Handicap International experience in Afghanistan - CBM

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Figure 12: Distribution of Persons with Disability HavingCommunication Difficulties According to Main Types of Disability9080• Physical Disability • Sensorial Disability • Mental Disability• Associated Disability • Epilepsy/Seizures706050403020100Difficulty toRememberDifficulty toTalk to OthersDifficulty toUnderstand PeopleDifficulty toMake OneselfUnderstoodDifficulty toHear ClearlyDifficulty toSee ClearlyDepression and Anxiety SignsAfter more than two decades of conflict, anxiety and depression related disorders are widespread throughoutthe country’s population. Nevertheless, the corresponding symptoms appear to be much more frequentamong the persons with disabilities. Ten items can be used to characterise these disorders: “want to staylocked up inside the house”, “feel very sad or cry without reason”, “do not feel hungry for long period oftime”, “feel afraid for no reason”, “sit for a long time thinking”, “want to live somewhere else”, “have rapidchanges of mood”, “feel oppressed for no reason”, “feel suffocated for no reason”, “feel angry and resentfulfor no reason”. In order to look at the signs, the surveyors were trained to emphasise “for no reason” aftereach item.The existenceof anxiety anddepression signsis common inthe populationof physicallydisabled andeven moreamong thesensorialcategoryFor each item, persons with sensorial or physical disabilities seem to show less signs of depression andanxiety. Yet, a significant proportion has the following signs of depression: “feeling sad/ crying without reason”(proportion of persons with sensorial and physical disability 25.0%), “sitting for a long time and thinking”(24.2% and 30.3% for the same), “feeling oppressed without reason” (28.1% and 42.8%), and “feelingsuffocated without reason” (32.3% and 42.8% respectively). The existence of anxiety and depression signs iscommon in the population of physically disabled and even more among the sensorial category. This suggeststhat not only the trauma of impairment and of its causes (war, accident, disease…) is highly affecting themental health of these people, but also that hopelessness and frustration are probably taking their toll ontheir mental health.The situation is extremely worrying for persons with mental disability, epilepsy and associated disability. Outof the ten symptoms, the proportion of persons with mental disability that have experienced them recentlyranges above 40% for all of them, and above 70% for half of them: “feel sad/cry” (74.6%), “sit and think”(79.4%), “feeling oppressed” (72.6%), “feeling suffocated” (77.8%), “feeling angry and resentful” (69.8%).While family is the major value in the Afghan culture, more than half of the people with mental or intellectualdisability would “like to live away from their family”, followed distantly by the proportion of people withassociated disability (29.1%) and people with epilepsy/seizures (21.5%). 6 out of 10 signs are presentin more than half the proportion of people with epilepsy/seizures or with associated disability: respectively68.9% and 65.5% by “feel sad/cry”, 56.3% and 69.1% by “sit and think”, 66.7% and 63.0% by “rapidchanges of mood”, 51.1% and 65.5% by “feeling oppressed”, 79.3% and 65.5% by “feeling suffocated”,48.1% and 58.2% by “feeling angry and resentful”. As for persons with epilepsy/seizures, these findingsmay indicate that a certain portion of these may also present some additional mental problems such asdepression.24 Understanding the Challenge Ahead
Figure 13: Distribution of Persons with Disability Above 14 ShowingDepression or Anxiety Signs According to Main Types of Disability90• Physical Disability • Sensorial Disability • Mental Disability• Associated Disability • Epilepsy/Seizures80706050403020100Want to Stay Locked UpFeel Sad/CryNot Feel HungryFeel AfraidSit and ThinkWant to Live ElsewhereRapid Mood ChangesFeel OppressedFeel SuffocatedFeel Angry/ResentfulThese results also suggest that persons with these disabilities are painfully aware of their situation. They mayalso believe that they are a burden on the family and rejected by the community. This is clearly a consequenceof lack of social understanding and, as a result, of social acceptance of these forms of disability. A previousstudy 20 has shown that often causes for mental forms of disability are believed to be supernatural. There is anurgent need to build awareness and sensitize the close family members to these forms of disability.Mental Health of Women with DisabilityFirst, we can notice that the proportion of women reporting violent episodes is higher than that of men. Thisdifference is even more obvious when we look at episodes regarding violence towards oneself.Figure 14: Distribution of Persons with DisabilityAbove 14 Showing Violent Episodes and by GenderPersons withmental difficultiesare painfullyaware of theirsituation. Theymay also believethat they area burden onthe family andrejected by thecommunity50• Females • Males454035302520151050Episodes of FitsPhysical ViolenceTowards OthersVerbal ViolenceTowards OthersSelf ViolenceFainting/PassingOut20THAKKAR M., CERVEAU T., DAVIN E., (2004), “Afghan Perception on Disabilities, A Research Project on the Perceptions and practicesRegarding Disability in Afghanistan, to Inform a Communication Strategy”, Study carried out by ALTAI Consulting for UNICEF, UNOPS,UNDP, Kabul.The Health Picture25
Page 3 and 4: Islamic Republic of AfghanistanUNDE
Page 5 and 6: ContentsAcknowledgementsAbbreviatio
Page 8: Figure 25 : Retention, Transition a
Page 11 and 12: AbbreviationsAFAs : AfghanisBPHS :
Page 13 and 14: PrefaceThe National Disability Surv
Page 15: IntroductionAs the process of recon
Page 18 and 19: Figure 1. Sampling Stages of NDSA1s
Page 20 and 21: A variety of subjects and fields ad
Page 22 and 23: • Beliefs and expectations of wha
Page 24 and 25: Prevalence Threshold with Regard to
Page 26 and 27: The proportion of persons with disa
Page 28 and 29: Mental disability shows a much more
Page 30 and 31: The effectiveprevalencerate of seve
Page 32 and 33: to a maximum of 37.4% unable to coo
Page 34 and 35: Table 3. Proportion of Persons with
Page 36 and 37: Table 4: Proportion of Persons with
Page 38 and 39: Figure 9. Distribution of Persons w
Page 42 and 43: Comparing the situation between mal
Page 44 and 45: Figure 17. Number of Visits to Heal
Page 46 and 47: Table 5: Yearly Average Expenses (A
Page 48 and 49: 32 Understanding the Challenge Ahea
Page 50 and 51: A crucial aspect that influences ac
Page 52 and 53: Table 6 highlights the advantage th
Page 54 and 55: Figure 26: Retention, Transition an
Page 56 and 57: to take this into consideration whe
Page 58 and 59: • Boys with physical disability a
Page 62 and 63: Figure 32: Distribution of Persons
Page 64 and 65: to others: usually they benefit fro
Page 66 and 67: Figure 37: Distribution of Active P
Page 70 and 71: According to NRVA 2003, poverty is
Page 72 and 73: means that the average living space
Page 76 and 77: Figure 46: Distribution of Househol
Page 80 and 81: The inability tobear children is am
Page 82 and 83: The situation is somewhat different
Page 86 and 87: 706050• Landmine/UXO Survivors•
Page 88 and 89: ConclusionInclusion is a major fact
Page 90 and 91:
of persons with disability 48 . Thi
Page 92 and 93:
GHOSH N., MOHIT A., MURTHY R.S. (20
Page 95:
The National Disability Survey in A
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Handicap International experience in Afghanistan - CBM

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