It was the image that woke up the world to the shocking horrors faced by women in Afghanistan.
The photograph of Aesha Mohammadzai, whose nose and ears were hacked off as punishment for attempting to flee an abusive forced marriage, came to embody the appalling abuse suffered by many at the hands of the brutal Taliban regime.
And her story of survival and resilience despite that harrowing ordeal captivated and enchanted the world.
But now four years on, Aesha faces a new battle – a struggle to put the disturbing experiences behind her as she attempts to make a new life for herself in America.
Aesha, won political asylum in 2011, having fled to the U.S. a year earlier, aged just 18, after being promised reconstructive surgery.
She arrived without speaking a word of English and illiterate in her mother tongue of Pashto.
Since then she has undergone pioneering reconstructive surgery to give her a prosthetic nose and been given the education denied women back in her homeland under the Taliban.
However, it appears the psychological scars from her ordeal have proven harder to heal.
Those who have become close to Aesha have spoken of her displaying volatile mood swings – oscillating between violent tantrums and displaying deep affection to people around her.
Her plastic surgery had to be delayed because it was thought she was still not yet emotionally stable to cope with the painful and lengthy surgery required.
Psychologist Shiphra Bakhchi, 31, who has helped treat the 22-year-old for post-traumatic stress disorder believes the trauma of her disfigurement may have caused deeper mental scars than physical ones.
‘I really hope at some point she’ll be a functioning young lady that had a terrible trauma,’ the private practitioner told CNN.
When Aesha was 12, her father promised her in marriage to a Taliban fighter to pay a debt. She was handed over to his family who abused her and forced her to sleep in the stable with the animals.
The UN estimates that nearly 90 per cent of Afghanistan's women suffer from some sort of domestic abuse.
When she attempted to flee, she was caught and her nose and ears were hacked off by her husband as punishment.
'When they cut off my nose and ears, I passed out. In the middle of the night it felt like there was cold water in my nose.
'I opened my eyes and I couldn't even see because of all the blood,' she told CNN reporter Atia Abawi.
Left for dead in the mountains, she crawled to her grandfather's house and her father managed to get her to an American medical facility, where medics cared for her for ten weeks.
They then transported Aesha to a secret shelter in Kabul and in August 2010, she was flown to the U.S. by the Grossman Burn Foundation to stay with a host family.
She was taken in by a charity in New York called Women for Afghan Women who supported her and helped pay for her eduction.
But Aesha soon became unhappy and her behaviour gave rise to concern. During one outburst during, she threw herself to the floor and slammed her head against the ground, grabbing at her hair and biting her fingers.
Her primary guardian figure at the centre Esther Hyneman, who witnessed the tantrum said no one was able to prevent her from inflicting the injuries and they had to call 911 for help, Ms Hyneman said during the CNN interview.
Aesha was admitted to hospital for 10 days following that episode.
Those who knew her said Aesha craved the close-knit family environment the centre was unable to provide.
She left in December 2011, to live with with Mati Arsla and Jami Rasouli-Arsala, from Fredrick, Maryland - who are relatives of a Women for Afghan Women former board member - where she now appears to be adapting to home life.
Ms Hyneman - who Aesha affectionately used to call 'grandma' - told CNN: ‘When she first came to us, she was an emotional wreck.
‘By the time she left, she was a different human being... So we’re all happy if she’s in the right place to further her development, but we miss her.’
During the momentous few years since arriving in America, Aesha has had a prosthetic nose fitted at the non-profit humanitarian Grossman Burn Center at West Hills Hospital in California as part of her eight-month rehabilitation.
Dr Peter H Grossman said they hoped to give Aesha a more 'permanent solution', which could mean reconstructing her nose and ears using bone, tissue and cartilage from other parts of her body.
Dr Grossman's wife Rebecca, the chair of the Grossman Burn Foundation, said Aesha was just one of the thousands of women who are treated with appalling harshness.
She said: 'Aesha is reminded of that enslavement every time she looks in the mirror. But there are still times she can laugh. And at that moment you see her teenage spirit escaping a body that has seen a lifetime of injustice.'/dailymail.co.uk/