Women’s Health in Afghanistan, Research Paper Example

Prior to the attacks on the World Trade Center of September 11, 2001, most Americans had little idea about the location or details pertaining to Afghanistan.  Clearly, this was not the case for the people involved in national security issues, as evidenced by the speed with which they were able to identify who was responsible for the attacks, (Osama bin Laden ) and from where they were launched.  Since those days, Afghanistan has remained in the headlines nationally and globally, following the American invasion of Afghanistan, the heavy price paid for that war, and the awareness of the threats posed by the existence of al Qaeda.  Recently, the escalation of the war in Afghanistan has ensured that it will be in the headlines for a very long time.

The Islamic Republic of Afghanistan has been alternately described as being in South Asia, Central Asia, Western Asia or the Middle East.  For centuries, it has been the target of a range of invaders, including Alexander the Great, Genghis Khan, and, more recently, the Soviet Union and the United States.  The country also has been in a constant state of civil war between tribal factions.  Its craggy, uneven terrain is scattered with caves and other places for people to hide, making it an extremely dangerous setting in which to be waging a war.

Afghanistan is widely considered to be a failed state; according to this definition, “(f)ailed states can no longer perform basic functions such as education, security, or governance, usually due to fractious violence or extreme poverty. Within this power vacuum, people fall victim to competing factions and crime, and sometimes the United Nations or neighboring states intervene to prevent a humanitarian disaster. However, states fail not only because of internal factors. Foreign governments can also knowingly destabilize a state by fueling ethnic warfare or supporting rebel forces, causing it to collapse” (Global Policy Forum, 2005.) By this definition, Afghanistan certainly meets the criteria for being a failed state.  This paper will discuss various aspects of Afghanistan, its political, economic, social, and cultural climate, with a particular emphasis on the country’s health structure including the mortality rate for women, and for children under the age of five..

Even before the U.S. invasion of Afghanistan in 2003, the health status of this country was among the worst in the world.  Afghanistan’s maternal mortality rate is 1800 deaths per 100,000 live births; one of its provinces is also home to the worst maternal mortality rate in history anywhere on earth, in Badakshan province, where the mortality rate is 6500 per 100,000.  This can be compared to the maternal mortality rate in the United States, which is 11 per 100,000. (Kanani, 2010.)

In other sobering statistics regarding health in Afghanistan, 600 children under the age of five die every day, mostly from preventable causes, and at least 50 women die every day from obstetric complications. (Unicef, 2006).  Some of the most reliable indicators of a nation’s overall health are based on the child mortality and infant mortality rates, so that one can draw the obvious conclusion that the infrastructure of Afghanistan’s health system is devastating.  Most children die from easily treated diseases such as diarrhea, parasitic infections, tuberculosis, respiratory infections, malaria, measles and malnutrition.  The vast majority of these illnesses could be prevented if the citizens received proper healthcare; however, there is only one health center to care for 100,000 citizens on average.  A very low percentage of women have access to obstetric care during pregnancy, and a very small percentage of children receive immunizations.  Those factors, combined with the extremely low number of doctors practicing in the country, create a disastrous lack of care for Afghan citizens.  As a result, many of them turn to healers such as midwives, herbalists, and even barbers who perform circumcisions, let blood, and pull teeth. (Health Afghanistan, Table of Contents.)

Added to the above-named problems regarding the health infrastructure, the Afghanistan war has caused deteriorating economic, social and physical status both in the country and the cities.  The result has been much damage to housing, environment and sanitation for the population.  By the end of 1996, estimates were that more than 1 ½ million men and women, as well as children, had become disabled from war injuries such as amputations, blindness and paralysis.  There were also large outbreaks of infectious diseases such as polio and leprosy.  The inadequacy of prenatal and neonatal care has resulted in chronic disabilities such as cerebral palsy and mental retardation.

