Health & Medicine

“Why were you destroying government property in Afghanistan?”

Malcolm Potts

I first went to Afghanistan in December 1969. I still remember the bitter cold. USAID had begun to invest in family planning and an American gynecologist had been assigned to the US embassy in Kabul to start a program. He was who had invented a new experimental  intrauterine device. It looked to me rather like a crumpled razor blade.

At the time I was the Medical Director of the International Planned Parenthood Federation, working out of London.  I visited a number of clinics and found out that the Afghan physicians were required to fill in a 16 page book with irrelevant information about each woman receiving this new device. When one Afghan doctor asked me what I thought about the booklet, I ripped it in half, threw it on the floor and stamped on it.

Some months later several people waylaid me in the corridors of  USAID and asked why I had been destroying government property in Afghanistan.  Fortunately, Dr Ray Ravenholt,  the head of USAID¸ totally agreed with my response.

At the time I believed that women deserved access to family planning and that rapid population growth was a serious problem. I didn’t fully realize, as clearly as I do now, that Afghanistan was never going to develop unless women could be educated and the population growth slowed by improving access to family planning.

In 1969 there were 12 million people in Afghanistan. Today, there are over 33 million and in 2050 there will be 76 million. In the 1960s a sensible program to offer women the freedom to decide whether and when to have a child could have made a difference. The tide was flowing in favor of women’s autonomy and it should have been taken on the flood.

In 1969 there was no certainty the Afghanistan would develop but it was a real possibility.  Although it was a desperately poor country, some women were in school and not all women wore a headscarf.

When the Russians invaded Afghanistan 10 years later, the knee-jerk response of America was to arm the Taliban, help create Al Qaeda. Whatever their defects, the communists would have given women access to family planning and the schools would have been open to girls as well as boys. Afghanistan would be a much better place to be a woman today if  America had not helped drive out the Russians..

Our last chance to help Afghan women was after the collapse of the Taliban in 2001. The wars in Iraq and Afghanistan have cost is $1 trillion. One billion dollars (that is 12 hours of current defense expenditure by the US) invested in women’s education and in family planning could have done a great deal to help women and to slow rapid population growth.   Again we failed to put women center stage.

The only certainty now is that when the Americans pull out the women of Afghanistan will be married off at puberty, be pregnant and rearing children until the menopause, likely beaten by their husbands,  and if they do venture outside the house it will be inside an all enveloping burqa.

By 2050 there will be as many young men aged 15 to 30 as there were men, women and children of all ages as there were when I was in the country in 1969. These 12 million angry young men will have no education and practically none will have genuine employment opportunities. If only one in 1000 decides to be a suicide bomber, Afghanistan – and the world – will pay a high price in conflict and terrorism.

Afghanistan is a prototypical example of tragically missed opportunities, There are still places in Africa and northern India where we can salvage some semblance of progress by investing in women and making family planning accessible. Women are key to economic progress, to restraining corruption and slowing unbridled population growth. But we need to act quickly and on a large scale. History is a one way road and mistakes are increasingly expensive to repair the longer we wait.

 

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