HEALTH CARE – Restrictions on Women Worsen an Already Fragile System

In 2022, 95% of the population did not have enough food to eat. It is projected that in 2023, over 3 million children and 840,000 pregnant and breastfeeding women will suffer from acute malnutrition. These figures alone suffice to imagine the health conditions of Afghans. But malnutrition is part of an extremely fragile healthcare situation, and the data is alarming:

• Tuberculosis causes about 13,000 deaths every year;
• In 2022, 78,441 cases of measles were recorded, more than double compared to 2021, with 394 deaths;
• In mid-2022, a severe cholera outbreak occurred, affecting children under 5 years in 55.4% of cases;
• 208,771 cases of Covid-19 were registered with about 8,000 deaths, numbers that the WHO considers underestimated due to limited tracking and diagnosis;
• In recent years, the Taliban have made polio vaccination impractical in every territory they occupied, putting up to three million children at risk of infection;
• Afghanistan has one of the highest infant mortality rates in the world with 638 deaths per 100,000 live births (2017 data, the latest available).

In addition to diseases, there are thousands of injuries from attacks, armed clashes, and natural disasters. The Afghan public healthcare system is underfunded, short-staffed, and dysfunctional, while the private system, due to high costs, is prohibitive for most of the population.

Until August 2021, the Sehatmandi project, funded by the World Bank, supported about two-thirds of all public facilities. With the suspension of funding, the system collapsed and healthcare workers stopped receiving salaries: “This happened,” reads the 2023 report by Doctors Without Borders, “after many had not been paid for months due to a mix of insufficient funds and poor management, including misuse of the funds themselves.”

In June 2022, UNICEF, the World Bank, and WHO agreed on a $333 million funding for the provision of emergency health services, but concerns about the management of these funds remain.

In fact, humanitarian organizations like Doctors Without Borders, the International Red Cross, Emergency, and UN agencies have been replacing the public healthcare system for years.

The chronic shortage of qualified healthcare personnel worsened after the Taliban’s return due to restrictions imposed on women, whose presence among healthcare workers was very high. For the same reason, most entities supporting people with disabilities have closed or reduced their services.

While it is very complex and costly for all Afghans living in rural areas to reach healthcare facilities, for women, due to movement restrictions, it has become an almost impossible task. Consequently, the health of women and children is further compromised.

As reported in the June 2023 Human Rights Council report, women routinely give birth without professional assistance or incur significant debts to give birth in private healthcare facilities. Women attempting to enter pharmacies alone have been denied access.

Another scourge is mental distress: contrary to Taliban claims that suicides have decreased and mental health has improved since August 2021, reports of depression and suicide are widespread, especially among adolescent girls prevented from continuing their studies.

But another grave abuse against women is occurring, as noted in the UN High Commissioner for Human Rights’ annual report: officials from the Ministry for the Promotion of Virtue and Prevention of Vice conduct inspections at medical facilities to ensure male doctors are not treating women. This ban equates to a death sentence given the obstacles to the work of female doctors, whose numbers will further decrease due to the ban on women accessing universities.