Curse of insanity. Afghanistan. Pakistan

A mental patient is chained in a small cell at Mia Ali Baba Shrine. Patients are chained in Spartan cells around the shrine for 40 days and fed with bread and water. Jalalabad, Afghanistan 2011. Diego Ibarra Sánchez / MeMo
A depressing wall of the shrine MIA ALI BABA shows the poor conditions of the mental patients have to face. The Spartan approach to take care of mental patient forced them into inhuman conditions. Jalalabad. Afghanistan 2014. Diego Ibarra Sánchez / MeMo
Abdul Wahed, 25 years old, resident of Peshawar, Pakistan. He is stuck in the shrine Mia Ali Baba. His family brought him 60 days ago. The keeper said this patient had to discharge in 40 days but none of his family members has been showed up yet. Afghanistan 2014.
A wall of the shrine MIA ALI BABA. Many rural residents still require sending the patients to shrines, where they may be chained, neglected and poorly looked after. Shrines offer draconian approach to mental illness. Afghanistan 2014. Diego Ibarra Sánchez / MeMo
Rab Gul, 35 years old, sleeps at his cell. He is chained in a small cell at Mia Ali Baba Shrine without any kind of contact with the outside world. A Spartan cell is supposed to miraculously heal his mental perturbation. Afghanistan 2014
Rab Gul, 35 years old, sleeping at his cell. He is chained in a small cell at Mia Ali Baba Shrine without any kind of contact with the outside world. A Spartan cell is supposed to miraculously heal his mental perturbation. Afghanistan 2014.
Write words (TAWEEZ or SHOHEST) on pieces of paper that are burnt after the healing process is finished. Afghanistan 2014.
Chained in his cell at the shrine of Mia Ali Baba Shrine. According to the local belief, the shrine has magical qualities to heal mental illness. Afghanistan 2011
Marks of the “consciences” shaking the wall in Herat. The mental health situation in Afghanistan is characterized as an extremely incapacitated mental health care system. Afghanistan 2011.
A Mental patient kills time at a corridor in the mental asylum in Herat. Afghanistan 2011.
A mental patient kills time in a mental Asylum of Herat. War and drugs has a catastrophic effect on the health. Death as a result of war is simply the "tip of the iceberg". More than three decades of conflict have led to widespread human suffering and population displacement in Afghanistan. Diego Ibarra Sánchez / MeMo
A mental patient lost in his thoughts in Herat. Afghanistan 2011.
A mental patient inside a mental asylum of Herat. Afghanistan 2011. Diego Ibarra Sánchez
A relative of a mental patient looks trough a tiny window of Ali Abad hospital in Kabul. Ali Abad hospital It is the only public Neuropsychiatric hospital in the country. There are 12 doctors in this branch. They have two sections (female and male). The patient used to be in cage back in the days, however now they use medicine on timely bases to keep the patient calm. Afghanistan 2014. Diego Ibarra Sánchez / MeMo
An afghan nurse removes a curtain in a room of the Ali Abad hospital at the female section.The hospital was built in 1933 by the Turkish government, which is now reconstructing the facility. It was damaged during the fighting between the warring Mujahedeen factions. Afghanistan 2014. Diego Ibarra Sánchez / MeMo
A drug addict and mental patient posses for a portrait in a mental asylum in Kabul. Afghanistan 2009. Diego Ibarra Sánchez
A group of Afghan nurses keeps the entry of the female section at Ali Abad hospital in Kabul. Afghanistan 2014.
A mental patient at the mental Asylum in Herat is tortured by his thoughts. Afghanistan 2011. Diego Ibarra Sánchez
A mental patient’s hand looks for the light in Edhi Village. Pakistan 2010. Diego Ibarra Sánchez
A ray of light bathes the thoughts of a group of mental patients at the mental asylum of Edhi Village. Pakistan. 2010. Diego Ibarra Sánchez
A depressing wall of the shrine shows the poor conditions of the mental patients have to face. The Spartan approach to take care of mental patient forced them into inhuman conditions. Multan. Punjab. Pakistan 2011. Diego Ibarra Sánchez
The bars isolate the violent patients from the others inside the Punjab Institute of Mental Health. This Institute was founded in the year 1900 AD to provide Health care to Mentally Sick persons. It was named “Lunatic Asylum”. The Governing Law Lunacy Act 1912 being unsuitable and inconvenient was replaced by “Mental Health Ordinance in 2001”. The name of “ Govt. Mental Hospital ” was changed to “ Govt. Hospital for Psychiatric Diseases in 1996, and was renamed as “Punjab Institute of Mental Health” in 2002. Lahore. Punjab. Pakistan 2011. Diego Ibarra Sánchez
A lonely drawing paper shows and reflects the thoughts of a mental patient in a Pakistani shrine. Pakistan 2011. Diego Ibarra Sánchez
A mental patient lost in his thoughts at the Punjab Institute of Mental Health in Lahore. Pakistan 2011.
A ray of light bathes the hand of a Pir in Karachi. According to the local beliefs the mental illness is labeled as being possessed by an evil spirit known as "Jinn". Self-proclaimed exorcists thrive on these beliefs. Pakistan 2012. Diego Ibarra Sánchez
A young Pakistani during a healing ceremony outskirts Lahore, Pakistan 2012. Diego Ibarra Sánchez
A magical shrine at Sehwan Sharif, one of the most ancient towns of Indus valley. Sindh. Pakistan 2012. Diego Ibarra Sánchez
A devotional dance known as "dhamal", being a frenzied and ecstatic swirl of the head and body, is a special ritual that is performed at the rhythmic beat of the dhole (a big barrel-shaped drum), some of them being of giant size and placed in the courtyard of the shrine. Sindh, Pakistan 2012. Diego Ibarra Sánchez
An isolated mental patient drinks water at the Punjab Institute of Mental Health. Lahore. Punjab, Pakistan 2011. Diego Ibarra Sánchez
A mental patient sleeps on the floor deserted, chained and ignored by the Pakistani society in a shrine of Multan. Devotees consider this shrine as a magical place for the recovery of patients suffering from mental diseases. Multan. Punjab. Pakistan 2011. Diego Ibarra Sánchez
Allah Rakha has visited a lot of hospital but with not good results. His relatives are still trying to find the way to heal him. One neighbored and closed friend told them to bring Rakha to the shrine. Multan. Punjab. Pakistan.The wife of Allah Rakha takes care of him. Besides his long illness, she has decided to be with him until the end. Multan. Punjab. Pakistan 2011. Diego Ibarra Sánchez
Ghulam Qadir tries to touch a leaf. He has spent the last month at the shrine. While mental health treatment in Pakistan has improved in cities there are still not enough resources to take care of them. Many rural residents still require sending the patients to shrines, where they may be chained, neglected and poorly looked after. Multan, Pakistan 2011. Diego Ibarra Sánchez
The sister of Allah Rakha, a mental patient, sleeps on the floor. She has also mental problems. Mental patients have to spend nights on the floor with poorly kind of human facilities. Multan. Punjab. Pakistan 2011. Diego Ibarra Sánchez
A group of mental illness waits for its treatments at the Punjab Institute of Mental Health. This Institute is providing services to patients belonging not only the Punjab but also to adjacent areas of all provinces including Azad Jammu and Kashmir. Round about 500 to 600 patients are taken care of in Out-Patient Department daily. Lahore. Punjab, Pakistan 2011. Diego Ibarra Sánchez
A mental patient goes the stairs up at the Punjab Institute of Mental Health. Lahore. Punjab, Pakistan 2011. Diego Ibarra Sánchez
Ritzwan has spent the last 5 years in a hotel of Sujawal. He is suffering mental problems. He is living alone. The owner of the hotel is taking care of him. Sindh. Pakistan 2012. Diego Ibarra Sánchez

