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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Qatar is determined to stand up to its Gulf neighbours – but at what price?

The tensions date back to the maverick rule of Hamad bin Khalifa al-Thani.

For much of the two decades plus since Hamad bin Khalifa al-Thani deposed his father to become emir of Qatar, the tiny gas-rich emirate’s foreign policy has been built around two guiding principles: differentiating itself from its Gulf neighbours, particularly the regional Arab hegemon Saudi Arabia, and insulating itself from Saudi influence. Over the past two months, Hamad’s strategy has been put to the test. From a Qatari perspective it has paid off. But at what cost?

When Hamad became emir in 1995, he instantly ruffled feathers. He walked out of a meeting of the Gulf Cooperation Council (GCC) because, he believed, Saudi Arabia had jumped the queue to take on the council’s rotating presidency. Hamad also spurned the offer of mediation from the then-President of the United Arab Emirates (UAE) Sheikh Zayed bin Sultan al-Nahyan. This further angered his neighbours, who began making public overtures towards Khalifa, the deposed emir, who was soon in Abu Dhabi and promising a swift return to power in Doha. In 1996, Hamad accused Saudi Arabia, Bahrain and the UAE of sponsoring a coup attempt against Hamad, bringing GCC relations to a then-all-time low.

Read more: How to end the stand off in the Gulf

The spat was ultimately resolved, as were a series of border and territory disputes between Qatar, Bahrain and Saudi Arabia, but mistrust of Hamad - and vice versa - has lingered ever since. As crown prince, Hamad and his key ally Hamad bin Jassim al-Thani had pushed for Qatar to throw off what they saw as the yoke of Saudi dominance in the Gulf, in part by developing the country’s huge gas reserves and exporting liquefied gas on ships, rather than through pipelines that ran through neighbouring states. Doing so freed Qatar from the influence of the Organisation of Petroleum Exporting Countries, the Saudi-dominated oil cartel which sets oil output levels and tries to set oil market prices, but does not have a say on gas production. It also helped the country avoid entering into a mooted GCC-wide gas network that would have seen its neighbours control transport links or dictate the – likely low - price for its main natural resource.

Qatar has since become the richest per-capita country in the world. Hamad invested the windfall in soft power, building the Al Jazeera media network and spending freely in developing and conflict-afflicted countries. By developing its gas resources in joint venture with Western firms including the US’s Exxon Mobil and France’s Total, it has created important relationships with senior officials in those countries. Its decision to house a major US military base – the Al Udeid facility is the largest American base in the Middle East, and is crucial to US military efforts in Iraq, Syria and Afghanistan – Qatar has made itself an important partner to a major Western power. Turkey, a regional ally, has also built a military base in Qatar.

Hamad and Hamad bin Jassem also worked to place themselves as mediators in a range of conflicts in Sudan, Somalia and Yemen and beyond, and as a base for exiled dissidents. They sold Qatar as a promoter of dialogue and tolerance, although there is an open question as to whether this attitude extends to Qatar itself. The country, much like its neighbours, is still an absolute monarchy in which there is little in the way of real free speech or space for dissent. Qatar’s critics, meanwhile, argue that its claims to promote human rights and free speech really boil down to an attempt to empower the Muslim Brotherhood. Doha funded Muslim Brotherhood-linked groups during and after the Arab Spring uprisings of 2011, while Al Jazeera cheerleaded protest movements, much to the chagrin of Qatar's neighbours. They see the group as a powerful threat to their dynastic rule and argue that the Brotherhood is a “gateway drug” to jihadism. In 2013,  after Western allies became concerned that Qatar had inadvertently funded jihadist groups in Libya and Syria, Hamad was forced to step down in favour of his son Tamim. Soon, Tamim came under pressure from Qatar’s neighbours to rein in his father’s maverick policies.

Today, Qatar has a high degree of economic independence from its neighbours and powerful friends abroad. Officials in Doha reckon that this should be enough to stave off the advances of the “Quad” of countries – Bahrain, Egypt, Saudi Arabia and the UAE - that have been trying to isolate the emirate since June. They have been doing this by cutting off diplomatic and trade ties, and labelling Qatar a state sponsor of terror groups. For the Quad, the aim is to end what it sees as Qatar’s disruptive presence in the region. For officials in Doha, it is an attempt to impinge on the country’s sovereignty and turn Qatar into a vassal state. So far, the strategies put in place by Hamad to insure Qatar from regional pressure have paid off. But how long can this last?

Qatar’s Western allies are also Saudi Arabia and the UAE’s. Thus far, they have been paralysed by indecision over the standoff, and after failed mediation attempts have decided to leave the task of resolving what they see as a “family affair” to the Emir of Kuwait, Sabah al-Sabah. As long as the Quad limits itself to economic and diplomatic attacks, they are unlikely to pick a side. It is by no means clear they would side with Doha in a pinch (President Trump, in defiance of the US foreign policy establishment, has made his feelings clear on the issue). Although accusations that Qatar sponsors extremists are no more true than similar charges made against Saudi Arabia or Kuwait – sympathetic local populations and lax banking regulations tend to be the major issue – few Western politicians want to be seen backing an ally, that in turn many diplomats see as backing multiple horses.

Meanwhile, although Qatar is a rich country, the standoff is hurting its economy. Reuters reports that there are concerns that the country’s massive $300bn in foreign assets might not be as liquid as many assume. This means that although it has plenty of money abroad, it could face a cash crunch if the crisis rolls on.

Qatar might not like its neighbours, but it can’t simply cut itself off from the Gulf and float on to a new location. At some point, there will need to be a resolution. But with the Quad seemingly happy with the current status quo, and Hamad’s insurance policies paying off, a solution looks some way off.