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Borderless Medicine with Health Tourism
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The only mental hospital in Afghanistan for over 30 million people

I went to the Mental Health Hospital (Kabul Mental Hospital), where tens of people are referred daily because of stress. In this hospital, doctors first treat clients and refer them to a psychologist if necessary. Some are hospitalized due to the severity of their problem.
When I arrived at the main courtyard of the hospital, where patients were being cared for in separate male and female sections, I encountered those who were wearing special clothing. One was kneeling on the floor in the armpit and the other in the corner of the garden for several hours seemingly trimming her nails. According to statistics, one out of every four people in the world has some form of mental illness. But the situation in Afghanistan is worse. World Health Organization statistics show that about half of the country's population is suffering from mental disorders.

Many were not willing to speak to me at the hospital, but Ehsanullah volunteered to interview me. In his first sentences he complained about poverty and unemployment.
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As he and his brother said, he has been an American translator for five years, but schizophrenia has changed the course of his life.
Ehsanullah is the father of four children who has not seen them for six months. "I would like to find something again and bring home the bread," she says. But he has to stay at the clinic.
I found Hafizullah on his bed. He repeated to himself that his brother had been a victim of the mine and had lost his father. In between her sentences she suddenly says that she does not know her mother.
War and violence seem to have affected his psyche. The doctor's diagnosis at the hospital shows that he has bipolar mood disorder. Hafizullah has lost his sadness and happiness. Sometimes he is happy and sometimes sad.
Afghanistan has been experiencing war for forty years and violence is one of the main causes of psychological problems in Afghanistan.

Many women in Afghanistan are also subject to psychological stress. But in the patriarchal society of this country they are less taken care of. Because of culture and traditions, families send less girls and women to health centers. One of the reasons is being labeled by others. So people don't like to be seen in psychiatric centers or this hospital.
Shiba, who is 5 years old, hates the hospital environment. He has been struggling with mental illness for nine years. "There is nowhere else to go from Pakistan and India to Iran but no drug has worked," her husband says.
Shiba has been hospitalized for the third time. Her husband says she had worsened last time six months ago after an unsuccessful delivery and was hospitalized.

 
 

The only mental health center in Afghanistan

In Afghanistan, one out of every five people suffers from mental disorders. However, there is only one mental health hospital in Afghanistan. The mental health hospital is the only center with 2 beds for about 2 million people in Afghanistan. It has 3 beds for men, 2 beds for women, 2 beds for addicts and 2 beds for children under 9. Every day at least 4 people come to the center and at least 3 get the chance to be admitted.

authorities sometimes have to discharge hospitalized patients even before a full course of treatment is completed.
Dr Shafi Azim, a hospital official, says the center has been operating for more than five years. She has worked at the center for the past five years, she says, but most people suffer from anxiety, mood disorders and addiction. Mr Azim considers the facilities and services of this hospital appropriate.
The center offers group therapy services, electric shock, individual and family counseling for patients, she said. It seems that for all those admitted here, the drug is prescribed and less commonly used in counseling and psychotherapy. When I asked one of the patients if anyone was talking to you on a regular basis, he said, "I've been on the bed all day and it hurts my bones. No one listens to me." Then she showed me her medicine and said she was taking it morning and night.

Rouhollah Razvani, a psychotherapist who owns a counseling center in Kabul, says the volume of clients and specialized staff at the mental health hospital is low. According to him, except for the mental health hospital, Aliabad and some addiction treatment centers, there is no longer a center for these clients in Afghanistan and people from other provinces are coming to the mental health hospital in Kabul.
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• There are fewer than six private counseling centers in Kabul that focus on motivational psychology rather than clinical treatment.
• He says war, lack of amenities, poor economy and social insecurity have made the average mental illness in Afghanistan far higher than in other societies. But what makes it even more difficult is the lack of awareness and acceptance of people with mental illness.
• Mental illness is not taken very seriously in Afghanistan. No, they are not interested in going to health centers and there is not enough investment in this sector. There is no place for clinical psychology in the Afghan education system either.
• "There is no system in place for psychotherapists to go to treatment if there are people who also want to go to treatment," says Mr. Razvani. "We also don't have enough professional therapists and there is no monitoring and training system." "He thinks insecurity and distrust of doctors, especially psychologists, is another reason for people's disinterest."
• According to him, it does not kill one's mental illness and because one does not see himself at risk of dying, he does not experience tangible symptoms because he is physically ill and on the other hand is ashamed to accept mental illness, so that the symptoms do not worsen and severely affect daily life. She doesn't see a psychologist.

bbc.com
 
 

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