I am here to try and understand how Afghanistan’s epidemic of violence is impacting on the psyche of its everyday citizens. Having seen first-hand the tragic human cost of combat during a deployment with military surgeons in Helmand in 2011, I wondered about the long-term psychological impact of war. We worry about the impact on our soldiers, as we should, but what about those left behind?

Doctor Alemi works a shift in the public hospital every morning, and sees up to 120 patients in his private clinic every afternoon. During his lunch break he answers phone calls from patients and their families seeking advice. Many patients who live far away can’t afford frequent visits and rely on this remote advice and locally sourced medicine.

Doctor Alemi offered to be my host. His outpatient clinic will remain open until the last of the patients have gone, which is often not until after 11pm. His hospital has never been short of people since it was founded twelve years ago. Such is his reputation that some travel 700 kilometres for what may be no more than a ten-minute consultation with him. His dedication to his profession is legendary, as is his impartiality: his security guards do not carry Kalashnikovs — they carry no arms at all — and his clientele include rich and poor, the neurotic, psychotic and suicidal and, given his fluency in Pashto, the Taliban too. He has treated well over a thousand Taliban, he thinks, a number that is hard to verify but easy to imagine seeing the continuous stream of outpatients every day, six days a week. So long are his working days, in fact, that he moved his family to the upper floor of the hospital such that they get to see their father at least occasionally.

“Doctor saib, ma mokhles shoma astom. Khuda tora az ma kam nakona (Respectable doctor, I am sincerely yours. May you always be there for us).” A young man with a bright piece of cloth tied pirate-style around his head, shoots out of bed and embraces the doctor, kissing him repeatedly.

Amanullah shows scars on his hands after being flogged for 40 days by a local mullah.

“It’s good to see you too my friend”, Alemi replies with a smile and a kiss, and gently presses him back onto his bed. Amanullah is thirty-four years old and bipolar. His mullah had told him he was possessed by a jin, or demon, and ordered he be chained in a dark room for forty days, his sustenance limited to water, bread, and raw spinach. The mullah made daily visits to flog Amanullah, using a horsewhip, to target, he had said, not him but his jin. When, forty days later, there had been no miraculous recovery, his brother decided to take him to a hospital they could ill afford, where he’d been given an injection to help him sleep.

The impact on the family has been profound. “We keep him chained up or else he destroys everything and everyone. We dare not leave him alone with our mother.” His brother says his wife was beaten repeatedly by Amanullah and, for their protection, he had moved her and their eight-month old daughter out of the family home. The aggression comes and goes, he says, the latest spell set off by a recent spat with the traffic police who had hit him across the head with a baton. Asked when it began, he tells me of an incident when they and their father had been selling fruit from their street cart. A Taliban had purchased a watermelon and, furious at it not being ripe enough to eat, had smashed it over their father’s head. The injustice had so enraged Amanullah that he’d jumped from behind the cart and pushed the Taliban to the ground. Fearing repercussions, his family arranged for him to be taken across the border immediately, into Iran, for his own protection, and ever since then, the brother said, he’s never been the same.

Sayed, a much older in-patient, likewise has a history of violence. While he sleeps off last night’s injection, his son tells of his father’s antics. “He talks to himself and beats himself, and so we have to keep him chained to the ground with four pins.” He says his elderly father has night terrors so frightening that he arranged for his own children to stay with neighbours so as to minimize the impact on them. Diagnosed as schizophrenic, it is imperative that he continues to take his medication. But they ran out, the son says, and there are no pharmacies where they live, and so they spent the equivalent of two weeks’ household budget just on the six-hour road trip to Alemi’s hospital.