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Afghanistan has a long history of war by foreign conquerors and fighting internally with conflicting groups.

Currently under rule by the Taliban, who returned to power in 2021, they believe in imposing Sharia law and other aspects of Islam.

The Quran and hadith are the two main sources of Sharia Law.  Quran is the word of God, hadith is the practice and sayings of Prophet Mohammed. (Robinson, 2021)

Islamic law significantly restricts women’s rights.  Inequality by limiting education, employment opportunities, and initiating divorce. (Robinson, 2021)

Sharia isn’t the same as Islamic law. Muslims believe sharia refers to the perfect, values understood only by God, while Islamic laws are those interpretations of sharia. (Robinson, 2021)

Robinson, K. (2021, December 17). Understanding Sharia: the Intersection of Islam and the Law. Council on Foreign Relations. https://www.cfr.org/backgrounder/understanding-sharia-intersection-islam-and-law

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Prayer is considered very important for healing illness.

A strong emphasis on personal daily hygiene, including washing before prayer, regular exercise, eating fresh food, a balanced diet, and getting enough rest are considered important for health.

Traditional beliefs for illnesses are an imbalance of hot and cold forces in the body, not adhering to the principles of God, being possessed by the evil spirit Jinn, and being given the evil eye.

Older Afghans occasionally prefer traditional treatments over Western treatments and also prefer same-sex health care providers helping with personal care.

Unfortunately, mental health issues in men have a stigma attached to it as a sign of weakness.

https://www.health.qld.gov.au/__data/assets/pdf_file/0032/156398/afghan2011.pdf

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Many Afghan refugees face severe trauma, having lost family and homes. Some children, coerced into fighting, struggle with PTSD, depression, anxiety, and physical pain. Alcohol abuse is common. Mental health issues often manifest as anger in boys and withdrawal in girls, and domestic violence is also prevalent.

Refugees frequently suffer from diarrheal diseases, respiratory infections, measles, and intestinal parasites, along with malaria, tuberculosis, hepatitis, dental problems, skin conditions, eye issues, kidney diseases, blood disorders, and heart problems.

The Australian Refugee Health Guide advises focusing on health concerns related to trauma, rather than the actual trauma during psychosocial assessments and conducting full mental health evaluations if needed.

(“Refugee Health Assessment» Australian Refugee Health”)

“Refugee Health Assessment» Australian Refugee Health.” Refugeehealthguide.org.au, 2018, refugeehealthguide.org.au/refugee-health-assessment/#Psychosocial_history. Accessed 26 Aug. 2024.

https://www.azdhs.gov/documents/preparedness/epidemiology-disease-control/disease-integrated-services/refugee-health/providers/community-profile-afghan.pdf

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Social determinants of health are the non-medical factors that influence health outcomes. (World Health Organization, 2024).

Studies have shown refugees have challenges including employment, a socio-cultural atmosphere of society, as well as socio-religious barriers within the Afghan community. While legally Australian citizens, they feel they are still not being accepted as members of society. (Rezaei et al.)

This can lead to barriers to employment and discrimination, which can affect mental health, or enhance already existing mental trauma from past experiences.

Many refugees claim they face employment problems in their chosen field, or have their overseas qualifications not recognised. (Staff, 2021)

Staff, ANMJ. “Afghan Refugees Face Discrimination, Employment, and Social Challenges in Australia.” ANMJ, 13 Dec. 2021, anmj.org.au/afghan-refugees-face-discrimination-employment-and-social-challenges-in-australia/.

Rezaei, O., Adibi, H., & Banham, V. (2021). Integration Experiences of Former Afghan Refugees in Australia: What Challenges Still Remain after Becoming Citizens? International Journal of Environmental Research and Public Health, 18(19). https://doi.org/10.3390/ijerph181910559

World Health Organization. “Social Determinants of Health.” World Health Organization, 2024, www.who.int/health-topics/social-determinants-of-health#tab=tab_1.

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Unfortunately, women's rights and the rule of the Taliban do not belong together in the same sentence.

As of Wednesday 21st August 2024, The Taliban have banned women's bare faces and voices in public.

The new laws were created by the supreme leader of the group, to combat vice and promote virtue. (“The Taliban Publish Vice Laws That Ban Women’s Voices and Bare Faces in Public”)

Article 13 directly relates to women. Women must wear a veil at all times in public, in person with Muslims, and in front of non-Muslim men to avoid being corrupted. No singing, reciting, or reading aloud, as a woman's voice is deemed intimate. (“The Taliban Publish Vice Laws That Ban Women’s Voices and Bare Faces in Public”)

“The Taliban Publish Vice Laws That Ban Women’s Voices and Bare Faces in Public.” AP News, AP News, 22 Aug. 2024, apnews.com/article/afghanistan-taliban-vice-virtue-laws-women-9626c24d8d5450d52d36356ebff20c83.

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Afghanistan has 40 to 59 languages spoken. Dari and Pashto are the main languages, spoken by 77% and 48% of the population, respectively. Dari, a form of Persian, serves as a common lingua franca. Other languages include Uzbeki (11%), English (6%), Turkmeni (3%), Urdu (3%), Pashai (1%), Nuristani (1%), Arabic (1%), and Balochi (1%).

(“Language Data for Afghanistan”)

https://translatorswithoutborders.org/language-data-for-afghanistan

Hazaragi, a Dari dialect spoken by the Hazara ethnic group in Afghanistan (16-20% of the population), is used by many Afghan refugees in Australia. (Afghan Australians)

Hazara education levels are lower, and rural speakers often struggle with Dari interpreters. There's a shortage of Hazaragi interpreters in Australia and concerns about confidentiality.

(Afghan Australians)

https://www.health.qld.gov.au/__data/assets/pdf_file/0032/156398/afghan2011.pdf

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For me, the most significant aspect of treating and caring for patients with diverse backgrounds and needs is considering their cultural differences in patient care. While some may be suffering from PTSD, it is important to assess each patient as an individual and provide the appropriate informed care as stated in clinical practice 1.2. (Culturally Responsive Clinical Practice, 2019)

Leading with no judgment and prejudice, my care will focus on the immediate help for my patient, and potentially creating a plan for aftercare with suitable allied health professionals that will aid their recovery and past trauma issues once discharged.

“Redirecting.” Murdoch.edu.au, 2024, moodleprod.murdoch.edu.au/pluginfile.php/4119639/mod_resource/content/3/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf.