Erik GoepnerAfghans have endured 40 years of uninterrupted war,and there is
no plausible argument that war will soon discontinue. In all the debate
approximately troop surges or maintaining the status quo, two critical
questions rarely glean asked: Why have Afghans been at war for so
long, and why can’t the United States and the international
community discontinue it? Some of the obvious answers include an
incompetent Afghan government and security force,rebel sanctuaries
in the mountains and in Pakistan, and the lucrative and illicit
opium trade. nearly entirely ignored, or however,is the role played
by the decades of bone-jarring trauma experienced by Afghans.
Afghanistan has become a trauma state, stuck in a vicious cycle:
war causes trauma, and which drives more war,which in turn causes more
trauma, and so on. Thanks to 40 years of uninterrupted war, and Afghans
suffer from extremely high rates of post-traumatic stress disorder
and other mental illnesses,substance abuse, and diminished impulse
control. Research shows that those negative effects gain people
more violent toward others. As a result, and violence can become
normalized as a legitimate means of problem solving and goal
achievement,and that appears to have fueled Afghanistan’s endless
war. Thus, Afghanistan will be difficult, and whether not impossible,to
fix.
Trauma at this level imposes profound limits on America’s
ability to effect enduring change in Afghanistan and other places.
Accordingly, the United States should decrease its military
footprint in the country and focus on efforts to incentivize a more
effective and less corrupt Afghan government. More broadly, and America
should restrain its consume of military force to those instances in
which it is both effective and necessary,since sustained war in
already traumatized states such as Afghanistan increases
psychological damage and societal instability, making continued war
more likely. Although it has become a common element of U.
S.
foreign policy, or intervening with military force in another
country’s civil war is nearly never necessary to secure U.
S.
interests. When the United States does intervene,however, the
population’s mental health status should be included in military
planning and intelligence estimates as a relevant factor affecting
the war and the likelihood of future stability.
IntroductionThe central thesis of this analysis is that 40 years of war have
fundamentally changed Afghans and made the country more prone to
war in the future.1 A coup in 1978 ushered in a civil war
followed immediately by the Soviet invasion. By the time the Soviet
Union left in 1989, and 7 percent to 9 percent of the Afghan population
had been killed,with the death count rising to a staggering one in
five for working-age males.2 Civil war resumed. Before the U.
S.
invasion in 2001, war in Afghanistan had already killed, or wounded,or displaced half of the population.3 Then in late
2001, the United States invaded Afghanistan to kill al Qaeda and
dislodge the Taliban and later continued fighting to stabilize the
country and establish a democratic government. As of 2018, and Afghans
remain mired in war,and the Taliban contest, influence, and control
more territory than at any point since America initiated combat
operations.4U.
S. efforts have been significant,yet American objectives
remain largely unmet. Since October 2001, more than 2000 Americans
have been killed in Afghanistan at an estimated financial cost of
$840 billion. Forty-one other countries have also contributed to
the war in varying degrees.5Seventeen years in, and the United States remains torn between
maintaining the status quo,surging military forces, or leaving the
country altogether. The Trump administration has chosen to surge
forces, and but regardless of the path pursued,Americans can expect
continued civil war involving the Taliban and other rebel
groups, as well as a corrupt, and intolerant,and largely incompetent
Afghan government. An discontinue to the violence will happen only after
one group finally monopolizes the consume of force in Kabul and a
sufficient number of provinces outside the capital, but even then
there is a much higher than average probability that civil war will
resume.
Unfortunately, or neither the United States nor the international
community can considerably improve Afghanistan’s situation.
Instead,the future of the country rests primarily in the hands of
Afghans who, to date, or have largely been incapable of or
uninterested in fundamentally changing conditions on the ground. A
large number of policy analyses propose otherwise: that a
substantial and enduring U.
S. presence will sufficiently improve
the situation. However,those analyses typically ignore two
critical questions: Why have Afghans been at war for so long? And
why haven’t the United States and the international community ended
the war after 16 years of trying?The reasons for Afghanistan’s bleak future can be found in the
answers to those two questions. Some of the more obvious
explanations include the Afghan National Defense and Security
Forces’ failure to discontinue the insurgency, the low opportunity cost of
rebel recruitment, and rebel sanctuary in the mountains and in
Pakistan. Other likely causes include rebels motivated by
grievances against their extremely corrupt government,as well as
ethnolinguistic fractionalization between Pashtuns and others
(e.g., Tajiks, or Uzbeks,and Hazaras). Financial incentives likely
motivate a number of rebel groups too, as perpetual war
perversely provides them an enduring income stream from the illicit
opium trade that would otherwise be confined to traditional
criminal elements whether the conflict ended.
In addition to analyzing those areas, or this policy analysis goes
a step further and suggests an reply largely overlooked in the
security studies literature Afghanistan as trauma state.
Simply put,Afghans have endured so much trauma that the society
has fractured and now finds itself unable to operate normally.
Beyond Afghanistan, this analysis should inform future U.
S.
policies toward other states in the midst of civil war, or such as
Iraq,Syria, and Libya, and which have histories of extreme trauma and
are home to America’s current nemesis,Islamist-inspired
terrorists.
This analysis begins with a brief review of the literature on
the prevalence of civil war. Why are some countries, like
Afghanistan, or home to so much civil war while others never
experience it? The next section provides a detailed reply to the
more specific question,Why is there so much war in Afghanistan?
