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Afghanistan mental health: Treatment caught between ancient and modern worlds

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Neuropsychiatrist Mustafa Noorzai heads a mental ward at the Ali-Abad Hospital in Kabul. With more than 70 beds and a dozen trained neuropsyciatrists, the facility has plenty of capacity, he says, and the services are free.

One patient, a university student named Ghulam Nabi, arrived four days ago and was diagnosed with psychosis. On the first day he broke windows, but now he is walking calmly around his light-filled room. Mr. Nabi says he is "getting better" and is "treated well."

A few years ago, says neuropsychiatrist Sayed Abdullah, the hospital would have chained up Nabi. But an ongoing World Health Organization effort called the Chains Free Initiative has educated doctors in Afghanistan to rely on alternatives instead.

"Now we increase the relief medications," says Dr. Abdullah. "Sometimes we tie with a belt, in old times we tied with a chain. But that ... affects their psychology."

Despite the improvements, the hospital has had families remove relatives once they learn of the shrines.

"We come here and find no patient, and when we ask, they say he has been taken to the shrine," says Noorzai. He notes: "I don't think it is the last generation of these [shrines] because they are linking some of their own traditions with Islam."

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