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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After his latest reshuffle, who’s who on Donald Trump’s campaign team?

Following a number of personnel shake-ups, here is a guide to who’s in and who’s out of the Republican candidate’s campaign team.

Donald Trump’s campaign chairman, Paul Manafort, stepped down last week. A man as controversial as Trump himself, he has departed following the announcement last Wednesday of a new campaign manager and CEO for Team Trump. Manafort had only been in the post for two months, following another campaign team reshuffle by Trump back in June.

In order to keep up with the cast changes within Team Trump, here’s the low-down of who is who in the Republican candidate’s camp, and who-was-who before they, for one reason or another, fell out of favour.

IN

Kellyanne Conway, campaign manager

Kellyane Conway is a Republican campaign manager with a history of clients who do a line in outlandish statements. Former Missouri Congressman Todd Akin, whose campaign Conway managed in 2012, is infamous for his comments on “legitimate rape”.

Despite losing that campaign, Conway’s experiences with outspoken male candidates should stand her in good stead to run Trump’s bid. She is already credited with somewhat tempering his rhetoric, through the use of pre-written speeches, teleprompters and his recent apology, although he has since walked that back.

Conway is described as an expert in delivering messages to female voters and has had her own polling outfit, The Polling Firm/WomanTrend for over 20 years and supported Ted Cruz’s campaign before he was vanquished by Trump in May. Her strategy will include praising Trump on TV and trying to craft an image of him as a dependable candidate without diminishing his outlier appeal.

She recently told MSNBC, “I think you should judge people by their actions, not just their words on a campaign trail”. Given that Trump’s campaign pledges, particularly those on immigration, veer towards the completely unworkable, one wonders what else besides words he actually has to offer.

Perhaps Conway, with her experience of attempting to repackage gaffes will be the one to tell us. Conway also told TIME magazine that there is “no question” that Trump is a better candidate than Hillary Clinton. Given Trump’s frightening comments on abortion, to name just one issue, it’s difficult to see how this would prove true.

Stephen Bannon, campaign CEO

While Conway may bring a more thoughtful, considered touch to Trump’s hitherto frenetic campaigning, Stephen Bannon promises to bring just the opposite.

Bannon is executive chairman of right-wing media outlet Breitbart, also the online home of British alt-right provocateur Milo Yiannopoulos. Once described by Bloomberg as “the most dangerous political operative in America”, the ex-Goldman Sachs banker can only be expected to want to up Trump’s rhetoric as the election approaches to maintain his radical edge.

Trump has explicitly stated that: “I don’t wanna change. I mean, you have to be you. If you start pivoting, you’re not being honest with people”.

As Bannon leads a news site with sometimes as outlandish and insensitive views as Trump himself, one can safely assume that Bannon will have no problem letting Trump “be himself”.

The Trump Brood, advisers

While his employed advisers come and go, the people that have been unwaveringly loyal to Trump, and play key advisory roles, are his four adult children: Donald Jr, 38, Ivanka, 34, Erik 22 and Tiffany, 22. With personalities as colourful as their father’s, the Trump children have been close to the campaign since its inception.

Donald Jr personally delivered the bad news to Lewandowski, the younger Trumps describing him as a “control freak”. Although it’s common for the offspring of politicians to take part in their parent’s campaigns (see Chelsea Clinton), in Trump’s case the influence of his children goes undiluted by swathes of professionals. This, despite his actual employed campaign directors being experienced establishment figures, adds credence to the image of Trump’s brand as family-based and folksy, furthering also his criticism of Hillary Clinton as being “crookedly” in the sway of bankers and elites.

Lewandowski’s ultimate downfall has been attributed to his attempts to spread negative stories in the media about Jared Kushner, Trump’s son-in-law and husband of Ivanka. Ivanka and Kushner were long-time critics of Lewandowski for his indulgence and encouragement of Trump’s most divisive instincts, and apparently they were integral to his firing.

Whether any good came from this is hard to discern, as Trump still managed to insult the Muslim community all over again with his comments last month about the late solider Humayun Khan, also insulting veterans and “gold star” families in the process.

OUT

Paul Manafort, former national campaign chair

Although Trump called his departing campaign manager “a true professional”, Manafort has recently been beset by personal controversy and criticised for failing to deliver results. Manafort has taken the blame for the poor polling results that have followed Trump’s awful last few weeks, with Trump’s recent (lacklustre and unspecific) apology representing a complete change of tack.

Despite his many years of experience in politics, Manafort fell out of favour with Trump partly because of his spending on media, such as a $4 radio appearance in Ohio, Pennsylvania, Florida and North Carolina. Trump was judging these investments worthwhile.

Manafort’s personal cachet was also diminished by his dodgy links to ex-clients including Ukrainian former prime minister, the pro-Russian Victor Yanukovych. As Trump has already racked up a number of Russia-related gaffes, continued association was Manafort would have likely proven electorally unwise.

Corey Lewandowski, former campaign manager

Campaign manager until Trump’s team shake-up in June this year, Lewandowski was not the picture of a calm and collected operative. With a list of antics behind him such as bringing a gun to work and then suing when it was taken away from him and lacking the experience of ever having directed a national race, Lewandowski was a divisive figure from the start of Trump’s bid for the nomination.

Although Lewandowski most often accompanied Trump on the nomination campaign trail, it was Manafort, even then, who was in charge of most of the campaign’s logistics, making use of his 40 plus years of experience to do so.

Trump was clearly taken with Lewandowski’s aggressive campaign techniques, as he stood by him even when Lewandowski was charged with battery against former Breitbart reporter Michelle Fields. Although the charges were later dropped, these kind of stories do not bode well for Conway’s hopes for a more women-friendly Trump.

***

Perhaps this latest round of hiring and firing will do him some good, but with only three weeks to go until absentee voting begins in some states, the new team doesn’t have much time.