JALALABAD, Afghanistan — No one here knows the man whose left leg is shackled to the wall of cell No. 5. Last week, he finished tearing his mattress to shreds and then moved onto his clothes, ripping his shirt and pants off before falling asleep naked.
“He’s insane,” say the villagers who have come to gawk at him. “He doesn’t know whether he’s in this world or another.”
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“He’s getting better!” said Mia Shafiq, the man responsible for his recovery and the one who shackled him to the wall of a shrine in this eastern Afghan city.
The man’s brothers drove him here from southern Kandahar province two weeks ago, drawn by the same belief that has attracted families from across Afghanistan for more than two centuries. Legend has it that those with mental disorders will be healed after spending 40 days in one of the shrine’s 16 tiny concrete cells. They live on a subsistence diet of bread, water and black pepper near the grave of a famous pir, or spiritual leader, named Mia Ali Sahib.
Every year, hundreds of Afghans bring mentally ill relatives here rather than to hospitals, rejecting a clinical approach to what many here see as a spiritual deficiency. The treatment meted out at the shrine and a handful of others like it nationwide might be archaic, but the symptoms are often a response to 21st-century warfare: 11 years of nighttime raids, assassinations and suicide bombings.
For over a decade, Western donors have helped train Afghan psychiatrists, who diagnose many of their patients as having an ailment with a distinctly modern acronym: PTSD, or post-traumatic stress disorder. Mental health departments in Afghanistan are plastered with posters detailing the disorder’s symptoms. Pharmacies are stocked with antipsychotic drugs.
But many of those suffering from the disorder never see doctors or pharmacists. Instead, they are taken on the long, unmarked dirt road, through a village of mud huts, that leads to an L-shaped agglomeration of cells.
The brothers of the man in cell No. 5 drove back to Kandahar, more than 400 miles away, once the shackles were in place. They left an indecipherable phone number on a scrap of paper. They paid $20 for the treatment, as all patients must. If they told anyone the name of the man, no one remembers.
“What will I do with this man?” asked Shafiq, the shrine’s director and a descendant of Sahib. “Who is this man?”
Shafiq wondered: Was the man’s mental state a product of war? Was he a former soldier? A civilian who had seen too much horror? Shafiq had helped check men like that into the shrine. He’d watched them writhe and scream and, eventually, he said, recover.
“For a lot of these people, faith is a key part of the healing process, and they have faith in the shrine,” said Humayun Zahir, a doctor and the director of Nangahar Hospital, which is funded by the European Commission.
In his office 10 miles from the shrine, Zahir, too, has treated soldiers and civilians affected by the shock of war. Some came to the hospital after 40 long days shackled to Mia Shafiq’s wall. Often, Zahir said, the shrine did more damage than good.
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