Mental health in emergencies feature profile: Dr Abdul Alimi, National Mental Health and Psychosocial Support (MHPSS) Officer Dr Basharat Hussain, WHO Technical Officer for[...]

Responding to crisis within hours

When a powerful earthquake struck Afghanistan's Kunar province in the waning hours of 31 August 2025, communities already living with conflict and displacement faced another blow. The exact toll is difficult to quantify but reports from local and international media suggest at least 2200 people killed and more than 3600 injured across Kunar and neighbouring Nangarhar provinces. WHO's Eastern Mediterranean Regional Office also noted that confirmed numbers remain fluid as assessments continue.

For Dr Abdul Alimi, the national Mental Health and Psychosocial Support (MHPSS) officer in Afghanistan, the disaster was both urgent and deeply personal. Having spent nearly two decades building mental health into Afghanistan's health system, he knew that rapid psychosocial support would be just as critical as physical care.

Within 48 hours, WHO-working alongside national authorities and partners-mobilized three mobile MHPSS outreach teams to the affected areas. Before the earthquake, WHO trained over 612 healthcare staff in the eastern region, including 207 community health workers, in psychological first aid (PFA) and stress management.

Within a week, Dr Alimi was on the ground with them. WHO produced and distributed 56 000 leaflets and posters on loss, grief, and self-care; and Dr Alimi co-led the first meeting of the MHPSS technical working group to coordinate the response across agencies - all done by 7 September.

His colleague Dr Basharat Hussain, WHO Technical Officer for Mental Health, underscores the urgency: "People were coming to the regional hospital with injuries, but also with grief, insomnia, and psychosocial distress. We needed to be there."

Building local capacity for sustainable support

Dr Alimi has spent much of his career focused on capacity building-ensuring that mental health services reach the community level from hospitals. That investment proved vital in the Kunar province response. From 21-22 September, Dr Basharat and Dr Alimi coordinated with MHPSS stakeholders, implementers and authorities to conduct PFA training to 105 community health workers. PFA is a simple but vital technique: offering comfort, active listening, and practical support in the immediate aftermath of crisis.

Prior to the earthquake, WHO also trained 344 Afghan doctors in the Mental Health Gap Action Programme (mhGAP)-a WHO initiative that equips general health workers with the skills to recognize and manage common mental health conditions. In Afghanistan, this approach is crucial given the shortage of mental health specialists.

WHO and partners established referral centers, which serve both earthquake survivors and returnees from Pakistan. Coordination with other agencies through the health cluster has helped reduce duplication and extend services further into affected communities.

Gaps and challenges in the system

Despite progress, Dr Basharat and Dr Alimi are clear-eyed about the challenges. "We have trained more than 300 doctors in the eastern region, but the needs are immense," they said. Nearly 3000 people have received MHPSS consultations since the earthquake, according to WHO field reports, yet shortages of psychotropic medicines and trained psychosocial counsellors remain.

Local authorities urged WHO to deploy more female counsellors to reach women in Kunar province. Specialized services at Kunar Provincial Hospital are still limited, leaving many referrals dependent on Nangarhar regional hospital in Jalalabad. And while international agencies and funders, including the Asian Development Bank, World Bank and UNICEF, are coordinating to provide medicines nationally, these have not consistently reached government health facilities - so Dr Alimi and his colleagues help fill the gap.

At the same time, WHO and partners continue to build long-term capacity. The training-of-trainers programmes for mental health gap action programme (mhGAP) and Problem Management Plus (PM+)-a WHO intervention for stress management-and the Thinking Healthy manual for perinatal depression are being contextualized for Afghanistan. A self-care intervention for humanitarian workers helps protect the wellbeing of staff delivering services under immense pressure.

A career built on advocacy and care

Dr Alimi's commitment to mental health stretches back to 2006, when it was not yet part of Afghanistan's Basic Package of Health Services (BPHS). "We started a pilot project in some provinces," he recalls. "When we presented our results, the Ministry of public health accepted mental health as a component of BPHS. When I spent five years in mental health services, in different provinces and mostly in capacity building, I decided I should specialize in this field. Now I am happy working with our team. We are providing mental health services and working at primary and secondary levels, and community levels."

His colleagues echo his dedication. Dr Hussain recalls his first experience in the 2005 Pakistan earthquake, when survivors told him: "We don't need anything, but we need someone to sit with us, to talk with us." Dr de Lara reflects on decades of advocacy: "MHPSS is not a minor program. It must be integrated-it is about saving lives."

Together, their efforts highlight what Dr Alimi has always known: that mental health support is inseparable from humanitarian response.