Afghan Women are Essential to Humanitarian NGO Work

Co-authored by Arash Nemat, M.D.

Feb. 27, 2023

Originally published in the Lancet Global Health Journal

In a joint statement, officials across the UN agencies have criticised Afghanistan’s Taliban-led government for its prohibition on women attending work at non-governmental organisations (NGOs). The ban, which was announced on Dec 24, 2022, has sparked significant concern. According to the UN, the ban will disproportionately affect services aimed at women and girls in the general population, since many NGOs that employ women offer important services such as health care, support for survivors of violence, and education. The UN and other aid officials have urged the Taliban to reverse the ban and to collaborate with NGOs to resolve any concerns or challenges.

The restriction came shortly after the Taliban also banned women from attending universities in the country, making Afghanistan the only country in the world where women are denied education. There is no justification for this severe action that excludes the majority of the Afghan population from education, which is a fundamental human right. This exclusion is particularly troubling given that education can have indirect positive effects on many important issues, such as poverty reduction, public health, and economic growth. The international community must denounce this injustice and defend Afghan women’s and girls’ rights to access education.

Of the 8000 people employed by the International Rescue Committee in Afghanistan, over 3000 are women. Due to the recent ban, and for the first time since 1988, the committee has suspended its work in Afghanistan because it cannot deliver its services without female staff. Médecins Sans Frontières (MSF) has been similarly affected and has condemned the Taliban’s decision. Over 90% of MSF medical staff at the maternity hospital in Khost province are women, and they assist with the delivery of 1800 babies every month. If the restriction is fully enforced, more women would be confronted with severe—and perhaps insurmountable—hurdles to antenatal, labour, and postnatal care. If women are prevented from working in health-care facilities, and if women can only be treated by women, it will be virtually impossible for them to access health care. As a result, no health-care provider will be able to deliver equitable medical services in Afghanistan.

Women have made substantial contributions to the health-care sector in Afghanistan. The Afghanistan Midwives Association, which was established in 2002, is one notable example. The association has worked to enhance the quality of maternity and newborn care in Afghanistan by educating and supporting midwives, who are frequently the sole source of health care for women and children in remote areas of the country. The organisation has also advocated for the rights of midwives and the importance of their role in the health-care system.

Women have always contributed to Afghanistan’s health and economic development. Excluding them will mean economic adversity and rising unemployment. In a country that is confronted with rampant poverty fuelled by increasing unemployment and is at least partly dependent on humanitarian aid for survival, female workers are crucial in providing humanitarian assistance and health-care services.

The absence of women working in health care could lead to a decline in the quality and accessibility of health-care services. It could also perpetuate gender inequality and hinder progress towards achieving gender-responsive and inclusive health-care systems. Virtual education is being offered by international universities and other institutions, which can help to partly fill the education gap. However, this solution is limited in scope and can only be offered to those who have access to an electronic device and reliable network coverage. It is therefore essential to ensure that women are able to fully participate and contribute to the health-care sector in Afghanistan. We call on universities around the world to join forces and provide teaching and training resources to Afghan universities and to female students who want to complete their nursing, midwifery, or medical education.

Within such an oppressive and restrictive environment, Afghan women are likely to experience increased trauma and negative mental health consequences from being excluded from key social activities and personal development opportunities. As a consequence and in anticipation, the national health system (with international support) needs to be ready to ensure women, adolescents, and girls have access to sufficient and quality mental health resources. The international community must stand in solidarity with Afghan women and work to create a more equitable and just society where they can thrive.

We declare no competing interests.

Arash Nemat, M.D. is a cardiologist and research specialist at Karolinska Institutet in Stockholm, Sweden.