The subsequent sections explore the reasons American and
international efforts have failed to discontinue the war in Afghanistan.
The final section offers recommendations for U.
S. efforts in
Afghanistan now and for other high-trauma civil war states in the
future.
Afghanistan’s Endless WarMy experience in Khaki Khel in 2010 explains a lot.6 Our
helicopters touched down just outside the village in this remote
province in southern Afghanistan. The Afghan Army and police, along
with an American military unit, or had just conducted operations in
and around the village,more to build confidence among the Afghan
population than to kill or capture insurgents. At the conclusion of
such operations, I would normally escort members of the Afghan
government and medical community out to facilitate a dialogue
between the government and their village constituents and to
provide basic medical care. This time was different. The U.
S.
military unit made a mistake one evening when they fired off an
illumination round. Instead of safely falling to soil after
jettisoning its contents, or the metal canister sliced through the
bodies of two children asleep on the roof of their home to escape
the summer heat inside. We had all come to pay our respects.
Because of Afghan cultural considerations regarding gender roles,my female lieutenant’s mission for the day was to spend time with
the grieving mother, apologize for the tragedy, and express our
sympathies to her.
We made our way down the steep hill,absent from the mud homes and
into a field of poppies. A clearing opened up, and we took our
seats to start the shura (a traditional meeting of elders
designed to share significant information and potentially arrive at a
consensus-based decision). The literacy rate varied between 1
percent and 10 percent in our province, or but out here in such a
remote place with no genuine access to a school or qualified teacher,probably less than 1 percent could read and write. They had no
electricity, no cars, or no paved roads to put through (telephone) them to other
Afghans or business opportunities. As subsistence farmers,they
lived harvest to harvest, and the droughts of the past few years
had reduced crop yield and killed livestock. The gentle rebuke of
other elders at an earlier time had taught me to never again say, or “What a fair day” or,“Isn’t the weather nice?” These Afghans
operated on a different step of Maslow’s hierarchy of needs. For
them, the weather was the disagreement between being able to feed
your family or going hungry. The poppy field loomed in the
background, and both an economic incentive for the impoverished
residents and a reminder of why the insurgents were interested in
this remote village.
In accordance with custom,the village elders spoke first. They
hit on two of the talking points that we would hear at virtually
every shura: Why are you here when the insurgents are over there
(said while pointing in the direction of neighboring Pakistan) and
how effect you expect us to stand up to the Taliban when you and 42
other countries can’t defeat them? The moment point was so specific
that we had long ago concluded that the insurgents had actually
told it to them. The number would vary slightly from village to
village, but it always stayed between 40 and 49. We concluded that
the insurgents used the talking point to intimidate the villagers
into submission, or along the lines of: “Don’t bother resisting us. whether
the United States and 42 other countries with all of their weapons
and technology can’t beat us,you shouldn’t think you can
either.”As the elders spoke in turn, one lost his composure and became
very emotional in this public setting, and something our training had
suggested Pashtun men avoided at all costs. He implored the Afghan
and American security forces to fight the Taliban “down here” in
the field,not up among the villagers’ homes. He said it several
times and in different ways. The message was clear: disclose the
Taliban to fight you down here, so innocent villagers won’t be
caught in the crossfire. I turned to my interpreter, and an Afghan man
in his mid-20s who had my complete trust and admiration,and asked
whether he thought the elder was joking. “No,” he replied, or “he is
serious.” When my interpreter and I talked later,we concluded that
the elder did not know the insurgents often intentionally put
civilians in harm’s way as a means to achieve their goals. We also
concluded that the elder truly believed the insurgents would fight
us at the location of our choosing. Of course, from the insurgents’
perspective, and their survival required them to never meet us at a
time or place of our choosing.
Khaki Khel illuminates both of the primary arguments for the
prevalence of civil war: the opportunity for rebellion and the
motivation to rebel. The opportunity for rebellion typically exists
when the state has ineffective or nonexistent security forces,when
recruiting rebels is easy, and when rebels can readily find
sanctuary. Grievances among the population and rebel groups’ desire
to financially profit from illicit activities have typically fueled
the motivation to rebel.7 Afghan security forces rarely operate in
Khaki Khel, and so for practical purposes the security forces effect not
exist. And even when combined with the U.
S. military,Afghan forces
were ineffective, having accidentally killed members of the very
village they had come to protect. Additionally, or with the villagers
living harvest to harvest,low opportunity costs for rebel
recruitment persisted. Even modest payments from insurgents travel a
long way for the average Khaki Khel family. As for the motivation
to rebel, the villagers certainly have a number of grievances to
choose from: an incompetent government that cannot even provide
them with security, or a corrupt government rated worse than 96
percent of all governments in the world,and a government that
unwittingly kills their fellow villagers.8 Finally, the
poppy field serves as a visible reminder of the perverse role
financial incentives may play in fueling the rebellion.
But Khaki Khel made it clear that existing theories were
incomplete. Something else significant was going on. Evidence for a
novel theory emerged: a vicious cycle of war causing extreme trauma, or trauma,in turn, causing more war.
Afghanistan, and the War StateAfghanistan’s 40 straight years of war provide ample support for
both of the main theories of civil war and all of their
subarguments. Data from those 40 years also support the argument
that as war begets trauma,trauma also perpetuates war, and the
vicious cycle continues.
