Taliban coaching Afghan girls as medical doctors to segregate medical care

Medical residents watch and assist during a Caesarean section at the Rabia Balkhi public women’s hospital, one of Kabul’s busiest, on Oct. 23. Despite the ongoing training of 55 residents, the hospital is facing an uptick in patients, which has spread the remaining doctors thin. (Elise Blanchard for The Washington Post)
Medical residents watch and help throughout a Caesarean part on the Rabia Balkhi public girls’s hospital, one in every of Kabul’s busiest, on Oct. 23. Regardless of the continuing coaching of 55 residents, the hospital is dealing with an uptick in sufferers, which has unfold the remaining medical doctors skinny. (Elise Blanchard for The Washington Submit)


KABUL — After the Taliban took management of Afghanistan final 12 months, practically a 3rd of the resident medical doctors in Omeida Momand’s class at a Kabul girls’s hospital fled the nation, she mentioned, leaving the workers stretched skinny.

Momand determined to remain, to complete the final step in her 11 years of coaching to look after Afghanistan’s girls. By day, she examines gynecology sufferers and screens moms with high-risk pregnancies in a room generally so crowded that sufferers lie on the ground. Night time shifts are spent performing emergency Caesareans.

Her dedication to apply drugs in her residence nation has aligned, satirically, with the Taliban’s personal pursuits. Within the extremely conservative Islamic society the Taliban hopes to create, officers say, girls must be cared for by different girls. Which means educating extra feminine medical doctors.

This marks a uncommon occasion of the Taliban publicly and loudly selling girls’s training and employment. Coaching feminine medical doctors and nurses is a part of the motion’s effort to show it might present important companies whereas constructing a society structured on gender segregation.

Muhammad Hassan Ghyasi, appearing deputy minister of public well being, mentioned in an interview that his ministry has acquired “clear directions from the highest stage” to deliver insurance policies in keeping with the Taliban’s strict interpretation of sharia, or Islamic regulation. A brand new coverage submitted just lately to the Taliban’s supreme chief, Haibatullah Akhundzada, for approval would formalize a rule already utilized in some hospitals that feminine well being employees ought to deal with girls, whereas male well being employees ought to deal with males.

Ghyasi mentioned the coverage will stipulate that if there is no such thing as a certified feminine physician accessible, a feminine affected person can see a male physician. However with Afghanistan’s well being system beneath pressure — and an financial disaster fueled by Western sanctions exacerbating starvation and illness — the necessity for certified medical professionals of each genders is bigger than ever.

The Taliban effort to develop medical training for girls, particularly in fields historically dominated by males, contrasts with the federal government’s draconian restrictions on women and girls. Since taking energy, the Taliban has barred many ladies from secondary faculty and shut girls out of most professions. This fall, authorities prohibited feminine college aspirants from enrolling in topics together with journalism, engineering and economics.

The academic restrictions appear sure to restrict the variety of girls within the coming years who can prepare as medical doctors. Different Taliban insurance policies, comparable to necessities in some areas that ladies solely journey with male guardians, have hamstrung the efforts of feminine medical doctors to apply.

However at a number of government-run institutes for nursing, radiology and different well being fields, the proportion of ladies admitted — no less than 46 % this semester — represents a slight improve in contrast with 2020 figures, in response to the Worldwide Committee of the Pink Cross, which helps the institutes.

Taliban authorities additionally level to residency packages just like the one at Rabia Balkhi Hospital, the place Momand works, as proof of their dedication to educating feminine well being employees. Hospital director Seemin Mishkin Mohmand mentioned the Taliban well being ministry has been supportive of her ambitions to develop this system and provide more-advanced coaching.

Momand is ready to graduate this fall on the prime of her class, and hopes to open a gynecology clinic in a rural province.

“After I was a baby, this was my hope — to change into a health care provider, to serve my nation and my individuals, particularly to serve our poor girls,” she mentioned.

A well being system on life help

The wants in Afghanistan are monumental. The maternal mortality charge is among the highest in the world. Worsening malnutrition has contributed to an increase in untimely births and being pregnant problems, in response to Hamida Hamidi, a health care provider at Rabia Balkhi and head of its coaching packages.

The well being system, closely reliant on international assist, neared collapse within the wake of the Taliban takeover. After billions in funding had been lower, the ICRC and the United Nations stepped in final 12 months to cover tens of thousands of health workers’ salaries. Nonetheless, some hospitals have closed. Important numbers of medical doctors have left the nation. And with conflict over, the quantity of sufferers looking for care is rising.

The primary hospital in Wardak, a province neighboring Kabul, was on the entrance line of combating. For the reason that finish of the conflict, the variety of sufferers has doubled, hospital director Mohammad Nader Rahmani mentioned.

As in lots of areas in Afghanistan, households right here favor that feminine family see girls medical doctors. However whereas girls make up a majority of sufferers, they account for less than 1 / 4 of the hospital’s medical doctors.

The hospital, run by the Swedish Committee for Afghanistan, just lately employed a feminine radiologist, Rahmani mentioned. However the restricted pool of feminine well being employees has made it tough to rent extra.

