First Quarter 2002 Newsletter (Last Updated On: ) The Plight of Afghan Refugees Uniaza Niaz, M.D., a Pakistani psychiatrist and WFMH Life Member, visited two relief centers for Afghan refugees in January, one at Chaman Quetta near Pakistan�s border with Afghanistan, and one across the border at Spin Buldak in Afghanistan. Both centers are run by the Pakistan Islamic Mission Association (PIMA). She was part of a four-member team that also included a clinical psychologist, a medical registrar and a medical journalist. She reported that the group had intended to visit the camps to identify and document the psychological impact of the war on the civilian population � �but obviously this was impossible as the people were dying of hunger, starvation and exposure to the cold�.Secondly, we wanted to educate and debrief the voluntary workers seeing this enormous human misery. But the actual visit to the camps shocked us even more as the Afghans were fighting for survival from hunger. The onslaught of the elements, particularly the dusty storms and freezing temperatures on the ground, were making survival impossible.� Dr. Unaiza Niaz with two sick refugee children. The refugees were affected by cumulative disasters – two decades of tribal conflict, a prolonged drought, and now modern warfare. She found that families had suffered losses (often of several members) and injuries from bombing raids and mine explosions. Malnutrition contributed to other deaths, particularly of children. Although she thought that almost 90% of the refugees were affected by bereavement, PTSD or depression/anxiety, and that �the psychological trauma endured by the Afghans is undoubtedly tremendous and needs urgent recognition and help,� there were even more urgent requirements, so that �psychiatric help comes last on the list.� She named as priorities food and emergency medical care. �Medical facilities are appalling right now.� She singled out the medical needs of women and children as deserving special attention. At the refugee camp in Spin Buldak there were few female doctors and no gynecologists. Women were unwilling or unable to breast-feed babies. She saw an urgent need for educating mothers about basic hygiene and infant nutrition. Dr. Niaz commented on the patience and endurance of the refugees, and the strength of their religious faith. �Strangely, we found no overt expression of anger, or signs of frustration. Perhaps they are numbed by the twenty years of war.� Tents in an Afghan refugee camp. Although the relief efforts in the camps she visited were generally inadequate, she commented favorably on facilities provided by the Red Cross with support from the United Arab Emirates, and praised the work of PIMA and Islamic missions from Malaysia and South Africa in Spin Buldak. A Collaborating Center reports on human trafficking Prof. Syed Arshad Husain, who heads the International Center for Psychosocial Trauma at the University of Missouri, USA (a WFMH Collaborating Center), has been involved in trauma counseling in Pakistan for many years and has been working recently at a camp for Afghan refugees near Peshawar. His team established a counseling center there and raised funds to support it. He reports that while working in camps in Pakistan, his group has become aware of a common practice among Afghan refugee families of selling women and children who have lost their husbands and fathers to other Afghan men. The extreme poverty of these families contributes to the situation. The Center�s training courses for professionals in countries affected by conflict include education about human trafficking as part of the general curriculum in trauma psychology. Prof. Husain views it as �a major complication of war.� First Quarter 2002 Newsletter