A doctor in central Afghanistan says surviving the conflict in her war-torn country was her biggest worry as she helped women through pregnancy and childbirth in a rural region.
“There were days when firefights broke out just outside the hospital walls,” Zarghuna, an obstetrician-gynecologist who requested a pseudonym because of fears for her security, told RFE/RL's Gandhara. “Those were dangerous times, but now we face a much bigger killer in the form of hunger.”
Treating about 70 women most days at her hospital in the Maidan Wardak Province, Zarghuna says the most pressing issue now is the suspension of international aid that followed the Taliban’s seizure of power on August 15.
Her hospital had previously relied on assistance from the Swedish Committee for Afghanistan (SCA), an international NGO that has helped vulnerable Afghans for more than 40 years.
But now the hospital is running out of medicine, can no longer provide food for patients, and faces power shortages.
“These days I’m forced to help women deliver their babies by the flashlight on our smart phones because our hospital ran out of money to buy fuel for the generator,” Zarghuna says. “Carrying out a C-section by flashlight is a nightmare we now have to face regularly.”
Hundreds of health-care clinics throughout Afghanistan have already closed since the Taliban takeover, and she worries the country will once again become one of the world’s worst countries for women and children.
Twenty years ago, Afghanistan had some of the highest infant and maternal mortality rates in the world, with nearly 90 children dying from every 1,000 live births and 1,800 mothers dying for every 100,000 giving birth. Today, the infant mortality rate is half that rate and the maternal mortality rate stands around 600 out of 100,000.
The hospital staff also hasn't been paid in three months.
“I am responsible for looking after my family. We have three children. If I don’t receive my salary I will have no choice but to leave [the hospital],” Zarghuna says.
Risk Of Total Collapse
Since the Taliban takeover, hundreds of thousands of qualified Afghans -- government officials, professionals, aid workers, intelligentsia, businesspeople, and other technocrats -- have fled the country.
Across Afghanistan, humanitarian aid and development projects worth billions of dollars are in jeopardy after international aid was suspended and government assets frozen following the Taliban’s taking control of the country.
Many organizations have left completely, some have relocated all or most of their staff to other countries, while others are not yet sure how to work under the Taliban-led government.
Amid a looming humanitarian crisis and an economy spiraling downward, the Taliban has not made clear how it will deal with the aid groups helping Afghans with health care, education, agriculture, and poverty alleviation.
The world community pledged more than $1 billion in humanitarian aid to Afghanistan this week but delivering assistance to the most vulnerable people will require negotiations with the Taliban-led government, which has still not been internationally recognized.
During the militants’ previous stint in power from 1996 to 2001, their restrictions on international organizations and donor reluctance meant aid was hard to come by for a population long ravaged by war and natural disasters.
"After decades of war, suffering, and insecurity, [Afghans] face perhaps their most perilous hour," UN Secretary-General Antonio Guterres warned on September 13, adding that there is a risk of the collapse of basic services and their "entire country -- all at once."
Working With The Taliban
Some NGOs such as the SCA have a history of dealing with the Taliban and are ready to work with the new rulers.
The organization ran one of the largest aid projects during the Taliban’s first regime, operating thousands of clinics and schools, including some for girls. The NGO also dealt with the militant group as it expanded control over rural regions in the 17 provinces in which the SCA currently has projects.
“We do not see any changes in how we operated under the republic and now [under the Taliban],” says Syed Habibullah, who heads an SCA-founded high school for girls in Maidan Wardak’s Jalreez district. He told Gandhara that the Taliban captured Jalreez three months before the fall of Kabul. To alleviate fears among his students -- who stopped attending school after the Taliban takeover -- a local Taliban official visited them at his request.
“Qari Sayed Aziz, in charge of the Taliban’s education branch here, assured us there won’t be any problem,” he said. “We were told to convey to our teachers and students to observe hijab, which they were doing anyway,” he added. “Overall, so far we are happy because the Taliban has not created any problems for us.”
In Kabul, senior representatives in the Taliban-led government are eager to portray recent UN humanitarian pledges as a success. On September 13, donors pledged $1.2 billion in response to a UN appeal.