Tragically, the segment of the population that are disabled continues to increase because of an estimated 10,000,000 landmines and unexploded ordnance that pervade the landscape.  These dangers cover an estimated 465 square kilometres which are direct threats to residential areas, farm lands, livestock fields, and canals that affect the water supply.

Culturally, Afghanistan is an Islamic nation in which this religion is practised by the great majority of the population, and which governs the personal, political, economic, social and legal lives of its citizens.  The Islamic religion calls for strict adherence to its principles such as praying five times a day, observing Friday as the holy day in which most businesses, including government offices, are closed, and women being covered from head to toe, was only their eyes showing.  Ramadan, the holy month of Islam, demands that all Muslims must fast from dawn to dusk and are only permitted to work six hours a day.  Foreigners are not required to fast; however, they must not eat, drink, or smoke in public.

The country is made up of a large mix of ethnicities and tribal groups, such as the Pashtuns, the Shiites, Uzbeks, and the Turkomen.  In Afghan society, the family is the major and most important group.   Gender roles are defined along traditional lines, with women usually responsible for household duties where men earn their living outside the home.  Typically, families arrange marriages for their children using factors such as status, tribal origins, wealth and contacts as the main criteria for the unions.  Families live together and when a son gets married, he and his wife conduct their married life under the same roof.

Regarding the status of women in Afghanistan, before the extremist Islamic fundamentalists, the Taliban, came to power, women were participants in the economic and political life of the society.  They were instrumental in drafting the 1964 Afghan Constitution.  During the 1970s and up until the 1990s, women participated in the Parliament as well as working in the professions as teachers, physicians, academics, lawyers, judges, writers, and poets.

After the Taliban came to power, the human rights of women and girls were systematically eliminated and they experienced discrimination on every level.  Females were limited in their ability to go to school, receive healthcare, and work.  The decrease in women’s employment also affected education for the boys because the majority of teachers had been females.  Substandard health conditions and lack of access to healthcare caused pregnancy and childbirth to become dangerous and often tragic for Afghan women.

The Taliban also severely limited women’s ability to move about freely in society; they could travel only when accompanied by a male relative, they were banned from driving cars, and the result was a sense of isolation for women which prevented them from connecting with each other.  If they disobeyed the Taliban’s strict rules for them, they risked being harassed and severely beaten or even stoned to death.  Under the Taliban rule and even prior to that, Afghan women were subject to domestic and other types of abuse, including being murdered by husbands or family members for “dishonouring” the family for such minor offenses as speaking with a member of the opposite sex.

The standard of living in Afghanistan is among the lowest in the world.  According to the CIA’s website, the World Factbook, the gross domestic product is $23.35 billion, which places it at number 113 in the world’s ranks.  The per capita income is $800, ranking number 217 in the world.  The gross national product is $6.96 billion; the GNP per capita is $222.  The main exports of Afghanistan are: opium, fruit, nuts, handwoven carpets, wool, cotton, and lambskins.  The major imports are petroleum, foodstuffs, textiles and other manufactured goods.  Because of the never-ending civil war, the amount of exports has decreased significantly except for the illegal drug trade.  The country has also increased its production of heroin due to the poppy product.

The economy of Afghanistan continues to be overwhelmingly agricultural, although its production is limited because of unpredictable snow during the winter, as well as rain during the spring.  Irrigation is primitive, and there is very little use of machinery, fertilizer or pesticides to preserve crops.  While wheat and cereal were formerly the major viable crops in Afghanistan, overall production declined when there was a drought that lasted for over four years; in addition, the constant struggling and fighting in rural areas prevented a successful crop growth.

Many Afghani citizens have taken advantage of the successful drug trade in order to put money into forming small businesses.  Despite the fact that the drug trade is illegal, many farmers are willing to take the risks of dealing with criminals in order to be financially successful, and have been unwilling to resume growing wheat and cereal.

