The Mental Health Dimension
Park, Katrin Eun-Myo, UN Chronicle
One of the most pressing issues facing Afghan refugees, especially women, today is their mental health, according to the World Health Organization (WHO) and advocates for women. Although the issue of survival takes priority, more people are recognizing the importance of the mental health of refugees and internally displaced persons.
The common mental disorders found in refugees are post-traumatic stress disorder (PTSD), depression, anxiety and adjustment disorders, and psychosomatic symptoms, say WHO experts. Noting that over 2 million Afghans are estimated to suffer from mental health problems, WHO urged the re-establishment of mental health services to treat them. Afghan refugees suffering from such illness are even worse off because, after decades of war and repression, there are no family or community structures left in Afghanistan from which they can draw psychosocial support.
A WHO fact-finding mission to Pakistan found that 30 per cent of Afghan refugees who seek medical care at local facilities are presenting psychosomatic complaints resulting from psychological illness. "One of the problems right now is the lack of information from Afghan people themselves", said Dr. Shekhar Saxena, Coordinator of the WHO Mental Health and Substance Dependence Department. "All that we have written or talked about is based on past experiences or what is likely, rather than what is actually present."
In early 2001, there were eight psychiatrists, eighteen psychiatric nurses and twenty psychologists for a population of 25 million, according to the WHO Project ATLAS: Mental Health Resources in the World. Facilities for treatment are also limited. There were fifty psychiatric beds available in Kabul (thirty for men and twenty for women). Other psychiatric facilities included two centres in Jalalabad and one in Mazari-Sharif. Patients were reported to include those tortured years ago by Soviet soldiers or later by the Taliban, as well as those traumatized by the recent bombings.
Afghan women, above all, have experienced a dramatic decline in their psychological health over the past decade. Under the Taliban rule, they were excluded from education and employment, but still had to take care of their families. In Kabul, for instance, approximately 60,000 widows had been forced to live without traditional family support. As a result, many have resorted to begging on the street, according to WHO.
An article published in the Journal of the American Medical Association found that among the 160 women interviewed in Kabul and refugee camps in Pakistan, 81 per cent reported a decline in their mental health status. …