Girls’ education and the future of healthcare in Afghanistan

On 15 August 2021, after the US government’s decision to withdraw its troops from Afghanistan, the Taliban invaded Kabul and took control of the country. Under Taliban control, government workers, minority groups, and supporters of the coalition forces are particularly vulnerable. Women and girls have been affected more than any other group.1 The Taliban’s imposition of policies that violate the rights of women and girls has had a devastating effect: it has created enormous problems for their health, education, and freedom of movement and expression, and it has deprived many of their livelihoods.

The requirement for women and girls to have a male chaperone, called a mahram, whenever they leave the house limits every facet of their lives, from their freedom to go to the shops and provide for their family to their participation in household decision making. Compulsory face coverings and the presence of a mahram adds to the growing invisibility of women and girls in Afghan society.

The situation is worsening because Taliban laws prevent girls and women from attending high school and higher education, and have adjusted curriculums to emphasise Islamic studies.23 Depriving girls of the right to education worsens poverty and increases the likelihood of child marriage.4

Restrictions imposed by the Taliban, including mandating male family members to accompany women to medical appointments, and prohibiting male healthcare professionals from treating girls, further impedes access to healthcare.5 Access to sexual and reproductive healthcare has reduced, and the consequences for maternal and newborn health have been disastrous.

A government mandate stipulates that women be seen only by female doctors, and at the same time introduces legislation that bans women from attending high school or higher education, thereby preventing women and girls from training as doctors. Prohibiting women and girls’ education has negatively affected the growth of the healthcare workforce. Even before the Taliban’s takeover, health indicators in Afghanistan were deteriorating.6 The country’s healthcare system was struggling because of understaffing and inequality, making it difficult for people to access health services staffed by adequately skilled health professionals. The restrictions on education have already resulted in major disruption to, and grave repercussions for, the future of healthcare for women and girls.

Under Taliban control, women in medicine are caught between the growing demands for healthcare and the insecurity of services. The uncertainty threatens the future of women in healthcare, causing them mental anguish. Public health in Afghanistan is in danger, with women at risk of being targeted, isolated, discriminated against, and punished.7

Healthcare professionals fear that the situation will be much worse for the next generation. The disruption of women’s and girls’ education and training, coupled with the threats to their lives, will result in a long term shortage of female healthcare staff in Afghanistan.

Afghan girls and women are losing their fundamental rights, and no solution seems to be in sight.8 The exclusion of Afghan women from policy making will further silence their voices when determining national and international health priorities, and will lead to the collapse of women’s support platforms.

It was inevitable that women would be marginalised under the Taliban. The previous government failed to achieve gender equality and representation of women in policy making. Now it is even less probable that women’s skills and viewpoints will be adequately represented in government decision making and public health policy, including women’s health. During the past quarter century, healthcare for women in Afghanistan has been limited by instability and violence, as well as poverty, tradition, shortage of health facilities, and lack of knowledge. Half of Afghanistan’s population lives below the poverty line, and this will be perpetuated now that Afghan women lack the right to education.9

Afghanistan is facing a global humanitarian crisis caused by the collapse of its economy. The World Food Programme estimates that more than 19.9 million people are at risk of acute food insecurity.10

The Taliban must act to avoid a catastrophe. It could start by allowing women to return to work and education. It must respect the human rights of vulnerable groups by withdrawing oppressive tactics that have exacerbated this humanitarian crisis. The result will be improved relations with the international community and the end of foreign aid sanctions.11 Governments, the United Nations, the World Bank, and the Taliban must agree to pay essential workers and food security programmes. Until such an agreement is reached, the United Nations and philanthropic organisations must continue to send humanitarian aid to Afghanistan, and the Taliban must allow shipment without interference.2 Afghans, who have endured for so long, will then be able to rebuild their country and live with the dignity they deserve.