A decades-long war, such as the one in Afghanistan, can often leave visible and invisible scars. It leaves behind traumatic imprints on the psyche of an entire generation—ones that may never heal. However, that hasn't stopped Afghans from attempting to erase, quite literally, the unwanted reminders of conflict.
While making small talk with some Afghans I met at the airport last month, I found that it wasn't uncommon for a lot of them to pursue cosmetic surgeries in Kabul and abroad. These were especially popular among those who have survived some form of violent attacks and explosions that are occurring with increasing frequency in the country. My curiosity piqued, I looked for the most popular cosmetic surgeon in Kabul and made an appointment with one Zalmay Khan Ahmadzai.
Posters on the outside of his clinic in Kabul show the before and after effects of the services offered—one such poster shows a frail and tired looking Hillary Clinton and the image next to it has a photo of a happier, made up Clinton, with fewer wrinkles (who, I imagine, has never been anywhere near this clinic).
I waited for my turn to speak to the doctor, explain to the people at the front desk several times that I wasn't a potential client, rather a journalist interested in their work. That—of course—didn't discourage them from recommending skin and hair treatments for me. "Ours is the only world-class clinic in Afghanistan; all doctors here studied abroad," one of the female doctors tells me, adding that they've had several popular Afghan celebrities as clients.
A muted corporate video featuring Ahmadzai plays on a television in the waiting area, illustrating the services offered. Nearly all of the other patients who wait alongside me—about eight of them—are women, accompanied by a family member. A few of them of them wear the full niqab or a burqa, shielding their faces from public view. Later, one of them, a 38-year-old named Maryam, lifts her burqa to show me the tattoos, faded blue and grey marks, on her face—her forehead and chin–she needs to have removed.
"I got this as a child; it was a [design to protect against] evil eye that my parents had etched on my skin," she tells me. "But my in-laws have always criticized me for having it since tattoos are considered un-Islamic. Before this I never had the chance to have them removed." She had been saving money for years and had travelled all the way from the province of Paktika to get a plastic surgery to cover the tattoos. "I hope this will stop their daily insults about my face," she tells me, exasperated.
As it would turn out, Maryam is one among the many Afghan women that Ahmadzai's clinic attends to. "About 60 percent of my clients are young women looking for aesthetic corrections, while about 30 percent or so are here for treatments for skin diseases and a smaller group of patients come for post-traumatic surgeries," Ahmadzai says, adding that his clinic (which has four doctors, two nurses and other medical staff) sees up to 50 to 60 individuals a day for consults—sometimes even more.
He invites me, with the permission of the patients, to sit in on some of the consultations of the day. Three of the patients, all women, agree to talk to me about why they were pursuing Ahmadzai's services.
Forty-two-year-old Gulali is visiting the clinic for the third time this month. Accompanied by her 11-year-old daughter, Gulali consults with Ahmadzai on getting botox injections to smooth the lines on her upper brow. She also wants her eyebrows to refashioned to look more like a popular music personality in Afghanistan. "I'm getting older, but I want to look younger," Gulali tells me. "Besides, it keeps my husband happy to know he has a younger-looking wife," she adds with a chuckle.
Gulali may not come from an impoverished background, but her cosmetic treatments are definitely an indulgence for her and her family. "I first heard about the these treatments in a television advertisement, and after much thought I decided to come for consultation," she explains. "Sure it's expensive, but it has been worth every Afghani [local currency] that I spent here," she says. One injection of Botox imported from India and Pakistan costs roughly about AFN 20,000 (about $300). "I have never felt more confident and optimistic about my life and future," she explains.
While for Gulali these treatments are a new lease at life, for 32-year-old Sharifa, aesthetic corrections are way of avoiding unwanted consequences of being a widow. Sharifa lost her husband, a soldier with the Afghan army, to the persistent conflict eight years ago. Over the last few years, she's developed a severe case of adult acne that has left marks on her face; "a likely result of lack of sex life; common among widows," one of the female doctors tells me. I nod, pleased to find that ludicrous, misogynistic pseudo-diagnoses are still going strong, globally.
"My mother-in-law is always taunting me about my looks, but now she wants to marry me off to an older cousin of my late husband," Sharifa says stoically, betraying no signs of anger or sadness over the situation. She tells me the "older cousin" is in his 70s. If she looks more attractive, Sharifa feels, she will have a stronger say in her own future. Will it make her mother-in-law happy, I ask. "Nothing can please my mother-in-law; she hates my face," she responds.
The doctor recommends treatment for acne as well as for removal of marks and some aesthetic improvements for Sharifa. However, when he finds out that she is a widow, he offers to cover her costs. "The clinic," he tells me, "keeps a small fund to treat widows and orphans, and the poor." Because everyone has the right to look dignified, he explains.
But in a deeply conservative country like Afghanistan, cosmetic enhancements, much like tattoos, could be perceived as anti-Islamic. To that, Ahmadzai responds passionately, "Who says they're against the religion? Not only does Islam permit cosmetic surgeries, there are in fact several hadith [verses] from the Prophet Mohammad that support it." It's evident that he's had this debate many times before with his critics.
Jalil Fiqi, a religious scholar with a doctorate in Islamic studies from Jamia Millia University in New Delhi, India adds insight to the Ahmadzai's questionable party line. "There are some Fatwas [directives] in Islam about cosmetic surgeries," he explains. "A Muslim can only opt for a cosmetic surgery when they need it to allow them to live a fulfilling life, not otherwise," he adds. Surgery for vanity's sake is not permitted, according to Fiqi.
"Many conservative people will say that their defect was given by Allah; and I often have to counsel patients and inform them of the impact their condition could have on their health," he shares. "I always encourage those who object to my work to come and talk to me, the doctor says, paraphrasing a hadith. "After all, Allah is beauty, and he loves beauty."
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