Our author was in Afghanistan to report on women who set themselves on fire to protest their social status. Then it got personal.

In Bed 19, a woman suffers from high blood pressure and burns to her feet from boiling water spilled from a pot; Bed 21 burned herself lighting an oil lamp; Bed 20 fell against a hot water heater.

Then there is the girl in Bed 18. She looks no older than fifteen. Stray wisps of black hair lie limply against her cheeks. Rank smelling blankets cover her bandaged-wrapped body, and she stares mutely at the ceiling, flakes of charred skin peeling off burns to her chin and neck. Beside her sits her pregnant sister-in-law who looks about the same age. They live in Lashkar Gah, the capital of Helmand Province, a Taliban stronghold far south of Herat. They have never left their home before; have never been to their village bazaar and the cities beyond it. The girls won’t look at us. This is the first time they have not covered their faces in the presence of men outside their families.

Dr. Naeema Nikzad, a psychologist who counsels burn victims at Herat Regional Hospital, considers both girls while adjusting a blue-patterned scarf around her head. When they came to the hospital, Dr. Nikzad told the sister-in-law to remove her burqa. She gave her a smock, flip-flops, and a surgical cap and told her to put them on.

Dr. Nikzad then took the burned girl into surgery and told her, now I have to strip you. You cannot wear a burqa. No one will touch you. No one from your village will see you.

The girl felt Dr. Nikzad raise the burqa above her head.

“I am exposed,” she said.

My Afghan colleague Aziz looks at the burned girl with mournful eyes. He is dressed in gray slacks, blue shirt. Silver hair combed back, beard trimmed to perfection. But he has the drawn look of sleepless nights.

I can only guess what he is thinking. The sister of his son’s wife burned herself to death just two days before in Kabul.

The mother of a young man the girl liked had asked her parents if he could marry her. Her mother said that she would rather see her daughter burn than have him for a son-in-law. The girl overheard, and told her mother, you will see me burn. She walked into the kitchen, poured kerosene over her head, and set herself ablaze. She burned 75 percent of her body and died in the hospital. She used to be white as a sheet, Aziz had told me, but in the hospital she was black.

“Our families are sad,” Aziz told me.

Perhaps more than thirty years of war and suffering has reduced grieving in Afghanistan to the bare minimum of expression. Something so common that loss no longer evokes shock. I don’t know, but the gross understatement spoke as loudly to me as the monotone exhaustion I heard in his voice.

I had flown to Afghanistan to write about women who attempt suicide by setting themselves on fire. Despite the 2001 ouster of the Taliban regime, women still have few opportunities for education and a career. They rarely have input in choosing a husband and little if any say in the mundane decision making of everyday life. The husband and his family dominate. Men rule, women obey. And for some women it becomes too much and they set themselves on fire.

Herat in western Afghanistan is only a few miles from the Iranian border. Aziz and I would base ourselves in the burn unit of Herat Regional Hospital, one of the few facilities in Afghanistan that treats self-immolation victims. It’s no accident the hospital was built in Herat. Iran has a culture of suicide by burning dating back centuries, and the practice is now common in western Afghanistan.

But it was just a story, another assignment. It never occurred to me someone close to Aziz might do the very thing I had come to write about.

To make matters worse, the dead girl’s sister, the wife of Aziz’s son Nabil, had just recently given birth to a baby boy. Her family was afraid to tell her about her sister. They worried she might get so upset her milk would dry and she would not be able to feed her son.

So they buried their dead daughter without telling her sister and the next day, Aziz and I flew to Herat.

“She is very sad,” Dr. Nikzad says of the girl in Bed 18. She looks in denial, shame.

“There’s no problem,” the sister-in-law says as Aziz translates. “She caught fire cooking.”

Dr. Nikzad does not believe her. In the first six months of this year, she has seen sixty-nine self-immolation patients. Two of them men. One man wanted to marry a girl but her family refused him. The other man… Dr. Nikzad shrugs. She does not know why he burned himself. 65 percent of his body. There were family problems. He was jobless. He felt the shame of his family. He probably wondered what his life meant. She supposes he decided it meant nothing. He will likely die.

