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2.6. Healthcare professionals and humanitarian workers, including individuals working for national and international NGOs

Last update: April 2022

COI summary

Over the past years, the Taliban increasingly tried to present themselves as a government overseeing the delivery of services, and accordingly interacted with aid organisations. However, incidents of targeting healthcare workers were reported, including killings, threats, intimidation, harassment, and abduction of healthcare personnel. Clinics often bargained a deal with the insurgents in order to be able to operate in a certain area. The situation for healthcare workers differed from area to area, depending to the degree of control versus contestation by insurgent groups [COI query on humanitarian workers and healthcare professionals; Key socio-economic indicators 2020, 2.6.2].

In some cases, NGO workers were targeted by actors in the conflict as a result of their activities being perceived as non-neutral or in violation of cultural or religious norms. Other examples included targeting of people active in polio vaccination campaigns (sometimes considered as spies) or in de-mining programs (considered as an activity contrary to the military interests of the Taliban). It is also reported that healthcare workers were threatened in order to provide better services for certain communities, more specifically with regard to COVID-19 measures [COI query on humanitarian workers and healthcare professionals].

Incidents with Taliban or (pro-)State actors often occurred in cases where hospitals and aid workers were accused of having treated (or of refusing to treat) wounded fighters or were accused of spying or covert support of the other side in the conflict [Conflict targeting, 1.2.6, 2.4].

ISKP considers humanitarian workers as legitimate targets because of links with foreign organisations or donors [COI query on humanitarian workers and healthcare professionals].

Targeting of humanitarian workers was also reported by UNAMA for the first half of 2021. Such targeted killings included the attack on de-miners, polio vaccination workers, and NGO staff in June 2021 [Security September 2021, 1.4.2, 2.23].

In the first six months of 2021, WHO recorded 30 incidents involving attacks on healthcare in Afghanistan, affecting eight provinces and 18 districts; 22 of these attacks occurred between March and end June 2021. This marked an increase compared to the same six-month period in 2020, when 19 incidents occurred [Security September 2021, 1.4.3]. Incidents of killing and injuring healthcare practitioners were reported in a number of provinces. In some incidents, healthcare providers were also detained [Security September 2021, 2.4, 2.5, 2.8, 2.11, 2.12, 2.15, 2.16, 2.23, 2.35].

Soon after the takeover, the Taliban reportedly asked women working within healthcare to return to their jobs. However, Taliban officials had reportedly provided a written agreement providing ‘unconditional’ permission to women aid workers in only three provinces, while in the rest of the country women aid workers were restricted to effectively engage to their job by the requirement of male guardianship. Many female health workers were too afraid to resume their duties despite the Taliban’s request of their return to work. It was reported in September 2021, that the reality of health care workers differed across Afghanistan, and the lack of clear guidance on the rules in force and how the situation may evolve was stated to cause distress and self-restriction among healthcare workers, leaving many female health workers at home [Country Focus 2022, 2.8].

It was reported that midwife services have been able to continue under Taliban rule to some extent. However, the Taliban’s view on women’s education and work remained unclear, and rules and norms were reportedly applied seemingly ‘haphazardly from region to region’. For example, local Taliban leaders reportedly allowed some flexibility on gender segregation at a local clinic where men and women often worked side-by-side. On another occasion, a midwife in Paktika stated that the clinic where she works was intruded by a Taliban commander and two fighters who said that women ‘have no right to go out or work’, and that midwives are not necessary as death is in the hands of God [Country Focus 2022, 2022, 2.8].

On 2 November 2021, the Kabul military hospital was reportedly attacked as two explosions detonated near its entrance and was followed by heavy gunfire which resulted in 19 dead and 43 people injured. ISKP later claimed responsibility for the bombing [Country Focus 2022, 2.8].

Risk analysis

The acts to which individuals under this profile could be exposed are of such severe nature that they would amount to persecution (e.g. abduction, killing).

Not all individuals under this profile would face the level of risk required to establish well-founded fear of persecution. The individual assessment of whether or not there is a reasonable degree of likelihood for the applicant to face persecution should take into account risk-impacting circumstances, such as: gender (i.e. women), nature of activities (e.g. activities for national/international NGO related to polio vaccination, demining, activities being perceived as non-neutral or in violation of cultural or religious norms, etc.), link with the former government or foreign donors, speaking out or acting against the Taliban or another armed group, origin from areas where ISKP has operational capacity, etc.

Nexus to a reason for persecution

Available information indicates that persecution of this profile is highly likely to be for reasons of (imputed) political opinion.