COMMON ANALYSIS
Last update: January 2023

This profile refers to people with disabilities, including mental disabilities, as well as those who have severe medical issues, including mental health issues.

COI summary

Under the former Afghan government, most healthcare was provided by NGOs due to lack of government funds. A very expensive healthcare private sector was also in place. Destructions and closures of healthcare facilities in several provinces as well as incidents of violence against medical personnel had been reported. Mental healthcare facilities were also often under-equipped and qualitative mental healthcare was scarce [KSEI 2020, 2.6, pp. 46-48; 2.6.2, pp. 49-52; 2.6.3, pp. 55-56]. After the Taliban takeover there have been additional reports on a deteriorating situation. The Director-General of World Health Organisation (WHO) described the Afghan health system as “on the brink of collapse” and pointed out the cuts in donor support leading to reduced operations and health facilities shutting down. [, 1.2.1., p. 21; 2.8, p. 52-53].

Women with more complex health needs, such as pregnant women, have reportedly been facing major issues with regard to access to healthcare, including fear and insecurity, mobility restrictions due to the need to be accompanied in public by a mahram or the need to travel long distances to reach health services. Female patients were also reportedly allowed to be attended only by women healthcare professionals. Women lacked sufficient means of safe transportation and there was a shortage of trained female personnel [KSEI 2022, 6.3, p. 49].

An article quoted health workers from Ghazni district describing an incident where two unaccompanied women were reportedly forced out of a clinic by the Taliban. In another incident, a midwife was reportedly detained, and medical staff of the clinic was facing prosecution for having attended to a single woman giving birth. Taliban reportedly denied that such incidents took place [Targeting 2022, 5.1.6, p. 95; 5.2.3, p. 113].

In March 2022, the Taliban MPVPV ordered healthcare institutions to deny medical assistance to female patients without a hijab [Targeting 2022, 5.2.5, p. 120].

In Afghanistan, people with mental and physical disabilities are often stigmatised. Their condition is at times considered to have been ‘related to God’s will’. Mistreatment of those people by society and/or by their families has occurred. Women, displaced persons and returned migrants with mental health issues are particularly vulnerable. There is also lack of appropriate infrastructure and specialist care that covers the needs of people with disabilities. The existing structures were largely concentrated in a few urban centres [KSEI 2020, 2.6.6, p. 59].

Risk analysis

The lack of personnel and adequate infrastructure to appropriately address the needs of individuals with (severe) medical issues fails to meet the requirement of Article 6 QD regarding the existence of an actor that inflicts persecution or serious harm, unless the individual is intentionally deprived of healthcare.

The actor requirement may be satisfied in specific cases of denial of healthcare, such as in the case of women denied access to healthcare due to not being accompanied by a mahram, not wearing a hijab, or not being allowed to be seen by a male healthcare professional. See the sub-section a. Restrictions of rights and freedoms under the Taliban under the profile 3.15 Women and girls.

For persons living with mental and physical disabilities, the individual assessment whether discrimination and mistreatment by society and/or by the family could amount to persecution should take into account the severity and/or repetitiveness of the acts or whether they occur as an accumulation of various measures. The individual assessment of whether there is a reasonable degree of likelihood for the applicant to face persecution should take into account risk-impacting circumstances, such as: nature and visibility of the mental or physical disability, negative perception by the family, etc.

Nexus to a reason for persecution

With regard to women, see 3.15. Women and girls.

With regard to persons living with noticeable mental or physical disabilities, available information indicates that the persecution may be for reasons of membership of a particular social group, defined by an innate characteristic and distinct identity linked to their stigmatisation by the surrounding society.