The New Humanitarian Annual Report 2021

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Losing Hope - Women in Afghanistan

When Afghanistan's long civil war finally came to an end with the fall of the Taliban in 2001, its women dared to hope. But six years later, broken promises and a resurgent Taliban have left their dreams in tatters.

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HORIA MOSSADEQ (human and women's rights activist): In late 2001 when the Taliban government was overthrown by international forces, we hoped the situation would change for the Afghan people with the establishment of the rule of law, with respect for women's rights and gender equality in all life of Afghanistan, but unfortunately the situation has not changed for a big proportion of the women population. Women are still suffering from domestic violence, lack of security. Women are still being kidnapped, raped and abducted by illegal armed groups. Women are getting no justice when they go to the judicial system, so how can we say the system has changed? The attention and focuses have gone to the security, to the poppy eradication. They were paying much more attention in those areas, and actually they forgot about another case, which is the women, half of the population of Afghanistan.

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At Faizabad Hospital, in Afghanistan's northeastern province of Badakhshan, staff at the maternity unit swing into action for an all too familiar case. Twenty-five-year-old Khair Mesah has arrived from her village two hour's drive away in excruciating pain. Years of experience with late pregnancy complications tell the medical staff attending Khair that they're fighting as much for her survival as for her baby's.

This is the only medical centre in Badakhshan capable of providing comprehensive obstetric care for almost 200,000 women of child-bearing age.

And Khair's case is a typical example - of a woman out of reach of medical help when complications first surface, who arrives at hospital when it is too late for doctors to do much for her baby. It's important to get it out of the womb as quickly as possible. Khair survives. The baby doesn't. Its tiny misshapen form is the latest addition to the province's tally of what health experts maintain are preventable deaths. Its mother is left drained by the experience. If she hadn't made it to qualified medical help, she too would almost certainly have died from obstructed labour.

SYNC LINDA BARTLETT (expert voice on MMR [maternal mortality rates] seconded to UNICEF): Having so many women die of obstructed labour shows the complete lack of access to care. Women in Badakhshan are chronically malnourished and therefore their growth is reduced so they're small to start with. They have a small body to give birth to a baby. Secondly, women get married in Afghanistan - and in remote more conservative areas like Badakhshan especially - at very young ages.

In their efforts to bring new life into this austere province, expectant women face a greater chance of losing their own lives than any other mother on the planet. For every 100,000 babies born alive here, 6,500 of their mothers will die in the process.

The figures were last measured five years ago, and experts acknowledge they may have gone down slightly since. But, they say, wherever the numbers stand, they still speak of huge gaps in healthcare for women, more than five years after Afghanistan emerged from the years of conflict.

Badakhshan is singled out by a string of misfortunes. This is a remote part of Afghanistan, the only one of 34 provinces that the Taliban failed to conquer in their sweep across the country in the 1990s. It's served by few roads and even fewer basic health centres. More than likely, transport to whatever help is available is a donkey. The vast majority of women give birth in their homes. A skills drain and lack of education in the provinces, mean there's rarely qualified help when things go wrong.

During winter, many parts of the province are cut off for six or seven months. But the reasons for the excessive maternal mortality rate go deeper - into cultural values which place the welfare of men and boys, far above that of women and girls.

Dr Hajera Zia Baharestani is a leading gynaecologist who came to Faizabad with her family 14 years ago, on a mission to build maternity services at the hospital from practically zero. Through Afghanistan's civil war and the Taliban takeover, she trained doctors and increased the number of beds. She had high hopes that the country's parlous medical facilities would improve noticeably with the removal of the Taliban. It's not the lack of equipment, or even supplies, although they are basic. It's the space. Women who've just delivered recover two to a bed, their babies nestling beside them.

Electricity supplies haven't been fully functioning in years. And so midwives and doctors are forced to perform difficult deliveries in semi-darkness.

SYNC HAJIRA BAHARESTANI: I was really hoping that once Afghanistan was stabilised and the war was over, far more attention would be paid to mothers and maternal mortality would come down. In Badakhshan the level is a tragedy. It's to be expected that 23 years of war have destroyed Afghanistan. Rebuilding it will take a lot of patience and plenty of skilled manpower. It's going to take time to meet the needs of women.