Other Afghani citizens are involved in fishing, raising livestock, engaging in forestry, and providing services such as banking and opening stores.  Recently, it was speculated that Afghanistan may possess large areas of natural gas, petroleum, and large mineral deposits that may total more than one trillion dollars.  These assets could potentially provide the revenue that the country needs in order to modernize the infrastructure and provide a solid footing for the Afghan economy.  Still, the unemployment rate is 40% and 36% of the citizens live below the poverty limit.  Afghanistan’s external debt is $2.7 billion.

Regarding the Afghani citizens’ access to food and clean water, because of the decades of warfare and invasions, many Afghanis are in danger of starvation and illness resulting from a lack of food and clean water.  Even prior to the current war, the country faced severe food shortages.  Most recently, the food crisis has increased because of a shortage of international food assistance.  This has resulted from the intensified war and U.S. airstrikes, which have caused thousands of Afghani citizens to escape to the countryside, disrupting the trucking routes used to supply millions of civilians with food aid.  Often, humanitarian agencies are not permitted to deliver aid that would avert starvation.

The United States has failed to draw a distinction between military and humanitarian motives, so that the relief operations are sabotaged, leaving the Afghanis vulnerable to starvation.  The United States has waged bombing campaigns in areas that are heavily populated, forcing the citizenry to leave their homes and settle in refugee camps where they are dependent on food deliveries.  Airstrikes have destroyed warehouses and food deliveries so that the war zone is unable to receive supplies.  In addition, the Taliban have prevented food deliveries frequently.  Other forces have also looted supplies by taking over the highways and making them impossible to use for food delivery.  Foreign forces are not willing to put their own soldiers at-risk by traveling on these hazardous roads, even though their mission—to deliver food and clean water—is essential to the survival of the Afghanis.

The politics of Afghanistan has had a long history of power struggles, violent struggles for control, and it has been led by many different forms of rule over the past centuries: a monarchy, a theocracy, a republic, and a communist state.  In 2003, the country was structured to be a republic consisting of three branches of government, such as that in the United States: the executive, the legislative and the judicial arenas.  The president is Hamid Karzai, who has been in charge since December, 2001.  The most recent election, held in 2009, was characterized by corruption and electoral fraud and was followed by a period of tremendous unrest, protest, and a feeling of illegitimacy that still hangs over the Karzai administration today.

The U.S.-led invasion of Afghanistan was designed to capture Osama bin Laden and to destroy the terrorist training camps that allowed al Qaeda to have a home base in that country.  The invasion was significantly understaffed, never captured bin Laden and completely diluted the resources invested in that struggle by diverting considerable resources to fight in Iraq. That mission proved to be a disaster both militarily, diplomatically and in terms of winning over the Afghani people, as well as antagonizing the American public once it was discovered that the war had been undertaken based on false information and outright lies.

Regarding foreign aid, Probe International has found that there is evidence to indicate that billions of dollars in foreign aid have wound up in the pockets of corrupt government officials  (Yauch, 2010).  In the same article, the Wall Street Journal reported that billions of dollars have been shipped from the Kabul Airport to overseas bank accounts.  Reportedly, the money came from the United States, Europe, and NATO allies and was supposed to be used to provide security, supplies, and reconstruction work.  The amount being stolen totals more money than the Afghanistan government collects from taxes and other official revenues.

Afghanistan has experienced three distinct eras of receiving foreign aid, beginning in the second half of the 19^th century when the British Empire offered regular funds to the emirs in order to promote cooperation from the tribal leaders.  The second period of assistance was following the Cold War, when the United States and the Soviet Union began a 30 year effort to assist Afghanistan to cope with Pakistan.  The third era began with the civil war in Afghanistan in 1979 and lasted through the fall of the Taliban rulers in 2001 (Bossin, 2003.)  There are many reasons why the attempts at foreign aid have failed in Afghanistan, including a weak political system, a complete lack of statistical records, and a lack of popular support.  All of these factors combined to cause failure in Afghanistan’s ability to form and sustain a viable, prosperous and peaceful nation and a government supported by its people.

