Afghanistan, conflict, violence, mental health
A boy mourns by the coffin of a victim of the twin suicide bombings in Kabul on August 26. Photo: Aamir Qureshi/ AFP via Getty Images

‘Not a Single Afghan Without Trauma’: How Endless Cycles of Conflict Are Shattering Afghans

Half of Afghanistan's population reportedly lives with depression, anxiety, or PTSD.
Pallavi Pundir
Jakarta, ID

It was Ali’s 21st birthday when the Taliban entered Kabul. On TV screens, the local news channels showed Taliban militants entering in jeeps, waving their flags and brandishing guns. The country’s own president, Ashraf Ghani, and other politicians had fled the previous night. Afghanistan was left in chaos.

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Instead of celebrating his birthday, Ali locked himself up in his room and resorted to self-harm. “This is what I did to myself on the first night they came,” he told VICE World News. “I wanted to kill myself. But I controlled [myself] just because I didn’t want my mother to cry for me at a time like this.” Ali’s name has been changed, as have others’ in this piece who talk about their mental health, for their safety. 

Ali was diagnosed with depression and anxiety, after a bomb went off outside his school when he was a child. In the days following the Taliban’s return, Ali said he’s been barely coping. His father, a court judge, is in hiding.

His family struggled to survive the first Taliban regime. Now, their terror has returned, and they are worried about their safety. 

Even some of his friends who posted anti-Taliban messages online are being hunted down too, Ali added. 

Afghanistan, conflict, violence, mental health

There is very little faith in the “new Taliban” among many Afghans, which is triggering more anxieties. Photo: Marcus Yam/ Los Angeles Times via Getty Images

“I’ve spent all my life in war. Bomb blasts, killings—this is all I’ve seen,” he said in one of the messages shared with VICE World News over the last 10 days. “I’ve never enjoyed life, but I studied hard, I have great scores. I wanted to have a future.”

“But there is nothing left in me now,” he added. “I die a little every day in fear, stress and depression.”

Since 1978, Afghanistan has seen recurring cycles of violence that not only left the people disabled, displaced, jobless or in abject poverty but also caused deep psychological scars that transcend generations. Over half the population suffer from depression, anxiety, or post-traumatic stress, according to a study by Human Rights Watch (HRW).

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Over the last two weeks, several people in Afghanistan talked to VICE World News about living with anxiety, chronic stress, and trauma that they say only gets worse with each day. 

“I can’t sleep well at night. I am in constant paranoia that the Taliban will come and capture me,” said Jamal, a 24-year-old media professional. “I don’t know how to explain my emotions. I have nightmares. I sometimes wake up at night screaming.” 

“I’ve spent all my life in war. Bomb blasts, killings—this is all I’ve seen. There is nothing left in me now,” said Ali from Kabul.

Jamal said he was once beaten up by some Taliban soldiers for doing his job. “I’m going through emotional turmoil, but I have nowhere to go.”

Last night, a series of explosions outside Kabul’s international airport—where thousands of Afghans were trying to get on evacuation flights—is estimated to have killed at least 100 and injured more. Many Afghans took to social media to vent their deep despair, anger, and hopelessness. 

“It’s very difficult to find someone in Afghanistan who wouldn’t fit the diagnostic criteria of trauma,” Heather Barr, associate director of the women’s rights division and former Afghanistan researcher at HRW, told VICE World News. “When you hear people’s family stories or personal experiences, it’s unlikely you’ll meet someone who hasn’t suffered an irreparable loss. This pattern is repeating as we see another exodus of people after August 15.”

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A 2021 survey conducted across 16 provinces involving over 4,000 Afghans found that 86.16% of the sampled population had either personally experienced or witnessed at least one traumatic event. It also found that collective violence such as assault with a weapon, combat or exposure to a war zone, was very frequent. 

The World Health Organization recommends an investment of $3 to $4 per person to establish a mental health system in low-income countries like Afghanistan. Despite the crisis, the Afghan government spent only $0.26 per person on mental health, whereas it has spent $7 per person yearly on general health services.

Many parts of Afghanistan lack basic healthcare facilities, and where they exist, they tend to function poorly. There are only 172 hospitals and four doctors for every 10,000 people, according to a 2019 government report. One-third of the country’s 31.4 million people don’t have a functional healthcare facility close to their homes, according to a UN report

The public healthcare system depends completely on foreign aid. A 2021 HRW report said the country’s health services, especially for women, “remain far below international standards” despite two decades of donations worth billions of dollars. 

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“It’s very difficult to find someone in Afghanistan who wouldn’t fit the diagnostic criteria of trauma,” Heather Barr, associate director of the women’s rights division and former Afghanistan researcher at HRW, told VICE World News.

The resurgence of violence has further blocked Afghans’ access to what little healthcare is available to them, according to a recent Doctors Without Borders (MSF) report. NGOs remaining in Afghanistan are “in a kind of limbo, waiting to see who will be in charge,” MSF country representative Filipe Ribeiro said in an NPR interview last week. 

In another HRW report titled Afghanistan’s Silent Mental Health Crisis, researcher Jonathan Pedneault found that in the last 15 years, the Afghan government trained around 750 psychosocial counsellors to give basic mental health services and facilitate referrals, but less than 10 percent of the population actually availed of these services. 

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Pedneault said there was a strategy to ensure there would be some form of mental health and psycho-social support among the villages. “But that policy was never completely implemented for a number of factors—partly because the health officials had to operate in Taliban-controlled areas at the time, which made providing those services very difficult,” he told VICE World News. 

“Now, of course, with the current situation, there is extreme uncertainty as to whether and to what extent international health aid will continue in Afghanistan. It’s not clear the new rulers of the country will prioritise it.”

The trauma tends to be more acute among the socially vulnerable, experts said. These include women, children, minorities, and people whose jobs make them targets of the Taliban, such as human rights workers and activists.

Women were especially targeted, oppressed and brutalised during the Taliban’s first regime. Their torment continues. “It’s there in the minds of women who lived through it in the 1990s, or those who escaped the abuses. Even their daughters grow up with this trauma,” said Barr. 

A 2021 survey conducted across 16 provinces involving over 4,000 Afghans found that 86.16% of the sampled population had either personally experienced or witnessed at least one traumatic event.

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Pedneault said many of the people he interviewed in 2019 were still living with their trauma from the 1990s, when they lived through the first Taliban regime. 

Even Afghans who escaped the regime and now live in other countries have opened up about the deep trauma the recent events in Afghanistan have caused them. Harrowing experiences escaping violence were reignited, and even those who were born abroad and have never been to Afghanistan report going through ancestral trauma.

“The crisis is more traumatic for those who were able to experience a modicum of stability. However, a majority of Afghans continue to live in the cruel realities of war,” said Pedneault. 

As for the younger generation, Barr said they are determined to fight for their dreams and excel in different fields almost as if “they’re driven by the trauma.” 

Pedneault said the world needs to keep Afghanistan under constant scrutiny. 

“So far, the Taliban have broken a number of promises. This lack of trust triggers high levels of anxiety in people,” he said. 

That’s already the case less than two weeks since the Taliban overthrew the government. Although the so-called “new Taliban” are claiming to be moderate, 23-year-old Aysha said she doubts the hard-line militant groups’ promises of liberty and rights for women. Even now, the Taliban are asking women to stay at home.

“They killed one of my colleagues who worked in my office,” she told VICE World News in a voice note. “Surely, they will be coming for me. The anxiety is indescribable.”

If you or someone you know is considering suicide, help is available. Call 1-800-273-8255 to speak with someone now or text START to 741741 to message with the Crisis Text Line.

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