Afghanistan is still a long way from becoming a stable state, where women can enjoy equal rights and live in safety. Today, after 15 years of international military intervention, the picture is a sobering one: A UN survey recorded the highest ever number of civilian casualties in a single year. In 2016 about 3,500 people were killed and 7,920 injured.

  • UN figures report 60 per cent of all marriages as forced, with most of these brides younger than 16.
  • More than a half of all female prison inmates are serving sentences for “moral crimes: they are charged with adultery, although in most cases they are victims of rape or forced prostitution.
  • Self-immolation is unfortunately a common way to commit suicide in Afghanistan and many Afghan women are driven to this as a last resort to escape overwhelming psychological and physical violence.
  • On paper women actually have equal rights – a law to combat violence against women came into force in 2009. However, in practice, judges seldom apply the law. For Afghan women, life outside the family is almost unthinkable.
  • On average, there are 6.2 pregnancies per woman.
  • Only 36 per cent of births are supervised by midwives or doctors.
  • Afghanistan has one of the highest maternal mortality rates in the world – an estimated 460 cases per 100,000 live births: every 2 hours a woman dies in Afghanistan while giving birth to her child. The causes of this maternal mortality include young age, vitamin deficiency and poor medical care during pregnancy.
Advocacy-Meeting of Medica Afghanistan. Copyright: Elissa Bogos/medica mondiale
Advocacy-Meeting of Medica Afghanistan.

medica mondiale has been working on a range of projects to benefit women and girls in Afghanistan since 2002. The organisation’s workers there offer them psychosocial, medical and legal support, aiming to provide practical measures to help them deal with the trauma they experienced. At the same time, women’s rights within Afghan society need to be strengthened. The project work mainly takes place in the cities Kabul, Herat and Mazar-i-Sharif. Support provided in Kandahar had to be discontinued at the end of 2008 because of the difficult security situation.

In 2011, the Afghan workers took over full control of the work. An independent Afghan NGO was founded in Kabul: Medica Afghanistan - Women Support Organisation. medica mondiale continues to work very closely with Medica Afghanistan, providing both advice and funding.

Psychosocial group session by Medica Afghanistan. Copyright: Lizette Potgieter
Psychosocial group session by Medica Afghanistan.

Project region: Kabul, Herat, Mazar-i-Sharif

Activities & Objectives: Community­based; trauma­sensitive support; fight against torture and inhumane treatment; advocacy work towards stronger women`s rights; Transnational health training programme

Local partner: Medica Afghanistan – Women Support Organisation

Funding: German Federal Foreign Office, German Federal Ministry for Economic Co-operation and Development (BMZ), European Commission, treatment center for victims of torture (bzfo), private donations

Project expenses 2015: 642.603 Euro for Medica Afghanistan

238 women received emergency and psychological counselling at the bedside

38 health workers in Afghan hospitals were trained in stress-and trauma-sensitive treatment of patients in 2015

 

Source 'facts & figures': annual report 2015

Counselling Center Medica Afghanistan. Copyright: Lizette Potgieter
Counselling Center Medica Afghanistan.

Psychosocial counselling programme:

  • In several Kabul, Herat and Mazar-i-Sharif, counsellors from Medica Afghanistan offer counselling for women who are suffering from the mental or physical consequences of sexualised and other forms of violence. Regular conversation groups and individual counselling sessions help them deal with their trauma and find a new lease of life.
  • Medica Afghanistan set up consultation rooms at key locations of throughout the Afghan capital Kabul. This makes it easier for as many women as possible to find a protected space near their home where they can come to meet others and benefit from psychosocial support.
  • To ensure sustainability, Medica Afghanistan developed a new concept in 2014: under the guidance of former Medica Afghanistan clients, women come together in selfhelp groups where they can discuss their problems and experiences of violence and exchange views on their rights. This in turn strengthens the autonomy of the clients who set up these groups, as they see that they themselves can be agents of change.

     

Legal assistance project:

  • The legal assistance project run by Medica Afghanistan offers general legal advice to women and provides female prisoners with criminal defence in court. The project’s female Afghan lawyers are committed to ensuring a fair trial for the women. Additionally, they also provide legal advice in civil affairs such as divorce and custody cases. Medica Afghanistan’s lawyers and social workers also help to mediate between women and their relatives to mitigate family conflicts. Many women are imprisoned as a result of such conflicts escalating, so this mediation work helps to prevent court cases in advance.
  • Mediation rooms in Kabul, Herat and Mazar-e Sharif offer a place for families to receive counselling.

Political commitment:

  • The central political call of Medica Afghanistan: To enforce the statutory rights of women in everyday life.
  • So Medica Afghanistan is campaigning among politicians and in society at large for the implementation and realisation of equal rights for women in Afghanistan.
  • Medica Afghanistan is working together with national and international women’s and human rights organisations to achieve the enforcement of new laws to combat violence against women (EVAW Law). In December 2014 Medica Afghanistan organised a conference concerning this law. The organisation is also working to achieve other aims, such as reforming family law and ending the practices of forced and child marriages.

Training for medical and psychosocial professionals:

  • Medica Afghanistan offers training programmes for female professionals who work in medical and psychosocial professions. The objective: to ensure an improved, trauma-sensitive approach to health care for women who suffer from violence.
  • Afghan women doctors, nursing staff and midwives learn about trauma and retraumatisation, psychosomatic illnesses and trauma-sensitive methods of examination and treatment. Another important aspect covered during the training is how to avoid overload at work. Participants learn how to preserve their own strength despite intense contact with traumatised patients and how to avoid secondary traumatisation – where the helpers themselves develop trauma symptoms. In addition, Medica Afghanistan offers lectures in the hospitals to raise awareness among male staff of the special issues faced by women.

Public education

  • To prevent violence against women by law, Medica Afghanistan has set itself the object of informing society and the legal community about the EVAW law and campaigning for genuine acceptance.
  • Medica Afghanistan specifically targets forced and child marriages, educating families, judges and the public about their consequences. In September 2009 the organisation risked a particularly proactive measure: working together with the Afghan Ministry of Islamic Affairs, 36 spiritual leaders (mullahs) from in and around Kabul were educated about children’s rights and legal marriages. A second such workshop was then held in Herat in May 2010.
  • To raise awareness of violence against women and its consequences Medica Afghanistan produces radio programmes with interviews and reports on the topic of “Psychological health”.
  • Medica Afghanistan carries out trainings for police staff on the topics of human rights and violence against women. Results are visible with police referring more cases of domestic violence to the legal advice team at Medica Afghanistan. Also prison staff gets informed about regulations governing the treatment of prisoners under binding international law and their awareness of the special situation regarding imprisoned women is raised.