In poverty-stricken areas of easter Afghanistan, girls are too often the ones at risk. Photo: Tony Karumba/AFP/Getty Images
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Being a gynaecologist in Afghanistan is one of the most dangerous jobs in the world

A doctor in Afghanistan is using her medical training to provide healthcare and other support to women – at great risk to herself and her family.

 “When I started working, I would not help people when they came to me for an abortion. I would say no,” says Dr Lima, an Afghan gynaecologist who embarked upon the dangerous trade of offering desperate women secret access to contraception and abortion. Her decision was prompted by the sheer scale of suffering and violence against women she witnessed.

Her initial refusal was a predictable reaction in a country where abortions are illegal in the majority of circumstances, but in 2006 Dr Lima was confronted with a case that brought home the devastating scale of the hardships faced by Afghanistan’s women. It would change her mind on the need for access to safe abortion.

“The girl was 17 years old and pregnant. After her parents found out they secretly gave her some medicine to weaken her – medicine that made it easier for them to suffocate her with a pillow and kill her. After that incident, I decided to help people like her,” Dr Lima recalls.

Dr Lima’s decision – to start using her medical training to provide healthcare and other support to women – put her own and her family’s lives in constant danger.

“Whatever I do, I do in secret. The only person who knows is my husband,” she says.

Many of the women that Dr Lima has provided abortions to had become pregnant as a result of rape. She also helped women to take contraceptives secretly when their husbands were forcing them to have more children.

She explains: “That was risky too, sometimes when women did not become pregnant for some time the husbands would ask why and may beat their wives. Then the woman would bring them to me and I would explain to the husband that because his wife had too many children without a [break], her body is now weak and it needs times to return to normal. Then the husbands would accept my [explanation] and the women could stay healthy and enjoy their lives for one or two years before they got pregnant again.”

Dr Lima’s mission took her to eastern Afghanistan, to a remote, poverty-stricken province on the border with Pakistan. It is a region where the influence of the Taliban is at its strongest, and respect for women’s rights is almost non-existent.

Girls are not given access to education, husbands routinely abuse their wives and for many families the preferred response to a girl becoming pregnant outside marriage – even by rape – is to murder her and cover it up as an illness or accident.

In some areas tribal rules dictate that if the people in the community find out that a girl is pregnant outside marriage they will kill the girl in order to “preserve honour” and if the girl’s family resist, they too will be killed. If the rapist is identified, he and the victim will both be killed publicly.

One girl in a tribal region who became pregnant as a result of being raped came to Dr Lima to ask for an abortion. The girl told Dr Lima that the pregnancy served as a constant reminder of her ordeal. She was also terrified she would be killed and her family would be torn apart by a “blood feud”.  

Another woman, a mother of six, was locked up with the livestock by her husband, who had married another woman. “When she came to me I helped her to get in touch with the Ministry of Women’s Affairs and after many months of legal arguments she finally managed to get a divorce.”

“No matter what a man does in these areas, he will get away with it,” says Dr Lima.

While working in Kunar, Dr Lima would wear a burqa to help protect her identity, but that didn’t stop the death threats from the Taliban.

“I started to receive warning letters, saying that what I was doing was un-Islamic,” Dr Lima says.

In 2009, the peril of Dr Lima’s courageous mission was brutally laid bare.

“My son was playing in the front garden of our home in the evening. I heard an explosion and rushed outside the yard to see my son covered in blood,” she recalls.

The 11-year-old boy had been the victim of a Taliban grenade attack to Dr Lima’s family home. Despite suffering a debilitating leg injury, he survived and is now able to walk with the aid of a stick.

But worse was to come six months later.

After receiving further threats and warnings from the Taliban, Dr Lima’s 22-year-old brother was killed in another grenade attack opposite her clinic.

She was forced to move to a secret location, but the experience did not dent Dr Lima’s commitment to help the women of Afghanistan. “I want to serve my country and my people who have suffered a lot. I cannot just sit in the corner of my house,” she says.

“My son was injured and my brother was killed as a result of my work, but I have never given up. These activities cannot be done without suffering. In Afghanistan, all women are suffering.”

Details of an Amnesty campaign calling for greater protection for professional Afghan women like Dr Lima are available at www.amnesty.org.uk/afghanistan

A pseudonym has been used to ensure the security of Dr Lima and her patients

Horia Mosadiq is Amnesty International’s researcher on Afghanistan.

