International Policy Digest

Kanishka Afshari/FCO/DFID
World News /11 Sep 2020
09.11.20

Afghanistan’s Gendered Healthcare System Resurfaces Amidst COVID-19

While some Western countries are attempting to reopen their economies, Afghanistan is still contending with the spread and impact of COVID-19. While its rates of infection are not particularly high, its healthcare infrastructure is severely lacking. Amidst the challenges the country is facing, Afghan women face a particularly unique challenge. Not only is the national economy and sophistication of medical infrastructure far from adequate for handling a health crisis like COVID-19, the country’s social environment frequently puts women at a disadvantage.

In areas where the Taliban maintain control, women are prohibited from getting an education, working outside the home, and their mobility is severely restricted. Most relevant to the mitigation of COVID is the taboo of male doctors treating female patients. With women being barred from education, and by extension, unqualified or simply prohibited from becoming doctors, women with health issues have essentially no avenue for treatment. These circumstances are especially dire in the context of the current COVID-19 crisis, but they also expose a much deeper and ongoing problem of inaccessibility to healthcare along gendered lines.

The Taliban controlled virtually all of Afghanistan between 1996 and 2001. For periods of time during their rule, women were prevented from accessing healthcare through official decrees, barred from treatment at hospitals, and the Taliban forced female doctors out of practice. Even in emergency situations, such as war-related injuries like bullet wounds, women were turned away from hospitals on account of their gender. While these regulations have relaxed with the transition of political authority, women living in Taliban-controlled areas continue having difficulty accessing critical medical treatment.

The COVID-19 pandemic is both a health crisis and a political one, as Afghan authorities and the Taliban attempt to obtain political stability in the country. The healthcare system in Afghanistan is under attack by both the Taliban’s political agenda and the pandemic. Female healthcare has become a disposable pawn, with women’s human rights being violated in a social context that already disadvantages women, and routes for medical care often being destroyed.

While the United States largely dismantled Taliban strongholds in Afghanistan when they removed the Taliban from power in 2001, Taliban-controlled areas still remain and are growing. Healthcare in these areas is virtually nonexistent. In April of 2019, the Taliban banned the entry and operation of the Red Cross from their territory after the World Health Organization pledged to vaccinate 9.3 million children from polio, though the ban was later lifted. Taliban leaders issued threats to both the Red Cross and the WHO, alerting them that attacks were imminent if members of the organization were to enter Taliban controlled areas. Attacks on internationally funded and operated clinics and hospitals are not uncommon in Afghanistan. One example being the deadly 2017 attack on an orthopedic center. As a result, standard healthcare is absent in Afghanistan, leaving people to work with inadequate systems that are scarcely available.

Even when healthcare is available, women are explicitly prohibited from accessing it. Under the Taliban, male doctors and nurses can only touch female patients above their burqas. This law has severe consequences for women’s health, especially reproductive health, which often requires invasive examinations. These constraints on reproductive health have led to nearly 5,000 Afghan women dying during childbirth every year. The Red Cross and other interim medical institutions are allowed to work in Taliban-controlled areas with the group’s approval, but they must adhere to Taliban regulations, rendering doctors helpless when it comes to women’s health operations that conflict with Taliban doctrine. In further violation of women’s rights in the healthcare system, Taliban militants are often stationed in hospitals or in other medical locations to ensure that operations and examinations are done in accordance to their rules, and are given the green light to intercept any activity contrary to said rules.

The Taliban have taken other measures to dismantle healthcare, both in an effort to continue marginalizing women within the system and to undermine the legitimacy and strength of the central government. In 2019, 192 healthcare facilities were closed down after the Taliban initiated attacks. Of these, only 34 have re-opened. These closures and healthcare constraints will foster the spread of COVID-19.

The Taliban may see this pandemic as an opportunity to gain political legitimacy. A logical attempt at exploiting COVID-19 for this purpose might entail an increased investment in healthcare and its requirements. Yet recent comments suggest that the Taliban’s manifestation of this investment would simply be a refrain from medical infrastructure bombings, thereby letting sites of healthcare exist in the first place. Notably, Taliban spokesman Suhail Shaheen remarked that the group “assures all international health organizations and WHO of its readiness to cooperate and coordinate with them in combating the coronavirus.” However, this cooperation has yet to extend to any meaningful slackening of the regulations surrounding female accessibility to healthcare.

A local Afghan woman living in Northern Afghanistan pondered, “who will test the women?” when the single health clinic in her village was staffed with only male doctors. Despite the Taliban’s pledge to cooperate with medical authorities to stop the virus, they must recognize that the virus is not limited by gender. Slowing the spread of COVID-19 requires equal treatment of all victims.

The current pandemic is a lesson to the Taliban that health rarely sees gender, and to ensure a sustainable population to assert control over and gain political legitimacy from, women must be viewed as humans first by not only accepting but advocating for their basic human rights.