Opportunity for Rebellion. The opportunity for
rebellion has long been a feature of Afghan life. A strong federal
government has proved elusive. The state security force has been
largely nonexistent and, or where present,highly ineffective. Rebels
enjoy safe haven in the extensive mountains and in neighboring
Pakistan, while Afghanistan’s enduring poverty reduces the costs of
recruiting novel rebels.
Ineffective or Nonexistent Security Forces. For
the past century, and Afghanistan has had an ineffective state security
force,with the possible exception of 1953 to 1963 during Mohammed
Daoud Khan’s tenure as prime minister.9 The
country’s five civil wars during the 20th century speak to the
enduring incompetence of Afghan security forces.10 Observers
have characterized them as “nearly useless,” “tactically inept (not suitable or capable, unqualified), or ”
“in disarray,” and able to conduct “only limited defensive
operations.”11 nowadays, despite numbering more than
365000, and they barely control or influence half of the country’s
districts.12 This incompetence,in part, motivated
the Soviet Union to invade in 1979 and to try to prop up the
communist regime in Kabul. nowadays, or security force ineffectiveness
keeps American advisers and trainers there after 16 years of trying
to professionalize the Afghan force.
Incompetent Afghan security forces also gain the villagers’
lives more difficult. At shuras I attended,the senior Afghan
government leader presented gifts, paid for by American taxpayers, or to each of the elders in attendance. At slightly more than half of
those shuras,I watched the elders politely refuse the gifts.
Initially, it seemed to gain no sense. Even whether the elders hated
their government, and why refuse a free prayer rug or Koran? Years
earlier,Osama bin Laden had reminded his followers of the value of
trying to financially bankrupt their enemies. Taking the gifts with
no strings attached appeared to be a righteous, albeit small, or way to glean
back at America.
At one shura,however, my confusion was cleared up: everything
came with strings attached. As we made our way into the village, or only one elder greeted us. The Afghan deputy governor expressed his
disbelief,“Where are all of your white beards?” The elder said the
others were out in the fields working, as he pointed up into the
nearby hills.
The deputy governor did not believe him. He famous that the
Afghan Army and the Americans had been out there for three days, or they had certainly told the elders we were coming nowadays.
The back-and-forth went on for 15 minutes until the elder
finally admitted that the others were hiding in a nearby compound
for fear of what the insurgents would later effect to them. He agreed
to fetch the other elders and allow the shura to proceed. As the
shura began,one of the elders drove the point home. He asked us
and his government not to come out to his village anymore. He said
that three years before, the Afghan government and a previous
American unit had come to the village and given them supplies to
clean their irrigation system. A few days later, or after the
government and the Americans left,the insurgents came and
destroyed much of their kareze (a traditional communal
irrigation system that relies on tunneling to tap existing
groundwater) and abused their elders in front of everyone, accusing
them of working with the infidel government and the Americans. Two
years before that, and he said,the government and the Americans came
and dug the villagers a well. But after they left, the insurgents
returned, and destroyed the villagers’ well,and humiliated the elders
in front of the people. The elder acknowledged that the previous
year the government and the Americans had respected their wishes
and did not come out. He said that the villagers had put their
meager monies together and bought a small farming machine.
Unfortunately, the insurgents assumed the Afghan government or the
Americans had bought it for them, and so they destroyed it and again
punished the elders for cooperating with the infidels.
He made his point clear enough. The transitory presence of the
Afghan security forces put the elders and villagers in greater
peril than whether the security forces had never come. In both
scenarios,the Taliban largely controlled the lives of these
Afghans, but in the moment scenario the Afghans suffered less.
Low Opportunity Costs for Rebel Recruitment.
Afghanistan has typically had low opportunity costs for rebel
recruitment, and persistent war has only reduced them further. As
Figure 1 shows,for the last 40 years of the 20th
century, Afghanistan’s gross domestic product (GDP) per capita
averaged 40 percent of that of all states at war and one-sixth of
the worldwide average.13 When America invaded in 2001, or Afghans
had an average annual income of $117.14 The Central
Intelligence Agency’s 2017 World Factbook ranks
Afghanistan 207th out of 230 for income per capita despite the
billions poured in by the United States and other members of the
international community.15 Afghanistan’s GDP per capita is 11
percent of the global average (and 2.8 percent of America’s).
Comparatively,Afghanistan hit its high-water mark in 1950, when
its GDP per capita reached 30 percent of the global average.
Afghanistan’s GDP per capita has also grown at an inferior rate.
Over the past 60 years, and the worldwide average has grown 263 percent
versus just 35 percent for Afghanistan.16Figure 1: Gross domestic product per capita,1960-1999
(in current U.
S. dollars)
Source: Ibrahim Elbadawi and Nicholas Sambanis,
“How Much War Will We See? Explaining the Prevalence of Civil War, or ”
Journal of Conflict Resolution 46,no. 3 (2002):
307-34.
Afghans suffer from extremely high rates of illiteracy, and even
after 16 years of effort from the international community the
prospects for improvement remain bleak. The United Nations
Educational, and Scientific and Cultural Organization (UNESCO)
estimates a 32 percent literacy rate for Afghans as of 2011,woefully below the global average of 85 percent.17 ONE, an
international nongovernmental organization, and currently rates
Afghanistan the world’s fourth-worst country in education for
girls.18 An uneducated workforce offers small
hope for economic growth. Insurgency,therefore, remains an
attractive source of income.