“I put water on her,” the sister-in-law says. “I called the family.”

Girls as young as nine burn themselves but most are between twenty-two and thirty, Dr. Nikzad tells us. They are forced into marriage, tolerate it for two or three years, and then set themselves on fire. Or they are not married. They are just very young and frustrated with their lives. They don’t understand how badly they will hurt themselves. They come into the hospital and their clothes stink of gasoline.

“The fire came up with the wind,” the sister-in-law says.

They have knowledge of self-immolation, Dr. Nikzad continues. They learn from other women it is a way to die. When they burn themselves, the family sees it. They want to make a demonstration of their unhappiness.

She looks at the burned girl and adjusts her blankets.

“Maybe she has mental problems,” Dr. Nikzad says. “Maybe she is a very sensitive girl. We have counseling centers for women but they don’t come. The families don’t give permission.”

“I put water on her,” the sister-in-law says. “I called the family.”

The girl in Bed 18 falls asleep. Her sister-in-law appears worn out and can hardly keep her eyes open. Aziz and I decide to leave and return in the morning.

Outside, the cold clear air washes over our bodies. Aziz breathes it in and raises his arms. He seems rejuvenated to be away from Kabul and the tragedy that struck his family. He reminds me of someone who has come to town for their high school class reunion and for a moment occupies once more a distant time that was free of all restraints. It is while he is in this carefree mood that he reflects on the family he has temporarily left behind in Kabul and tells me how he met his wife.

“I have been married for thirty-three years,” Aziz tells me. When he turned twenty-five, the age the Koran instructs men to marry, his mother began searching to find him a wife. Her friends suggested one family with an eligible eighteen-year-old daughter, the best time, the Koran says, for a woman to marry. She introduced herself to the girl’s parents and after four visits asked if Aziz could marry her. She offered them one thousand dollars for the kindness of their hospitality and they consented.

Aziz did not meet his bride-to-be until the engagement party, a week later. Which one is to be my wife? he wondered. He and his fiancée were seated together across from their parents. It would have been rude for him to look directly at her before the engagement became official so his mother gave him a hand mirror. He stared at her reflection, at her long black hair, deep dark eyes and wide full mouth and approved. After the families formally announced the engagement to one hundred guests, Aziz told his fiancée’s mother that he wanted to take her to the bazaar for twenty minutes to help him buy more food for the party.

Her mother thought twenty minutes was too much time for them to be alone together, and told him he should be gone no more than ten minutes. But Aziz insisted on twenty minutes, arguing that walking to the bazaar would require ten minutes at least, and she relented.

Aziz did not tell his fiancée what he had told her mother. Instead, he flagged a taxi and had the driver take them to a restaurant where they discussed their future together. Did she really want to marry him? Aziz wanted to know. Was she willing to live with him in the house of his parents? Did she enjoy cooking? Did she want children? Then he stopped talking and just looked at her and she smiled and he decided that she was very beautiful.

They did not share the same bed on their wedding night. Or the following night, or the night after that. They had never slept with anyone before and Aziz was so nervous he could not achieve an erection. He saw a doctor who diagnosed his condition as stress and advised plenty of rest. One night, thirty days after they had married, thirty days after they had begun sharing a house and meals and daily chores, thirty days after they would sometimes glance at each other and for no reason start laughing, Aziz looked at his wife and realized he was no longer nervous.

“Let’s do it,” he said.

“Ok,” she said.

Years later, after giving birth to three boys and two girls, his wife told Aziz, please no more.

“Ok,” he said.

And they stopped doing it.

The following morning, Aziz and I catch a taxi to the hospital. Our driver races down the wide streets, cutting in front of other cars and honking incessantly. We pass sidewalks crowded with crates of bananas and grapes, and slabs of raw meat hanging from hooks in a bazaar. Tuck-tucks—multicolored carts attached to motorcycles—whiz past us with families hunched together inside. Mud brick buildings bristle with flecks of grass and twigs like a day’s growth of beard, their towering, centuries-old wood doors heavy with metal knockers stand as bulwarks against the commotion, Biblical in their ancient solemnity.