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“Journalists are too scared to come”: Refugees on the forgotten war in Yemen

Only the few who have managed to flee the war-torn country can reveal the suffering of those left behind.

Last weekend’s BBC Our World report on the humanitarian crisis caused by the Yemen civil war highlighted that not only is the conflict a forgotten war, it is also an unknown war. Since war broke out 18 months ago in March 2015, surprisingly little has been written about the conflict, despite its similarity to ongoing and widely-reported other conflicts in the region, such as the Syrian crisis.

The main conflict in Yemen is taking place between forces allied to the President, Abdrabbuh Mansour Hadi, and those loyal to Zaidi Shia rebels known as Houthis, who forced Hadi to flee the capital city Sana’a in February. The loyalties of Yemen’s security forces are split, with some units backing President Hadi and others his predecessor Ali Abdullah Saleh, who is seen as the leader of the Houthi forces.

While these two forces have been at war, separate terrorist groups have been gaining more and more influence on the ground. Opposed by both the Houthis and Hadi’s forces, al-Qaeda in the Arabian Peninsula (AQAP) have staged deadly attacks from strongholds in the south and south-east. They are also opposed by Islamic State, which has claimed responsibility for a number of suicide bombings in Sana’a.

After rebel forces closed in on the president's southern stronghold of Aden in late March, a coalition led by Saudi Arabia responded to a request by Hadi to intervene and launched air strikes on Houthi targets.

I have spent the last couple of months working in the “Jungle” refugee camp in Calais, home to refugees from Sudan, Afghanistan, Syria, Iraq, Eritrea, Somalia – to name just a few. Having heard very little about the civil war, I was surprised to meet a handful of Yemeni men living inside the camp.

Hussein*, 28, is a film producer and dancer from Yemen who fled the country two years ago and has travelled through 11 countries to reach the Calais camp, where he has been living for just over a month. In a mixture of English and French, he tells me how groups of Houthi militia forcibly try to confiscate cameras and notebooks from both local and international journalists. He knows local journalists, friends of his, who have been threatened, tortured and even killed by Houthi forces.

He pulls out his phone and shows me a picture of his friend, Mohammed, who worked as a photojournalist, documenting brutality as a result of the war. Mohammed’s friends and family have not heard from him since April; the best-case scenario is that he is being detained, but Hussein seems pretty certain that he is dead. As a result, many who otherwise would have reported on the conflict have fled from besieged cities such as Sana’a, Aden and Taiz to the relative safety of the countryside in the north of the country, or have left Yemen altogether.

His friend Jamil, with whom he shares a tent, adds: “from other countries journalists [they are] too scared to come”. He claims that there are only “five or seven” foreign journalists in the capital city, Sana’a and tells me about journalists from the UK, France and the US who, after spending days being held up by countless militarised checkpoints while trying to reach the main cities, are then interrogated and detained by Houthi forces. If they are let go, they are harassed throughout their visit by National Security officers.

After watching his mother die during an airstrike in the city of Hodaida in January, Jamil took the decision to flee Yemen and claim asylum in Europe. He is worried about his father and his friends who are still in Yemen, especially after hearing reports that random border closures and cancelled domestic flights have been preventing crucial aid convoys of food, medical supplies and trained aid workers from accessing the citizens who are desperately in need of humanitarian assistance. Jamil reminds me that Yemen was in economic crisis even before war broke out, with widespread famine and limited access to healthcare or clean water.

Movement within the country is restricted and dangerous, and in the last twelve months alone, four Médecins Sans Frontières (MSF) facilities have been attacked and destroyed by airstrikes. Writing on 15 September 15, MSF head of mission in Yemen, Hassan Bouceninem spoke of:

“Other health centers, schools, markets, bridges . . . [that] have been attacked and destroyed by airstrikes, shelling, or bombs. Such attacks create direct victims but the war (economic failure, access problems, closing of hospitals, no health staff etc.) also causes a lot of indirect victims within the population.”

Such widespread instability and the resultant lack of access for journalists and aid workers means that it is difficult for the world to know how much Yemen is suffering. Only by speaking to the few who have managed to flee can even begin to grasp the realities of daily life for those left behind.

*Names have been changed to protect the identities of our sources.

Neha Shah has been volunteering in the Calais camp.