Young afghans experience constant violence that is not just limited to acts of war

Young afghans experience constant violence that is not just limited to acts of war

An article published Online First and in a future edition of The Lancet reports that young Afghans experience violence that is constant and not limited to acts of war. The article is mental health. It stresses the significance of understanding trauma in the context of everyday forms of suffering, violence, and adversity.

There is confirmation of substantial mental health problems in adults in Afghanistan. But there is little evidence relating to children. Researchers surveyed in the country young people aged 11 to 16 to evaluate mental health, traumatic experiences, and social functioning. The study included interviewing of 1,011 children, 1,011 caregivers, and 358 teachers, all randomly sampled from 25 government-operated schools within three purposely chosen central and northern areas (Kabul, Bamyan, and Mazar-e-Sharif). Possible psychiatric disorder and social functioning in students was assessed. The mental health of caregivers was also evaluated. In addition, they analyzed risk factors for child mental health and reports of traumatic experiences.

Research indicated there was an association between all child psychiatric outcomes and both trauma exposure and caregiver mental health. About 22 percent of children met the criteria for probable psychiatric disorder. Girls were around two-and-a-half times more likely to have disorders than boys. Children who had suffered five or more traumatic events were two-and-a-half times more likely to have a psychiatric disorder. Also, they were three times more likely to report symptoms of post-traumatic stress than those who had experienced four events or less. The mental health of the caregivers was interconnected to the wellbeing of the children under their care: there was a 10 percent increase in the probability of child psychiatric disorder for each and every symptom of psychological distress reported by caregivers. Children living in Kabul were more likely to have a psychiatric disorder and symptoms of post-traumatic stress than those living in Bamyan or Mazar-e-Sharif. The study also provides confirmation of the resistance and strength among Afghan children in dealing with violence and daily hardship.

The authors explain: "Afghan Government policy has recognised the need for public health interventions to alleviate trauma, mental health disorders, and psychological distress in the general population. There is, however, an acute shortage of qualified mental health care practitioners, constraints on the current provision of basic health and social services, and inherent challenges in creating effective youth-focused programmes."

They write in conclusion: "In Afghanistan, there is a spectrum of violence - ranging from armed insurgency to family conflict - which generates sudden pain and persistent suffering. Our data suggest that, in Afghan children's lives, everyday violence matters just as much as militarised violence in the recollection of traumatic experiences...Our study emphasises the value of school-based initiatives to address child mental health, and the importance of understanding trauma in the context of everyday forms of suffering, violence, and adversity."

In an associated note, Dr Andrew Dawes, University of Cape Town, South Africa, and University of Oxford, UK, and Dr Alan J. Flisher, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa, warn that school-based interventions may not be practical because of the tension under which the Afghan education system operates. In particular, inadequate resources could mean teachers do not have sufficient time and emotional resources to monitor child mental health. In conclusion, they call for more investigations of this kind in different settings. Also they emphasize that interventions need to draw on traditional systems of support as much as modern methods.

"Violence, suffering, and mental health in Afghanistan: a school-based survey"

Catherine Panter-Brick, Mark Eggerman, Viani Gonzalez, Sarah Safdar

DOI: 10.1016/S0140-6736(09)61080 -1

The Lancet

Have We Won in Afghanistan? VICE Podcast 004 (Video Medical And Professional 2020).

Section Issues On Medicine: Psychiatry