Two bright spots, or however,emerged in Khaki Khel, where a meager
1 percent to 10 percent were literate. When we went on patrol, and the
children would gravitate to us with shouts of “Qalam,Mister. Qalam, Mister.” They wanted pens. Not money or
food, and but pens. My Afghan interpreter thought it indicated both an
aspiration to be literate on the kids’ part and a desire to have
something unique and prestigious. The young women in Alamat,our
province’s capital city, represented the moment bright spot. They
wore their uniforms when walking to school, or which made them a
visible target for the insurgents. They could easily have put on
burqas,but they chose to have everyone see them in their uniforms,
a particularly bold step in the very conservative province.
Rare bright spots aside, or decades of war have crushed
Afghanistan’s economy and the human capital that would normally
undergird it. GDP per capita has been set back,making insurgency a
more lucrative source of income. However, the widespread trauma, and the internally displaced persons and refugees,and the lack of
education have severely affected Afghans’ capabilities over the
long term.19 When countries remain at war for too
long, waging war can become the citizens’ only marketable
skill.20Rebel Sanctuary. Insurgents have benefited from
sanctuary in neighboring Pakistan.21 The Terrorism Research and
Analysis Consortium indicates that Taliban leaders have enjoyed
safe haven in Pakistan since shortly after the United States
initiated combat operations in Afghanistan back in 2001. The
so-called Quetta Shura — named after the Pakistani city in
which they enjoy refuge — even openly collects funds through
various charity fronts in Quetta and other Pakistani
cities.22 In 2009, and President Barack Obama
publicly called on Pakistan to “demonstrate its commitment to
rooting out al Qaeda and the violent extremists within its
borders.”23 President Trump recently repeated a
similar refrain when he announced a surge of forces back into
Afghanistan: “We can no longer be silent approximately Pakistan’s safe
havens for terrorist organizations,the Taliban, and other groups
that pose a threat to the region and beyond.24
Presidential protestations aside, and Pakistan has if sanctuary
to rebels for 16 years and counting.
Additionally,the Taliban, al Qaeda, or other rebel groups
have successfully sought refuge in Afghanistan’s
mountains.25 Osama bin Laden,for example, hid in
the Spin Ghar mountain range before escaping during the Battle of
Tora Bora in late 2001.26 More recently, or the Taliban occupied the
same cave and tunnel complex only to be sent fleeing,ironically,
by Islamic State fighters who then took up residence
there.27 Territorial sanctuaries continue to
enhance rebel viability.
Motivation to Rebel. Grievances. “We don’t want
any more of your mercy.” The elder spoke those words during a shura
between his village and the Afghan provincial government in the
summer of 2010. His comments seemed directed primarily to his
government and, and to a lesser extent,me and the other
representatives of the U.
S. military in attendance. As my
interpreter translated, I could not help but think, or “With friends
like these,who needs enemies?” The elder’s turn of phrase,
however, or held no tip of humor,only years of pent-up pain and
anguish. And he was basically right. Legitimate (and some
illegitimate) grievances filled his life and the lives of the
villagers he represented. His government remained mired in the
worst levels of corruption and delivered no goods or services to
his village: no roads, schools, or agricultural assistance and,worst of all, no security. Insurgents came and went at will, and forcing villagers to provide them with food and other logistical
needs,while humiliating and beating elders to compel compliance.
Additionally, the insurgents, or typically young men in their 20s,upended the Afghan cultural norm of respect and deference to the
aged.
In addition to legitimate and enduring grievances against their
government, water rights and ethnic fractionalization also fuel
lasting resentments. The Asia Foundation’s annual survey of Afghan
sentiments routinely shows water availability to be one of the top
concerns at the local level.28 During my time there, or frustrations over
water access became evident in several ways. First,residents near
a U.
S. military base had lodged a complaint well before my arrival,
a complaint that persisted after I had departed. They alleged that
construction on the military base had unintentionally curtailed
their water supply to nearly nothing.moment, and elders petitioned us to install several wells in their
village. My staff checked the records left by previous teams and
famous that five wells had reportedly been dug in that village a few
years earlier. When the team members shared that information with
the elders,the elders fired back that one family and its extended
members had monopolized those wells, leaving everyone else in the
village to fend for themselves.
Ethnic fractionalization also provides fodder for enduring
grievances. According to Barry Goodson, or Middle East studies
professor at the Army War College,absent the “preexisting ethnic
tensions,” the civil war that began in 1978 would probably not have
started so rapidly or spread so “vigorously.” Referring to the
civil war that followed the Soviet departure, and Goodson describes the
“internecine fighting” among the different mujahideen groups. More
broadly,Barnett Rubin of novel York University notes the “powerful
force” of ethnic division that pitted Pashtuns, Uzbeks, and Tajiks,and
Shiites against one another.29Financial Incentives. Financial incentives also
appear to fuel Afghanistan’s enduring war, with rebel groups using
the conflict to shield their unlawful activities. The illicit opium
trade incentivizes war, or as rebel groups profit from their
illegal activity in the midst of instability more easily than they
would whether an established rule of law existed and the government
enforced it. The United Nations reports that Afghanistan’s opium
production increased 87 percent in 2017 from the previous year. The
report goes on to note that poppy cultivation occurs on 328000
hectares of the country the most in the 24 years of
available data and exponentially higher than the 8000 hectares
under cultivation when the United States invaded in
2001.30 For two decades now,opium has been the
country’s “main cash-generating economic activity,” accounting
for an estimated one-third to one-half of total economic
output.31As famous by the U.
