No Country for Women

In a country like Afghanistan, being a woman is a not easy and is quite a complicated matter. According to the World Bank statistics, there are around 49.5% women of the total population in Afghanistan with around 27% of females who were able to represent in the Parliament before the Taliban takeover. The World Health Organization reports that Afghanistan has a higher maternal mortality rate than all its six neighbours combined, however, the situation has further worsened under the Taliban government, which has banned girls’ education and their movement without male guardians. Ultimately such extreme restrictions have negatively impacted women and girls’ ability to seek medical care. So here the issue comes to a head: What’s the status of healthcare for women in Afghanistan under the Taliban rule?

Muhammad Hassan Ghyasi, acting deputy minister of public health, said in an interview that his ministry has received “clear instructions from the top level” to bring policies in line with the Taliban’s strict interpretation of sharia, or Islamic law. A new policy submitted recently to the Taliban’s supreme leader, Haibatullah Akhundzada, for approval, would formalize a rule already applied in some hospitals that female health workers should treat women, while male health workers should treat men. Ghyasi said the policy will stipulate that if there is no qualified female doctor available, a female patient can see a male doctor. But with Afghanistan’s health system under strain — and an economic crisis fuelled by Western sanctions exacerbating hunger and sickness — the need for qualified medical professionals of both genders is greater than ever.

This marks a rare instance of the Taliban publicly and loudly promoting women’s education and employment. Training female doctors and nurses are part of the movement’s effort to prove it can provide essential services while building a society structured on gender segregation. The educational restrictions seem certain to limit the number of women in the coming years who can be trained as doctors.

Other Taliban policies, such as women can only travel with male guardians, have hamstrung the efforts of female doctors to practice. According to Gala Melgar, a gynaecologist in Khost, after the Taliban took control of the government, the hospital opened its admissions to women who were having normal deliveries because other facilities in the area weren’t able to accept all of the patients. At that point, hospital staff were seeing about 2,000 deliveries a month. Though the Taliban says they have allowed women to hold jobs that men can’t perform, such as certain healthcare positions, reports suggest that women haven’t returned to work because they were afraid of retaliation or harassment from Taliban officials. Many healthcare professionals have left Afghanistan out of fear for their safety, among other reasons.

Before the Taliban took control of Afghanistan in August 2021, many women and girls were already struggling to receive adequate healthcare due to a widespread shortage of medical professionals. According to WHO, Afghanistan before the Taliban takeover had 4.6 medical doctors, nurses and midwives per 10,000 people, which is below the threshold for a critical shortage of 23 professionals per 10,000 people while facilities such as modern forms of contraception that included prenatal and postnatal care, as well as cancer treatment, pap smears and mammograms, were often unavailable or non-existent, and that medical facilities often lacked staffing and essential supplies. Epidemics of polio, measles, malaria, dengue, cholera and Covid-19 had further strained the country’s healthcare system.

The Taliban announced in December 2021 that women weren’t allowed to travel more than 45 miles without a male relative to escort them. HRW previously found that nearly 10% of the population had to travel more than two hours to reach a medical facility, and nearly half had to travel more than 30 minutes. That could mean women without a male guardian might not be able to visit a healthcare professional. Some news outlets have reported on Taliban officials preventing doctors from treating women without a mahram. And even women who have a mahram may not feel comfortable discussing certain needs, such as reproductive care, in front of the guardian.

The scope of banning women from seeking education is not limited to Afghan women alone but applying restrictions on the working mechanism of international Non-Governmental Organizations (NGOs) too. Many NGOs working in the healthcare sector face severe backlash such as on 24 December 2022, the Taliban barred female employees of NGOs from coming to work. The move, although not unexpected, has thrown the global health NGOs that have been at the forefront of the country’s public-private healthcare delivery model, into disarray.

Initially, several organisations, including Afghan Aid, CARE International Rescue Committee, Islamic Relief, Norwegian Refugee Council, and Save the Children— long associated with the delivery of primary healthcare services in Afghanistan—decided to suspend operations. Save the Children, Norwegian Refugee Council, and CARE International said in a joint statement that they cannot effectively reach children, women, and men in desperate need in Afghanistan without their female staff.

“More than 51% of our medical staff are women,” said Filipe Ribeiro, MSF country representative in Afghanistan. “Nearly 900 female doctors, nurses, and other professionals strive every day to give thousands of Afghans the best care possible. MSF operations couldn’t exist without them,” he said.

Some women who have continued working in healthcare told Amnesty International they were ordered to stop treating male patients. One dentist said her male patients stopped seeing her because they were afraid of facing repercussions from the Taliban. The Amnesty International report stated that a nurse in Kabul said that the Taliban asked me not to wear my uniform but I respect my uniform, because I worked so hard to get it, and they had no right to tell me what to wear. … One of them slapped me in the face, and another pointed his gun at me, and said they could kill me, and I wouldn’t be able to do anything.

It’s because of socio-cultural issues that limit the movement of women and girls, and sometimes make it difficult for them to access basic services, including health services. Since the Taliban takeover, Afghan women remain constantly in the international headlines. The internal community and UN Chief call on the Taliban to reverse the girl’s education ban as it is the mother of all ills. The Taliban are not realizing that banning women’s education has an impact on their healthcare sector where female doctors are disappearing due to harsh policy measures and the marginalization of women is leading to a healthcare crisis.