Afghan Women Can’t Become Doctors and Male Doctors Are Told Not To Treat Them

A pregnant woman in much of Afghanistan is now caught in a trap of the Taliban’s making. Women are barred from training as doctors, nurses and midwives, so the female clinicians she is expected to see are vanishing. And in a growing number of places, a male doctor can be ordered not to treat her unless a male relative stands at her side.Two women ran into that wall in Parwan Province on August 8, when Taliban morality police turned them away from a health facility because no male guardian was with them, the United Nations Assistance Mission in Afghanistan said in its quarterly human rights update, released October 15. The same report logged at least 443 arbitrary arrests and detentions by the morality police over three months.Ten days earlier, the International Criminal Court unsealed arrest warrants for four senior Taliban leaders, including the supreme leader, Haibatullah Akhundzada, on charges of gender persecution.Outside the cities, the consequences show up in the delivery room.“For a woman in rural Afghanistan, the absence of a female midwife or doctor can literally mean the difference between life and death,” the executive director of LEARN Afghan, Pashtana Durrani, whose nonprofit educates Afghan girls, tells The New York Sun.“Imagine being in labor, experiencing complications, and having no trained female healthcare worker available. The nearest hospital might be hours away, transportation is expensive, and you may need a male guardian to accompany you.”If women can no longer become doctors, and a woman cannot always be seen by a man, who is left to deliver her baby? Increasingly, the answer is no one.The Last Door Closes on Women’s Medical TrainingWomen lost their last route into medicine in December 2024, when Mr. Akhundzada ordered them out of nursing and midwifery institutes, according to Human Rights Watch. Health ministry sources said about 35,000 women were enrolled at the time. The order followed three years of tightening rules. Girls were kept out of secondary school in 2021, and in 2022 women were barred from universities and from most jobs with aid groups, apart from health care.A vice and virtue law passed in 2024 put new limits on how they could travel.The ban hit a system already short-staffed. A UNICEF analysis released in April warns that Afghanistan could lose up to 5,400 female health workers by 2030.Those still on the job are wearing out, according to a grassroots network of young Afghan women.“To be frank, in my view, the signs of this surge are already visible today — no woman has graduated in midwifery or entered the workforce in Afghanistan for five years,” a member of the board of directors of the Lamarbano Foundation, Adeleh Zamani, tells the Sun in comments translated from Dari. Lamarbano is an NGO aimed at supporting women in Afghanistan.“The women who previously worked in this field are now facing severe professional burnout; some have left the country, and every maternity hospital and healthcare center across Afghanistan is calling out for trained midwives,” Ms. Zamani says.The losses compound because nobody replaces them.“Every year we lose midwives and nurses to retirement, aging, and people leaving because conditions have become too difficult,” an assistant research professor in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health, Shatha Elnakib, tells the Sun. “Those losses are no longer being replaced so that the workforce will shrink a little more every year.”For an Afghan girl, the math is unforgiving. A 12-year-old today cannot finish school or train as a midwife. By the time she has children, many of the women trained to deliver them will be gone.Male Doctors Told to Hold Back as Female Doctors VanishPublic health researchers noted last year that men cannot legally serve as midwives. In a report covering January through March, the United Nations mission said morality police in Uruzgan, Paktia and Kandahar told health facilities not to treat women arriving without a male guardian. Female health workers were told to travel with one.Afghanistan International reported in September that, according to local accounts, Helmand, Zabul and Uruzgan provinces have no female specialists and Kandahar has three.Men cannot simply step in, experts warn.“No. There will be some substitution, but nowhere near full substitution,” Ms. Elnakib says. “Some nursing roles can be partly filled by men, but midwifery in Afghanistan is an entirely female profession. If we stop training midwives, the profession will eventually disappear.”There are not enough men to begin with. The World Health Organization reports about 10 health workers per 10,000 Afghans. It says a country needs 44 for basic universal coverage.“Male doctors cannot realistically fill the gap. First, there are already far too few male doctors in Afghanistan. Second, persistent social and security barriers will hamper women’s access to male doctors,” the executive director of Physicians for Human Rights, Sam Zarifi, tells the Sun.Even where the rules might bend, the idea of men stepping in to deliver babies runs into custom.“It’s not a reasonable solution in this context. How can males be OBs? How can they deliver a baby? How can they touch a woman and examine her?” an epidemiologist-biostatistician at Johns Hopkins University, Nadia Askeer, tells the Sun. “It’s impossible in the Afghan tradition, especially in rural areas.”What the Projections Say About the CostUN Women has warned that the education restrictions could raise maternal mortality by at least 50 percent. A modeling study published in August by Johns Hopkins researchers put the rise at 29 to 41 percent. It projected 3,215 to 4,509 additional maternal deaths and 7,438 to 10,864 additional newborn deaths through 2035.The worst of those warnings may not be far off.“It is very realistic,” Ms. Askeer says of the 50 percent projection. “The ban on women’s medical education means no new female health providers will be trained and deployed, there is an ongoing shortage of existing female health workers, and those who do work have severe restrictions on mobility and freedom.”Many of those still working have gone months on reduced pay or none at all, she notes. “I would give it a matter of one to two years before we start seeing extreme deaths during childbirth,” Ms. Askeer says.Put plainly, fewer women are allowed to deliver babies, fewer families can reach the ones still working, and more mothers and newborns die in the gap.Conditions are not much better in the capital. When a doctor delivered a neighbor’s baby at home in Kabul recently, the mother’s first question was whether it was a boy or a girl. It was a boy, and he soon turned dark blue.The doctor with the family for three hours as he worsened. A nearby hospital told her it could do nothing for him, and no one else would take him. She finally found an oxygen cylinder through a neighbor and rode with him to what she calls the French hospital, where staff found a problem with his esophagus and operated. He died the day he was born.“Now, what difference does it make if it was a boy or a girl? Neither boys nor girls, nor mothers, have access to health care during pregnancy and childbirth,” a doctor formerly at Sardar Daud Khan hospital who now trains with Lamarbano, Jamila, tells the Sun in comments translated from Dari, withholding some details for safety. “For God’s sake, this is Kabul. I am not even sharing what is happening in the provinces.”Farther out, it is worse.“It may mean that she gives birth at home, alone or with female family members, but without skilled personnel to monitor her condition and her baby’s, without essential medicines to prevent bleeding after birth, or equipment to help a baby that struggles to breathe,” an associate in the same Johns Hopkins department, Hannah Tappis, tells the Sun.Ms. Zamani tells of a 23-year-old bride from a remote village in Ghor Province who developed gestational diabetes during her first pregnancy. The condition is usually treatable when caught early. But the young woman, Sima, had no routine prenatal care, and her blood sugar went untreated.She gave birth at home without a trained midwife or access to emergency obstetric care, and both she and her newborn died.“Sima could have been alive today. She could have become a mother, held her baby in her arms, and continued building her family,” Ms. Zamani says.Ms. Elnakib sees one quick fix.“In the meantime, there’s an untapped resource: the many trained midwives who are currently unemployed. Bringing them back into the workforce, with refresher or bridging training for those who haven’t practiced in a while, would make an immediate difference,” she says.If nothing changes, Afghanistan risks sliding back toward where it started.The country recorded 1,346 maternal deaths per 100,000 live births in 2000, under the Taliban’s first rule, and roughly half that by 2020, according to earlier United Nations estimates. The latest puts it at 521 for 2023. UNICEF has warned, according to Afghanistan International, that the loss of female doctors and midwives could add 1,600 maternal deaths and more than 3,500 infant deaths.Lamarbano plans to train young midwives online, then arrange clinical experience inside Afghanistan. Ms. Durrani, however, doubts small Afghan groups can carry that load alone.“The international community cannot claim to be addressing Afghanistan’s maternal health crisis while accepting the systematic exclusion of girls from the education required to become its future doctors and midwives,” she says.