“In a mad world, only the mad are sane.” ― Akira Kurosawa

Abandoned, chained, forgotten... Mental patients in Pakistan and Afghanistan face the lack of resources to take care of them. There are ignorance and stigma in regards to these mental disorders while mental health care facilities available for their use are very sparse.

Many rural residents still require sending the patients to shrines, where they may be chained, neglected and poorly looked after. Shrines offer draconian approach to mental illness. They offer them ancient rituals for healing the mental patients to take out the evil spirits. According to the local beliefs the mental illness is labeled as being possessed by an evil spirit known as "Jinn". It's assumed that the ones who could break the chains would be the only ones that can be healed in the shrine

Mental patients live between divine and curse

Afghanistan. War has a catastrophic effect on the health. Death as a result of war is simply the "tip of the iceberg". More than three decades of conflict have led to widespread human suffering and population displacement in Afghanistan. The effects of war include long-term physical and psychological harm also resulting in drug addictions

Pakistan. While mental health treatment in Pakistan has improved in cities there are still not enough resources to take care of them. There are no exact numbers for the mentally ill in Pakistan, due largely to the associated stigma

In the past, the government of Pakistan has attempted to make progress in the area of mental health by introducing the Mental Health Ordinance on February 20, 2001. When this ordinance came into effect, The Lunacy Act of 1912, enacted by the colonial government, consequently stood repealed. However, the situation is still far from satisfactory, since psychiatric departments tend to be under staffed and to lack basic facilities. Chance has been slow