Shrines where the chained and padlocked mentally ill are ‘cured’

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The age-old practice of chaining the mentally ill to trees, to release them as “cured” after 40 days, persist in much of Afghanistan and Pakistan, reports The Daily Telegraph.

In a dusty graveyard behind nameless tombstones, six men sit with their hands and feet chained to trees, the heavy locks leaving marks and bruises on their skin. The Daily Telegraph reports that here, at Mia Ali Sahib shrine in Samarkhel, a village in Afghanistan’s eastern Nangarhar province, Shafirkullah Mia, 45, says he has “cured” more than 600 people (of mental illness) over the past decade.

The report says the century-old tradition has families from all over Afghanistan – and even neighbouring Pakistan – bring people struggling with mental illnesses to the shrine, believing that they will be healed after restraining them for 40 days and giving them only dry bread, salt, pepper and water to eat and drink. Considered a holy site, people pay a daily fee of 250 Pakistani rupees (£1.30) per person – the currency predominantly used in Nangarhar due to its close proximity and strong trade links to Pakistan – to have their ill family members treated, believing that Mia Ali Sahib, a “local saint and good, influential leader” buried in the graveyard, continues to spread his supernatural healing powers.

The report says Shafirkullah Mia, who previously worked as a baggage loader at Jalalabad airport, about an hour’s drive west from Samarkhel, says that he has received no formal training to treat his “patients”. “I’m a descendant of Sahib and our family is famous in all of Afghanistan because we continue to be able to treat severe cases of mental illness,” he explains, while catering to the six men. “Sometimes we have more patients, other times less, but people keep coming, even women. They trust me because of my family lineage – it doesn’t require me to learn about my job because I’m a relative of Sahib’s.”

The report says the area behind the graves sits in the shade of trees and smells of urine and unwashed clothes. While all of them sleep on the floor outside during the hot summer months, small cave-like rooms, empty and built out of brick, provide shelter during cooler, rainier winters. The chains are never taken off during their 40-day stay. Mia Ali Sahib shrine is in the midst of the approximately 5,000-family village. Many people cross the graveyard on a daily basis, but don’t interact with the people who are put in chains.

After 40 days, most men leave quietly, broken.

The report says the practise of chaining people in health facilities was only abolished across Afghanistan in 2008, with Mia Ali Sahib shrine being one of the last places to continue with the method. This however still means that hundreds of people are victim to it each year. “It’s a religious place and people believe that the dead can perform supernatural wonders,” explains psychiatrist Dr Bashir Ahmad Sarwari, director of the department of mental health at the Afghanistan Ministry of Public Health.

“What is seen as ‘healing’ can be numbness caused by trauma,” explains psychologist Lyla Schwartz, who recently set up a mental health awareness initiative in Afghanistan. “Medical or physical restraint is sometimes used to protect and ensure clients don’t harm themselves or others, but it should only be temporary and under professional supervision. Physical retrain can exasperate the problem and the lack of integration and social interaction can lead to severe anxiety, panic, depression and aggression. That might be part of the reason why they don’t respond anymore after those 40 days.”

According to Fatima Jafari, a psycho-social officer working with Schwartz, people throughout the country continue to lack an understanding of mental health. “In rural areas, many still believe in ghosts and jinns. Our culture has to adapt in order to prevent practises such as restraining people,” she is quoted in the report as saying. “It’s dangerous,” Schwartz says. “Going through something so extreme can prevent the hippocampus – the part of the brain which stores memories – from forming new neurones due to high levels of stress, which can cause memory loss and affect the ability to regulate feelings.”

The Daily Telegraph report

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