BAMYAN, Afghanistan—On a note tacked to the wall of a health clinic in December 2021, in the now Taliban-controlled district of Kahmard, there was a new directive: “From now on,” it read, “no women can come to health centers without a mahram.”
A mahram is a male chaperone.
Restrictions like these are showing up all over the country. In the southern province of Ghazni, a 42-year-old midwife said the Taliban have been preventing doctors from examining women without a mahram present since November 2021. (We are not identifying Afghans who spoke to us by name to protect their safety.)
“When the Taliban understood the two women were not accompanied by men, they forced them out of the clinic and beat them with the butts of their rifles,” she said, citing a recent example. They had brought a sick infant in for a checkup.
The new requirements—officially announced by the Taliban’s ministry of virtue and vice in late December—are preventing many Afghan women from seeking the health care they need at a time when COVID-19’s omicron variant is spiking across the country. At the end of January, Afghan health officials reported a 70 percent increase in positive COVID-19 cases, with positivity rates reaching upward of 47 percent. (The World Health Organization said any positivity rate above 5 percent is dangerous.)
Accessing COVID-19 vaccines, testing, and treatment was already difficult in Afghanistan. The country’s health care system depended almost entirely on foreign aid for almost two decades. But when the United States abruptly withdrew in August and the Taliban reclaimed power, that aid dried up. As a result, almost all of the programs designed to fight the coronavirus in Afghanistan have been forced to shut down.
On top of that, the United States froze Afghanistan’s central bank assets, plunging the country into a severe economic crisis. Around 90 percent of Afghans are now living below the poverty line, and many families are unable to afford food—compounding the health care crisis.
Despite hundreds of millions of dollars spent on developing Afghanistan’s health care system over the last 20 years, access to quality health care remains far below international standards. Those standards are particularly low for women, according to a report by Human Rights Watch.
“Women and girls struggle to access even the most basic information about health and family planning,” the report said. “There is an unmet need for modern forms of contraception; prenatal and postnatal care is often unavailable; specialty care, such as modern cancer and fertility treatment, is largely nonexistent; routine preventative care such as pap smears and mammograms are almost unheard of; and a large proportion of births are still unattended by a professional.”
None of this, however, has distracted Taliban leaders from pursuing the kinds of gender apartheid policies that made them famous when they first ruled Afghanistan between 1996 and 2001. During that period, the Taliban issued edicts and decrees that banned women from work and education, denied them access to health care, and severely restricted their social mobility.
On Aug. 17, 2021, in the group’s first press conference after the Taliban retook power, Taliban spokesperson Zabihullah Mujahid reassured the world that the group would respect women’s rights within “the framework of Islam” this time.
But the promise of a changed Taliban faded quickly. A week later, the same spokesperson urged women to “stay home” because fighters hadn’t been trained to respect them. Since then, the Taliban have tightened their restrictions on women with every passing day.
“Measures like requiring a mahram to escort women to health appointments or banning them from seeing male health care providers have a major impact on women’s ability to access care,” said Heather Barr, associate women’s rights director at Human Rights Watch. “Access to health care is one area where the Taliban have always claimed that they are committed to protecting women’s rights. But we see that their policies are still cutting many women off from urgent and sometimes life-saving care.”
In early February, at a health clinic in Afghanistan’s southeastern Ghazni province—the first province to ban women’s access to health care without a male chaperone—a local doctor said a pregnant woman in labor arrived on her own. After giving birth, fearing she’d be punished for not being married, she fled without her child.
Three days later, after local Taliban officials found out, they detained the midwife who delivered the baby, along with her husband, and are now moving to prosecute all 18 employees of the clinic, according to several health care workers connected to the clinic. The charge? Violating the order not to provide health care to women without a male chaperone.
Taliban officials in Kabul, for their part, deny these stories are true. “I don’t confirm it. Such a thing has not happened,” a spokesperson for the Taliban’s ministry of virtue and vice said.
The evidence, however, is overwhelming. Five months into the Taliban’s new rule, a group of United Nations human rights experts warned that the “Taliban leaders in Afghanistan are institutionalizing large-scale and systematic, gender-based discrimination and violence against women and girls.”
A health care professional who works in the city of Ghazni, southwest of Kabul, said Taliban leadership lacks coordination between departments and regions and each jurisdiction seems to be operating its own set of restrictions.
In one way, however, the professional said the Taliban were consistent everywhere: “All their animosity is with women. Almost all their restrictions target women,” the professional said in a phone interview.
Shakiba Hakimi and Laila Yousufy contributed reporting from Afghanistan for Rukhshana Media.