Monday, May 16, 2011

"The Only Therapy Is Prayer": A Whole Country With PTSD


Journalist Anna Badkhen has written an unnerving piece (Trauma Center; How do you bring peace to a country where everyone has PTSD and the only therapy is prayer?) about Afghanistan posted 13 May 2011 on Foreign Policy.com. She describes something we can scarcely imagine - a country so ravaged by war and violence that the mental effects of war are widespread and where mental health resources as we in the West understand them are virtually non-existent. The lens through which she tells the story is Abdul Hamid, a hospital attendant whose loss of vision after exposure to ghastly sights is a sign of conversion disorder, the brain protecting itself from further horrors by shutting down the eyes. For Badkhen, Hamid comes to stand for the 1 in 3 Afghans who suffer from some kind of war-induced mental injury, and his reponse, making a pilgrimage to a Muslim shrine, is the only recourse available to those who dwell in a country where "the only therapy is prayer".

Her account of Badkhen's visit to the shrine is as memorable as it is horrific:

"Last Wednesday, Abdul Hamid's sisters led the gardener into the shrine's putrid crepuscule and anchored him, teetering, on the floor near the northwest corner of the tomb. Next to him, a young man clasped the railing and shook. A few paces away, another man, recently paralyzed on his left side after a stroke, moaned a lament he alone could comprehend.

A woman ran fierce laps around the tomb, as she has done for 20 years, marking each footfall with a sharp, piercing shriek, as though her voice could scare away the destitution, horror, and war all around her. Then she collapsed on the floor in defeat.

Disoriented and frightened, Abdul Hamid wept.

The ammoniac reek of urine wafting from the floor of a place supposed to be holy, the cacophony of sounds -- the rattle of the metal railing, the woman's screams, the incoherent keening, the slapping of palms against adobe walls -- made no sense to him. His sudden blindness made no sense. "I am afraid," he whimpered, again and again, "I am so afraid."

He curled up against the corner of the tomb railing and tied, with his sisters' help, a plain white string to a metal post with long fingers he could not feel. His sightless eyes teared. He lay on the floor awhile. Unseen by him, swallows tumbled down elegantly out of their nests in the ceiling and dove through the shrine's open green door to somersault above the golden plains."


Badhken's elegant and poetic prose is deployed to make the point that in a country where there are only 200 beds for mental health patients, this shrine to a dead holy man is an inaqequate substitute. Her style -- "putrid crepuscule", "amoniac reek of urine", the whimpering and tearful sufferer -- underscore the title's implied scorn for "prayer" as "the only therapy" available to these poor people. The counterpoint of the unseen swallows enjoying their freedom "above the golden plains" underscores the bondage of those poor wretches as the birds tumble freely above them in a presumably uncaring heaven.

As you can imagine, I take issue with Badkhen here. I was just in a mental health ward here in Canada yesterday and I wish with all my heart that such comfortable facilities, with such well trained staff, were available to the people of Afghanistan. But go into any western hospital or nursing home and you'll smell the "amoniac reek of urine" and see and hear the whimpering and screaming of the deranged and the mentally ill. It's not pretty, but it goes with the territory of mental illness.

That a pilgrim shrine should stand for the pitiful inadequacy of Afghanistan's mental health resources is unfair. Badkhen's choice of focus has undertones of patronising scornfulness, saying, in effect, "this is the best these poor benighted people can do and it doesn't make the slightest difference", and I wonder if this is permissable because it's an account of a Muslim country. Would Badkhen have used such a tone and such images to describe those who visit a Christian shrine, such as Lourdes? Would Foreign Policy have published it? Perhaps. Post Dawkins and Hitchens, scorn for religion and spirituality is permissable for our educated and dispassionate observers of the human condition. That such scorn should be entrenched in an otherwise moving acount of the widespread mental damage caused by war is disappointing.

1 comment:

Sidney Roundwood said...

Mike
Thank you for a really excellent post. And a link to a very interesting, and powerfully written, article.

As you mention, there is a deep undercurrent of scepticism in Anna’s article. Possibly it’s even deeper than scepticism – is there, perhaps, a tinge of disbelief? In many ways that scepticism and disbelief is understandable. It’s difficult not to share it, contemplating the images she describes.

But I thought the really interesting quotation was this one: “ ‘Miracles happen here,’ promises Ishani Abdul Ahi, whose ancestors have maintained the shrine for seven generations. ‘Crazy people come away cured.’ " Do the 500 or 600 pilgrims each week travel to the “eerie oasis” out of desperation, or out of faith? How many stories are told in the local towns and villages of the changes which have happened to people they know, to people to have derived some help, or assistance at the shrine? 500 pilgrims over seven generations – how many people is that – hundreds of thousands of Afghans?

No one would ever argue that the almost-medieval description of the shrine is the best that the modern world can do to help those suffering mental illness in places like Afghanistan. Clearly there is much more to undertake. However, having a respect for the subtleties and depth of Afghan culture and faith means having an open mind to people like Ishani Abdul Ahi and the shrine he keeps, and what he tries to do there.

Best wishes, Sidney

Mad Padre

Mad Padre
Opinions expressed within are in no way the responsibility of anyone's employers or facilitating agencies and should by rights be taken as nothing more than one person's notional musings, attempted witticisms, and prayerful posturings.

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