MAZAR-I-SHARIF, Afghanistan — They strutted around in black turbans, they drove big pickups, they looked tough. But on the inside, the Taliban were actually a bunch of pretty depressed guys.
At least that's what their shrink says.
"I remember one Taliban commander telling me he hadn't seen a sunny day his whole life," said Dr. Nader Alemi, director of mental health at Mazar-i-Sharif's General Hospital.
Another commander, Alemi recalled, wanted to commit suicide but couldn't because of Islamic strictures. "Every time he went to battle--and this was a big general--he hoped someone would shoot him.
"I don't think the Taliban needed more guns," the doctor added with a grin. "But more Prozac."
When the hard-line Islamic Taliban invaded this northern Afghan city 3 1/2 years ago, Alemi was stuck in the unenviable position of dispensing mental health care to a group of people who, with their appetite for war and medieval punishments, would seem certifiably insane almost anywhere else.
His Taliban patients are gone now. But Alemi, who deposits a soft touch and a gigantic "Ho-bas!" (Good!) on each person he meets, is still very, very busy. Every day, there's a line 50 patients long outside his office: children traumatized by bomb blasts, soldiers who were tortured, schizophrenic shopkeepers, sleepless farmers worried about drought, sleepless girls worried about marriage.
Post-Taliban life is a little freer, a little brighter, though still unsettled. Alemi's practice offers a glimpse, however random or rushed, of how Afghan society is adjusting.
"Doctor, I can't remember any verses from the Koran, and my mullah says I'm crazy," began Mohammed Tahir, a distressed student, during a recent office visit.
"You seem as wise as the prophet," Alemi said, patting the young man on the head. "Don't worry so much. You'll remember everything."
Despite Alemi's soothing optimism, mental health care here is in a sorry state. For a population of 25 million, Afghanistan has perhaps two dozen psychiatrists. The only psychiatric hospital is a 50-bed facility in the capital, Kabul, and it is shut down half the time. In Mazar, Alemi works from a corner of the hopelessly crowded General Hospital and in a small private clinic above a vegetable shop.
Afghanistan has no practicing psychologists, social workers or counselors, said Dr. Azizullah Baig, one of Alemi's few colleagues. Most aid agencies are still in emergency mode, focusing on first aid, child immunizations and nutrition.
Modernity vs. Tradition
"We feed people first," said Dr. Abdul Wahid Wahidi, a Mazar-based program officer for the World Health Organization. "Then we worry if they are happy."
Extended families and mosques provide some support for the mentally ill. But they can also muddy things up.
The other day, Alemi's red-carpeted office, with its bare white walls and empty light sockets, became a boxing ring where modernity and tradition duked it out.
In one corner was a desk cluttered with price lists for modern psychotropic medications--Zoloft, Paxil, Lithonate, Prozac--or, more specifically, the Iranian-made generic equivalents available here.
In another corner lay a 25-year-old woman convinced that her in-laws had cursed her with a supernatural intruder--a jinni.
"All of a sudden, life does not interest me," said the woman, named Feriba. "I don't even wash my husband's clothes anymore."
Her mother had already taken her to see a mullah.
"Should we sacrifice another goat?" Feriba asked.
"Ney. Ney," Alemi said. No. No. "Allah has given these pills great power. It's like swallowing a little piece of god."
After she shuffled off, he said, "They usually trust the doctor."
A Practical Approach
Alemi's work is no Freudian analysis. With five to six patients an hour, many of whom have journeyed for days to see him, there's no time to sit alongside a couch and download an entire life story.
Often, he dispenses practical health advice.
To a farmer with insomnia and high blood pressure: "Eat less fat and nuts."
To a nibbled-fingered woman depressed about miscarriages: "Your baby will come, God willing. But you must rest more."
During the Taliban days, Alemi, 46, was careful to refer to many ailments as "nervous problems," not as mental or emotional ones.
"These guys were warriors," he said. "They couldn't be marked as mad."
Because Alemi grew up in the northeastern city of Jalalabad and is the only psychiatrist in northern Afghanistan to speak Pashto, the language of most Talibs, he became their doctor after they captured Mazar in August 1998.
Taliban forces used the city of 200,000 as a base for military operations across the north, and Alemi, an ethnic Tajik, estimates he treated at least 1,000 soldiers and commanders of the regime.
"Sometimes when they'd cry, I'd cry, and when they'd feel down, I'd feel down," he remembered. "One soldier once told me: 'This is great. Finally I meet a doctor who suffers from the same thing I do.' "