Since October 7, the Western province of Herat in Afghanistan has been struck by a series of powerful earthquakes and aftershocks, causing extensive human, psychological, and infrastructural damage. As of October 19, aftershocks are continuing, leaving communities in a state of fear and worry.
Devastating Earthquakes Hit The Western Region of Afghanistan
As of October 19, aftershocks are continuing, leaving communities in a state of fear and worry. The first earthquake, with a magnitude of 6.3, hit about 40 km northwest of Herat, the province’s capital, according to the United States Geological Survey (USGS). This earthquake was followed by a series of strong aftershocks. This earthquake was first said to have caused more than 2,000 casualties, but on October 11, the Afghan Minister of Health Qalandar Ebac revised his statement by saying that the death toll from the quakes amounted to around 1,000. The last known earthquake, also of 6.3 magnitude, hit the same region on October 15.
Even though reporting on exact numbers is a challenging endeavour due to the remote area where the earthquakes occurred, multiple NGOs have been multiplying efforts to collect information and provide adequate aid. According to the latest WHO health situation report, nearly 43,400 people across the districts of Injil, Kushk/Rabat-being, Zildjian, Gulran, Herat, and Kohsan have been directly impacted. 23 per cent are reported to be children under the age of five. Based on their assessment of material destruction, at least 40 health facilities and 3,330 homes have been damaged, together with infrastructure such as the water network. This has left thousands living in open areas and temporary shelters, with limited access to food and water and vulnerable to natural elements, such as aftershocks, cold, and sandstorms.
The situation is especially dire for women and children. On October 12, UNICEF wrote in a press release that over 90 per cent of those reported killed were women and children. The NGO launched a 20 million USD appeal to provide humanitarian assistance to the over 200,000 people in need, including 96,000 children in the most affected areas.
Context on Existing Health Crisis in Afghanistan
Adding to this crisis is the pre-existing exposure of Afghans confronted with a long-standing health crisis resulting from decades of political and economic instability, social issues, and malnutrition, amongst others. “In Afghanistan, this is a disaster on top of a disaster, on top of a disaster, on top of a disaster,” said Philippe Kropf, head of communications at the World Food Programme (WFP) Afghanistan, in an interview, urging the international community to provide humanitarian aid to the war-torn nation.
Afghanistan has been ranked within the top three countries most at risk of a worsening humanitarian crisis in the International Rescue Committee’s (IRC) Emergency Watchlist. Poverty remains one of the main causes of this ranking. IRC explains that since the Islamic Emirate of Afghanistan, more commonly known as the Taliban, took power in August 2021, international actors, on which most of the healthcare system depended, suspended most of the non-humanitarian funding and froze billions of dollars in assets. In addition, decades of conflict, and the intensification of climate change-related disasters (droughts and floods) have contributed to the vulnerability of both the people and the country’s infrastructure. IRC claims that 28.8 million people are currently in urgent need of support, with nearly 40 per cent of the Afghan population facing severe food insecurity.
A report published earlier this year by Médecins Sans Frontières (MSF) shed a light on the multiple factors that have been contributing to increases in people’s medical needs and the struggling healthcare system. The report found that socio-political factors, widespread poverty, strict restrictions on women, and decades of conflict were the strongest determinants of this crisis. Over 60 per cent of people surveyed declared that women already face greater obstacles than men when trying to access healthcare, mainly due to movement restrictions linked to the long-established socio-cultural practice known as “mahram.”
The Daily spoke with Dr. Maureen Mayhew, a former McGill student who worked for ten years with MSF in Afghanistan. She shared her account of working in Afghanistan and her thoughts on the current situation. “One thing to understand in Afghanistan is that the war has been going on for a long time, and it’s many wars, right? And so a lot of destruction had happened to the healthcare system, and a lot of the people who were educated had left the country. So therefore, you’re not going to have educated healthcare workers, because all of those people were able to leave the country and go somewhere else, like Canada or the US or Europe. So there were a lot of challenges in setting up anything,” said Dr. Mayhew.
Difficulties in Organizing and Implementing Response and Relief
The multi-sectoral Herat Earthquake Response Plan targets approximately 114,000 people living in high-intensity impact areas. By October 17, WHO and Health Cluster partners had reached 32,511 individuals across multiple districts. In collaboration with the Afghanistan Society of Obstetrics and Gynecology (AFSOG), WHO has deployed a dedicated team of 21 female healthcare workers from Kabul to Herat. Multiple international organizations, such as IRC, CARE, Save the Children, UNICEF, and the European Union, have been mobilizing to provide aid. However, since the de facto Taliban authorities came to power in 2021, not only has there been a large withdrawal of humanitarian agencies, but there have been many constraints on NGO work, especially women-led organizations. In addition, many countries have been reluctant to provide aid because of political disagreements and a lack of recognition of the Taliban government. Another factor that impedes aid provision in Afghanistan is the high degree of misinformation.
Victoria Jahesh, executive director of the Afghan Women Center of Montreal (AWCM), spoke to the Daily about the Afghan community’s organization in light of the earthquakes and their thoughts on the international community’s response. The AWCM aims to “empower socially isolated immigrant women within Canadian society by designing and implementing programs tailored to their specific needs and also through self-development workshops and collective actions or collective projects,” she explained. As an immediate response to the disaster members of the organization came together and “gathered donations, from the community members to provide this money to the family members living in the region through Western Union. And they will distribute it to the people affected. So far it gathered around $4,000. It’s not too much, but it’s still something.”