“Besides welcoming this pledge, we promise that the Islamic emirate will cooperate completely to deliver the aid to needy people,” the Taliban's acting foreign minister, Amir Khan Muttaqi, told journalists in Kabul on September 14.
But Filippo Grandi, the UN high commissioner for refugees, noted they are still in talks with the Taliban. “We also discussed other critical issues like ensuring that women staff can return safely to work, the importance of education for all Afghan children, and the safety and security of all Afghans, including minorities,” he said on September 15. “I encouraged the interim government to reiterate these important commitments publicly and to ensure that they are upheld in practice.”
In Kabul, Ahmad Khalid Fahim, a deputy country director for the SCA, says adopting a neutral stance and understanding local dynamics helped them work in the regions controlled by the Taliban. He says the Taliban allowed women to participate in their education, health-care, and development projects.
“They demanded that our women workers observe the Islamic veil in line with Shari’a law,” he told Gandhara. “They insisted on having separate classrooms for girls after the sixth grade and wanted them to be taught by women only,” he added. “Such policies varied greatly region to region and were ultimately tied to the attitudes of local Taliban commanders.”
Fahim says that with the help of community elders they were often able to persuade the Taliban not to tax the SCA’s development or construction projects. “Overall, there were problems but, in most instances, we were able to resolve them. Our engagement with the Taliban at local levels was aimed at securing access.”
The Shadow Government
After making a comeback in the mid-2000s, the Taliban insurgency began to take the form of a shadow government. The hard-line group created a bureaucracy made up of commissions for specific sectors. Fahim says NGOs would approach these commissions if their problems were not being resolved at the local level.
He cites the example of the Taliban’s requirement that working women be accompanied by male relatives.
“In most cases, this condition was only applicable to women traveling away from their home on longer journeys," he says. "It was hardly applicable to women going to a clinic or school in the same district in which they resided.”
Fahim says that based on what he learned from colleagues who worked under the Taliban in the 1990s, today’s Taliban has changed considerably.
“During the 1990s they didn’t allow higher education,” he said. “Then they did not allow women to work but they allowed women to work in regions under their control with certain caveats such as observing the Islamic veil and being accompanied by a male relative,” he said.
Anders Fange was the SCA’s director in the 1990s and still occasionally deals with the Taliban in his role as a board member.
Last year in Doha he was part of a team to discuss the organization’s work with the Taliban office there. His takeaway from the talks was that the Taliban wanted to control whom they hired.
“Now when they are a government it will be a problem if they are going to approve all the teachers we are going to have on the Swedish committee,” he told Gandhara. “All aid organizations are concerned about being able to recruit employees without Taliban interference.”
Standing Up For Aid
Fange says the international community has to stand up for humanitarian assistance in the form of food, shelter, and health care.
“If the Taliban government is putting conditions on this, then the international community has to take a stand,” he says. “But it has to go pretty far before you abandon the humanitarian imperative.”
The unwillingness of Western donors to deal with the Taliban is a huge potential obstacle.
“It looks like the priority for the Taliban is their own coherence, and they are not so bothered yet about what is happening economically, financially, from a humanitarian point of view,” he said.
The freezing of Afghanistan’s nearly $10 billion in assets and the suspension of IMF and World Bank funds means the Taliban will find it difficult to pay hundreds of thousands of government workers, many of whom are civilians who have continued working under the new regime.
With few prospects of direct aid from Western donors and Kabul’s dependence on foreign funding, the economic crisis could rapidly become a humanitarian catastrophe.
The UN estimates that already 18 million Afghans -- nearly half of the country’s population -- need emergency humanitarian assistance.
Senior Taliban leaders are not completely in the dark on this.
“America is a big country, they need to have a big heart,” said Muttaqi, in urging the United States to unfreeze his country’s assets.
But in Washington and other Western donor capitals, any future relations with the Taliban-led government are tied to the hard-line Islamists’ treatment of Afghans and whether they prevent Afghanistan from lapsing into becoming a global terrorist hub.