Snow-capped mountains rise beneath a vacant sky far beyond the bazaar, and a frosty wind blows through our windows, carrying with it the shouts of vendors and the sharp smell of fresh dung and the clopping noise of donkeys and horses drawing carts sagging with fire wood. The commotion stays with us, growing in volume until we turn off the road and enter the hospital grounds through an open pair of rusted red gates, past armed security and a glut of beggars assailing passersby.

The burn unit emerges from behind a cluster of clinics, dirt-grimed and forbidding in its solitude. Nearby, a weed-covered lot holds the broken remains of metal cots. Aziz and I walk past the lot and up a ramp to the entrance of the burn unit. Wide cracks above the doors snake through the walls, pausing at vast holes where the plaster has broken off before the cracks continue in ruinous flows.

A nurse holds an infant whose head is wrapped in brown-stained bandages. The child peers at us through a lopsided window. A man tells us the boy is his nephew. He may take him to Iran. There is nothing more they can do for him here.

Inside, a janitor leads us to a locker room and instructs us to put on blue smocks, torn rubber flip-flops, and surgical caps, the hospital’s idea I suppose of sterile clothing. The smocks appear stained from bleach and smell of the previous user.

We follow a nurse down a dim green hall; past wards filled with the groans and cries of bandaged women and infants. Their charred skin rolls in waves across their chests and arms and legs like cooled lava. No, no, not all self-immolation, the nurse tells Aziz. Too often they light gas lamps that explode, showering themselves in fire.

The sister-in-law of the girl in Bed 18 tells Aziz her name; Balanaz. Her sister-in-law is Shagufa. Neither girl knows their age. Balanaz spends her days and nights at the hospital. Shagufa’s family will not visit. Her mother has other children to care for; her father must tend to his crops and farm animals. It remains for Balanaz to look after her.

“Did she take a capsule for pain today?” Dr. Nikzad asks.

“Yes,” Balanaz says.

“Give her another one.”

Balanaz fingers an ibuprofin tablet into Shagufa’s mouth and offers her water, waves flies away from her face. She spoon-feeds her crushed pomegranate from a tin plate. Shagufa moans.

“Shh, be quiet,” Balanaz says stroking her forehead. “Your pain will go down.”

Dr. Nikzad gives Balanaz small tasks. Throw this bottle away, empty that trash, go to the other room for more bandages. Balanaz dashes here and there with an eagerness and authority that comes from having stayed at the hospital for days and days, observed the doctors and nurses, and learned every nook and cranny of its wards and supply rooms.

I tell Aziz that she reminds me of when I was a small boy happy to do chores adults gave me because it made me feel grown, made me feel I was catching up to my older brothers who were able to leave the house and go off with their friends.

Aziz translates what I said to Balanaz. She listens, looks at me, and then turns back to Aziz.

“I don’t know about his life,” she says.

When I first came to Afghanistan in 2001, I hired Aziz’s eldest son Khalid as my translator. At the time, his wife had just given birth to a daughter. Now these many years later, Khalid has five daughters. He loves his girls, Aziz says, and as an Afghan man he is passing on a new kind of thinking; girls are not for sale, they should not be forced into marriage, they can hold jobs, they are as good as boys.

But Aziz’s wife complains that Khalid’s wife has yet to produce a son.

“She is old school,” Aziz says of his wife.

In 2009, when Nabil turned twenty-two, Aziz’s wife selected a young woman for him to marry, but Nabil refused. If I must marry, I will marry this girl I know from work, he told her. Her name is Fadwa. She is a good girl, a nice girl, and I like her.

“Part of the new thinking,” Aziz says.

They married a few months later. Aziz gave them money for a honeymoon in India. When they returned to Kabul, Nabil and his bride moved into the third floor of Aziz’s house. They had no wish to start a family immediately, but Aziz’s wife wanted more grandchildren, preferably boys, and threatened to beat Fadwa if she did not become pregnant. Fadwa quit her job as a computer programmer, and a year later, gave birth to a son now four weeks old. Nabil sleeps by himself, leaves the baby with his wife so the infant does not awaken him in the middle of the night to be fed.

“Old school,” Aziz says.

