Afghanistan's Indestructible Doctor

It is hard to find anything that has survived the social and political destruction that is the modern history of Afghanistan. Villages and towns have disappeared, cultural heritages thousands of years old destroyed, and the intellectual legacy of an entire nation lost in a paroxysm of fundamentalist paranoia.
 
In this perfect storm of insanity, Dr. Sima Samar has remained a rock of reason and inspiration.
 
Her Shuhada Organization, which works to reconstruct and develop Afghanistan through operating schools, running hospitals, and empowering women and children, has changed the lives of thousands. Dr. Samar points to the graduates of the schools she helped found as evidence of her legacy.
 
In a nation where the Taliban once barred girls from attending school beyond the sixth grade, Shuhada schools have given young females from Ghazni and the surrounding areas where Dr. Samar is based a chance at a life most in their generation were denied.
 
"Many girls who graduated from schools that I helped establish have gone on to university," she says. "This is an achievement I am proud of – it is a complete exception to the rule to have such a high number of female university students from one district, much more than a lot of other provinces and big cities."
 
Some former students go on to study law, while others study education – and a talented few have followed in their mentor's footsteps and enrolled at medical school.
 
Dr. Samar graduated from Kabul University Medical College in 1982, soon after Soviet tanks rolled into the mountainous nation that separates South Asia from the Middle East. She fled to Pakistan when her husband was arrested, but returned to open her first hospital for women in 1987, and establish Shuhada in 1989. But as the fundamentalist Taliban government established greater control over the country in the 1990s, many schools run by Shuhada were forced to operate underground because girls were being educated to high school level.
 
These years were perhaps the darkest and most dangerous for Dr. Samar, who received death threats from mujahedeen leaders on an almost daily basis. Under Taliban-controlled Afghanistan, women – under penalty of death – were forbidden to attend schools, work, or go out in public unless escorted by a male relative.
 
Many of her most harrowing and yet inspirational stories come from this period. Once, a family brought to her clinic their 16 year-old daughter, who was six months pregnant following a rape. According to some interpretations of Islamic Shariah law, a rape victim must have four male witnesses to testify that she was not guilty of "fornication," a crime sometimes punishable by death.  Disapproving of abortion except in very extreme cases, Dr. Samar cared for the young woman for a month, performed a cesarean section and showed the parents the placenta, saying it was a tumor. She later gave the premature baby to another woman, who was married but infertile – a condition also subject to serious punishment under Taliban law.
 
Today, the political environment for women in Afghanistan has much improved. "We have more women in Parliament and many serve as ministers on various commissions," she says. Dr. Samar herself was minister of women's affairs and deputy premier in the interim government of Hamid Karzai after the U.S.-led invasion of 2001.
 
Despite these gains, the human rights situation and position of women remains far from ideal, particularly in the countryside. "Women in rural areas still live in the same conditions (as under the Taliban)," she says.
 
The lack of accountability in the justice system also has become a growing problem. Dr. Samar says the biggest concern is related to impunity for crimes committed before the Karzai government was installed and lack of effective law enforcement. "In some parts of the country, the government doesn't have access. The government really isn't working as the people were expecting," she says.
 
A prime example of where the justice system has come off the rails, says Dr. Samar, is the amnesty law passed earlier this year. The bill covers a 25-year period from 1987, and exonerates the atrocities committed under the Taliban. "We have a lot of people who are accused of war crimes or crimes against humanity who are sitting in Parliament… there is a small group of people who believe in democracy and human rights, but they are in the minority," she says.
 
Shortly after the bill passed the lower chamber, a number of mass graves were found in the north of the country. In July, another large mass grave dating from the 1990s was found just north of Kabul. Many believe that part of the reason the Afghan Parliament pushed the legislation through was to protect sitting members from prosecution related to crimes committed at these sites.
 
This has exasperated a large number of Afghans who want to bring their previous leaders to trial. "The people responsible are all in the Parliament, and they are making the decision whether to investigate or not," says Dr. Samar.
 
Another key factor in improving the lives of Afghans is rebuilding infrastructure in the war-torn nation. But progress on reconstruction also has slowed to a halt in many areas. "There was not a proper plan for the reconstruction… and there was no even distribution of development projects around the country," says Dr. Samar. This fact, combined with poor governance, has undermined hopes for Western-led efforts to remake Afghanistan into a modern democracy.
 
Locals have been disappointed with U.S. efforts in particular. Many are of the opinion that Washington allocates too much of its resources to military hardware and not enough to schools, hospitals and training programs. Dr. Samar says this creates the perception that the United States is less committed to promoting human rights than many might think.


She points to Norwegian efforts in the northern province of Faryab to rebuild infrastructure and the corresponding improvement in both quality of life and security there. "They spend a lot of money on reconstruction, as much as they spend on the military," she says.
 
The policy discourse in the United States has long been focused on civil and political rights at the expense of broader economic and social rights, she says, despite the fact that both types are contained in the Declaration on Human Rights and numerous international treaties. Dr. Samar suggests that this is translating into a dearth of long-term programs and overall lack of effectiveness in Afghanistan. "You should say access to education is a basic human right, access to health care is a basic human right, access to clean water is a basic human right, in order to promote equality within society," she says.
 
Not only are Afghans continuing to struggle in poverty because of  such policies, but the nation appears also to be sliding back into a violent spiral. Opium production is on the rise and Afghanistan is now reportedly the source of 90 percent of the world's heroin. Terrorist attacks have tripled since 2002 in the region around Kabul, while the former Taliban stronghold of Kandahar has seen an even worse leap in violence. Many of these attacks are suicide bombings, a phenomenon that was once culturally alien to Afghanistan.
 
"If you look at the history of Afghanistan, we have never had suicide attacks and now we have them… the security situation is really getting worse – hostage taking, beheading of people, and so on was not the case before," says Dr. Samar.
 
Though it may seem as if Afghanistan is a theater in which religious extremism is threatening progress, Dr. Samar doesn't see any real clash of civilizations, or blame religion for her country's problems. Indeed, she finds some religious groups to be quite active on such issues as women's rights. Some have helped her case by punishing families that give up their child for prostitution, while others help educate women about a bottom-up, rights-based approach to improving their lives.
 
"Fundamentalists don't really argue the teachings on sexual equality that are in the Qur'an, but of course they try to misguide people by saying that we want to promote immorality," says Dr. Samar. She sees the main problem with Islam as that the religious debate has always been dominated by narrow-minded men. "Of course, they interpret it the way they want," she says.
 
The remarkable thing about Dr. Samar is that she has been able to survive a lifetime of political chaos while actively working to thwart the goals of those who oppose equality. "My major accomplishment is that I am still alive, and I am still imposing myself on these extremists in Afghanistan – they really hate me."
 
Her ground-breaking efforts continue to be recognized by the international community. In September 2007, Forbes named Dr. Samar one of the 100 most powerful women in the world. More recently, on Monday, Nov. 10 the Taiwan Foundation for Democracy announced that she would receive the 2008 Asia Democracy and Human Rights Award.
 
With freedoms and human rights still fragile in Afghanistan, criticisms against United States and NATO forces on the rise, and a recent upsurge in Taliban influence, a concerted effort will be needed by the Afghan people and the international community to defeat extremism and bolster democracy. "People on the street don't have much belief in democratic institutions currently," says Dr. Samar. "How could they?"
 
UPDATED November 2008