The Fate of Mental Health in Afghanistan under the Taliban
Blue scars concealed under the black burkha yearn for emancipation, as a teardrop rolls down the face of an Afghan woman, just like the slackening hope for a better tomorrow.
While the eyes long for the clement kiss of sun rays, the quotidian headlines only seem to thicken the black clouds hovering over Afghanistan. The thread of hapless images going viral on the internet has perturbed each one of us. Meanwhile, the Taliban continues to stitch and seal the pipe-dream of the majority of the Afghans.
Individuals across the globe are well-versed with the ongoing predicament in Afghanistan. Plagued by destitution, bloodshed and social inequality, this war-torn country has witnessed extreme terror for generations and generations together. During the Taliban rule from 1996–2001, various human rights violations have been carried out over the years — from massive systematic exploitation of women and brutal carnal punishments to the proscription of education, religion, and expression, and effects remained even after this period. Post the end of the Taliban rule, women gained autonomy over their choice of clothing, with over 8.2 million students enrolled in school, 40% were female. Now, with the Taliban in power once again, the world is fearing the repetition of a traumatic history.
I wonder, what will all of this mean for mental health?
As an Indian woman living in India, and a media student at Manipal Institute of Communication who has also studied some psychology, the devastating situation in Afghanistan has gravitated my attention towards its citizens’ plight, especially their mental health. Seeing the inhumane trauma women are being put through, I hope to voice their struggle through my words.
“I want my daughters to be respected as human beings; that’s the country I’m fighting for.” — Fawzia Koofi (Former Afghan Politician and Women’s Right Activist)
Previously, women’s mobility, conduct, attire, and almost every aspect of their lives was severely controlled by the Taliban regulations. They were prohibited from working outside the house, female education was forbidden, and public floggings were common. Reading through these autocratic rules imposed by the Taliban leaves us fearfully wondering what circumstances will be once again constructed for these women in the 21st century.
“We have to change this idea that women are only supposed to work in the house. Women should go out and be what they want.” — Malala Yousafzai (Pakistani activist for female education and a Nobel Peace Prize laureate)
Prior to the promulgation of the Afghan national constitution of 2003, eliminating discrimination against Afghan women in all forms, the situation of women under the Taliban was abysmal. War traumas, sexual oppression, rape, premature and involuntary marriages, sex slavery, conservative detrimental behaviours, domestic violence, and cultural restrictions on social activities were all facets of the degradation of Afghan women’s mental health issues.
Due to the direct repercussions of violence and the war-induced destruction of public health, security, and infrastructure, the conflict in Afghanistan continued to claim lives in the post-Taliban era as well. Crossfire, improvised explosive devices (IEDs), killings, bombings, and night raids on suspected militants’ homes led to the murder of many civilians. Thus, even the democratic period could not thwart the practise of certain violation of human rights.
Ever since the recent Taliban takeover, the women have again been locked behind closed doors as futile laws have been implemented. Women teaching boys above 6th grade or at co-ed institutes has been banned, new dress code and gender segregation rules have been introduced, women protesting for equal rights were whipped and beaten with electric batons, strict interpretation of Sharia Law are to be practised, the newly formed Taliban government has also replaced the Women’s Affairs Ministry with the Ministry of Vice and Virtue.
While there is no recent data available on the current status of women, the news updates undoubtedly hint towards the ever so exacerbating mental health concerns across Afghanistan.
Real men don’t cry.’
The problem of toxic masculinity has been on the table for decades, and for an orthodox country like Afghanistan, there is little room for the importance of mental health. Under the previous Taliban rule, men were coerced into wearing turbans in all government offices, men with trimmed beards were beaten up, sports were banned, executions and amputations of hands were carried out, and men were compelled to go to the mosque five times a day for prayers. Activities like these impacted the mental health of Afghan men.
The stigma associated with mental disorders is grim enough for people to believe that mental illness is synonymous with weakness and disability, leading to some being utterly oblivious to their illness and going about their daily lives. Consequently, victims of mental health ailments, especially Afghan men, prefer to conceal their maladaptive behaviour and psychological distress.