Aziz and I take breaks from the hospital and loiter on its grounds by the lot with the discarded bed frames. We watch men with heavy black beards waiting outside clinics to see a doctor. They adjust their turbans, look at us, and I decide the ones who return my greeting of a raised hand like westerners. Those who look at me without expression I think support the Taliban. A pointless engagement with paranoia that distracts me from dwelling on what I see and hear inside the hospital— a doctor peeling skin off like cellophane, she screaming.

The restaurant fell silent when we entered.

“He’s one,” I say. “He’s a Talib.”

Aziz says I am being ridiculous but it becomes a game between us.

“What do you think?“ Aziz says nodding at one man smoking a cigarette and staring sullenly at us.

“Oh yeah,” I say. “He’s one.”

(rotted flesh stuck to discarded bandages, the putrid odors)

Our guess. The Taliban game not only stops me from thinking about burned and disfigured patients, but is grounded in a real concern for our safety that we first encountered in Kabul. After Aziz had picked me up at the airport, we stopped for lunch near my hotel. The restaurant fell silent when we entered. The stares directed at me, Aziz explained, reflected the anger Muslim people felt toward the Florida pastor who had threatened to burn volumes of the Koran on the ninth anniversary of September 11th. The pastor backed down days before my trip, but the issue still inspired outrage.

We sat quietly absorbing the hostile looks. Aziz told me that in the days leading up to September 11th, leaflets were distributed in his Kabul neighborhood exhorting people to kill at least one westerner for every burned Koran. One leaflet even urged Afghans to storm the American Army base in Bagram, about a forty-minute drive outside Kabul. Many of us would die, the writer of the leaflet declared, but we would at least get one of them.

I told Aziz about an Afghan man I sat next to on my flight from Dubai. His name was Said and he worked for the U.S. army. He was born in Kabul but raised in Long Island where he still lived. Married with two kids. Ran a convenience store. Then the recession hit, he lost his store and signed on with the army as a translator. Two hundred grand a year, three week vacations every six months.

The Americans, he said, don’t trust the Afghan soldiers they train with live ammunition. Army snipers peer down from parapets ready to take out anyone who experiences a sudden urge for jihad. Said never tells the trainees when he leaves the base. They might call someone and have him shot for working with the Americans.

Now is a time of no trust, Said had told me.

One week later, Aziz and I wonder who here in Herat might be hostile.

“Look at that guy,” I say nodding toward a man with a heavy black beard and black turban.

Aziz watches the man without comment. In some ways, he says, life was better under the Taliban. He liked that they required women to cover their bodies and faces. A burqa, he tells me, prevents men from leering at other men’s wives and daughters. It enforces respect. His wife wears a burqa when she leaves the house as do his two daughters both in their early twenties.

Under the Taliban, Aziz continues, there was no stealing. A man could leave two thousand dollars on a table and no one would take it because if they were caught their hands would be cut off. Sometimes a thief would bribe Taliban officials so they would not lose their hand. Then the police brought in somebody else to replace the thief and that person lost their hand. The Taliban were not perfect, Aziz admits.

“There’s one,” he says. “What do you think?”

(terrified Shagufa looking at me with suffering eyes I take notes I have no answers)

“What do you think?” Aziz says again.

“Yeah, definitely Talib,” I say.

The hospital closes on Friday, a Muslim holy day similar to Sunday for Christians. Only one nurse and a doctor wander the empty halls, the sound of their flapping sandals rises and diminishes with each slow step that takes them past small wards designated with matter-of-fact simplicity; skin graft bedroom, emergency room women (where a baby suckles the burned breast of her sleeping mother), emergency room men, infected adult women, acute men.

She knows women feel they must burn themselves to escape their homes. They can’t wait for change.

Balanaz sleeps on the floor on a prayer mat at the foot of Bed 18. Curled up, sandals beneath her head, bare dirt-grimed feet twitching against the floor. The red smock she wears torn in back. A fan whirs the silence of her sleep into a soft wheezy breeze that rustles her hair. I smell sharp odors rising from pans stained with iodine. Somewhere I hear water splash.