The recent surge in opium production in Afghanistan and the export of heroin to addicts in the west has been well documented. Less has been seen of rising drug abuse by Afghans. Many people, living far from clinical centres, still see opium as a medicine for any ailment - for themselves and their children.

Mohamaddin offers his five children a meagre meal of bread and tea. He looks after them by himself after his wife died hours after giving birth to their sixth child at their home in a mountain village. He says she was 55 years old, and was haemorrhaging badly. Instead of taking her to a medical centre, he heeded the advice of neighbours and left it until the morning - too late. She bled to death. He was forced to give the baby away to another villager, saying he wasn't able to look after it.

SYNC MOHAMADDIN: After my wife died I've had many problems. I beg help from women in the village. I offer them 10, 20, 30 Afghanis to persuade them to make me bread. They help me out and then go home. Whenever I come back into the house my youngest boy comes to me and says, Daddy I'm hungry. If I have bread I'll give it to him. Otherwise he'll burst into tears. A child without a mother is a big problem.

During the day Mohamaddin sets his children to light tasks, shifting small stones to build a wall. He can't leave to work in a local flour mill because there's no one to look after the younger ones. His loss reveals the impact that the death of a mother has, not just on a family, but on a small community governed by strong belief in family unity.

SYNC MOHAMADDIN: When my wife died everyone was sad. But now that's gone and no one cares. No one cares about other people in this world. The people in our village don't have enough sympathy to say: Look there's no women in his house, so let's help. They don't make fun of me here, but they don't treat me as anything special either.

Mohamaddin's wife might well have benefitted from advice here: at a family planning clinic in Badakhshan's main hospital. The women here are in a tiny minority. The UN Children's Fund says 97 per cent of women questioned in a recent survey said they weren't using any form of contraceptive. The average fertility rate in Afghanistan is seven children. But many women can expect to go through up to 10, perhaps 13 pregnancies during their child-bearing years.

Although contraception is widely frowned upon, many women are waking up to its obvious advantages, not least because it gives their bodies a chance to recover from child birth, and fewer children mean fewer mouths to feed.

There's a faint air of secrecy about this clinic. The function and virtues of condoms are discussed along with the contraceptive pill, but women here prefer other means of birth control - a jab, undetectable by husbands, administered every three months.

Conservative views on the role and rights of women predate the Taliban and its harsh interpretation of Islamic strictures by centuries not just decades. Women's rights campaigners say early marriage and control of women as the property of men and families are still prevalent across the country. They say most men perpetuate a patriarchal system with its roots, they'll argue, in religion as well as cultural tradition.

1. There are a lot of people around who won't let their wives go out to see a doctor. I know a man whose wife died for that reason.

2. In our province a woman must get permission before she goes to the clinic. If her husband isn't about she must ask her relatives. If she goes anyway she should be punished.

3 Illiteracy of women is high in our province. Women don't know anything about their rights. Men tell them not to go out because strange men will stare openly at them. And that's a bad thing.

Many believe the answer to the problems confronting women lies in education - the antidote to inequality, poverty and poor health. In 2001 when the international masterplan for the reconstruction of Afghanistan was being designed, education - in particular for girls - was the beacon ambition.

Literacy, the theory was, would guarantee future generations of women an active role in the social and economic repair of their country. Four out of every five Afghan women are illiterate. In Badakhshan, where around two thirds of girls attend primary school, the plan is working well. Across the country, the average is far lower, but still a big stride after the years of the Taliban when girls weren't allowed to go to school.

But in the more violent southern and eastern provinces, the policy is under threat. As Taliban insurgents and other deeply conservative forces have strengthened over the past two years, many schools have been burned down, female teachers have been killed and the parents of thousands of children have been terrorised into keeping them at home. Nonetheless, for many investing in the future of Afghanistan's women, education is a project that has to continue.

Few would disagree. But some women's rights activists say successes in one development area, like education, mask abundant failures in others that were also deemed important at the time. True, they say, fewer women feel compelled to wear the `burqa’, signifying a greater sense of freedom to mix in open society. True, many women now have a loud, if precarious, voice in the media. But they alone are no comprehensive measure of progress in women's rights. Scratch the surface, campaigners say, and those most actively supporting women's empowerment would be shocked at what they discover underneath: a string of threats that directly affect women's security and opportunity for advancement.