The Taliban’s acknowledged objective of making a separate however equal well being system for women and men stays a distant dream, hospital directors and worldwide assist employees mentioned. “Within the quick time period, this coverage is unimaginable to implement,” Rahmani mentioned.

In Afghanistan, as in lots of different international locations, the important process of caring for moms and infants has lengthy been dominated by girls. Ladies make up a considerably smaller proportion of different medical specialists, Afghan medical doctors and hospital directors say.

Six years in the past, the World Well being Group raised the alarm about how an absence of feminine health-care employees was stopping Afghan girls from receiving satisfactory care.

Nevertheless it wasn’t all the time this manner. When Hamidi was in medical faculty within the early Nineteen Nineties, the nation had feminine neurosurgeons and urologists, she recalled. When civil conflict broke out in 1992, many fled to the West. The Taliban took energy, for the primary time, 4 years later and “all the things modified,” Hamidi mentioned. Households grew uncomfortable with their daughters getting into medical fields exterior of maternal well being, and that perspective outlasted preliminary Taliban rule.

On the hospital in Wardak and others run by worldwide organizations, gender segregation has not but been enforced, directors say. The ICRC has additionally not noticed gender segregation at authorities hospitals it helps, in response to Lucien Christen, ICRC spokesperson for Afghanistan.

On a latest Saturday afternoon, a younger girl named Shayma who had gone into labor arrived on the hospital in Wardak, needing an emergency C-section. The one medical doctors accessible at the moment had been males. After some convincing, Shayma’s husband and brother agreed to let two male medical doctors carry out the operation alongside two feminine midwives.

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If male medical doctors had been prohibited from working on girls, “we’d have misplaced our daughter and my grandson,” mentioned Shayma’s mom, Sharifa, who makes use of just one title.

Whereas gender segregation has not been enforced within the Wardak hospital, no less than thus far, three present or former feminine surgeons at public hospitals in Kabul mentioned female and male workers have already been compelled to work individually.

One of many surgeons, a first-year resident from Wardak, mentioned she wished to change into a surgeon to assist the ladies of her province. However in September 2021, Taliban officers barred girls at her hospital from working night time shifts and mentioned they need to work in separate rooms from their male colleagues.

“The issue is you can not separate women and men as a result of we have to work collectively,” mentioned the resident, who spoke on the situation of anonymity for concern of retaliation. “That’s why we acknowledged we can’t be separated. They despatched us residence and suspended us.”

Greater than a 12 months later, she has not been allowed to return to her put up.

Kobra Safi labored at a educating hospital in Kabul as a plastic reconstructive surgeon till August 2021, treating burn sufferers. A number of days after Kabul fell, Taliban officers advised her she might now not have contact along with her mentor, a male surgeon. “That destroyed my dream of doing cosmetic surgery,” she mentioned.

Safi acquired on an evacuation flight two months later and spent practically a 12 months in Abu Dhabi within the United Arab Emirates earlier than resettling in Canada this September.

Counterproductive insurance policies

Even because the Taliban says it’s trying to develop medical coaching for girls, different insurance policies are limiting the flexibility of ladies to supply well being care — or entry it.

Fouzia Shafique, senior well being adviser for UNICEF in Afghanistan, mentioned the company is listening to increasingly studies, particularly within the nation’s south and east, of ladies being advised at well being amenities that they need to arrive with a male guardian to get remedy. Feminine well being employees, in the meantime, have confronted “vital points” touring to work in some areas as a result of they need to discover a male family member to take them.

Ghyasi, the deputy well being minister, mentioned he had “not seen” studies of ladies being turned away from well being amenities, although he added: “We’re not denying it, as a result of in the intervening time now we have some issues.”

The pipeline for future feminine medical doctors can be narrowing. Faculties in 24 out of Afghanistan’s 34 provinces stay closed to ladies above sixth grade, U.N. particular rapporteur Richard Bennett told the U.N. Human Rights Council in September.

The Taliban closed the highschool Wajeha Kazimi, 19, attended simply earlier than she completed twelfth grade. She was nonetheless capable of graduate, and spent greater than a 12 months learning for the college entrance examination at a test-prep middle in Kabul. In September, she survived a suicide bombing there that left greater than 50 individuals lifeless.

Kazimi hopes to enter public well being or pediatrics, and ranked drugs as her best choice on the college examination.

“After we had been selecting, we remembered our associates who had been killed who wished to change into a health care provider,” she mentioned. Her 15-year-old sister, although, stays shut out of formal training.

A year of peace in one of Afghanistan’s deadliest provinces

The Taliban’s curbs on women’ training are additionally costing the nation a few of its greatest male medical doctors. 5 of the eight surgeons on the Emergency NGO-run trauma hospital in Kabul left the nation after the Taliban takeover — some so their daughters might proceed their education, medical coordinator Dimitra Giannakopoulou mentioned.

Support businesses proceed to foyer Taliban authorities to reopen secondary colleges for the sake of public well being.

“Women must have completed highschool in the event that they’re going to enroll in a midwifery course, in the event that they’re going to be a paramedic or in the event that they’re going to coach as vaccinators,” Shafique mentioned. “And we now have two years of which now we have no cohorts graduating out of highschool and due to this fact no individuals to coach.”

Susannah George and Zahra Nabi in Kabul contributed to this report.

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