The story of the young Afghan woman whose nose and ears were hacked off by the Taliban has faded from the headlines, but Bibi Aisha?s road to recovery has only just begun.
The 18-year-old has been undergoing physical and psychological evaluations at the Grossman Burn Center in California, which specializes in reconstructive plastic surgery. Bibi Aisha's doctors say that before any physical work can begin, emotional healing must happen first. The center says doctors are moving slowly to build trust between Bibi Aisha and her caregivers.
Trust does not come easy for a woman mutilated by her own husband. Bibi Aisha says her plight began when she was just 12 years old, when she and her younger sister were offered to the family of a Taliban fighter as a peace gesture. She says she was treated as a slave for years, and that she was given hope by two women who offered to help her run away. Those women ended up trying to sell her to another man. They were arrested, and so was Bibi Aisha.
After spending four months in jail, Bibi Aisha says she was referred to Afghanistan?s human rights commission, but her father came and returned her last year to her in-laws. She says this Taliban-allied family cut off her nose and ears to bring as much shame to her as she had brought to them. She eventually made it to U.S. troops, who referred her to the shelter run by Women for Afghan Women.
Bibi Aisha was extremely traumatized when she first arrived at the shelter, said Esther Hyneman, a member of the group?s board of directors. Hyneman said she appears to have had a brief relapse since coming to the United States earlier this month.
Listen to Kate Woodsome's interview with Esther Hyneman
?She was very attached to people in the shelter where she lived for nine months. Probably experienced there the first kindness and love maybe in her whole life, certainly in the last five years,? Hyneman said. ?She received a lot of attention there, and when she arrived last November, she was in quite a fragile stage emotionally. She regained a lot of strength psychologically and calmed down a great deal.?
Bibi Aisha is showing signs of progress, said Hyneman, adding that the shelter's executive director and counselor are in regular phone contact with her to reassure her that she has not been abandoned.
Moving beyond trauma
The Medical Foundation for the Care of Victims of Torture in London believes Bibi Aisha is experiencing post traumatic stress disorder, or PTSD. Alex Sklan, the foundation's director of clinical services, said people with PTSD often have intrusive thoughts, memories and flashbacks of the traumatic event.
Listen to Kate Woodsome's interview with Alex Sklan
?They probably wouldn't be sleeping at all well. They probably would be hyper-vigilant if somebody opened the door and somebody came in and reminded them of the trauma that happened," explained Sklan.
In western countries, psychotherapy is generally the course of treatment for PTSD; talking about the painful events has helped victims move past the trauma. Sklan said in Bibi Aisha?s case, it also will be important to recreate a sense of community so that she can begin to feel safe again. But he warned this will be particularly challenging if she faces the risk of returning to Afghanistan.
"If that threat of being removed [from the U.S.] is taken away, then she can start processing what has happened to her and how she can begin to rebuild her life,? Sklan said. ?But without that foundation, it's unlikely or extremely difficult for any kind of therapeutic process to take place because what predominates is fear of being sent back.?
Finding a home
It is premature to discuss Bibi Aisha?s long-term plans, said Hyneman of Women for Afghan Women.
?She has to participate in any decision-making, and we?re certainly not going to bring this up now. We?re talking about months and months in the future. We want her to go to school here and become literate,? said Hyneman.
U.S. Citizenship and Immigration Services is not commenting directly on Bibi Aisha?s case, but an official with the agency in Washington said that ?humanitarian parole? has been used in similar cases. This allows the U.S. government to bring people to the United States for medical treatment or other services they could not receive in their own country. Such cases often involve life or death situations.
Humanitarian parole can last up to a year and can be extended annually, depending on the situation. The USCIS official said this is not a means to another type of immigration status, like U.S. residency or citizenship. But he said Bibi Aisha has the right to apply for asylum if she chooses to create a new life in the United States.