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Afghanistan: Gender Taboos Keep Women From Seeking Medical Care

Despite the collapse of the Taliban regime more than two years ago, Afghan men continue to prevent women from receiving care at hospitals with male staff -- even when the lives of the women are in danger. Afghan militiamen serving with the U.S.-led antiterrorism coalition even prevent mothers from visiting children hospitalized at the most sophisticated emergency medical center in the country -- the U.S.-run Combat Support Hospital at the coalition's Bagram Air Base.

Bagram, Afghanistan; 3 March 2004 (RFE/RL) -- Even in life-or-death emergencies, Afghan taboos against women mixing with male strangers are apparent.

That's according to medical staff at Afghanistan's most sophisticated trauma and surgical-care unit -- the U.S.-run Combat Support Hospital at the Bagram Air Base north of Kabul. The 140 doctors and nurses at the hospital, located inside a ventilated U.S. Army tent, have treated about 6,000 seriously injured people since being deployed to Afghanistan last June.

Their patients include U.S. and allied Afghan militiamen as well as civilians who are in danger of losing their lives or limbs. But the chief nurse at the hospital, Colonel Judy Tracy, says Afghan men only rarely bring female relatives to the high-tech facility for treatment. "We don't have very many of the women patients come to us, and the ones that do are mainly mine victims unless they are a case with an explosion in the whole house where a whole bunch of people are injured," she said. "We haven't had [many women as] individuals come in."

"I went out to the front gate and spoke with the guards out there and said, 'You know, it's very important for these mothers to visit their children.'"
One of the rare exceptions was a young woman from Jalalabad who was recently brought to the facility by Afghan officials who suspect she tried to commit suicide by lighting herself on fire. Yesterday, the woman lay unconscious in an intensive care unit after surgery for burns on her hands, arms, and chest. Female U.S. nurses hovered over her motionless body, trying to bring her comfort. Her face, which also showed traces of blackened skin, was frozen in an expression of pain and despair.

If the Afghan officials are correct, it is one of hundreds of instances of female self-immolation since the collapse of the Taliban regime. Many women who have survived such an ordeal say they tried to kill themselves because they felt trapped in forced marriages to husbands who beat them. The trend appears to be most widespread in Herat, but it also is noticeable to hospital staff and aid workers in other parts of the country.

The case at the U.S. Combat Support Hospital demonstrates why accurate statistics are difficult to come by. The story behind the woman's injuries remains a mystery to the Bagram staff for now. The burn victim is in no condition to speak about her ordeal, and her family refuses to provide details.

Even when the woman's condition improves, the U.S. doctors and nurses may not hear her true story. All of the Dari and Pashto translators at Bagram are men -- and the country's women often are reluctant to speak openly and honestly about their plight in the presence of Afghan men. Even outside of the Bagram base, the directors of humanitarian-aid organizations complain that they have difficulty recruiting female translators because men in their families often refuse to allow them to mix with foreign men.

Captain Michael Moyle, a public affairs officer for the U.S.-run hospital, says there is an additional stigma associated with the Bagram base because of the abuse of women there during the Soviet occupation when Russian soldiers allegedly used Afghan women as prostitutes. Captain Moyle says Afghan men still worry that women will be "corrupted" if they visit the U.S.-run air base. He admits the U.S. military has had to bribe Afghan warlords to ensure Afghan mothers could visit their children at the Bagram hospital.

Judy Tracy confirms that troops from Afghan Defense Minister Mohammad Qasim Fahim's militia -- a faction that works with the U.S.-led antiterrorism coalition and guards the outer gates of the Bagram base -- have prevented Afghan mothers from visiting their critically injured children inside.

"We have an awful lot of sick children. We've noticed that the mothers never come to visit them. And with one of the children that came into the hospital, the father came in and his wife wanted to come and visit the child. He said that she was stopped at the gate. The Afghan militia force soldiers out at the front gate, who guard the outer front gate, would not let his wife come in to visit her child," Tracy told RFE/RL.

Tracy says she was compelled to act when she realized that women were being prevented from entering the base -- even when escorted by their husbands. "I went out to the front gate and spoke with the guards out there and said, 'You know, it's very important for these mothers to visit their children.' And so we have seen a little bit of an improvement in that area," she said. "But certainly, women [still] don't get around and visit a whole lot."

Tracy says the distrust of Afghan men toward U.S. medical workers is especially apparent when the workers leave the base to try to help women elsewhere. "It's hard for women to get out of their own houses,” she said. “And when you get out into the field, you can see this. They can't do anything without the permission of their husband or brother, or things like that. [We also see this] when we do get the women in the hospital, and we see a few of them."

Tracy says she feels she has won a small victory in the occasional instances when she helps women visit their injured children. She called it one "little step" in a country where progress toward women's rights comes only in little steps.