Sun, Oct 19, 2008 - Page 13 News List

Chains or drugs? The treatment choices for Afghanistan’s mentally ill

In a country ravaged by war and with minimal resources for psychiatric care, some Afghans suffering mental illness turn to the Mia Ali sanctuary, where care is based on the teachings of a 17th-century mystic

By Thibauld Malterre  /  AFP , JALALABAD, AFGHANISTAN

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This is the standard “treatment” for mentally ill people who have been coming to the Mia Ali sanctuary in eastern Afghanistan for 300 years.

“Here, we don’t give medication or advice, there is no other treatment than belief in God,” says Mia Mohammed Naeem, one of the guardians of the shrine in Samar Khel village, 10km from the city of Jalalabad.

“It’s a spiritual treatment with the Koran and diet,” he says.

In a country destroyed by three decades of conflict, about 2 million people suffer mental illness, according to the World Health Organization. But in 2005 there were only 160 beds in the nation’s psychiatric facilities, it says. At the Mia Ali sanctuary the patients, presumed to be possessed by jinns (demons), are chained by the wrist to a tree or in a concrete room, under shelter or in the open, for 40 days. They are fed only bread and water and get no change of clothing. In a shack close by, Ghulam Haider, 45, crouches on the ground, tirelessly writing in Arabic the different names of God and verses of the Koran on pieces of paper.

“Some of these taweez [amulets] will be poured in a glass of water and then drunk. Others will be burned or used as a necklace. Every single word of the holy Koran is healing,” he says.

The taweez, not recognized by orthodox Islam, are used to treat mental sickness and are also sought after by the pilgrims who come to visit and pray at the tomb of Mia Ali Sayed, a Sufi sage from the 17th century. Among one family that has arrived is a woman in a burqa who holds a baby in her arms: everyone has come to pray for the child to not cry the whole night. Other visitors ask for headaches or stomach pains to stop.

“We don’t ask Mia Ali for a cure, we ask God. Mia Ali is only the way to God,” says Mia Mohammed Naeem.

As his name suggests, he is a descendant of the Sufi as are the roughly 50 people who maintain this sanctuary, each taking turns for a few days a month. In normal life, Mohammed Naeem is a driver. Only Asadullah, an old man of 85 whose fingers play with the keys to the locks on the chains of the current eight patients, works full-time at the site.

“My responsibility is to tie up the patients. During the night, I go to see how they are; I clean them. Some can be violent but they respect my white beard,” he says.

Behind him a rake-thin young man is tied up inside a concrete room. Bare-chested and emitting a strong smell, Wali arrived here from Kabul, 150km away, about 20 days ago.

“I drank whisky, I smoked hash … so my family brought me here,” he says with a dark look.

The keepers of the sanctuary have no doubt about the success of this method of treatment developed by Mia Ali himself.

“Most of the people get well after 40 days,” says Mohammed Naeem. He gestures to an electricity generator. “This was built for us by a patient who came here in a bad condition and, as a miracle, was cured,” he says, adding that patients come from all over Afghanistan and even neighboring Pakistan.

“Families pay US$100 for food and cleaning. We stay in contact with them by phone,” he says.

The sanctuary has no links with the psychiatric section of the public hospital in the city of Jalalabad, even though it is close by.

“Family members bring the people here after treatment in the hospital has failed,” says Jan Baz, a 22-year-old soldier who is also a member of the Mia family. The hospital has had a psychiatric section for 30 years but can no longer admit permanent patients, allowing people to stay for only three weeks even though many return.

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