Comm Eye Health Vol. 10 No. 23 1997 pp 44 - 45. Published online 01 September 1997.

VISA in Afghanistan

DC Minassian MSc FRCS FRCOphth

Briar Whitehead BA DipJ

54 Redvers Drive, Belmont Hills, Lower Hutt, New Zealand

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VISA (Visual Impairment Services in Afghanistan) has worked in Kabul, Afghanistan for about 30 years – through the Soviet occupation of the Eighties and the intense factional fighting of the Nineties. It stayed while the city was being reduced to ruins and almost all foreign NGOs left. When its premises were demolished by rocket-fire three years ago VISA not only continued its services to Afghanistan’s blind community from a new location in Kabul but expanded into northern Afghanistan. VISA is a dedicated group, experienced in working with the visually impaired, who pass their skills and experience on to colleagues and co-workers. It co-operates with the Government of the Islamic State of Afghanistan under special protocols. The size of the visually impaired and blind community in Afghanistan is increasing as a result of war injury, war related malnutrition, poor hygiene and disease.

Briar Whitehead, journalist and author of several books, learned about the work of VISA when she was in Afghanistan in 1996.

After three months in Afghanistan I am overwhelmed with a thousand impressions.


The first picture I have is of a 32 year old man, Siddiq, whose life plunged into total darkness several years ago when shrapnel from an exploding rocket tore into both eyes. I can see him now sitting quietly at a desk with five or six other men reading Braille, his skin grafts sunken deeply into his eye sockets (see photo). Then, looking into the summer sun, my eyes follow him up the concrete steps at the new VISA centre in Mazar-i-Sharif in northern Afghanistan, as he shows me how he uses his long cane to get around. Later, I watch him sitting on a mat with other visually impaired men who are being taught a trade. He is making the rush brooms that are found in even the poorest Afghan household. He had no trade or training before he came to VISA. Now he is literate, able to get around independently and earn a small income. He says VISA has given him hope.


Najib is a male in his early thirties. He was very unhappy the day we saw him – depressed at what he had lost and the obstacles ahead. His face is still pock-marked with shrapnel that lodged in his body when a mine exploded near him three years ago. It took away his right hand, the thumb of his left hand and his sight. VISA has given him a Braille typewriter and with the four fingers of his left hand and the stump of his right arm he is able to set up the typewriter and write a few words (see photo). He has been taught orientation and mobility and he has no problems walking by himself from his brother’s house down to the main road a mile or so away, boarding a bus and getting into the centre of the city. Najib lost his job when he lost his sight, but VISA is helping him to realise that the outlook isn’t all bad. It has introduced him to a community of other blind and partially-sighted people who have overcome considerable difficulties, and that’s an encouragement.

The VISA Centre

The next impression is the VISA centre itself – a big two storey building in the heart of Kabul that is the centre of care for around 250 people. It became VISA’S temporary home when its former accommodation was demolished by rocket-fire three and a half years ago. It is full of activity: the constant movement of visually-impaired people negotiating their way around the grounds and the building; the clatter of braillers, the voices of teachers and adult students at their studies (biology, science, religion, English); the printshop downstairs where written material is converted from Farsi into Braille lead-type, and from lead-type to Braille school textbook, Braille calendars, and the VISA community’s own Braille magazine. The father wheeling his blind and severely disabled daughter about in a wheelbarrow; the old man squatting alone against a wall, grasping his crook and gazing sightlessly into the sky; the chadori-clad women with visually-impaired husbands – all waiting for the relief trucks to arrive with the provisions that will help them through the approaching winter: oil, flour, tea, rice, beans, salt, soap.

Pictures of work among the blind community in Afghanistan, pictures that are both heartbreaking and full of hope. Heartbreaking because life in Afghanistan is heartbreaking and particularly heartbreaking for those who cannot see. Hopeful because VISA is giving a future to people who would otherwise be widely ignored.

War-induced Blindness

The war has brought much human suffering (see boxed comment). Thousands of people are being killed, maimed and blinded by mines each year, many of them returning refugees and displaced people. (It is estimated that about 10 million landmines are lying around the country). Irrigation systems have been destroyed, arable land abandoned, people displaced: agricultural production has reduced dramatically. The country has one of the world’s highest rates of malnutrition, and vitamin A deficiency is an increasing cause of blindness in Afghanistan. The fighting has made an already poor country much poorer. Many Afghans have been reduced to subsistence living. (The annual per capita GDP is US$200). Crowds of men wait for work and whatever work is available does not go to blind people.

Afghanistan has experienced war for the last 18 years, first against Soviet occupiers from 1979 to 1989, then (in the Nineties) conflict between rival mujahideen groups for control of the capital city and the country. While power groups have bombarded each other and conscripted young men at will, the ordinary people have suffered the effects. The fighting has produced millions of refugees – many of them professionals and educated people. It has destroyed hospitals, schools, workplaces, families and individuals. In Afghanistan today one child in four dies before the age of five. The average life expectancy is 44 years. Somewhere between 15% and 25% of the population is permanently disabled. Wives have lost their husbands (an estimated 25% of Afghan women are war widows) and children have lost their parents. Prices for fuel and basic provisions continue to rise. In Kabul rumours endlessly anticipate another outbreak in the fighting, another round of rocketing. No-one knows if their house will be next or their family killed. The winters are harsh – minus 15°C in the capital and food is short.


One agency in Afghanistan, the National Organisation for Ophthalmic Rehabilitation (NOOR) – a co-service with VISA – is doing outstanding work to save sight among Afghans. Its logo is one of the most well-known in the country and its reputation almost legendary. It runs eye hospitals and rural eye camps, it has trained many Afghan eye doctors and technicians, performed thousands of eye operations, prescribed countless spectacles, cured eye disease and taught basic eye care for some 30 years. It is one of very few sources of sight-saving medical intervention in the country and its work is invaluable. But sometimes it cannot save sight. Those whose sight is saved are overjoyed, but those for whom it is too late withdraw into a dark world of blindness, stigma and loss.

The Work of VISA

This is where VISA comes into its own. It is one of the very few organisations having any impact on Afghanistan’s blind community. For years VISA has been the only organisation in Afghanistan teaching Braille and offering educational opportunities to the Braille-literate. But VISA is about a lot more than Braille. Its aim is to integrate blind Afghans into the wider society in every possible way and create public acceptance by demonstrating that blind people (men and women) can become literate, are employable, can be independent and resourceful and productive and as capable as sighted people at many tasks – using different senses and different techniques.

It is rehabilitating adults who have suddenly become blind through war trauma or accident, or medical intervention that came too late – teaching them orientation and mobility, daily living skills, Braille, offering them a second chance at an academic education, or a trade. It is training Afghans – often partially-sighted – to be community rehabilitation workers, support teachers, Braille teachers, and ultimately to take responsibility for whole projects. Because of VISA, Afghans are learning that its blind citizens have every right to productive lives; vocation, marriage and family.

I still remember the pleasure with which Shahin listed the number of times he had been at or near the top of his classes from the time he began learning Braille and studying at VISA to the time he graduated from Kabul University with distinction. He had basically been telling me two things: how difficult it is for a blind person in Afghanistan, but how well he had done. He seemed to catch the irony himself for when he finished reciting his successes he stopped and grinned: “So it was very good for us when blind students did better than sighted students at University,” he said. “It showed what we can achieve”.