In Afghanistan, training to be a nurse is more than a career choice. It’s an act of bravery, a challenge to cultural norms and a vital public service.
“I’m here to learn something, so I can serve my village and my country,” says student Abida Nowroz, who studies at one of six nursing schools set up by the Afghan Ministry of Public Health with support from the United Nations Development Programme (UNDP) and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Nurses are hard to find in Abida’s home village in rural Nuristan Province in eastern Afghanistan. In isolated regions like this, health facilities are limited and security concerns prevent many health care professionals from working in the area.
As a result, Afghanistan has one the highest maternal and child mortality rates in the world and the fourth-highest malaria burden for its region. Under-staffed and ill-equipped health facilities struggle to cope with TB, which requires lengthy treatment. According to WHO, around 40 percent of health facilities in Afghanistan are without female staff, a significant problem in a country where community norms often mean that women are not allowed to receive care from men unless accompanied by a male family member.
But women like Abida are set to change this situation. She and 200 of her recently graduated nursing school classmates will go to work in some of the poorest villages in their home provinces.
In addition to two years of medical training, students at the school receive accommodation, transportation, three meals a day and a nominal living allowance. While the work is hard, Abida and her classmates know it is a unique opportunity in a country where young women often are not permitted to live or study away from home.
“My parents were very worried about how I could live away from them. But for months I fought back hard until I convinced my father,” says Abida. “I’m really proud to do this. I try to study as hard as I can.”
Original reporting by Jalaluddin Kasaat for UNDP Afghanistan. Photography: Omer Sadaat / UNDP.
Illustration information source:
Increasing Access to Health Care Services in Afghanistan with Gender-sensitive Health Service Delivery (WHO).
Tuberculosis in Afghanistan
Tuberculosis was one of the top 10 causes of death worldwide in 2015, responsible for more deaths than HIV and malaria. Of the estimated 10.4 million new cases in 2015, about 60 percent were men.
Afghanistan, however, does not follow the global pattern; it’s one of the few places where more cases are found among women. Gender inequality and stigma increase the risks for women, both of contracting TB, and of not being diagnosed and treated for it. Social norms dictate that women spend much of their time inside the home, where poor ventilation and exposure to smoke from cooking fires exacerbate factors such as malnutrition. In some settings, women fear a TB diagnosis will cause them to be ostracized by their families and communities. This can delay testing and treatment, and put women at risk for even more severe cases of TB.