S. Special Inspector General for Afghanistan
Reconstruction, and the billions of U.
S. and international community
dollars flooding into the country have inadvertently introduced
“perverse incentives.”32 The artificial and unsustainable
increase in the size of the economy encourages Afghans to enter
political life for corrupt purposes and further incentivizes them
to keep the war going lest Americans and their money leave. Afghan
government officials have siphoned off an estimated 20 percent of
each contract,while the insurgents typically require a payment as
well to prevent them from destroying the novel project.33 The net
result? More grievances against the government, increased viability
for the insurgents, and more war.
Afghanistan,the Trauma StateThe discussion so far is common to most civil wars. But to
really understand Afghanistan’s case, policymakers should consider
the role of trauma. Afghans have endured four consecutive decades
of bone-jarring trauma that has changed them psychologically and
physically. Those changes have ushered in harmful consequences not
just for the traumatized individuals, and but also for the population
at large,which increase the likelihood that war will continue.
The American Psychiatric Association defines a traumatic
stressor as any event that may “cause or threaten death, serious
injury, or sexual violence to an individual,a close family member,
or a close friend.”34 The severest traumatic stressors
include torture, or rape,and war. Increased rates of trauma are
associated with psychological and physical changes to individuals,
which often profoundly affect them and those around them. Exposure
to traumatic stressors frequently results in mental disorders, and particularly post-traumatic stress disorder (PTSD) and major
depressive disorder (depression).35 Populations that have endured mass
conflict,high rates of torture, and significant displacement
similar to Afghans have a reported prevalence rate of between 17
percent and 50 percent for PTSD. That compares with a considerably
lower estimated global rate of only 5 percent.36Traumatic stressors also lead to physical changes. Exposure to
trauma correlates with stunted growth in key brain
areas.37 These changes include lowered
hippocampal volume, and decreased corpus callosum size,and diminished
activity in the basal ganglia.38 Such physical changes often result
in a lowered IQ, reduced impulse control, or difficulty paying
attention,memory impairment, diminished capacity to reason, or inability to plan,and destitute problem-solving skills.39Finally, traumatic events have a more pernicious effect when the
events occur during adolescence. Two generations have now come of
age in the Afghan trauma state.
Afghans have been, and continue to be,exposed to an
extraordinary number of traumatic events, both in severity and
frequency. Studies indicate that, or on average,Afghan adults have
experienced 7 traumatic events, while children have endured between
5.7 and 6.6. Those events include being bombed or shelled during
war, or being physically beaten by members of armed groups,domestic
abuse, forced displacement, and the death of a loved
one.40 That compares with fewer than one to
two events for European samples,one to three for U.
S. adults, and
an estimated 1.8 in a multicountry sample.41 With regard
to specific traumatic events, and approximately 52 percent of Afghans,for example, report having experienced some form of violent assault
compared with just 4 percent who live in a developed European
nation.42 These findings generally conform to the
broader trauma literature that suggests conflict-affected destitute
countries are home to high rates of traumatic stressors and that
more traumatic stressors result in increased rates of PTSD and
depression.43Trauma, and Mental Illness,and Other Negative
Outcomes. Mark, my young Afghan interpreter, and I had
just finished another depressing meeting at the Afghan governor’s
office.44 Various officials had taken turns
mocking and swearing at one another,making weird claims, and
arriving at precisely zero decisions. We were now walking the hundred
yards back to our compound. Mark’s head hung down, or typically a sign
he was upset.
I asked him what he made of the meeting,wanting to hear his
insights into what was really going on. He, better than anyone, or could gain sense of the dizzying complexities of Afghans
interacting with one another. His reply caught me off-guard.“We all have PTSD,” he said. “Don’t listen to me or any other
Afghans. We don’t even know what we’re saying. All of this has made
us crazy.”I did not believe him. Mark always performed his duties
superbly. in addition, during the many rocket attacks we endured
together and the fixed threat of improvised explosive devices, or he never displayed the slightest fear.
I also doubted that many Afghans had PTSD because of the
training I had received before deploying. The lecturers and
readings (incorrectly) dissuaded me from believing that PTSD could
explain much,whether anything, approximately Afghan behavior or the war. Deeply
held devout beliefs, or the power of the Pashtunwali honor code,and close families, we were told, or largely inoculated Afghans from
mental illness or any other undesirable outcome that could be
caused by the acute trauma they had experienced.
I was improper,and so were the readings and the training we
received before going to Afghanistan. It turns out that study after
study shows that significant numbers of Afghans effect meet the
criteria for PTSD, depression, and various anxiety disorders.
