WOMENS HEALTH AND HUMAN-RIGHTS IN AFGHANISTAN

Context. - During the past 20 years, social and political upheavals ha ve disrupted the way of life in Afghanistan. The Taliban regime, a rad ical Islamic movement that took control of Kabul in September 1996, ha s had extraordinary health consequences for Afghan women. Objective. - To assess the health and human rights concerns and conditions of wome n living in Kabul under the Taliban regime. Setting. - Residences in K abul; refugee camps and residences in Pakistan. Design. - A cross-sect ional survey of women who lived in Kabul, prior to September 1996, whe n the Taliban took control. Participants. - A total of 160 women parti cipated, including 80 women currently living in Kabul and 80 Afghan wo men who had recently migrated to Pakistan. Main Outcome Measures. - Se lf-reported changes in physical and mental health, access to health ca re, war-related trauma, human rights abuses, and attitudes toward wome n's human rights. Results. - The median age of respondents was 32 year s (range, 17-70 years); median formal education was 12 years, and 136 (85%) of respondents had lived in Kabul for at least 19 years. Sixty-t wo percent (99/180) reported that they were employed before the Taliba n takeover; only 32 (20%) were employed during their last year in Kabu l, The majority of all women reported a decline in physical and mental health status (71% [113/160] and 81% [129/160], respectively) and rep orted a decline in access to health care (62% [99/160]) during the las t 2 years living in Kabul. Many of the women reported symptoms that me t diagnostic criteria for posttraumatic stress disorder (42% [67/160]) , demonstrated evidence of major depression (97% [155/160]), and had s ignificant anxiety symptoms (86% [137/160]). Eighty-four percent (134/ 160) of women reported 1 family member or more killed in war. Sixty-ni ne percent (111/160) reported that they or a family member had been de tained and abused by Taliban militia, and 68% (108/160) reported extre mely restricted social activities. Almost all (96%) expressed support for women's human rights. Conclusions. - The current health and human rights status of women described in this report suggests that the comb ined effects of war-related trauma and human rights abuses by Taliban officials have had a profound effect on Afghan women's health. Moreove r, support for women's human rights by Afghan women suggests that Tali ban policies regarding women are incommensurate with the interests, ne eds, and health of Afghan women.