20 years after end of Taliban rule, Afghan women still face poor access to health care


Nearly 20 years since the ouster of the Taliban and billions of dollars spent on infrastructure and aid, many Afghan women still have desperately poor access to adequate health care and health facilities, a leading rights group said Thursday.

Human Rights Watch (HRW) offered a bleak assessment of women’s health care in Afghanistan in its latest report, saying that even basic information on health and family planning is not available to most Afghan women. Even when women can get the care they need, the quality of that care is often poor, the New York-based group said.

New health facilities that have opened over the years are often insufficiently staffed and don’t have adequate equipment, HRW said. The group’s researchers visited several health facilities in the capital of Kabul, where many of the country’s better clinics and hospitals are located.

The report says there are 4.6 medical professionals to every 10,000 people in Afghanistan; the World Health Organization considers 23 medical professionals to 10,000 people a critical shortage.

“What emerged is a picture of a system that is increasingly unaffordable to the estimated 61 per cent to 72 per cent of Afghan women, who live in poverty,” the report said.

A doctor briefs the mother of a malnourished child about how to feed her baby in a ward at Indira Gandhi hospital in Kabul in August 2019. (Rafiq Maqbool/The Associated Press)

It also noted that Afghan women often have more children than they want because they lack access to modern contraception, face risky pregnancies because of lack of care and undergo procedures that could be done more safely with access to modern techniques.

Most women cannot afford the increasingly costly medicines they need or even the cost of taxis to clinics, which are often at least a half hour away. Most Afghans live on less than $1.90 US a day.

Patricia Gossman, associate director of HRW’s Asia division, said the money that came to Afghanistan after 2001 was squandered due to widespread corruption. Before that, the Taliban regime, which was also heavily sanctioned, mostly ignored women’s health issues.

International aid effort dwindling

Washington alone committed $1.5 billion to rebuild Afghanistan’s health-care sector, according to a 2017 report by the U.S. watchdog overseeing the billions of dollars America invested in Afghanistan’s reconstruction.

“The question everyone should be asking is why after 20 years and hundreds of millions of dollars the state of women’s health care is so grim,” Gossman said in an email. “Where did the money go … a horrendous amount has been lost to corruption, and nothing — nothing — has really ever been done about it.”

She said some organizations have done better than others in delivering aid, particularly in rural areas and even in Taliban-controlled parts of the country.

According to Global Affairs Canada, Canada has provided $3.6 billion in international assistance to Afghanistan since 2001. About 40,000 Canadian troops served in Afghanistan between 2001 and 2014. 

International aid to Afghanistan has also been dwindling in recent years, in part because of the deteriorating security amid relentless violence, but also because of increasing demands on funds exacerbated by the coronavirus pandemic.

As U.S. and NATO troops continue their final withdrawal from Afghanistan, expected to be completed by Sept. 11 at the latest, assistance is likely to further decrease.

“This is a critical moment in Afghanistan,” said Humans Rights Watch, citing fears of a growing Taliban influence and escalating violence as U.S. and other NATO troops pull out.

“The need for international assistance is greater than ever,” it said.

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