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

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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US election 2016: Trump threatens to deny democracy

When asked if he would accept the result of the election, the reality TV star said that he would have to “keep you in suspense.”

During this insane bad-acid-trip of an election campaign I have overused the phrase “let that sink in.”

There have been at least two dozen moments in the last 18 months which I have felt warranted a moment of horrified contemplation, a moment to sit and internalise the insanity of what is happening. That time a candidate for president brought up his penis size in a primary election debate, for one.

But there was a debate last night, and one of the protagonists threatened to undermine democracy in the United States of America, which throws the rest of this bizarre campaign into stark relief.

It was the third and final clash between an experienced if arguably politically problematic former senator and secretary of state – Hillary Clinton –  and a reality TV star accused of a growing number of sexual assaults – Donald Trump – but the tone and content of the debate mattered less than what the latter said at one key, illuminating moment.

That statement was this: asked if he would accept the result of the election, Donald Trump said that he was going to “look at it at the time,” and that he would have to “keep you in suspense.”

If your jaw just hit the floor, you have responded correctly. The candidate for the party of Lincoln, the party of Reagan, the party of Teddy Roosevelt, declined to uphold the most fundamental keystone of American democracy, which is to say, the peaceful transition of power.

Let that sink in. Let it sit; let it brew like hot, stewed tea.

This election has been historic in a vast number of ways, most important of which is that it will be, if current polling is to be believed, the election which will bring America's first female president to the White House, almost a century after women's suffrage was enabled by the 19th amendment to the constitution in August 1920.

If the last near-century for women in America has been a journey inexorably towards this moment, slowly chipping away at glass ceiling after glass ceiling, like the progression of some hellish video game, then Donald Trump is as fitting a final boss as it could be possible to imagine.

For Trump, this third and final debate in Las Vegas was do-or-die. His challenge was near-insurmountable for even a person with a first-class intellect, which Trump does not appear to possess, to face. First, he needed to speak in such a way as to defend his indefensible outbursts about women, not to mention the increasing number of allegations of actual sexual assault, claims backstopped by his own on-tape boasting of theoretical sexual assault released last month.

This, he failed to do, alleging instead that the growing number of sexual assault allegations against him are being fabricated and orchestrated by Clinton's campaign, which he called “sleazy”, at one point to actual laughs from the debate audience.

But he also needed to reach out to moderates, voters outside his base, voters who are not electrified by dog-whistle racism and lumbering misogyny. He tried to do this, using the Wikileaks dump of emails between Democratic party operators as a weapon. But that weapon is fatally limited, because ultimately not much is in the Wikileaks email dumps, really, except some slightly bitchy snark of the kind anyone on earth's emails would have and one hell of a recipe for risotto.

In the debate, moderator Chris Wallace admirably held the candidates to a largely more substantive, policy-driven debate than the two previous offerings – a fact made all the more notable considering that he was the only moderator of the three debates to come from Fox News – and predictably Trump floundered in the area of policy, choosing instead to fall back on old favourites like his lean-into-the-mic trick, which he used at one point to mutter “nasty woman” at Clinton like she'd just cut him off in traffic.

Trump was more subdued than the bombastic lummox to which the American media-consuming public have become accustomed, as if his new campaign manager Kellyanne Conway had dropped a couple of Xanax into his glass of water before he went on stage. He even successfully managed to grasp at some actual Republican talking-points – abortion, most notably – like a puppy who has been semi-successfully trained not to make a mess on the carpet.

He also hit his own favourite campaign notes, especially his opposition to the North American Free Trade Agreement (NAFTA) - but ultimately his intrinsic Donald Trumpiness couldn't stop itself from blazing through.

Remember the Republican primary debate when Trump refused to say that he would accept the party's nominee if it wasn't him? Well, he did it again: except this time, the pledge he refused to take wasn't an internal party matter; it was two centuries of American democratic tradition chucked out of the window like a spent cigarette. A pledge to potentially ignore the result of an election, given teeth by weeks of paranoiac ramblings about voter fraud and rigged election systems, setting America up for civil unrest and catastrophe, driving wedges into the cracks of a national discourse already strained with unprecedented polarisation and spite.

Let it, for what is hopefully just one final time, sink in.

Nicky Woolf is a writer for the Guardian based in the US. He tweets @NickyWoolf.