Amid the rubble and Taliban restrictions, Afghan women struggle for aid

The UN Women team is assessing the damage caused by the earthquake in Nurgal, one of the worst-hit areas in Kunar Province, north-eastern Afghanistan.

At around midnight last night in August, a powerful earthquake destroyed homes and villages in Afghanistan – but restrictive policies imposed by the Taliban-controlled government exacerbated the suffering of the women and girls caught up in the disaster.

Women and girls living in eastern Afghanistan are bearing the brunt after a 6.0 magnitude earthquake killed and injured people and livestock and destroyed homes.

In the affected villages in the mountainous Nurgal region of Kunar, women and girls were trapped inside destroyed homes or in flimsy shelters.

Many did not receive medical care because health workers in the area were men. The Taliban's strict rules on gender interactions prohibit the treatment of females by male health workers – either entirely in some provinces or only in the presence of a male relative in others.

“Many female survivors were left without treatment because male rescuers could not examine them and there were no female health workers available,” Fas Al-Din Mukhles, a local relief volunteer in Kunar, told Health Policy Watch.

“Amidst the widespread chaos, (women and girls) were suffering in silence and waiting for help,” he said.

The United Nations International Organization for Migration reported this week that there were 1,992 dead, 3,631 injured and 8,489 homes destroyed.

Lack of female doctors

The World Health Organization estimates that about 90% of the health workforce in earthquake-affected provinces is men, with the number of female doctors and midwives shrinking every year under Taliban restrictions.

Last December, Taliban leader Hibatullah Akhundzada issued a directive prohibiting women from studying in medical institutions. Since December 2022, women have been excluded from universities, and for the past three years, girls have been excluded from secondary schools.

Ironically, some relief agencies reported that they were asked to provide female health workers to help in the aftermath of the earthquake, according to NPR.

However, the Taliban have ignored calls from the United Nations and the World Health Organization to ease their restrictions to enable female aid workers to work in emergency areas.

Dr. Mukta Sharma, deputy representative of the World Health Organization in Kabul, confirmed that in the initial phase of rescue and relief operations there were no female doctors who could treat long-term injuries.

“The big problem now is the increasing scarcity of female employees in these places,” Sharma told Reuters.

For survivors like 22-year-old Zar Mina, who was pulled from the rubble after losing her husband and two children, the consequences have been devastating. She was injured by shrapnel in her legs and back, but she waited days to receive treatment.

“She was in shock and very worried, as she only saw men around her,” her uncle, Hijranullah, told Health Policy Watch over the phone. “Now, she has no other family member left. I have moved her, along with some aid workers, to a safer place.”

He added: “If there had been a female doctor, the treatment would have been immediate and the recovery would have been less complicated.”

The World Health Organization estimates that at least 11,600 pregnant women were trapped in the earthquake, which affected areas across Kunar, Nangarhar, Laghman and Nuristan provinces.

Afghanistan already has the highest maternal mortality rate in Asia, and without enough female doctors and midwives, many pregnant women give birth to their babies in unsafe conditions.

The health of Afghan women and children is at risk, caught between a lack of resources and the Taliban's restrictive policies.

Afghan media reported that pregnant women died in hospitals due to a lack of female medical personnel and facilities.

Taliban officials insist that women's rights are respected “in line with Islamic law,” but have refused to change the requirement that women may travel only with a male guardian.

Aid groups say this translates into real harm, as widows cannot leave home without a living male relative, hospitals lack facilities for gender-segregated care, and girls drop out of school if they lose fathers or brothers.

Local media report that female-headed households across Afghanistan often face debt and devastated farmland, forcing families to sell their assets or arrange early marriages for their daughters in order to survive.

Before 2021, women made up a large part of the primary health workforce in Afghanistan. Since the Taliban's return in August 2021, decrees on women's employment and male guardian rules have led to a sharp decline in the number of female doctors, midwives and aid workers across the country.

Reductions in international aid

“Women and girls face not only immediate devastation, but also long-term catastrophe if urgent, gender-sensitive assistance is not provided,” said Susan Ferguson, Special Representative of UN Women in Afghanistan.

Ferguson said at a news conference in Geneva that Afghan women themselves had been present in the relief effort “from day one,” making up as much as 40 percent of some aid teams.

But lack of funding and restrictions imposed by the Taliban mean that there are very few women working in this field.

Since the Taliban seized power in 2021, foreign aid has declined. About 15 million Afghans face “severe hunger,” according to the World Food Programme. However, the World Food Program has cut its aid to the country as it faces a funding crisis.

“Two-thirds of female-headed households cannot afford a basic diet – almost 20% higher than their male-headed counterparts,” said Harald Manhardt, Deputy Country Director of the World Food Programme.

Indrika Ratwatte, the UN Deputy Special Representative for Afghanistan, described the situation as a “crisis within a crisis,” noting that 22.5 million Afghans already need humanitarian assistance, and more than 1.9 million Afghans have been repatriated from Iran and Pakistan this year alone.

Taliban faces international criminal case Most people displaced by the earthquake are still living in tents, joining millions of others recently forced to leave Pakistan and Iran.

In areas affected by the earthquake, many survivors are living in tents, as are those repatriated from neighboring countries. But as winter approaches, their survival is threatened.

UN Women has warned that temporary shelters also expose women and girls to violence and sexual exploitation.

UN Women has launched a $2.5 million appeal to support recovery over the next year.

The Office of the High Commissioner for Human Rights also condemned the Taliban's ban on female UN staff from entering compounds, describing it as illegal and in violation of Afghanistan's international obligations.

Earlier this month, the United Nations decided to establish an independent investigative mechanism “to collect, consolidate, preserve and analyze evidence of international crimes and the most serious violations of international law, including those that may amount to violations and abuses of international human rights law, committed in Afghanistan, including against women and girls.”

The purpose is to prepare independent criminal proceedings against the Taliban government.

Richard Bennett, the UN Special Rapporteur on Afghanistan, described the resolution as a “critical step to ensure that those responsible for serious international crimes are held accountable.”

Image source: UN Women, Al Ahmadi/UNICEF, International Organization for Migration.

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