Afghan Women Can’t Become Doctors and Male Doctors Are Told Not To Treat Them

Afghan Women Can’t Become Doctors and Male Doctors Are Told Not To Treat Them

More from the New York Sun

Dublin Sets Planning for United Ireland in Motion on an Island Haunted by the ‘Troubles’

Albania’s Capital Burns Over a Kushner Resort as Prime Minister Rama Blames a ‘Hybrid War’

Syria Shuts Women Out of Military Colleges and Paints Headscarves Into Schoolbooks

Why Putin Has So Much Room To Maneuver in War Against Ukraine

Italian Courts Undermine Giorgia Meloni’s Efforts To Uphold Law and Order Amid Spate of Riots

Congo’s Former President, Sentenced to Death for Backing Rebels, Now Leads Them Toward Key Border City

Personalized Cancer Vaccine Cuts Melanoma Relapse Risk by 42 Percent in Landmark Trial

As Breeders’ Cup Crowns Its Champions, Repole Challenges Horse Racing’s Establishment

More from the New York Sun

Dublin Sets Planning for United Ireland in Motion on an Island Haunted by the ‘Troubles’

Albania’s Capital Burns Over a Kushner Resort as Prime Minister Rama Blames a ‘Hybrid War’

Syria Shuts Women Out of Military Colleges and Paints Headscarves Into Schoolbooks

Why Putin Has So Much Room To Maneuver in War Against Ukraine

Italian Courts Undermine Giorgia Meloni’s Efforts To Uphold Law and Order Amid Spate of Riots

Congo’s Former President, Sentenced to Death for Backing Rebels, Now Leads Them Toward Key Border City

Personalized Cancer Vaccine Cuts Melanoma Relapse Risk by 42 Percent in Landmark Trial

As Breeders’ Cup Crowns Its Champions, Repole Challenges Horse Racing’s Establishment