WAR ON WOMEN
A Health and Human Rights
Crisis in Afghanistan
A REPORT BY
PHYSICIANS FOR HUMAN RIGHTS
BOSTON • WASHINGTON DC
Cover Photo: A woman wearing a burqa, begs on the streets of Kabul. Most
women are prohibited from working. © Physicians for Human Rights
Copyright © August 1998 by Physicians for Human Rights
All rights reserved
Printed in the United States of America
Library of Congress Catalog Card No. 98-067767
DESIGN: Visual Communications
PHYSICIANS FOR HUMAN RIGHTS
Physicians for Human Rights (PHR) mobilizes the health professions and
enlists support from the general public to protect and promote the human
rights of all people. PHR believes that human rights are essential precon-
ditions for the health and well-being of all members of the human family.
Since 1986, PHR members have worked to stop torture, disappear-
ances, and political killings by governments and opposition groups; to
improve health and sanitary conditions in prisons and detention centers;
to investigate the physical and psychological consequences of violations
of humanitarian law in internal and international conflicts; to defend
medical neutrality and the right of civilians and combatants to receive
medical care during times of war; to protect health professionals who are
victims of violations of human rights; and to prevent medical complicity
in torture and other abuses.
As one of the original steering committee members of the International
Campaign to Ban Landmines, PHR shared the 1997 Nobel Peace Prize,
awarded to the Campaign and its coordinator, Jody Williams. PHR cur-
rently serves as co-chair of the US Campaign to Ban Landmines.
The President is Charles Clements, M.D.; Vice President is Carola
Eisenberg, M.D. The Executive Director is Leonard S. Rubenstein, J.D.;
Deputy Director is Susannah Sirkin; Advocacy Director is Holly
Burkhalter; Senior Program Associate is Richard Sollom; Director of
Communications is Barbara Ayotte; Director of Finance & Administra-
tion is Lori Maida; Development Coordinator is Steve Brown; Campaign
and Education Coordinator is Gina Cummings; and Media Relations
Coordinator is Caitriona Palmer. William Haglund, Ph.D., is Director of
the International Forensic Program and Senior Medical Consultant is
Vincent Iacopino, M.D., Ph.D.
Physicians for Human Rights
100 Boylston Street, Suite 702
Boston, MA 02116
Tel. (617) 695-0041
Fax. (617) 695-0307
Physicians for Human Rights
110 Maryland Ave., NE, Suite 511
Washington, DC 20002
Tel. (202) 547-9881
Fax. (202) 547-9050
I. Executive Summary 1
Methods of Investigation 5
Summary of Findings 6
Summary of Recommendations 15
II. Introduction 19
Oil Companies and the Taliban 28
The Status of Women in Afghanistan 29
Human Rights Violations and the Taliban 31
United States Strategic Interests and Policy 34
Humanitarian Assistance in Afghanistan 37
III. Women’s Health and Human Rights Survey 43
Characteristics of Afghan Women Respondents 46
Physical Health and Access to Health Care 47
Mental Health Status 49
War-Related Experiences and Landmine Exposures 50
Human Rights Violations 52
Attitudes Toward Women’s Human Rights 53
Comments on Survey Findings 54
IV. Interviews with Afghan Women and Health Experts 59
Summary of Semi-Structured Interviews with Afghan Women 60
The Taliban’s Violations of the Human Rights of Afghan Women 64
Restrictions on Access to Health Care 64
Prohibition on Work and the Impoverishment of Women 73
Restrictions on the Education of Girls and Women 75
Restrictions on Freedom of Movement and Physical Abuse 76
Health Status in the Context of Human Rights 80
Violations Against Women
Women’s Perceptions of their Health 80
The Limitations of Humanitarian Assistance 84
V. Application of Relevant International Law 89
International Human Rights Law 89
Applicable International Norms 89
Status of Afghanistan’s International Legal Obligations 98
VI. Islam and Women’s Human Rights 105
VII. Recommendations 109
A. Taliban Decree of February 20, 1997 113
B. Taliban Decree of February 20, 1997 115
C. Taliban Decree of February 20, 1997 117
This report was written by Vincent Iacopino, M.D., Ph.D., Senior Med-
ical Consultant to Physicians for Human Rights (PHR), Boston, MA;
Zohra Rasekh, M.P.H., a Senior Health Researcher for PHR; Alicia Ely
Yamin, J.D., M.P.H., Assistant Professor of Clinical Public Health and
Staff Attorney for the Law and Policy Project, Columbia University
School of Public Health; Lynn Freedman, Law and Policy Project,
Columbia University School of Public Health; Holly Burkhalter, Advo-
cacy Director of PHR; Holly Atkinson, M.D., President and C.E.O.,
Reuters Health Information Services; and Michele Heisler, M.D., M.P.A.,
Department of Internal Medicine, University of Michigan.
