Health Crisis in Afghanistan

The worsening health crisis in Afghanistan can be attributed to a combination of factors including economic, political, and social challenges. All these factors contribute to the high healthcare costs that make even basic medical care difficult to access and costly. These burdens can be seen directly through medical expenses and indirectly through financial burdens like transportation and finding places to stay near a clinic or hospital. This is illustrated by interviews done by the Medecins Sans Frontier (MSF) in which 87.5% of people interviewed reported that their main healthcare barrier was cost-related. The consequence of this is that 88% of interviewees reported delaying or not seeking medical care at all due to this. The economic challenges have been brought on by the political changes that occurred in August 2021, along with the decrease in foreign assistance. This also causes many skilled workers, including medical personnel, to leave the country, further straining the system. 

Due to the new Taliban regime, there has also been a shortage of female healthcare workers, a situation which continues to get worse due to the ban on women working and acquiring higher education. This not only limits the number of available healthcare workers but also brings to light the challenge of gender inequality. When examining women’s health issues, we see that Afghanistan has one of the highest maternal mortality rates in the world. The combination of poverty, inadequate access to healthcare, and gender inequality causes the country to be recognized as one of the most dangerous places for women and mothers, as highlighted by the United Nations Population Fund (UNFPA). This issue can be analyzed through multiple key concepts, however, this speech will focus on power, human rights and development.

From the perspective of power, we see that the instability of the country contributes to the healthcare crisis. One of the main power struggles in Afghanistan is related to the Taliban's control over the government. This impacts health infrastructures in the regions because Islamic law influences healthcare policies. The Taliban hold the extreme view that illness is a test or punishment. The influence of this belief on healthcare can be seen when looking at women's access to healthcare and vaccination programs. International organizations that try to offer health programs often face challenges in engaging with the Taliban-led government, affecting the delivery of aid and support for health initiatives. On top of this, there is a lack of security brought on by the Taliban government as they establish their power. This creates obstacles to healthcare delivery as well. Insecure regions make it difficult for health workers to operate, leading to disruptions in essential health services. 

There is also the use of soft power brought on through international influences. The country is being influenced by multiple foreign powers, each wanting to defend their interests. While they do donate money to help Afghanistan fight the health crisis, the money is often used as a potential tool for exerting influence over the government. Additionally, in response to some of the Taliban policies and practices, many countries and international organizations have reduced or stopped sending aid to Afghanistan all together.  The international community's commitment to Afghanistan has declined, with support for long-term economic growth almost ending and the suspension of much of their development assistance. While some humanitarian assistance continues, the U.N.'s request for aid to Afghanistan is less than 30% funded, leading to a "gigantic shortfall" in the amount of aid available for the Afghan people.  This has had a direct and disastrous impact on the healthcare system in the country.

Finally, focusing on women, there is a fight for power dynamics within Afghan society. Afghanis have very strong conservative cultural norms that restrict women's power. In some areas under Sharia Law, as imposed by the Taliban, men hold all the power and can control women. This leads to a reduction in opportunities for women and restricts avenues for female advancement. An example of this can be seen in the 2022 ban on women undertaking higher education or working for international or national non-governmental organizations. Both of these policies have a direct impact on the presence of women in the healthcare system.

Secondly, when looking at the health crisis from a development standpoint, it is important to remember the multiple aspects of development. When looking at the country's development from an economic standpoint, according to the latest UN report Afghanistan remains a less economically developed country (LEDC). According to the NGO, Human Rights Watch, this economic instability contributes to the health crisis as limited financial resources limit the government's ability to provide the population with suitable infrastructure, supplies and jobs. Additionally, the economy crashed due to a combination of factors such as: millions of dollars in lost income from donor countries, spiking prices, and the collapse of the country’s banking sector. This adds to the health crisis. As the Save the Children’s Country Director said “Children are starving to death because their parents can’t afford to pay for food”. When a family is struggling to feed their child, the last thing they want to do is spend what little money they do have on healthcare. When looking at it from a marxist lens, we see that  Afghanistan's history of foreign intervention and imperialism have shaped the country both politically and economically. The constant exploitation of Afghanistan's resources has contributed to the economic problems which hinder the development of crucial services, such as healthcare. 

When looking at the country's development from the perspective of human development, we see that this also contributes to the healthcare crisis due to the unequal distribution of wealth and gender inequality. Once again, when looking at the problem from a marxist lene, we see that Afghanistan's economy has an unequal distribution of wealth. This means that the gap between rich and poor continues to grow. This contributes to the healthcare crisis as the unequal access to money, education and employment will impact the working class’ ability to find and afford adequate medical care.

Finally, when looking into this topic from the perspective of human rights, we see that it violates many articles of the Declaration on the Elimination of Violence against Women. This document states that women should have: the right to equality, the right to liberty and security of person, the right to the highest standard attainable of physical and mental health, the right to just and favorable conditions of work… The document also states that these rights are universal and should therefore not be restricted due to a women's race, sexual orientation or socioeconomic status. Many of these articles are violated due to the Taliban's control of the government and their extreme views on healthcare and on women, both of which have a direct impact on the healthcare system. In addition, the Taliban has an ambiguous stance on womens’ roles in the healthcare system and still requires women to travel with a mahram (or chaperone). The population in general has difficulties accessing medical care, and this struggle is exacerbated for women. Many women can't even access polio immunisations, something considered a basic health necessity.

 From a feminist theory perspective, we see that this lack of human rights could be catastrophic, as they take a woman's bodily autonomy away by limiting her ability to seek healthcare and have the final say over her body. On top of this, from a universalist perspective, this is very problematic as human rights should be applied to everyone, no matter which country they are in, their financial situation or their religion. In addition to the Taliba’s negative impact on the healthcare system, there is also the issue of the drastic reduction in international aid, mentioned previously, which played a crucial role in supporting healthcare in the past.

In conclusion, the health crisis in Afghanistan is caused by a variety of factors such as high healthcare costs, the economic collapse of the country, and the loss of international aid, all of which are worsened by the policy changes and extreme beliefs of the Taliban. The Taliban's restrictive policies limit the number of healthcare workers by taking women out of the labor market, creating shortages in staffing and qualified health providers. This is then worsened by gender inequality. Analysing this crisis through power, development, and human rights lenses shows the complex dynamic, emphasising the need for a multifaceted solution.