Balanaz rolls over, and looks sleepily at us. Pauses, mid-stretch. Her eyes snap open, and she leaps to her feet, flees to the far side of Bed 18 and covers her face with a sheet.

“She thinks she is in Helmand,” Aziz says.

“It’s just us,” I say, and Aziz repeats in Pashto, just us.

In the evening just before sunset, dust collects above the city and slowly stitches together to form an airborne particle carpet. A few domed buildings poke through the haze before finally submerging beneath a mantle of pink light, an Atlantis immersed until dawn when it will rise once more into the light of a pale desert sky.

But for now, within the enclosure of another day’s end, Dr. Nikzad returns home and thinks about the patients she has left behind this night. She removes her white hospital gown and head scarf, hangs them by a mirror, and catches sight of her lined face, bent shoulders, and decides to make tea.

She knows women feel they must burn themselves to escape their homes. They can’t wait for change. She suspects all patients burned themselves deliberately. Including Shagufa. Dr. Nikzad has spoken to her several times since she was admitted. When Balanaz left her side this morning to fetch some bandages, the girl complained to Dr. Nikzad about her married brother who always criticizes her. She could do nothing right in his eyes. Do this, do that, he tells her. Why can’t his wife do his bidding, Shagufa wanted to know. Why must she?

As she prepares her tea, Dr. Nikzad wonders if Shagufa set herself ablaze to strike back at her brother articulating her outrage through the purification of fire, her shrieks flaming upward in some kind of horrific present day stone-age rite exultant in its message of suffering.

Dr. Nikzad has seen many of these kinds of patients. After three, four days they begin talking. They cry and admit it. Or like Shagufa, they admit nothing other than their powerlessness and need to escape.

The dead patient is twenty-two. Burns on 90 percent of her body.

The situation in Afghanistan is not good for women. Why is this? Why are women and men always fighting? By thinking about these questions, Dr. Nikzad occupies her mind and copes with the pain she sees, the screams she hears, the curses of nurses who slap shrieking children because the supply of ibuprofin tablets has been depleted and they have nothing else to relieve their agony. It makes her sad. Pain is a way of life for Afghan people. She wants to know why this is. Her questions lift her mind into an abstract world of intellectual query far removed from the burn unit and the screams left lingering in her mind deep beneath her exhaustion. She wants to find a sensible answer to her questions although she knows there is none.

One morning at the hotel restaurant, as Aziz and I eat hard-boiled eggs and drink green tea for breakfast, Aziz overhears two women and two men talking at a table near us. The men offer to pay the women sixteen dollars for the use of their two rooms, plus another twenty-two dollars apiece for sex. The women want forty-four dollars for the rooms and one hundred sixty dollars apiece for sex.

“Not good women,” Aziz says.

I remind him of Said, the Afghan man I sat next to on my flight to Kabul from Dubai. He had asked me where I had stayed in Dubai. When I told him the name of my hotel, Said shook his head and suggested I try the Broadway Hotel next time. Russian women will sit on your lap at the bar until you arrange something further, he said. Very young, very cheap.

Aziz makes a disapproving face, then recalls a time in the nineteen eighties when he was a low-level bureaucrat in the Soviet-controlled Afghan government. In 1985, he was sent to Czechoslovakia for a year and trained to detect counterfeit money. He loved Prague, its wide streets, tall buildings, friendly people. Its entertainment. He visited night clubs. A girl asked him to dance one night. Later, she asked him to come home with her. He was tempted but his friends had warned him about AIDS.

No, I’m sorry, he told her, I can’t do this.

He still thinks of her sometimes. When they danced, he held her by the waist.

She was very soft, he says.

At the same time Aziz is telling me about Prague, the five doctors and twelve nurses of the burn unit are holding their morning staff meeting:

We have twenty-five patients total.

We have two skin grafts for today.

We have no supplies.

Last night a patient died.

Balanaz hears the woman in Bed 19 gasping. The harsh intake and exhalation of air. She watches the patient’s mother try to feed her, listens to her put down the spoon and read from the Koran.

The dead patient is twenty-two. Burns on 90 percent of her body.

