Afghan schoolchildren 'affected by everyday stress as much as war-related trauma'
21 August 2009
The first large-scale systematic survey of children's mental health in Afghanistan found that one in five schoolchildren in northern Afghanistan is likely to suffer from a psychiatric disorder. Researchers from Durham University, the University of Peshawar in Pakistan and ALTAI Consulting in Kabul, Afghanistan, found a range of mental health problems, including extreme anxiety, depression and symptoms of post-traumatic stress disorder.
The research team interviewed 1011 children aged 11-16, their parents or caregivers, and 358 teachers at schools in Kabul, Bamyan and Mazar-e-Sharif.
One in ten children said that the most traumatic injury in their life was due to an accident, being beaten by relatives or neighbours, or a painful medical treatment; only a few referred to a war-related injury.
The researchers say that poverty and poor-quality education were the source of many of the day-to-day pressures placed on the children.
"Their distress is focused on frustrations associated with poverty, which lead to violence in the family and the community," says Professor Catherine Panter-Brick from Durham University, lead author on the study.
"Huge numbers of children live in families where the father is struggling to make ends meet and many relatives are squeezed into inadequate housing. Many children have to work before and after school to help put food on the table. They walk long distances to school, have overcrowded classes and can't do homework at night because there is no electricity. The war-related suffering comes on top of all that."
The researchers say that mental health interventions must include efforts to stop persistent violence and lessen day-to-day stressors - and not just focus on trauma related to war.
Mental health programmes targeting families and schools, for example, have been proven to be successful in Pakistan and in the West Bank and Gaza. Raising the quality of education by increasing the pay for teachers and providing better supplies of textbooks would also help to improve children's lives, the researchers say.
"What is remarkable are the high aspirations and the determination children show, despite great poverty and day-to-day hardship," says Professor Panter-Brick. "They see hard work and education as the key to success."
"We found that children reported great distress and hardship in their lives. But they also had remarkable strength to function, to get on with their lives, to help their families, and to work and study."
Image: Afghan children. Credit: Ginny Barahona, 2004, The Advocacy Project on Flickr
Reference
Panter-Brick C et al. Violence, suffering, and mental health in Afghanistan: a school-based survey. Lancet 2009 [epub ahead of print].