FEATURE STORY

Atrocities Traumatize Afghans

MU psychiatry professor takes training program to refugees

By Rich Gleba

Ethnic cleansing in Kosovo. Terrorism in Oklahoma City. Devastating earthquakes in India. Israeli-Arab violence in the Middle East. Regardless of where war and tragedy strike, MU psychiatry professor Syed Arshad Husain, MD, finds the same mental scars.

The Afghan refugee camp that Husain visited last February is no exception. Signs of psychological trauma are rampant among the camp’s 110,000 residents. Widows struggle with depression. Repetitive nightmares force fathers to relive the deaths of their children. And the children — the most vulnerable victims — live in constant fear.

“The Afghans want help, especially for their children,” says Husain, MU’s director of child psychiatry. “They do not want their children to grow up hating people and being frightened all the time. They do not want the future of their nation to be so horribly damaged.”

Husain arrived at the camp with a team from MU’s International Center for Psychosocial Trauma. He led the five-member team through four cities in Pakistan, providing trauma psychology training to more than 200 teachers and health-care workers along the way.

As the center’s founding director, Husain created the crash course in trauma psychology to train teachers and health-care professionals in regions with a shortage of mental health experts. The trainees, in turn, learn to train other teachers and health-care professionals. Since 1995, Husain’s training programs at MU and abroad have made psychological trauma treatment available to thousands of children throughout the world.

“Much like the American Heart Association did in making knowledge of CPR commonplace, we are working to get this knowledge into the hands of teachers and others who can use it to help children,” Husain says. “Just as anyone can be trained to recognize and respond to a heart attack, they also can be trained to recognize and respond to the needs of a traumatized child.”

Husain has a personal understanding of war-traumatized children. In 1947, an 8-year-old Husain, his parents and his seven brothers and sisters were driven from their home in India when violence erupted between Hindus and Muslims. The family spent three weeks in a refugee camp before resettling in Pakistan.

Husain returned to Pakistan this year with funding from Human Concerns International, one of the few humanitarian agencies serving the Afghan refugee camp near the city of Peshawar. The organization invited Husain to create a treatment center for the camp’s children.

He was accompanied by Elizabeth Lowenhaupt, MD ’02, the first MU student to help Husain treat war-traumatized children in situ. “I watched Dr. Husain interview this child in front of 50 people, through a translator, and have this boy just completely open up,” says Lowenhaupt, describing the photo at the top of this page. “If that weren’t incredible enough, Dr. Husain showed all the other adults at the counseling center how they could get children to express emotions, too.”

Before Husain could help the children, he had to convince skeptical adults that the camp was suffering from psychological trauma. Many had been emotionally hardened by two decades of fighting Russians, warlords and the Taliban’s bloody rise to power. Others wondered why they should trust Americans when U.S. bombs were falling on their home country.

“They’ve lost track of who is on whose side,” Husain says. “They just want the deaths of their loved ones to stop.”

Suspicions began to fade as Husain asked the refugees how many of them suffered from depression, sleep disturbances and other signs of mental disorders. “They all raised their hands and began sharing stories about witnessing murders and losing family members,” he says. “We assured them that what they were feeling was similar to what others in their situation had experienced in other places throughout the world.”

“You could see the relief on their faces as they began to understand that they were not insane or possessed by a genie,” Lowenhaupt adds. “They gained hope as they learned about post-traumatic stress disorder and the treatment that is available.”

Husain’s team estimated that 80 percent of the adults who were examined in the camp exhibited signs of mental disorders. In addition to distributing medication, Husain encouraged the refugees to hasten the healing process by describing the cause of their suffering.

One of the first refugees to speak out was a former psychology teacher. The tall man stood up at a training session and described how eight of his children had been killed. “He began to cry, and we cried with him,” Husain says.

Then a widow told the story of how she had lost all five of her children. Neighbors stole what little possessions she had, and she could not find work. “Women with no connection to a man are very vulnerable and viewed with suspicion in this community,” Husain says. He found the former teacher a prestigious position at a camp school that serves 900 children.

The Afghan children reveal their emotions in less direct ways. “Some play with sticks, using them as machine guns. The big kids are the Americans, and they bully and throw rocks at the smaller children, who are the Taliban,” Lowenhaupt says. “Other children are too afraid to leave their homes. They are especially frightened of beards because they remind them of the Taliban.”

Counseling for the children involves organized role-playing and art therapy that helps them illustrate their feelings. Husain and Lowenhaupt, now a psychiatry resident, provided treatment and training with the help of a psychologist and an education professor. An MU journalist also joined the team.

The teachers and health-care professionals trained in Pakistan help staff the treatment center that was established by Husain. In August, several of them attended MU’s ninth annual Training the Trainers workshop, which teaches new trainees to teach others in their communities.

Of all the war-torn communities that Husain has visited, the Afghan refugee camps are the most destitute. Approximately 2 million refugees have crossed into Pakistan, and there are few humanitarian organizations serving them.

“I told the Afghan people that while they are in desperate need of food and shelter, those things may come tomorrow if resources are made available. But psychological trauma, if left untreated, becomes a lifelong problem that distorts its victims’ entire view of the world,” Husain says. “This could become the Afghan people’s greatest tragedy.”

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Last Update: March 12, 2007