Heidi Bauer, M.D., M.P.H., Alameda County Medical Center, Depart-
ment of Internal Medicine, Oakland, CA; and Michele Manos, Ph.D, Uni-
versity of California San Francisco, Department of Epidemiology and
Biostatistics, San Francisco, CA., contributed to data analysis and writing
related to PHR’s health and human rights survey. Drs. Bauer and Manos
are volunteer consultants to Physicians for Human Rights. The report is
based on research undertaken by PHR during a three-month period in
early 1998. The report was reviewed and edited by Leonard Rubenstein,
J.D., Susannah Sirkin, M.Ed., and Barbara Ayotte, all of Physicians for
This research was supported by a grant from the Edna McConnell
Clark Foundation, New York, NY. The authors are grateful to the organi-
zations that facilitated access to, and collection of, information used in
this study. We are especially grateful to the Afghan women who partici-
pated in this study despite years of suffering.
Burqa: A head to toe covering for women that has only a mesh cloth to
see and breathe through.
Chador: A veil that is culturally specific and variable among different
Hijab: Modest clothing (for women or men) that is culturally specific and
variable among different Islamic countries.
ICRC: International Committee of the Red Cross.
Jihad: A holy war.
Madrasas: Religious (Islamic) schools in Pakistan.
Mahram: A family member who is a husband, father, brother, or son.
Mujaheddin: Freedom fighters
MSF: Médecins sans Frontières.
Qur’an: The sacred book of Islam.
Pashto: The language of the Pashtun ethnic group.
Pashtun: An ethnic group of Afghanistan.
NGO: Non-governmental organization.
PHR: Physicians for Human Rights.
Shura: A council.
UN: United Nations.
UNHCR: United Nations High Commissioner for Refugees.
UNICEF: United Nations Children’s Fund.
UNOCHA: United Nations Office for the Coordination of Humanitarian
Assistance in Afghanistan.
Wakeel: A community representative. Wakeels who represent city wards
in Afghanistan are responsible for enlisting the needs of families in each
district to the aid organizations.
For a Credible Islamic Affirmation of the Universality of Human Rights
As a Muslim man from Sudan, I vehemently condemn the gross and sys-
tematic persecution of women and other violations of international human
rights law in Afghanistan documented by Physicians for Human Rights in
this report. I also affirm my unqualified endorsement of the essential
premise of the vitally important work of this and other human organiza-
tions around the world: that international human rights standards are uni-
versally valid and applicable as the legal entitlement of every human
being, without discrimination on such grounds as gender or religion.
However, what is happening in Afghanistan today clearly shows that it is
not enough for Muslims like myself to simply associate ourselves with the
principled and highly professional efforts of organizations like Physicians
for Human Rights. In addition to being proactive in making our contribu-
tions to such efforts, Muslims everywhere must equally vehemently chal-
lenge and rebut any alleged Islamic justification for any violations of
human rights and humanitarian law. Muslims and their governments must
strongly condemn human rights violations wherever they occur and who-
ever commits them, and not only when speaking out is convenient or polit-
ically expedient. This is particularly important, in my view, when violations
are committed in the name of some alleged Islamic agenda. Otherwise, how
can Muslims legitimately protest against negative stereotypes of Islam in
the media as sanctioning terrorism, cruelty and inhumanity?
Debates about Islam and human rights continue in many Islamic soci-
eties around the world today, but that has nothing to do with what is hap-
pening in Afghanistan today. As even the most conservative or radical
Muslims around the world know, most of the policies and practices of the
Taliban government documented in this report have no Islamic justifica-
tion whatsoever. Human rights organizations like Physicians for Human
Rights are condemning these policies and practices from a human rights
point of view. Unless Muslims do the same from an Islamic point of view
as well, the Taliban will get away with their false cl