Her determination to practice medicine in her home country is ironically aligned with the interests of the Taliban themselves. In the highly conservative Islamic society the Taliban are trying to create, women should be looked after by other women, officials say. That means educating more female doctors.
This is a rare example of the Taliban publicly and loudly promoting women’s education and employment. The training of female doctors and nurses is part of the movement’s efforts to prove that essential services can be provided while building a society based on gender segregation.
Acting Deputy Public Health Minister Mohammed Hassan Ghasi said in an interview that his health ministry has received “clear instructions from the top level” to introduce policies in line with the Taliban’s strict interpretation of Islamic law. A new policy, recently submitted to Taliban supreme leader Haibatura Akunzada for approval, calls for female health workers to treat women and male health workers to treat men. It formalizes a rule already in place in some hospitals.
Ms Ghyasi said the policy will stipulate that female patients can see a male doctor if a qualified female doctor is not available. But with Afghanistan’s overstretched health system and the economic crisis wrought by the West exacerbating hunger and disease, the need for qualified health professionals, both men and women, is greater than ever.
The Taliban’s efforts to expand medical education for women, especially in fields traditionally dominated by men, stand in contrast to the government’s strict restrictions on girls and women. Since coming to power, the Taliban have barred many girls from secondary school and barred women from most occupations. Authorities said this fall Ban Female college applicants enrolled in subjects such as journalism, engineering, and economics.
Educational restrictions certainly seem to limit the number of women who can be trained as doctors in the next few years. Other Taliban policies, such as mandating in some areas that women travel with a male guardian, have hampered efforts to practice female doctors.
However, according to the International Committee of the Red Cross, at several state-owned laboratories in nursing, radiology and other health fields, the proportion of women admitted (at least 46% this semester) is down compared to 2020 figures. slightly increased. Institute.
Taliban officials also cite residency programs, such as the Rabia Balky Hospital where Momand works, as evidence of efforts to educate female health workers. Hospital director Seemin Mishkin Mormand said the Taliban health ministry has supported her ambition to expand the program and provide more advanced training.
Ms. Momand is graduating with honors this fall and hopes to open an obstetrics and gynecology clinic in a rural area.
“When I was a child, this was my ambition: to become a doctor and serve my country and people, especially poor women,” she said.
Medical system for life support
The need in Afghanistan is enormous.Maternal mortality rate is tallest in the world. According to Hamida Hamidi, physician and head of the training program at Rabia Balkhi, worsening malnutrition is leading to an increase in premature births and pregnancy complications.
The health system, which relies heavily on foreign aid, has come close to collapsing following the Taliban’s takeover. After billions of dollars were cut, the ICRC and the United Nations last year cover the salaries of tens of thousands of health care workersStill, some hospitals were closed. A significant number of doctors have left the country. And since the war has ended, the number of patients seeking treatment has increased.
The main hospital in Wardak, a province bordering Kabul, was once on the front lines of the fighting. The number of patients has doubled since the war ended, said hospital director Mohammad Nader Ramani.
As in many parts of Afghanistan, families here prefer female relatives to see female doctors. Most of the patients are women, but They make up only a quarter of hospital doctors.
The hospital, run by the Swedish Afghanistan Commission, recently hired a female radiologist, Rahmani said. However, the limited number of female health workers makes it difficult to increase employment.
Hospital administrators and international aid workers said the Taliban’s goal of creating separate but equal health care systems for men and women remained a distant dream. It is impossible to do,” Rahmani said.
In Afghanistan, as in many other countries, The care of mothers and babies has long been dominated by women. Afghan doctors and hospital administrators say women make up a much smaller proportion of other health professionals.
Six years ago, the World Health Organization raised the alarm How a shortage of female health workers is preventing Afghan women from receiving proper care.
