Intended for healthcare professionals

Feature Pakistan

How the Taliban undermined community healthcare in Swat, Pakistan

BMJ 2012; 344 doi: (Published 21 March 2012) Cite this as: BMJ 2012;344:e2093
  1. Iftikhar Ud Din, public health officer1,
  2. Zubia Mumtaz, assistant professor2,
  3. Anushka Ataullahjan, research analyst2
  1. 1EDO Health Office, Dassu Kohistan, Khyber Pakhtunkhwa, Pakistan
  2. 2School of Public Health, University of Alberta, Edmonton, Alberta T6G 2T4, Canada
  1. Correspondence to: Z Mumtaz zubia.mumtaz{at}

Iftikhar Ud Din, Zubia Mumtaz, and Anushka Ataullahjan examine the difficulties experienced by Pakistan’s lady health workers

Pakistan is in the midst of Islamic militant violence. Although the conflict in the Swat district in northern Pakistan has officially ended, there is a threat of Taliban re-emergence and the Pakistani military continues to fight the militants.1 2

Swat is in the Himalayan region, and its high mountains, green meadows, and clear lakes made it a popular destination with tourists looking for skiing, hiking, fishing, and ancient statues of Buddha. The Taliban invasion during 2006-9 not only destroyed the tourist industry, it unleashed a reign of terror on the local population. A key feature of the Taliban militancy was a systematic attack on people suspected of behaviours that were in violation of the Taliban’s interpretation of the principles of Islam.

The Taliban publicly beheaded residents accused of crimes and hung their bodies in the busiest square of Mingora, the district capital. They prohibited polio vaccination campaigns for children, schooling of girls,3 and women working outside the home. Women working in schools and health centres have either been fired or killed,4 and those in non-governmental organisations have been forced to stop work. Men were killed for shaving their beards, listening to music, and watching movies.

Over the three year siege of Swat, Islamic militants destroyed 165 girls’ schools, 80 video shops, and 22 barber shops.4 They also destroyed infrastructure, including bridges, police checkpoints, and a generating grid station that provided electricity to 1.8 million people.5

Health systems and conflict

Health infrastructure in Pakistan has also been targeted: 29% of health facilities in the province of Khyber Pukhtunkhwa have been damaged in the conflict between the Taliban and the government forces.6 Health workers have been killed inside healthcare facilities as …

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