Analysis

Given this overview of Afghanistan, including its social, political, economic, and cultural environment, it seems inevitable that health issues such as maternal mortality rates and deaths of children under the age of five would be occurring at completely unacceptable as well as intolerable rates.  The country is extremely poor, and has been completely disrupted by foreign invasions as well as civil war for decades.  The terrain of the country, the very few medical providers available, and the poverty of its people are combined with basic mores that do not value the lives of women, resulting in such horrendous statistics.  In order to affect significant change in this area, there needs to be an educational component that teaches women and the men who love them about the importance of their receiving adequate healthcare.  In this society, the women are the cornerstone of each family, and the loss of the women would ensure that the family’s basic needs and its opportunities to succeed would be significantly compromised.  The women themselves need to be empowered and allowed to congregate with other women so that they could form connections that would allow them to realize that their health is a priority both for themselves and for their families and children.  It would be helpful if foreign aid workers became familiar sights in the communities and could be seen visiting women and helping them learn about and obtain medical care that they need.  It is unclear whether or not this strategy would be in keeping with the popular beliefs of the society because women tend to be devalued and the fact that so many are lost to preventable causes might not be as much of a priority as it is to people in other countries who are looking inward at Afghanistan.  Certainly, the Western providers of foreign assistance, as well as other men and women around the world, look at this situation with horror and a sincere desire to make changes.

In particular, the United States has an obligation to follow through in the efforts to improve the health and well-being of Afghan women as well as their families, because the U.S. invasion of Afghanistan has contributed significantly to the dire situation that the country finds itself in.  There is a moral obligation to rebuild the country that has been destroyed, and to try to help its citizens have a life not only better than they had prior to the war, but that they have ever had.  The centuries of strife have left Afghanistan in a particularly devastated circumstance, and it is the moral responsibility of those who have contributed to their sorry situation to see that the country is given a chance to rebound.

References

Afghanistan Debt–External. (2010, February 19). Retrieved July 19, 2010, from Index mundi: http://www.indexmundi.com/afghanistan/debt_external.html

Afghanistan: The right to food in conflict. (n.d.). Retrieved July 19, 2010, from Center for Economic and Social Rights: http://www.cesr.org/article.php?id=293

Bossin, Y. (2003, October 4). The Afghan experience with foreign assistance: lessons for the donors. Retrieved July 19, 2010, from Allacademic Research: http://www.allacademic.com//meta/p_mla_apa_research_citation/0/7/4/0/9/pages74092/p74092-2.php

Global policy forum. (2005). Retrieved July 18, 2010, from Failed States. http://globalpolicy.org/nations-a-states/failed-states.html

Kanani, R. (2010, July 17). Islam and maternal mortality in Afghanistan: a religious and cultural approach to saving lives.  Retrieved July 18, 2010, from the Huffington Post: http://www.huffingtonpost.com/rahim-kanani/islam-and-maternal-mortal_b_618826.html

South Asia: Afghanistan. (2010, June 24). Retrieved July 19, 2010, from CIA: The World Factbook: https://www.cia.gov/library/publications/the-world-factbook/geos/af.html

The World Bank. (n.d.). Afghanistan: data, projects, and research. Retrieved July 18, 2010, from Afghanistan: http://web.worldbank.org/Wbsite/External/Countries/Southasiaext/Afghanistanextn/0,,menuPK:305990~pagePK:141159~piPK:141110~theSitePK:305985,00.html

Ugly truth about foreign aid in Afghanistan. (2009, May 12). Retrieved July 19, 2010, from Global research: http://www.globalresearch.ca/index.php?context=va&aid=13578

UNICEF. (2006, January 30).  Unite for children.  Retrieved July 18, 2010, from: As leaders      prepare to agree to the Afghan compact, UNICEF urges women and children first.  http://www.unicef.org/media/media_30842.htlm

U.S. Library of Congress, Health, Afghanistan table of contents (Health, Afghanistan)  Retrieved July 18, 2010 from http://countrystudies.us/afghanistan/79.htm