AFGHANISTAN: Inadequate Care for
Trauma Victims
Photo:
IRIN |
The
government says that up to 85 percent of the population may have
psychological disorders |
KABUL, 13 February 2007 (IRIN)
- In October 2006, Jamila, a resident of Panjwai district in the southern
province of Kandahar, fled to Kandahar city after heavy fighting between the
anti-government insurgents and NATO-led forces. Every day she has flashbacks to
the planes flying overhead and bombs being dropped. She knows these images are
not real but cannot stop herself from shouting out.
Jamila’s experience
is not unusual. The psychological fallout from the conflict over the past three
decades continues to be neglected, although estimates suggest huge numbers
suffer from varying degrees of trauma. A spokesman for the Ministry of Health,
Abdullah Fahim, said psychological disorders could be affecting up to 85 percent
of the population, while the World Health Organization (WHO) spokesman, Sayed
Saeid Azimi, said the WHO estimated half the population had some psychological
problems or disorders.
Often invisible and largely unquantifiable,
mental health has been pushed into the background while agencies and health
personnel focus on the more visible physical ailments.
Only [having] medicine, food,
clothes and household appliances cannot help them
recover. |
“Only [having] medicine, food, clothes and
household appliances cannot help them recover,” says Hafizullah Hafiz, programme
manager of mental health at Healthnet, a non-governmental agency.
WHO
estimates the country has just two qualified psychologists in its health system
and there is only one mental health hospital, in Kabul.
Traumatised by bombing
Mahmood, a resident ofa
Sperwan village of Panjwayi district, has personal experience of the inadequate
mental health facilities. A young girl from his village was traumatised by the
bombing. Mahmood and others have taken her to “all the doctors in Kandahar
city”; the doctors say the girl is mentally ill but have not been able to help.
“We cannot tolerate listening to her crying. We are so troubled about her. We
would be happy if she dies.”
According to a 2006 WHO report on the
mental health system in Afghanistan, the budget allocation for mental health in
2004 was US$100,000 out of a total health budget of $289.4 million.
“Taking into account the budgetary problems, the Ministry of Health has
identified a series of basic health services to address the health emergency
problems of the patients and psychological/mental problems are prioritised in
the second line of this process,” said Health Ministry spokesman, Abdullah
Fahim.
Ruhullah Nassery, the national mental health coordinator in the
Ministry of Public Health, reckoned mental health was the most neglected aspect
of healthcare in Afghanistan and said a larger allocation for the sector had
been sought in the forthcoming budget. Nassery expressed hope that the donor
community would pay more attention to this aspect of healthcare.
We cannot tolerate listening
to her crying. We are so troubled about her. We would be happy if she
dies. |
Despite earlier declarations by the Ministry
of Public Health, the country has yet to initiate a mental health policy and
legislation.
Nassery said there was a need for integrated mental health
services in the provinces as part of basic primary healthcare. However, although
training in mental health issues has begun, funding constraints have limited
numbers.
Efforts by NGOs have been sporadic and are largely limited to
urban centres, especially the capital, Kabul. Yet the effects of psychological
trauma are being felt most acutely in the rural areas of the southern provinces
where violent fighting increased dramatically in 2006, and is expected to worsen
in 2007. Several agencies IRIN spoke to, including the Afghan Red Crescent,
United Nations High Commissioner for Refugees, and the International Security
Assistance Force’s provincial reconstruction team, all said they had no
programmes for mental health in the south.