Arguably, Afghan women are the worst affected and most tormented among the general population of Afghanistan. In 2002, the prevalence of mental health issues was less pervasive in Afghan men in contrast with Afghan women.
As the previous Taliban era witnessed its end, drastic measures were taken for the improvement of mental health across Afghanistan. In 2008, 85% of healthcare institutions saw at least 750 new patients per month. More than 900 community health workers and hundreds of doctors, nurses, and midwives were trained in mental health services between 2002 and 2012 when mental health care programmes were introduced.
Fast forward to 2018, resulting from the after-effects of the Taliban regime, a total of 66% of Afghans had personally experienced at least one traumatic event, while 84% had either personally suffered or witnessed a traumatic event. As of June 2021, the overall prevalence of psychological distress stood at 47%. The 12-month Post Traumatic Stress Disorder (PTSD) prevalence rate was 5%, the Generalised Anxiety Disorder (GAD) prevalence rate was 3%, and the Major Depressive Episode (MDE) prevalence rate was 12%. Thus, prior to the forceful acquisition of the country and mental health services available, Afghanistan still exhibited high numbers of mental health issues post the end of the Taliban regime and overall trauma of war and violence experienced.
“There are a lot of children in Afghanistan, but little childhood.” — Khaled Hosseini (Afghan-American novelist and UNHCR goodwill ambassador)
But what future are we referring to when Afghanistan’s youth take a leap in the dark with the passage of every day?
In a country, ripped apart by war and weapons for more than 40 years, the future of the next generation can’t help but seem sombre and forlorn. Will children, who are the torchbearers of tomorrow, see their years of happiness and freedom fading into an illusion? Will they suffer the same fate of prior generations? Will history repeat?
The traumatic experiences of the Afghan children have made them prey to severe chronic mental health disorders. For example, in 2019, 62% and 73% of parents reported, respectively, that their children had direct or indirect experiences of conflict, or that their children suffered terror and anxiety resulting from violence. Moreover, 48% of parents reported their children experienced prolonged sadness and insomnia, and 38% said their children self-harmed.
However, now that the Taliban is back in power, it would not be hard to assume that these numbers may escalate.
“The problem with the stigma around mental health is really about the stories that we tell ourselves as a society.” — Matthew Quick (American writer of adult and young adult fiction)
The Ministry of Public Health (MoPH)’s establishment in 2005 paved the way for mental health to be in the top five priorities, making it one of the ‘Basic Package of Health Services’ (BPHS) components. However, in 2006, Afghanistan’s massive gap between the deficit in mental health services and a dearth of human resources with experience in the treatment of mental illnesses was brought to light. Following the WHO’s report on the severe lack of mental health facilities in Afghanistan, the Afghan Government introduced a Health and Nutrition Sector (HNS) Strategy in 2008.
With the Taliban all set to rewrite the horrid tales of misery post its recapture of Afghanistan in 2021, the minimal mental health facilities offered under a democratic regime have surely met their end. The impositions implied post the recent Taliban takeover has begun alarming towards major red flags.
Dreading their existence and battling through the excruciating directives, the Afghanistan population is undergoing a massive humanitarian crisis, which is coercing them into fleeing their own country. The displacement of Afghan women and children due to the conflict has reached 80% of nearly a quarter of a million population that has been forced to abscond since the end of May. Struggling to meet the daily ends of food, shelter and water, caring about their dwindling mental health is probably not even the last priority of the struggling Afghans.
While the scars from the nightmares of the previous Taliban rule have not healed for the majority of the Afghan people, the band-aid is already being ripped off.
We can only hope for a better dawn.
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Here are some relevant mental health resources:
The UK Government has established helplines for British and non-British nationals (on GOV.UK) in need of assistance. The Mental Health Helpline has been made available for 24 hours to listen and offer assistance.
Call: 0800 132737
Text ‘Help’ to 81066
Non-British Nationals: Call +44 2475 389 980 if you are a non-British national in Afghanistan or a family member of a non-British national in Afghanistan in need of assistance (or 02475 389 980 in the UK).
Editors Note We, at Inspire the Mind, are proud to continue to provide a platform and an opportunity for those affected by the events in Afghanistan to share their stories. You can read more at the following: