Published in Washington, D.C.      April 11, 1988

Psychiatric center treats victims of Afghanistan torture

By Richard S. Ehrlich

PESHAWAR, Pakistan

      Afghans who have gone made from nearly a decade of war or who suffered mind-breaking torture at the hands of the authorities there now have a psychiatric center where they can go for help.

      "We want to know how people are affected by things like bombings, mass slaughter and torture," said Dr. Mohammad Azam Dadfar, who runs the Psychiatry Center for Afghans. Dr. Dadfar's simple, white-walled clinic 40 miles east of Afghanistan's Khyber Pass frontier is financed by London-based Amnesty International and other organizations.

      "Our aim is to rehabilitate victims of torture and treat post-traumatic disorders caused by the war," he said.

      The clinic's bookshelves are lined with the latest issues of Integrative Psychiatry and the New England Journal of Medicine and black folders labeled "Psychiatric History Sheets" containing extensive notes.

      In addition to treating victims, the center is also documenting its work to determine how war affects the general civilian population.

      "Among the Afghan refugees, there are many severe cases of mental disorders due to loss of social status, identity, family members, property and job because of the war," Dr. Dadfar said.

      "Also, they are now living in refugee camps, which are monotonous, non-productive societies, while they have expectations and a dependency on others but no stability, no prospects of a future, no motivation, no social dynamism," he said. "All of this causes psychological problems."

      The psychiatry center for Afghans has rehabilitated 341 torture victims aged 12 to 80, Dr. Dadfar said.

      About 90 percent of them were beaten, 73 percent were jolted with electricity and 33 percent suffered genital torture, Dr. Dadfar told the World Congress for Mental Health (WCMH) meeting in Cairo in October.

      He said that in 40 percent of the cases, Soviet officers were present during interrogation and 10 percent of the victims were tortured directly by the Soviets.

      Moscow and the Soviet-backed Afghan government deny all allegations of torture.

      Some victims were guerrillas fighting to oust the 115,000 Soviet troops from Afghanistan, while others were political prisoners, he said.

      "We sent their files to the Human Rights Committee and Amnesty International. Two members of Amnesty came here and interviewed 20 victims who were tortured last year," Dr. Dadfar said.

      Each day, about 60 patients show up for treatment: Turbaned, bearded men wearing traditional baggy cotton clothes sit waiting their turn next to women who are usually veiled.

      "Most of the people are severe cases. We use psychotherapy, discussions and meditation," Dr. Dadfar said.

      The clinic has treated some 15,000 patients since it opened two years ago, he said. When the clinic started, it had rooms for patients to live in, "but that was too difficult for us," so now it handles outpatients only.

      Financing comes from the United Nations Voluntary Fund for Victims of Torture, Amnesty International and West Germany's Help Committee.

      The clinic wants to expand so it can attend to troubled Afghans in scattered camps along Pakistan's barren, mountainous border with Afghanistan. "We need mobile clinics because it is difficult for refugees to come here from the camps," Dr. Dadfar said.

      Women and children are especially reluctant to leave the relative security of the camps to travel alone to and from Peshawar, he added.

      Dr. Dadfar, 41, received his M.D. at Kabul University in the Afghan capital, where he was also a junior lecturer in the psychiatric department for five years.

      He views Afghanistan's current Soviet-backed leader, Najibullah, with a psychoanalyst's eye.

      "Najibullah was my classmate at medical school for one year, so we know each other. He is paranoid. He is not normal," he said.

      "He is a type of personality who lives in the extreme and thus thinks in a static way. He never got the chance to think with liberty, to think on his own," Dr. Dadfar said.

      "When somebody had a logical criticism about his ideology, he got aggressive, he was ready to fight. He became intolerant when we were students.

      "He is unconscious, a suggestible personality. He is physically strong enough, but mentally naive. I don't know why."

      "He was the torturer himself while he was the head of KHAD for six years," Dr. Dadfar said, referring to Najibullah's role with Afghanistan's dreaded secret police before he became the nation's leader.

      "The torturer is a psychopathic personality. Moscow chose Najibullah to head the country because he was a violent personality," he added.

      Dr. Dadfar was jailed for 14 months when the April 1978 coup brought the Marxists to power in Afghanistan, "because I was active in the student movement, an anti-Russian student," he said.

      "I was tortured; it was mostly psychological torture." While in prison, he vowed to one day help rehabilitate other inmates.

      After the Soviets poured thousands of troops into Afghanistan during Christmas 1979, he was released in a general amnesty. He left his homeland in mid-1980.

      To recover from the nightmare of imprisonment, he conducted "self-therapy," relying on sports, meditation and his understanding of the human psyche.

      After he opened the Psychiatry Center for Afghans, he discovered that psychological techniques used in Westernized, urban societies have limited use when a therapist faces people coming from an ancient, impoverished land steeped in Islamic tradition and tribal rituals.

      The clinic has 18 staffers, all Afghans, including five doctors, three social workers, two nurses, a psychologist and a physiotherapist. Several staffers have been tortured, Dr. Dadfar added.

      The staff enjoys some advantages over Western therapists in dealing with refugees, such as common language and mutual trust, he said.

      However, one of the hardest tasks is to try and instill a sense of optimism among refugees living in bleak camps for a lengthy period with little hope of re-establishing a normal life.

Richard S. Ehrlich, Asia Correspondent

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