In few countries do women face as many challenges as they do in Afghanistan—a country which not only holds the record for the worst place to be a mother, according to Save the Children's “State of the World's Mothers Report 2010,” but is also home to the fundamentalist Taliban, one of the world's most repressive anti-women's rights regimes.
Afghan culture places many restrictions on the medical treatment of women by male providers. Additionally, women fear the repercussions that come with breaking the Taliban's extremist version of Islamic law. Women are not allowed to hold jobs, touch or medically treat a man. They're not allowed to leave their homes without the escort of a man under the extremist laws of the Taliban regime.
However, there is a glimmer of hope. In southern Afghanistan, one woman is making a difference not only for herself but for the health of the people of her country by providing medical treatment to the sick. As a medical assistant, she treats men, women, and children in a clinic in a region where the Taliban hold much influence. Her name is not mentioned for her protection.
“No one knows I work here,” she says with her face and hair hidden behind a burkha. “I haven't told anyone what I do.”
Working in an Afghan National Security Forces (ANSF) clinic, she provides medical treatment for civilians and both male and female ANSF personnel, as well as their families—many of whom won't attend clinics in other parts of the city fearing they or the clinics themselves become targets.
“This was the first clinic that we have seen in this region where the clinic commander trained a female assistant to help treat the women,” said Capt. Janice McDowell, NATO Training Mission-Afghanistan medical advisor. “This has helped break down some of the barriers to women receiving medical care. As such, it will be easier for the other clinics to be willing to have female assistants.”
The Afghan woman's husband and four brothers died during a suicide attack a block from the clinic; leaving her alone with five children. Afterwards, a doctor at the clinic hired her and taught her basic medical care. Six months later, she has treated men, women and children. There aren't any other women working at the clinic and even though she is not formally trained, her work saves lives.
“The doctor taught me everything I know. We try to do all we can with the medicine we have. Women become very happy when they see me. They want to be treated by a woman,” she said. “A woman came in once who had given birth through a C-section. The stitches had not been removed and the wound needed to be disinfected.”
She removed the stitches and disinfected her wounds. Her actions and maybe even her presence kept the patient from degrading in condition and becoming an Afghan statistic; one in eight women die from childbirth-related causes.
“If a woman doesn't feel comfortable, she more than likely will not seek the medical care that she needs,” said McDowell. “This barrier has led to the unnecessary deaths of many Afghan women and children from diseases that could have been treated or even prevented. Without a female assistant, the clinic would not be able to fully meet the needs of its employees and their families.”
Coalition members and nongovernmental agencies have provided clinics to care for women in the past. However, these have been temporary solutions; Afghans need to provide medical care for women through Afghan channels with respect to local culture and stigma.
“Although this is one female assistant at one clinic, it is a tremendous step in the right direction for both women and children. It is a tremendous step in the right direction for the future of Afghanistan,” said McDowell. “She's also is a role model to other Afghan women.”
With the addition of female personnel to the ANSF, the disparity between medical care for men and women is an issue that has come to the forefront. NATO Training Mission-Afghanistan has trained mentors like McDowell to help their Afghan mentees find solutions that will be self-sustaining; including solutions that will ensure appropriate medical care for all ANSF, male or female, and their families.