On our visits to Pakistan both before and after 9/11, our International Center for Psychosocial Trauma had contact with refugees from Afghanistan. After 9/11 the U.S. Department of State also made arrangements for us to work with physicians and educators from Kandahar, a major city in Afghanistan. Because of the hazards involved within the country, our team worked with the Afghans in Pakistan.
My first contact with the Afghan refugee problem came in October, 1999, when I met Ali Nawaz, a short, sharp-featured man who radiated energy. He was the Deputy Director of the Human Concern International in Peshawar, Pakistan, where many of the refugee camps for Afghans were located. A friend of the International Center’s leader Arshad Husain, he came to Islamabad to serve as our guide into the mountain resort area overlooking Kashmir.
Over the last 20 years the war across the border in Afghanistan had created many refugees, first from the Russians and then from the warring groups within the country. The agency Nawaz directed attempted to alleviate some of the trauma by training these refugees for new occupations. Among the refugees were 500 orphans who were being trained in a variety of skills: carpentry, weaving and other handicrafts. Having seen the feral children of Nairobi and Lima begging and stealing to stay alive, I was warmed by his concern and pleased at his ability to help at least one group of young refugees.
Islamabad, Pakistan, January, 2001
Afghanistan refugees who had fled from the Taliban were living in a shelter in Islamabad, the capital of Pakistan, in preparation for immigrating to the United States. The children, between 6 and 12 years old, were obviously shy around us, the strangers. Several of the girls were brave enough to send us cautious smiles.
"These particular children and their mothers are refugees from the Taliban in Afghanistan," said the director of the shelter and rehabilitation center for abused women and children. "They aren’t safe here in Pakistan. We won’t know where they’ll be placed until two weeks before they leave, but in the past some of them have gone to St. Louis."
The Taliban, the extremist Islamic group that controlled Afghanistan, had sent millions of citizens fleeing to neighboring countries.
The shelter director, a Pakistani psychiatrist, explained that she and her colleagues were teaching the children English and preparing them for the changes that a move to the United States entails. They expected that the mothers would have a harder time than the children adjusting to the new life.
With members of the International Center for Psychosocial Trauma from the University of Missouri-Columbia, I was visiting with the staff who were working to help solve many of the problems of abused women and children in Pakistan. Besides our leader, child psychiatrist Arshad Husain, our team consisted of psychologists Barbara Bauer and me, along with two observers, Danny Wedding and Arshad Bhutts.
The agency battling a myriad of social problems was called SACH, or Struggle for Change. SACH was a nongovernmental organization that has the support of a number of international organizations, including the Economic and Social Council of the United Nations. The agency had many different programs, each supported by a different international nongovernmental agency. The program developed to prepare Afghan refugees to immigrate to the United States was one among its many responsibilities.
Four of the physicians and psychologists with whom we discussed the agency’s problems had been participants in a three-day workshop on trauma psychology that our team had just finished presenting in January. Our workshop had been part of the 13th International Psychiatric Conference sponsored by the Pakistan Psychiatric Society.
Officially there were 1.4 million Afghan refugees in Pakistan at that time. Unofficially, I understand, there might have been another million. This meant Pakistan had the distinction of hosting the largest refugee population in the world. According to Human Rights Watch, Amnesty International, the United Nations and the U.S. Department of State, the refugees had plenty to flee. The Taliban controlled all major cities in Afghanistan and imposed its strict interpretation of Islam. The Taliban regime accepted neither the notion of secular law nor international human rights norms.
After the Taliban took power in 1992, religious laws, called sharia, were introduced throughout the entire country. Laws and decisions contrary to the sharia were abolished. The interpretation of those laws, however, could vary from district to district depending upon the conceptions of local leaders.
What consistency there was resulted from the Taliban’s establishment of the Ministry for the Enforcement of Virtue and the Suppression of Vice. Any person acting against Islamic rules, as interpreted by this group, was frequently given punishment that involved beatings by "religious police." In many cases, the person making the accusations was also judge, jury and punisher.
