Psychological Warfare

Retired Gen. Bariali Sabir's body is as disfigured as the Afghan landscape. Today the 53-year-old Army man, who lost his job under the Taliban, is back in Kabul's Military Hospital complaining of severe arthritis from decade-old bullet wounds. But Sabir's spirit is in just as much need of doctoring. "Sometimes I fly into a rage and can't recognize my family members," he says. "I've beaten them countless times. I fear I'm losing my mind." One of his four sons, a shy, freckle-faced 10-year-old named Abid, confirms that his father has often attacked family members. "About a month ago I wanted to ask my father a question, and he just hit me. He didn't even know I was his son," says Abid softly, with no apparent rancor. "I'm afraid of my father day and night."

Even as Afghanistan tries to piece its politics back together, the country faces one of the worst mental-health crises in the world. As a recent World Health Organization report puts it, "Twenty-three years of war have ravaged... the people in Afghanistan. Killing, executions, massive persecution, forced internal displacement, fear associated with living in mined areas, and the latest escalation of violence have left an indelible mark." The corridors of Kabul hospitals echo with grim tales. After her home was bombed, one woman was so traumatized she hasn't spoken since. A man whose wife died in a rocket attack suddenly lost his memory. At Kabul's Mental Health Hospital, a father who lost his son became severely disturbed and had to have his hands and feet tied together--at which point he declared, "I'm a cow," began making mooing noises and tried to eat grass outside the dilapidated ward.

The horrors of the past may also have something to do with the atrocities of the present. "In my opinion, 90 percent of all fighters are psychologically disturbed," says Dr. Mohamad, deputy administrator of Kabul's Military Hospital. In an upstairs ward, 28-year-old soldier Dad Moh has had posttraumatic epilepsy for six years, after being hit on the head by other fighters trying to steal a friend's AK-47. He cannot answer coherently when asked to imagine life without his Kalashnikov. "That would be very abnormal," he says finally. He's been carrying a rifle, he says, "ever since I can remember."

Add to that the psychic burden of poverty. At the military hospital, a common source of mental illness is severe injury or amputation. Amputees feel helpless and, worse, unable to earn money. "Several have jumped off high balconies at this hospital to their deaths," says Dr. Ismail. Drug dependency also increased under the repressive Taliban regime. "A lot of people got addicted to heroin," says psychologist Abdul Menon Hakiar, the newly appointed administrator of the mental-health hospital.

Many cases of drug addiction can also be traced to the posttraumatic stress of Afghanistan's long conflict, say doctors in Jalalabad's psychiatric hospital. Here, unlike in Kabul, inmates are considered incurable; some become violent and have their ankles chained to iron bars. Seventy percent of the cases are war-related, says psychiatrist Sayed Afundi. One patient calls himself "the king of Medina" and says the late Indira Gandhi is his wife. Babbling in a mix of Pashto, Dari, Russian and Uzbek, he claims to hold the rank of marshal and rambles on about the war. The "king" was apparently a military man; he was brought to a Kabul clinic 17 years ago, distraught and aggressive, by soldiers in a Russian tank. But he has no documents, and the cash-strapped hospital has no funds to trace his relatives. "The patients haven't even had any meat to eat in six months," says Afundi. "We hope some money will come in soon."

Already the past few weeks have brought some hope--and expertise. Hakiar, dressed in a neat Western suit, has just been appointed by the Northern Alliance; his predecessor was an uneducated Taliban mullah who fled. "The Taliban never understood psychology or psychiatric techniques," says psychologist Sima Usmani. "They thought the answer to mental problems was praying." Hakiar says music and occupational training such as carpentry classes will be emphasized as therapy. And he makes a point of treating the women--whether they are patients or psychologists--with respect.

Still, full recovery will take time. "Afghan society needs at least 10 years of peace for us to return to normal," says Sadiq, a military-hospital doctor who confesses that he himself occasionally hit patients out of frustration. "Psychologically, Afghans feel like they've been living in one big jail for a long time."

Psychological Warfare | News