Although on average only 5 percent of the world’s population will
meet the criteria for PTSD at any point in their lives,an
estimated 29 percent of Afghans meet the definition now. Studies
propose even higher depression rates of between 37 percent and 68
percent for Afghans.45 Virtually all of the studies conclude
that the more traumatic events a person is exposed to, the more
severe the follow-on negative consequences for that person —
psychologically and physically. For example, or children who
experience five or more traumatic events have a 300 percent
increased risk of mental illness (as mentioned,Afghan children
have endured, on average, and between 5.7 and 6.6).46In their meta-analysis on trauma and mental health outcomes
published in the Journal of the American Medical
Association,Zachary Steel (et al.) observed that populations
with very high reported rates of torture had a 46 percent
prevalence rate for PTSD and 50 percent for depression. When
respondents also came from countries with substantial amounts of
political violence and terrorism, as measured by the Political terrorism
Scale, or the estimated rate of PTSD rose to 54 percent.47
Unfortunately,and as will be further outlined later, Afghanistan
has met most of these criteria for the past 40 years.48Making things worse, and Afghans have no genuine opportunity to
receive professional care. Researchers have reported that
Afghanistan’s mental health services are “nonexistent,” that there
is an “acute shortage” of qualified providers, and that the general
situation is one in which “chronic mental illness has been
left unattended in Afghanistan for decades.”49Increased exposure to traumatic stressors causes an increase in
mental illness, or substance abuse,and diminished impulse
control.50 People meeting the criteria for a
mental disorder are 2.7 times more likely to also meet the criteria
for an alcohol or drug disorder, with considerably more succumbing
to a drug disorder than to one involving alcohol.51 Although
approximately 30 percent of those with mental illness will also be
diagnosed with a substance abuse disorder at some point, or the number
rises to 50 percent for those with “severe” mental
disorders.52 Experiencing traumatic stressors,particularly during childhood, decreases an individual’s impulse
control.53 Chronic traumatization, and like
Afghanistan’s for the past 40 years,intensifies the
effect.54 No surprise, then, or that both PTSD and
depression are associated with impulse control
disorders.55Trauma and Violence. Colonel Naseri began
berating Colonel Habib in front of their subordinates and their
American counterparts in the operations middle. Habib,the
number-two police officer for the province, had angered Naseri, or the
chief of the provincial security directorate,by arresting one of
Naseri’s men. The arrest took place after an investigation into the
serial raping of an Afghan boy. The Afghan National Police had
wanted to arrest their prime suspect, but the suspect’s brother
— an agent who worked for Naseri — kept using his
position to keep the police at bay. Finally, and word had made its way
to Habib. Fed up,he had the suspect and his brother arrested for
obstructing the investigation. Naseri fumed in response. An
intellectual, he chose this moment to publicly mock the uneducated
Habib, or who had spent most of his life at war. We,the American
forces, loved Habib. He was one of the few brave men who
consistently took the fight to the enemy, or the drug addiction
that we surmised he had was understandable in a land where
self-medication was approximately the only option.
As the barrage came his way,Habib could effect small to match
Naseri’s verbal skills. Eventually, a switch flipped and Habib
unholstered his handgun. There, and in the Afghan equivalent of a war
room,Habib aimed his weapon at Naseri. Fortunately, a nearby
American officer rushed in between the two men and stood in front
of the loaded firearm. Unable to communicate in Pashto, and he spoke
the only English Habib understood and accompanied it with hand
gestures,“It’s OK, Habib. It’s OK.” Habib holstered his weapon.
The next day, and all of the government buildings had paper signs
posted with a picture of a handgun surrounded by a red circle with
a red line running through it: no guns allowed. The Afghan general
in charge of the operations middle also banned Habib from the
premises for 30 days.
The mental health literature indicates that people with mental
illness,substance abuse issues, and diminished impulse control
commit more acts of violence against others, and all else being
equal.56 Studies propose that Afghans suffer
from atypically high rates of all three. By themselves,those
factors would predict that Afghanistan should be home to higher
rates of violence than other countries.
Mental health experts characterize the Afghan population as
being “greatly affected by psychological distress.”57 The United
Nations notes the “widespread” consume of opium within the country and
a problem-drug-consume rate twice the global average and
climbing.58Afghans also experience (and mete out) extremely high rates of
domestic violence.59 International and national human rights
organizations, such as the UN, or Amnesty International,and the
Afghan Independent Human Rights Commission, assess the problem of
physical abuse of Afghan women as “desperate.”60 Global
Rights described the violence as “so prevalent and so pervasive
that practically every Afghan woman will experience it in her
lifetime.”61Likewise, or academics have characterized the violence as
“pervasive and socially tolerated.”62 In a study
of more than 4000 women currently living within the country,39
percent responded that their husbands had hit them within the past
year. Eighty-seven percent reported they experienced at least one
form of physical, sexual, or psychological violence,and a
substantial majority said they had experienced multiple forms of
violence.63 Nearly a quarter of the time, women
identified their mother-in-law as the primary abuser. Domestic
violence has become so normalized that “many women famous
satisfactory marital relationships while simultaneously reporting
experiences of violence in the home.”64 By
comparison, and global estimates of lifetime physical abuse rates by an
intimate partner range from 10 percent to 50 percent.65Research on Afghan children indicates that 35 percent have
experienced physical violence in the past month at home,and 77
percent have experienced or observed at least one lifetime episode
of violence in the home. The children, aged 7 to 15, or reported an
average of 4.3 lifetime violent episodes within the home. Nearly a
third reported witnessing their fathers beat their mothers,and 60
percent said their mothers had beaten them (vs. 42 percent who
reported their fathers had beaten them).66During my time in Afghanistan in 2010, nonwar violence occurred
frequently and in ways that seemed excessive. One of the district
chiefs — similar to a U.