But it wasn’t always this way. In her early 1990s, when Hamidi was in medical school, she recalled, the country had female neurosurgeons and urologists. When civil war broke out in 1992, many fled to the West. It was four years after her that the Taliban first came to power, and “everything changed,” Hamidi said. Her family was uncomfortable with her daughter’s entry into the medical field outside of maternal health, an attitude that continued after the Taliban’s first rule.
Gender segregation has not yet been enforced in Wardak’s hospital, or in other hospitals run by international organizations, administrators say. According to Lucien Kristen, ICRC spokesperson for Afghanistan, no gender segregation has been observed in ICRC-supported public hospitals.
On a recent Saturday afternoon, a young woman named Shaima, who had started labor, arrived at a hospital in Wardak, requiring an emergency caesarean section. At that time there were only male doctors. After some persuasion, Shayma’s husband and her brother agreed that two male doctors and her two female midwives would perform the operation.
If male doctors were banned from operating on women, “we would have lost our daughters and our grandchildren,” said Sharifah, Shaima’s mother.
Gender segregation has not been enforced at Wardak Hospital, but at least so far, three current or former female surgeons at public hospitals in Kabul say male and female staff are already forced to work separately. says.
One of the surgeons, a first-year resident of Wardak, said he wanted to become a surgeon to help women in his state. However, in September 2021, Taliban officials said her hospital would ban women from working the night shift, requiring them to work in a separate room from her male colleagues.
A resident, who spoke on condition of anonymity for fear of retaliation, said: “The problem is that we can’t separate men and women because we have to work together.” They sent us home and suspended us.”
Over a year later, she is still not allowed to return to her post.
Until August 2021, Kobra Safi worked as a reconstructive plastic surgeon in a teaching hospital in Kabul, treating burn patients. Days after Kabul fell, Taliban officials told her that she could no longer contact her mentor, a male surgeon. “It ruined my dream of having plastic surgery,” she said.
Safi boarded an evacuation flight two months later and spent nearly a year in Abu Dhabi, United Arab Emirates, before being resettled in Canada in September of this year.
counterproductive policy
Despite the Taliban saying it aims to expand medical training for women, other policies limit women’s ability to provide or access health care.
Fozia Shafiq, UNICEF’s Senior Health Advisor in Afghanistan, said the agency, especially in the southern and eastern parts of the country, said people must arrive with a male guardian to receive treatment, and to come to health facilities. said it is hearing more and more reports of women being told to. Meanwhile, female health workers face “significant problems” when traveling to work in some areas. .
Deputy health minister Gyasi said he had “never seen” reports of women being kicked out of health facilities, but “we are not denying it because there are some issues at the moment. No,” he added.
The pipeline of future female doctors is also narrowing. Schools in 24 of her 34 provinces in Afghanistan remain closed to girls above her sixth grade, said UN Special Rapporteur Richard Bennett. Said United Nations Human Rights Council in September.
The Taliban closed the 19-year-old Wajeha Kazimi High School, which she attended just before completing her 12th grade.She was still able to graduate and she spent more than a year studying for her university entrance exams at an exam preparation center in Kabul.In September, she survived. suicide bomb there Killed over 50 people.
Kazimi wanted to study public health or pediatrics, and chose medicine as the top priority in university exams.
“When we were making our choices, we remembered a friend who had been killed who wanted to be a doctor,” she said. I am still unable to receive
The Taliban’s restrictions on girls’ education have also killed some of the country’s best male doctors. Five of his eight surgeons at Kabul’s emergency NGO-run trauma hospital left the country after the Taliban took over. Part of it was so that her daughters could continue their schooling, said her medical coordinator, Dimitra Giannakopoulou.
Aid agencies continue to lobby Taliban authorities to reopen secondary schools for public health.
“If a girl wants to enroll in a midwifery course, become a paramedic, or train as a vaccinator, she must have graduated from high school,” said Shafique. “And now there are two years where there is no one to train because there is no cohort to graduate from high school.”
Susannah George and Zahra Nabi from Kabul contributed to this report.
