Afghanistan’s Taliban-controlled government is preventing thousands of young female medical graduates from taking a mandatory exam, at a time when there is a shortage of doctors in the country.
If they do not pass this “final examination,” conducted by the Afghan Medical Council, they cannot register as doctors.
The Taliban allows male graduates to take the exam, but has prevented nearly 5,000 female graduates from taking the exam.
Three young doctors shared their anguish over this situation with the BBC.
“A dark day”
The process of studying for medical school involved a lot of work and sacrifice to Rahima, 27 years old.
“Despite the difficulties, my experience was very pleasant because, with each passing day, I was closer to reaching my goal.”
Rahima’s childhood was marked by illnesses and multiple hospitalizations. When she was recovering from surgery, she started having big dreams.
“My surgeon was very kind and was my role model. He still works at the French Children’s Medical Institute in Kabul. “I wanted to be a good doctor like him.”
Rahima graduated in 2022. Just nine days before she was to take her medical license exam, the Taliban issued a decree that He forbade women to do so.
“We always say the nights are dark, but that day was the darkest,” Dr. Rahima tells the BBC, in a voice cracking with emotion.
“Life has lost meaning for me.”
Under the Taliban, women are enrolled in nursing and midwifery. Medical schools do not admit women, and female students who were already studying were prohibited from continuing from December 2022.
“Something precious was lost.”
The family of the Dr. Salma He fled to Pakistan when the Taliban first took control of the country in 1996.
His family returned after his fall in 2001. Due to multiple displacements, he finished his education later and only began studying medicine when he was 26 years old.
“My family did not have a stable income. Even during harsh winters, I used to walk to college in the heavy snow.”
The Taliban’s decision was a very hard blow. She often shares her frustration with her medical colleagues.
“The feeling of deprivation shook everyone. “I have lost something very precious,” Dr. Salma tells the BBC.
Two of her older sisters and a brother have already married and that puts pressure on Salma to do so as well.
She even made a presentation to the Taliban, along with her classmates. “Nothing worked,” she says.
And nothing will ever work, adds the Dr. Sultanaa doctor who graduated in medicine in Mazar-I-Sharif, a city in the north of the country, in 2021.
“The Taliban gave us false hope many times,” he explains.
Dr. Sultana wants to continue her studies and open her own clinic. Without a license, her life is on hold.
Since their return, the Taliban organized three final exams. Some women participated in the first, which was held on September 24, 2021.
They later reversed this policy, prohibiting women from taking the second (February 27, 2023) and third (September 1, 2023). In 2022, no final exams were taken.
A spokesperson for the Afghan Medical Council told the BBC that they do not know how many young women are waiting to take the exam.
Between 1,600 and 1,800 female students used to enroll each year in medicine, according to a former government official. For this reason, it is estimated that up to 5,000 female medical graduates are waiting to take the final exam.
The next one is likely to take place in early 2024.
A Medical Council source told the BBC that it is unclear whether Taliban authorities will allow women to come forward.
Doctor shortage
Just before the Taliban came to power in August 2021, Afghanistan had 4.6 health workers (doctors, nurses, midwives) per 10,000 inhabitants.
This figure is well below what the World Health Organization (WHO) defines as a critical shortage threshold of 23 health professionals per 10,000 people.
Following the return of the Taliban, thousands of qualified Afghan citizens – including doctors – left the country.
The Medical Council accepts that there is a shortage of specialized doctors, but says that there are enough general doctors.
“There are enough gynecologists, but we do not have female doctors specializing in ear, nose and throat, neurology, internal medicine, surgery and cariology, which is an urgent need,” said Dr. Gul Mohammad Osman, director of the Afghan Medical Council.
Even before the Taliban came to power, women in many rural areas only wanted to be seen by a female doctor.
“I can’t share all my problems with a doctor. With a doctor, I can talk freely and share my feelings. I can’t show my body to a doctor,” says Fatima, an elderly patient from Zabul province in the south of the country.
Little hope
The BBC is aware that there are doctors who are working in hospitals clandestinely. Since they do not have a license to practice, they receive a very poor salary.
Dr. Sultana tried to look for work in numerous hospitals, but so far she has not been successful.
“We have exhausted all options. Years of hard work thrown away. I don’t think I will get my license anytime soon,” she laments.
Dr. Rahima’s white coat rests on her study table, along with her stethoscope and blood pressure monitor. They are memories of a happier time.
“I wore that overall during my practice days. “It gives me a sense of hope.”
It takes a student seven years to complete his medical studies. After graduating, Rahima bought a new overall that she planned to wear on her first day as a doctor.
She has it stored in her closet, along with her certificates and jewelry. “I’m not going to open the new duster until I make it,” Rahima says.
Dr. Salma studied at a private university. Her family used all of her savings to pay for her education, hoping that the family’s fortunes would improve once she started working.
Now he feels guilty for not being able to help his parents financially.
“During the first Taliban rule, my family became refugees. In the second regime, they destroyed my chances of being a doctor,” she says.
He recently began visiting a hospital run by a friend of his father.
“I visit the hospital with my friends three times a week. We accompany doctors and observe, but we do not treat patients,” explains Dr. Salma, who takes comfort in having faith in the future.
“One day, I’m going to open my own clinic,” he says defiantly. “I’m not going to charge poor women and children.”
The doctors’ names have been changed for security reasons.
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