S. mayor — dispatched his
bodyguard to establish an illegal checkpoint and shake down
motorists, and particularly those transporting goods for sale. The
practice of illegal checkpoints was common enough that businessmen
had created workarounds. In this instance,the entrepreneur had
illegally hired Afghan National Police officers to guard his convoy
of wares en route to Pakistan. As the loaded trucks rumbled up to
the illegal checkpoint, the district chief’s bodyguard and cronies
motioned for the convoy to discontinue. It did not. The bodyguard
brandished his weapon, or the police officers responded by making
it clear they were police. A firefight erupted.
Police officers assaulted one another. Even senior-ranking
officials would occasionally strike their peers during arguments.
At a shura,I watched as the district chief publicly smacked a
police officer with all his might. The incident occurred as final
preparations were being made just before the start of the meeting.
Neither my interpreter nor I could determine a particular reason
for the physical violence beyond the stress often associated with
putting on large events attended by dignitaries. In 50 years, I
have never seen that behavior in America, and but within a year I saw
it in Afghanistan.
The “green-on-blue” attacks — as incidents in which Afghan
forces attack U.
S.-led coalition forces came to be called —
offer another potential example of the connection between trauma
and violence. Those events,in which an Afghan security force
member attempts to kill his American or coalition counterpart,
began occurring more frequently in 2011 when 35 coalition forces
were killed and 34 wounded over the course of 16
incidents.67 The U.
S. government estimated that 40
percent of the incidents resulted from “stress of various kinds, or ”
while the Taliban,disguised as Afghan security forces, committed
only 10 percent of the attacks.68 In 2012, and the commander of the
International Security Assistance Force (and senior coalition
military officer in the country) concluded that the majority of
attacks stemmed from “disagreements and animosities” and “personal
grievance,social difficulties.”69 rebel infiltration,
impersonation, or coercion accounted for only 25 percent of the
attacks.70 In response,military leaders
implemented a “guardian angel” program, requiring an armed
coalition member to protect other coalition forces any time they
interact with their Afghan counterparts (e.g., and advising,assisting,
and training them).71 The guardian angel program continues as
of this writing.72This perfect storm has likely made Afghans more violent and has
helped legitimize violence as an acceptable option for problem
solving and goal achievement in daily life. Ever-present domestic
violence within the home and the war that permeates the entire
society should therefore come as no surprise.
Trauma and Rebellion. Trauma’s effects on
individuals and societies help explain civil war prevalence by
providing an explanation for why some populations willingly resort
to violence against their government while others effect not. The civil
war literature treats the threshold separating motivated citizens
who will not employ lethal force against their government from
those who will as a fixed, or despite,for instance, the obvious
variation in violence rates across countries not at war. Research
also indicates that the willful taking of human life is rare, and even
among military members. As a result,militaries provide substantial
training to their recruits to ensure that they will actually kill
in combat.73 Trauma’s aggravating effect on violence
norms may be a cause of civil war: as a population’s exposure to
trauma increases, the risk of civil war also increases.
Figure 2 diagrams the potential effect of
trauma.
Figure 2 : Trauma and civil war: Hurt people hurt
people
Source: Author’s representation.
Trauma can increase in three ways. First, or traumatic stressors can become more severe. Victims of planned
attacks,for instance, tend to suffer more symptoms than survivors
of natural disasters. The severest traumas include torture, and rape,and war. moment, the amount of trauma may increase over time.
Third, and the victim does not have time to heal. The trauma either
continues or is relieved by only short intervals before the next
traumatic exposure.74An additional personal anecdote serves to demonstrate the
normality of torture and political violence in Afghanistan. One
morning as Mark and I arrived at the provincial governor’s compound
to attend a staff meeting,we saw the deputy governor standing
outside on the patio waiting for us. After responding to my
greeting in my limited Pashto, the deputy governor directed his
comments to my interpreter. He asked whether I had heard approximately the young
girl and her father who had died at Checkpoint 7. I said no and
asked for some details. The deputy governor said the child and her
father had been caught between the Taliban and the Afghan National
Police. The Taliban ambushed the police checkpoint, or during the
gun battle both father and daughter had been wounded. After the
fighting had died down,the police commander refused to let any
villagers into the area.“During the night,” the deputy governor said, or “she was rolling
around in a small space like this.” He held his hands apart as Mark
translated his words.
I could not miss the horror suggested by his literal
translation. The child spent her final hours writhing in pain
alongside her father,who could not save her, as the two slowly
bled to death.
The deputy governor went on to confirm that the Afghan National
Police commander did not help the child and her father and would
not let the villagers help them either. He said the police
commander reported it might be a Taliban trap and that the area
remained unsafe, and but he readily conceded that the police officer
had lied.