SYNC HORIA: The promises the international community made at the beginning [were] that they are not going to compromise the rights of the women, but actually we can see that the rights of women have been compromised. Women are still suffering from domestic violence, lack of security. Women are still being kidnapped, raped and abducted by illegal armed groups. Women are getting no justice when [they] go to the judicial system, so how can we say the system has changed? The only thing is, for example, I was working before the Taliban regime, and again I am back to work. This is the only change that you can see in the life of the women. And that's it.

Just ask Jamila. That's not her real name. She and the safe house in Kabul which protects her, didn't want to reveal her identity, fearing that the family who've scarred her for life could get to her. Jamila was married off at the age of 12 and in the four years since has endured nothing but physical and psychological misery at the hands of a violent husband and a mother-in-law pushing him on.

SYNC JAMILA: I was baking bread in the oven one day when by mistake I dropped two loaves. My husband came to beat me, and my mother in law poured kerosene on me and threatened to kill me. I said I would do it myself and set myself on fire.

SYNC URSALA: Domestic violence in Afghanistan like all other kinds of violence is getting worse. The phenomenon of domestic violence is global. It doesn't recognise any borders or level of development. But when it comes to countries which are in conflict and deep poverty like Afghanistan, then it's one of the top issues.

Jamila's mother forced her into marrying her husband after her elder sister rejected him and ran away. Afghan custom dictates such practice to protect family honour. She suffered burns to her chin, her chest, her hands and part of her legs. They were so severe, some of her fingers have welded together. Only extensive plastic surgery with outside help can help her now.

SYNC JAMILA: Now I can only eat. I can't do any work. I can't put my clothes on. I can only go to the toilet. I can't do any work.

SYNC URSALA: We encourage some of them to reintegrate back into their families and societies, on certain conditions - that the violence should not be happening to them again. But with some of them we find an alternative way of living. If they are as woman and they have children and they want to live with them we encourage them. We teach them some skills to make them able to live on their own. But in this society it's impossible for girls, single girls to live on their own, so that has been a challenge for us.

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[Duration: 19:41]

For women's rights campaigners, the issue is so taboo, so locked behind closed doors, that nothing gets done. But they say it lies at the heart of the debate on justice and judicial reform, not to mention gender equality - an issue which Horia Mossadeq says the west has chosen quietly to ignore for fear of upsetting the Afghan government.

SYNC HORIA: For me this is a scream to the international community to say, look how much we are suffering and no one is here to help us. Most of the time if a women brings up such an issue in court, she loses and I think the governmental institutions and even the cabinet haven't been gender sensitised."

This is one institution which government supporters inside and outside Afghanistan would argue proves exactly the opposite. The parliament is held up as the big showcase of post conflict success. More than a quarter of its MPs are women, most of them voted into office on a quota system designed to give women a greater voice in public affairs. According to the MP Shukria Barakzai these are golden times for women's rights, and parliament is a big part of it.

SYNC SHUKRIA BARAKZAI: Never, never have women in Afghanistan in whole history have had that much voice as today. Never did the media try to inform the people about women's rights like today. Never was the government afraid of women like it is today. I am very happy that women participate in the parliament. It at least shows that the Afghan women have this capacity and capability to be participant in political life, and still we are not united, but it's also a good exercise to change the belief of this society and show women in power.

Family life, enjoyed here at the Women's Park in Kabul, gives photographer Farzana Wahidy plenty to focus on.

She works for an international news agency and photographs her country's struggle for peace, for the enlightenment of those watching from afar - the moments of innocent pleasure that sit side by side with the lingering enmities and violence, the contradictory ambitions, the daily frustrations.

SYNC FARZANA: I'm not happy with all the change that happened in these five years. I was expecting more. But it doesn't mean that there is no change. But I want more.

She lived through some, but not all the violence, and like most Afghans has a deep hope that the next 25 years, even if they're difficult, will be nothing like the previous 25.

Afghanistan as it is, with the ruin and the bleak beauty all around, is Farzana's profession and her passion. She's a dedicated chronicler of the birth of a nation free of mass killing, raping and pillaging - relatively free, in the eyes of many, of attempts from inside and outside to subjugate the Afghan people. It's a difficult birth she says. But, as the mothers and midwives of Badakhshan will tell her for nothing, there's no such thing as an easy birth in their country.

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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information:

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