Handicap International experience in Afghanistan - CBM

Comparing the situation between males and females concerning the symptoms of anxiety and depression, wefind even sharper disparity than for violent behaviour. This is in line with the findings of other surveys 21 . Whilethe highest proportion of men with disability is 38.9% for “feeling suffocated”, the proportion of the same is70.1% for women with disability. Similarly, for four of the parameters, the proportion for men is about 30%,whereas for women these figures are above 50% : “feel sad/cry” (59.8% for women as compared to 30.2%for men), “sit and think” (50.4% compared to 34.9%), “feeling of oppression” (54.5% compared to 36%),“feeling of suffocation” (70.1% compared to 38.9%). These signs are particularly characteristic of depressionand show the distressing mental health situation of women with disability in the country. These results aresimilar to those found by the CDC survey held in the Nangarhar province of Afghanistan in 2002, which showthat all the trauma exposures were translated into significant scores for anxiety and depression 22 .Figure 15. Distribution of Persons with Disability above 14 ShowingDepression or Anxiety Signs and by Gender80• Females • Males706050403020100Want to StayLocked UpFeel Sad/CryNot FeelHungryFeel AfraidSit and ThinkWant to LiveElsewhereRapid MoodChangesFeelOppressedFeelSuffocatedFeel Angry/ResentfulThe statusof women inAfghan society ischanging. Due toa breakdown offamily structuresand migration tocities, the role ofmen as providersand protectors isno longer a givenThe higher proportion of women with depression and anxiety signs results from a combination of factors.First of all, because of disability, their social status, valorised by the ability to get married and become amother might be suddenly jeopardised by a disabling event, thus resulting in lowered self-esteem 23 .The status of women in Afghan society is changing. Due to a breakdown of family structures and migration tocities, the role of men as providers and protectors is no longer a given. As a result, a number of women haveto earn a living and step out of the houses in a context, which can be hostile and challenging.Last but not least, they have also suffered the war and its consequences. Among displaced persons due to war,women and children represent three quarters of the massive exodus of millions of people 24 . They were alsovictims of violence, experiencing and witnessing loss and mistreatment as well as lack of security and basiccommodities: all this can have resulted in psychological trauma and distress.21RASEKH Z. et al. (1998), JAMA, op. cit.22SCHOLTE W.F., et al. (2004) JAMA op. cit.23MEEKOSHA H. (2004),“Gender and Disability”, Encyclopedia of Disability, Sage.24BHUTTA Z. A. (2002),“Children of War: the real casualties of the Afghan Conflict”, British Medical Journal, 324: 350.26 Understanding the Challenge Ahead