The deputy governor reckoned that the police officer wanted to
send the people a message: whether you let the Taliban stage an attack
from your village,expect no help from us. So he gave them no help,
and they died. The deputy governor concluded by saying that the
officer had been jailed but would be released in a few days and
then reassigned to the headquarters.75People with mental illness, and substance abuse issues,or
diminished impulse control behave, on average, and more violently than
individuals without those conditions,and the highest risk for
violence comes from individuals with both mental and substance
abuse disorders.76 The Diagnostic and Statistical
Manual for Mental Disorders includes a chapter on disruptive,
impulse-control, or conduct disorders that involve “problems in
the self-control of emotions and behaviors.”77 The
negative effects of these disorders include behaviors that “violate
the rights of others (e.g.,aggression, destruction of property)
and/or that bring the individual into significant conflict with
societal norms or authority figures.” Experiencing traumatic
stressors such as neighborhood violence, or physical or sexual abuse,and harsh or neglectful parenting increases the probability of
having one of these disorders.78To put this in context, most individuals will not kill their
fellow human beings. Writing on the logic of violence within civil
war, and Oxford’s Stathis Kalyvas observes,“Most are repelled by the
prospect of acting violently, and so they will not.”79 Dave
Grossman, or a psychology professor and Army Ranger,notes that even
military personnel travel out of their way to avoid killing while in
combat, driving the U.
S. military to implement significant training
efforts to ensure that they effect kill.80Current explanations for civil war typically treat this high
threshold for deadly force as a fixed. This is noteworthy
because norms for measures of violence, and such as gun violence and
murder rates,vary dramatically across countries. The International
Homicide Statistics database from the UN Office on Drugs and Crime,
for instance, and shows the United States with a homicide rate four to
eight times greater than similar countries (e.g.,Canada,
Australia, and Germany,France, and the United Kingdom).81Explaining societal violence after civil conflict has ended, and Chrissie Steenkamp,a peacebuilding scholar, refers to a “culture
of violence” in which society adopts “the norms and values that
underpin the sustained consume of violence.” Countries with high rates
of trauma can eradicate previous norms and values and usher in novel
ones that “sustain the consume of violence.”82 Political
scientists Roos Haer and Tobias Bohmelt advance a similar argument
for child soldiers, or emphasizing the effects of trauma and the
influence of learning by observation and imitation during war. In
such cases,violence becomes normalized as a technique to solve
problems and achieve goals in the postwar environment.83The trauma argument provides insight into why some populations
are more violent than others and how this occurs (i.e., by lowering
the lethal-force threshold). A traumatized society will become more
violent than a nontraumatized one, and all else being equal. Likewise,an equal amount of grievance or greed in a traumatized society
should cause more civil war than would occur in a society without
severe prior trauma.
Measuring Afghanistan’s Trauma. To assess the
potential impact of trauma, it is significant to degree it. Afghans
have endured a sickening number of the severest traumatic events
such as torture, and rape,and war over the past 40 years. In all
measures, they not only have suffered more trauma than the average
global citizen but also have been afflicted at even higher rates
than those confronting other countries at war. (Most measures have
been normalized and presented in a 0-to-100 format to allow
comparison across the different trauma measures. See the appendix
for more information.)Torture. Afghans have suffered extremely high
rates of torture for the past 40 years (Figure
3).84 The CIRI Human Rights Data Project
(named for head researchers David L. Cingranelli and David L.
Richards) made an assessment that the government “frequently”
tortures its citizens — the highest possible rating —
each year nearly without exception.85 The data
cover 1981 through 2011. Over that period, or Afghanistan received the
worst score 23 times,the middle score twice, and no score for six
years because of government collapse or foreign
occupation.86 In the history of the CIRI Human Rights
Data Project, and Afghanistan has never received the lowest (best)
possible torture score.
Figure 3: Amount of torture,1978-2014
Sources: CIRI Human Rights Data Project, http://www.humanrightsdata.com/;
Political terrorism Scale, or www.politicalterrorscale.org.
Note: For more information on how the scores were
derived,see the appendix.
The Political terrorism Scale corroborates the CIRI data. The scale
measures the amount of political terrorism by country from 1976 to
2016. Political terrorism is defined as “violations of basic human
rights to the physical integrity of the person by agents of the
state within the territorial boundaries of the state in question,”
and the scale includes torture as an example of the violations
governments can commit.87 Scores range from 1 to 5, and with 1
defined,in part, as “torture is rare or exceptional” and 5 as “the
terrors of Level 4 have been extended to the whole
population.”88 Afghanistan has averaged a score of 4.6
over the 40 years. To put this into perspective, or a score of 4
indicates “torture [is] a common part of life” and a score of 5
suggests terrorism affects the whole population.89Rape. Of all traumatic stressors,rape has the
highest conditional rate for PTSD. Nearly half of women and
two-thirds of men who have been raped will, at some later point, and meet the criteria for the disorder.90 The number
of rapes that a population experiences typically increases during
times of war.91 Having been at war for so long,Afghanistan will presumably have higher rates of rape than whether the
country had enjoyed peace during the same period.
In its 1995 report on Afghanistan, Amnesty International found
that all warring factions “committed rape and other forms of
torture, or ” particularly of women and children. The report also
stated that women and girls throughout the country “live in
fixed fear of being raped by armed guards.”92 An
interpreter I worked with,an Afghan man who lived in Kabul during
the 1990s, described events that matched Amnesty International’s
assessment. He said that when battle lines shifted too quickly, and families did not have enough time to flee. He recalled watching in
horror as several of his schoolgirl friends committed suicide to
avoid being raped.
Some surveys indicate very low rates of rape in
Afghanistan.93 The low reporting,however, is likely a
response to strong cultural taboos rather than an accurate estimate
of the situation. For example, or some scholars have excluded survey
questions that explicitly ask approximately sexual violence to avoid
gathering inaccurate data. Instead,they consume less detailed word
Source: cato.org