A wave of violence hit Afghanistan on Tuesday: coordinated suicide bombing attacks by militants in two cities killed at least 46 civilians. One of the bombings blasted a busy outdoor market in Zaranj, the capital of Nimroz province in the southwest corner of the country. From the AP:

The area was crowded with shoppers from the city and outlying areas who were buying dried fruit, cookies and other sweets for the coming Muslim holiday of Eid. “It was very powerful,” [provincial police chief Musa] Rasouli said. “Everywhere there was smoke. With my eyes, I saw the dead bodies.”

The bodies, wrapped in blood-stained sheets, were ferried off in ambulances and pickup trucks. The legs of two victims hung off the back of a small truck that sped away with a long sheet dragging behind in the dusty road. Police fired bullets into the air to clear crowds from the scene. “We cannot carry on with our daily lives,” Sayed Ahmad said, lying on a bed in a hospital where he was being treated for injuries. “People are scared and cannot go out of their houses,” he said. “We don’t know what to do.”

The other attack occurred in northern Kunduz province, again, in front of a crowded bazaar. Twenty-five people were killed there, ten of them children.

After 35 years of physical and psychological terror, much of Afghanistan is suffering from Post Traumatic Stress Disorder, a diagnosable anxiety disorder that affects both soldiers and civilians. PTSD can dismantle entire communities, perpetuating domestic violence and armed conflict as a solution to civil disputes. Anna Badkhen, who published “PTSDLand” in the September/October issue of Foreign Policy, writes:

In 2002, shortly after the Taliban government fell in Kabul, the U.S. Centers for Disease Control and Prevention dispatched a research team to Afghanistan to study the prevalence of mental trauma among civilians there. That nationwide survey remains the only modern, comprehensive inquiry into the mental health of Afghans. It found that 42 percent of Afghans suffered from post-traumatic stress disorder and 68 percent exhibited signs of major depression. In other words, up to 19 million of the country’s 28 million people were suffering from psychological injuries. And that was a full decade of war ago.

A full decade of war ago. The humanitarian crisis is obvious, but Badkhen is one of the few mainstream voices to address the emotional toll:

What happens when physical and emotional battlefields converge in a land whose people have been eking out an existence amid unending violence for generations? In such war-wrecked countries, the trademark symptoms of individual war trauma — depression, anguish, and hyperaggression — leave whole populations envenomed with sectarian and ethnic mistrust, and with the certainty that only violence can end violence…

Two-thirds of Afghan children surveyed by British anthropologists in 2006 reported traumatic experiences; two years later, a study in the Journal of Marital and Family Therapy found that more than half the children surveyed in Kabul reported witnessing three or more types of domestic violence. Is this the knowledge that had hollowed out the eyes of the children I have met in Afghanistan’s villages and towns, that had turned preteen boys into little old men with skeptical down-curved mouths? The generation that will determine the country’s future is growing up today with the understanding that nowhere is safe and that cruelty is the norm.

A 2008 international study of Afghan mothers with children under the age of five found that nearly 30 percent of women surveyed exhibited symptoms related to PTSD. The prevalence of conditions was heightened by direct exposure to traumatic events and a lack of food security.

One American military officer recently suggested that building a viable Afghan resistance to the Taliban is a futile task akin to squeezing blood from a stone: the people are just too troubled and disconsolate. In this regard, according to Air Force Col. Erik Goepner, who is currently serving as a military fellow at the Center for Strategic and International Studies, the U.S-led counterinsurgency has been a flop. From Wired in April:

[Goepner] argues that the Afghan counterinsurgency was all-but-doomed before U.S. troops ever landed there. The reason, he writes, is “the high rate of mental disorders” in Afghanistan and other fragile states. Pervasive depression and post-traumatic stress disorder leads to a sense of “learned helplessness” among the people. And that makes it next-to-impossible to build up the country’s economy and government

Goepner points to studies indicating that the rate of PTSD among Afghans is more than 30 percent. Some have disputed the numbers, claiming that they are based on flawed surveys, a “legendarily imprecise” way of gauging mental health. But the numbers jibe with estimates provided by Afghan mental health officials struggling against the tide of need with few resources. In one AFP report, Dr. Bashir Ahmad Sarwari, director of the health ministry’s mental health department, claimed that two out of four Afghans are suffering from symptoms related to trauma. “They are in trauma mainly because of three decades of war, poverty, family disputes and migration issues,” he said.

The same applies to survivors of 14 years of civil war in Liberia, where PTSD rates are estimated at 40 percent, and in Uganda, where Joseph Kony and his Lord’s Resistance Army waged a brutal campaign against the government and civilian population before fleeing into the jungle in 2006. There, researchers found rates of PTSD at 73 percent and levels of depression at 44 percent. This 2006 review of research findings in the study of mental health consequences of war, published by the World Psychiatric Association (WPA), found similar eye-popping statistics in war-torn populations in the Balkans, Chechnya, Iraq, Palestine, Israel, Lebanon, Cambodia, Rwanda, Sri Lanka, Uganda, Somalia and Afghanistan.

It seems that Republican war hawk Mitt Romney and his new running mate Paul Ryan just don’t get it. Their foreign policy manifestos — while ignoring Afghanistan almost completely — are packed with messianic American exceptionalism and Bush-era boilerplate. Promoted with such soaring enthusiasm at Washington think tanks and the gushing right-wing commentariat, they seem naive and pathetically jingoistic in the face of new realities. Yet Ryan and Romney have turned to the usual suspects — neoconservatives like Dan Senor, Elliot Abrams, and the Kagans — who cajoled us into protracted, failed wars in Afghanistan and Iraq, and are pushing for war with Iran.

“A world without U.S. leadership will be a more chaotic place,” Ryan charged in a speech before the Alexander Hamilton Society in June. “A place where we have less influence, and a place where our citizens face more dangers and fewer opportunities…Today, some in this country relish the idea of America’s retreat from our role in the world …They say that it’s about time for other nations to take over, that we should turn inward, that we should reduce ourselves to membership on a long list of mediocre has-beens.” Then the clincher: “Instead of heeding these calls to surrender, we must renew our commitment to the idea that America is the greatest force for human freedom the world has ever seen.”

These are dangerous times indeed, beginning with these two men who blatantly ignore the consequences of war — here and abroad — running for president and vice president of the United States.