of self medication

for the trauma of war,

many Afghans use opium.

An estimated 10% of the population

is now addicted to the opium

poppy derivative, heroin.

Some of these addicts end up here,

at the country's only

secure psychiatric unit.

It's home to about 250 men and 50

women, many of whom are suffering

from drug induced

schizophrenia and psychosis.

Mohammed Essar is a former

member of the Taliban.

Mohammed Davood is a former

member of the Mujahideen.

Both men were drug addicts

and suffer from PTSD and were sent

here by their families.

Without a resident psychiatrist,

the unit relies on outside help.

Dr Saljoochi is the

visiting psychiatrist.

The most dangerous patient, Alli,

is kept isolated from everyone else

after biting off a staff

member's finger and the ear

of a fellow patient.

Many patients' families have left

for neighbouring countries

because of war and

cannot be contacted.

Jaffar is here because of

depression and schizophrenia.

This led to an out of control drug

habit and later to violence.

He was sent here by his parents.

Like so many other patients here,

Jaffar is well enough to go home,

but he's not sure when he can leave.

Through a locked metal gate

is the female section.

About 50 women live here,

some with their children.

Some have been here for years

and look likely to stay.

A couple of days later,

I've come back to the psychiatric

unit because I've heard

some news about Jaffar.

After three years at the psychiatric

unit, Jaffar really is going home.

Jaffar's dad has made

the 800km journey from Kabul

to collect his son.

Back at Herat's main hospital,

Azata, the 14-year-old we met

earlier who was diagnosed with PTSD,

is back to see Dr Noorzad

for her first follow-up appointment.

For Azata, the long journey

to recovery is just beginning

and she's lucky to have

her family's support.

For Farad, the volunteer counsellor

who we met working with Dr Noorzad,

recovery from his PTSD

seems a long way away.

The trauma that took his brother

away is still too recent and raw.

Farad's recovery is being aided

by the treatment and friendship

of Dr Noorzad.

At the local football stadium,

we've all come to watch

a game together.

Seeing these players run around

today, it's easy to forget this

stadium's dark past -

an execution ground during the reign

of the Taliban.

Seeing the scale of the problem,

it's hard to imagine how

and when the country

will heal, but there is hope.

The effects of recent decades of war

on people's mental health

is being recognised and some help

given, and it's clear that many

Afghans are determined

that they and their country

will overcome the trauma of war.