According to Amnesty International, thousands of women had been physically restricted to their homes under Taliban edicts that ban women from going to work or leaving home unaccompanied by a close male relative. Girls were restricted from going to school at the risk of physical assault by Taliban guards if they leave home without a reason acceptable to them. Some women had become so depressed under these conditions they committed suicide.
Women could be beaten if they were not wearing the burqa, the heavy garment that includes a mesh cloth covering the eyes. Showing an ankle might get the same treatment. Men could be beaten if they didn’t attend Friday prayers in the mosque.
The Taliban had also banned music, photography and children’s games such as kite flying. I think particularly upsetting to Americans had been Taliban-enforced Islamic punishments, such as beatings, public executions and amputations of one hand and one foot.
Refugees from Afghanistan
Pakistan had major problems providing services for its own population. For the past two decades, the country had paid a staggering price for fulfilling its moral obligations toward a large refugee population in need of international protection.
At the peak of the exodus it was estimated that there were more than 3.5 million Afghan refugees in Pakistan. In many districts, refugees outnumbered the native population, causing many problems. For example, being a pastoral people, the Afghan refugees brought their cattle and livestock. This resulted in the denuding of entire mountain ranges and severe soil erosion. At times, Pakistan had attempted to prevent further immigration, but border control in the mountains is almost impossible.
Another problem is that Pakistan lacks the means to protect the refugees from Taliban retribution. In addition to the general hardship experienced by many refugees in Pakistan, some had been the targets of intimidation, harassment and even assassination by Taliban armed groups operating in Pakistan.
Secular-minded Afghan academics and professionals, as well as members of Afghan political parties opposed to the continued fighting in Afghanistan, had faced frequent threats by these Afghan armed groups in Pakistan. Educated Afghan women, particularly those working for the education and welfare of Afghan women and children refugees, had also been threatened.
In many instances, the Pakistan authorities had been ineffective in their response to threats against Afghans. They were unable to provide adequate protection to prominent Afghans in Pakistan and to bring to justice the perpetrators of political killings. Some of these endangered groups were seeking refuge in countries such as the United States where the Taliban could not reach them.
The role of the United States
During 2001, the United States had plans to admit up to 80,000 refugees. Government officials felt the action was justified by humanitarian concerns or was otherwise in the national interest. Ten thousand refugees were from the Near East and South Asia. The children and their mothers whom we met in Islamabad would be included in those numbers. That means that the United States would take only a small number of refugees from around the world who were in danger.
Our experience with other refugee populations that have settled in St. Louis, Boston, Minneapolis and Des Moines, Iowa, indicates that children adjust quite well to the change. They quickly learn English and take up American ways. Their parents have many more problems, and some are sorry they came despite the dangers in their own country.
Rebuilding shattered lives
Besides working to help refugees from Afghanistan, SACH worked with torture victims, sexually abused children and women who were victims of violence. In regard to helping victims of spousal abuse and child sexual abuse, it seemed to me that Pakistan was about 30 years behind the United States. This agency was dealing with such problems in large numbers, despite people who did not want to admit these kinds of problems existed and consequently refused to discuss them.
SACH was housed in a modern building. That the agency had good quarters was not by plan. Built by the government, the building’s main purpose was to provide an opportunity for the graft involved in its construction. The building had group bedrooms and other facilities for both refugees and local women and children who had been the victims of abuse. In addition, SACH was running regular workshops and therapy sessions to help trauma victims whose lives had been shattered. One of the therapists at the agency used art to help the children deal with the traumas they had faced.
A group of Pakistani boys who had been victims of sexual abuse presented a talent show for us. They worked jobs in the mornings and had classes in the afternoon. More important, they were now in a protected environment.
We visited another agency in Islamabad that dealt with abused women, and there was much discussion with staff members about the need for Pakistan to revise some of its laws to protect women against physical abuse, rape and honor killings. If a woman is raped in Pakistan, she is stigmatized. As a result, women rarely report rapes.
Agencies like SACH cannot solve the refugee problem, but they were part of the solution and were making a difference in the lives they touched. We had hoped funds could be found to bring a group of mental health workers from Pakistan to Columbia that summer to give them further training on trauma psychology. (Support was not found.)