Balanaz sleeps, hears verses of the Koran and knows she is dreaming. Then she hears her name Balanaz Balanaz over and over and realizes she is not dreaming.

I put in a request to the government for supplies to cover poor patients. We have no medicines.

Their clothes burn off and we don’t have clothes to send them back home in.

The dead patient had severe burns to her lungs and larynx.

Balanaz… Balanaz… Shagufa asks for water and Balanaz wakes up and struggles to reach a plastic bottle by the bed. She notices a doctor standing by Bed 19. The doctor asks the time of death. A nurse tells him. The mother weeps.

Last week a man came in with five children. I bought milk for them out of pocket.

All the poor are dropped off here. Even the army and NATO drop them here.

The patient died about 1 a.m.

Balanaz looks at the dead woman’s mother. She is crying. Balanaz feels sad for her.

Just after we finish our breakfast, Nabil calls Aziz and tells him that he will be leaving Kabul the next morning on a three-day business trip. Nabil works for the Kabul office of Roshan, an international telephone company, and his supervisor wants him to attend a training seminar in Dubai. Nabil has asked his mother-in-law to tell Fadwa about her sister while he is away. He does not want to be home when she finds out.

But no one speaks to her. When he returns to Kabul, Nabil knows he can no longer put off the inevitable. He talks to his in-laws and they agree to a plan. Nabil will drive Fadwa to her parent’s house and her mother will take her aside and tell her. But on the drive there Fadwa senses something. By the time they reach the house, she is weeping and almost hysterical and does not want to leave the car. Take me home, she tells Nabil. He pulls her from the car, and when she sees her parents, their wan faces and red-rimmed eyes, she falls to the sidewalk screeching. No, No, No! Fadwa tears at her face, claws the air, and Nabil steps aside to let her mother hold her.

On our last day in Herat, Aziz and I stop at the hospital to thank the staff for their time. Dr. Nikzad tells us that Shagufa is well enough for skin grafts to her legs and abdomen.

Balanaz rests her hands on her stomach and watches us shake hands with Dr. Nikzad. She does not know when her baby is due. She does not know how old she was when she married. I was young, she says. Her father called her into a room and said, I want you to marry this boy. Before she married, she had not been allowed outside the house. Now, she can go to the barn and feed the farm animals.

Sometimes while doing her chores, she has seen American soldiers standing far away. Should they one day pass her house, she would say, salam. If they were to shoot their guns, she would run. She knows little about the war.

From her time at the hospital, however, Balanaz knows that women can become doctors. But she will not be one of them. Educated women start school when they are seven, she says. She is older than seven. She has never been to school. She is about to have a baby. Her future was decided by her father.

“It is too late for me,” Balanaz says.

I do not see Aziz for four days after we return from Herat. Alone, I walk to the restaurant beside my hotel where he and I had ordered lunch the day I arrived in Kabul. The customers are different, but the hostile stares and overbearing silence remain the same.

Across the city, Aziz is spending time with his wife. They go to the bazaar and buy wood to heat the house in winter. She wears a burqa but removes the hood to cool her face. Aziz does not object.

Nabil’s wife Fadwa leaves her parent’s house after spending several nights with them grieving for her sister. She lives again in Aziz’s house with Nabil and their infant son. She is sad but no longer weeps at night. Nabil continues sleeping alone although the baby does not cry as much now.

Aziz’s younger daughter has a twenty-six year old suitor. The young man’s mother saw her answering phones in a medical clinic where she works as a receptionist and liked her simplicity; the fact that she wore no makeup, did not look directly at male patients, and wore a burqa when she walked outside. A clinic doctor told her that Aziz’s daughter came from a good family and was just twenty-two-years old. The young man’s mother called on Aziz and his wife and asked them if her son could marry their daughter.

Aziz agreed to meet him. If he likes him, he will ask his daughter if she wants him for a husband. She will say, it is up to you father. Aziz will then meet the young man’s family. If he approves of them, he will make arrangements for the engagement party. His daughter will quit her job, marry, and have children.

“Old school,” I say.

“A little old, a little new,” Aziz says.

To contact Guernica or J. Malcolm Garcia, please write here.

Illustration by Emily Hunt