Sad Fate of Trauma Victims

Hameed saw his father murdered before his eyes, killed by a Taleban soldier. And in the depths of his torment and confusion, his tortured child's mind somehow came to identify his mother as the killer.

As his father lay dying, he had asked Hameed for a last kiss. Perhaps too frightened, the boy froze. He subsequently began to plot revenge, threatening to kill his mother in punishment for a crime he could not begin to comprehend.

"At the beginning, Hameed would just keep calling for his father," said psychologist Seema Osami, at the Kabul's psychiatric hospital. Had it not been for the treatment he received there, he might have spent the rest of his life agonising about his failure to grant his father's dying wish.

Staff at the hospital put the seven-year-old through a programme designed to find a way to help him rationalise his loss and find a way out of his self-constructed prison of hate.

"In the last stage of his treatment he began to pray for his father," Osami told IWPR. "He was able to find another means of responding to his tragedy. He was able to convince himself that avenging the murder would degrade his father's martyrdom, an act he had come to believe would have displeased him."

Another child, eight-year-old Sulaiman, saw Taleban soldiers arrest and take away his father at night. Soon after the abduction, the boy developed a terrible stammer, almost unable to speak, and has withdrawn into a shell.

As Sulaiman struggles to tell his story, his eyes begin to move unnaturally, he becomes nervous, to twitch and eventually he begins to weep.

Psychologist Zarghona Ahmadzai is trying to help him break his involuntary physical response to trauma. She is using word practice, recitation and tongue exercises, and also tries to help him overcome his fears.

She believes that children are particularly prone to post-traumatic stress because of their idealised view of life. "They believe that they are important, the world is secure and the future is lovely, but a single shocking incident can destroy this belief in a second. They lose all sense of self-belief, of security or self-confidence," she said.

But most Afghans are unable to understand how medical treatment can help cure children suffering from such conditions. "Many people think that a bottle of medicinal syrup will work better that psychiatric help," said Dr Sohaila Sadat. The most sceptical of all were the Taleban, who tended to regard mental illness as a consequence of lack of faith.

The hospital, opened in 1985, became the base in 1992 for the country's then newly-established Institute of Psychiatric Health. It boasted 530 professional and ancillary personnel on its wards. But the Taleban slashed the staff to 50.

Despite the fall of the student militia, it continues to run a limited service largely because there's not enough money for specialist equipment and support workers.

The hospital has also fallen victim to changes in policy by the international aid community. The UN children's agency, UNICEF, was forced to stop work with its traumatised children during the Taleban's reign. It now wants to help with their treatment again but through community programmes. The trouble is that without more direct support, the hospital itself can only provide basic therapeutic care.

Essential programmes like vocational therapy cannot begin without craft materials and instruments for music therapy. "Our hospital doesn't have the material for patients such as paper, pencils, toys, playroom equipment or a soundproofed room," said Dr Ahmadzai.

Patients' families have to buy medicines from the bazaar as the hospital dispensary cannot provide them. Breakfast for many patients is often no more than a handful of sugar; they must make their own lunches and suppers from rice and beans or potatoes.

Mohammad Daud Siyawash is a freelance journalist in Kabul.