Jahesh raised the issue of the lack of action taken by Canada’s government. She explained that “according to Canada’s law, Bill 41 recognizes the Taliban regime as a terrorist regime. So according to this clause and law, Canada refuses to provide any humanitarian help for the terrorism group.”
“There’s a lot happening in Afghanistan, and we see every day that women are banned from school, every day their rights to freedom are restricted. It’s shown in the media. Everyone now is aware. I believe it is our collective responsibility and efforts to shed light on how we can bring awareness and to shed light on the injustice and suffering faced by Afghans and especially the magnitude of violence inflicted through gender apartheid.” Jahesh then defined “gender apartheid,” saying “it means that Afghan women and girls are forced in systemic isolation, restricting their freedoms of assembly movements or maybe employment beyond their household, or they’re ultimately forced to function as an underclass in Afghan society these days.” In terms of international responsibility, she added that refusing to recognize and act upon gender apartheid in Afghanistan “sets a dangerous precedent for young girls as the systemic erasure of rights and freedoms become a norm in Afghanistan now.”
When asked if they had had any direct contact with people affected by the earthquake, Victoria Jahesh introduced one of the members of AWCM, Mohammad Tawfiq Fushanji, whose family lives in Herat. He described the difficulty his loved ones were going through, saying that “the services are not available for those in need there. No access to hospitals or medication. And people cannot do anything. They are all outside their homes.” He added that women were facing a difficult situation because their movements were restricted.
Focus on Women and Child Health
Women and children make up a majority of the victims of the earthquakes. The United Nations Population Fund (UNFPA) estimates that there are 3,000 women of reproductive age affected by the earthquakes, making it one of their priorities that they receive urgent maternal and reproductive health care. When the Taliban regime first came to power in 1996, the country had one of the world’s highest maternal, infant and child mortality rates. However, due to significant investments in health and the establishment of midwifery programs, the maternal mortality rate declined from approximately 1,450 to 658 deaths per 100,000 live births, between 2001 and 2017. Yet, it is important to note that since the Taliban took over, women have been experiencing the most drawbacks in terms of freedom and are amongst the most affected by the economic and health crisis, especially mothers and children. This contributes to their vulnerability in events such as the recent earthquakes.
The Daily talked with Dr. Mayhew about public, maternal and child health in light of the earthquakes and within the general socio-political context of Afghanistan. Referring to factors that contributed to the fragility of the health system and the vulnerability of women and children’s health, she mentioned the sustained climate of war for the past decades, the lack of medical infrastructures in rural areas, and the high rates of illiteracy, especially for women, which hinders the possibility of women working in the health system: “If you think about the lack of education of girls at this point is you’re going to run into a problem, a pipeline problem of human resources for educated girls to become healthcare workers and teachers who it’s really important to have female healthcare workers because men in Afghanistan, it’s not okay for them to do female examinations and things like that. Because of those cultural rules, male OBGYN, obstetrical gynecologists are not going to be able to provide adequate care because of the repercussions to them, even if they wanted to do it,” she explained.
Dr. Mayhew added that “the international community stopped funding a lot of NGOs, and a lot of NGOs pulled out. And because of that, the funding of healthcare workers was greatly reduced and hospitals were left to their own resources. Clinics were left to their own resources. And we do know that historically the healthcare sector was propped up by international funding. And because of political disagreements, that funding was removed. And so you could say that the international community is not supporting women and children because of political agendas. You could say that that in and of itself hurts women and children.”
Next Steps and International Responsibility
Afghanistan is frequently hit by earthquakes, especially in the Hindu Kush mountain range, as it lies near the junction of the Eurasian and Indian tectonic plates. So what will happen next? Many international organizations are calling on international actors to provide financial aid to Afghans.
Looking back at the projects that were established in the years she worked in Afghanistan, Dr. Mayhew told the Daily that “having a midwifery program was working. So that needs to continue to happen. It also means that women and girls need to be allowed to go into that and to be educated enough. And then to provide family planning in the ways that are acceptable in Afghanistan.” She highlighted that “to do that in the current milieu, you’re going to have to work with the Taliban to make that happen. And you’re going to have to swallow some of the judgment that you might feel while you move that agenda along. And then, of course, enough food is going to be important as well. So then you get into agriculture and social determinants of health. All of those things are going to be necessary to help women and children.” She also added that “another thing that people in North America often don’t know or forget about is that Afghanistan is a collectivist society. It is not an individualistic society. So if we can reframe health to be more family health, I think that would be helpful.”
Finally, what can we, as students, do to support Afghans? Victoria Jahesh suggests that students should gain more awareness of what is happening and highlights that she wishes to see more students get involved in terms of ideas and advocacy. “It’s all happening with the youth,” she says.
Dr. Mayhew concluded by saying “the first thing I would say is you need good information. Look for information that isn’t the same as what you would usually look at. Go look at Al Jazeera, or look at a Muslim source of information and just see. Is there a different perspective?” She then discussed the difficulty for North America to separate from the dogma that Muslim women need saving. She recalls, “Not all Afghan women need saving either. And there is power that these women have. And being able to recognize that power and then help capitalize on it, I think that would be a wonderful way to go.”