Sylvia's Journal

I spent most of the day at the ministry. Only one of the three meetings I had planned to attend actually materialized. So much for getting things clarified, straightened out and organized before I go off for a fortnight. Still, it is good to hang out at the ministry because you meet people and hear things one would not back at our office.

In the morning I attended a presentation by the private sector (for profit) office that has sketched out a plan for bringing them on board to work alongside the ministry towards better health services and products for Afghans.

It is a complicated undertaking because (1) there is a general mistrust of the private-for-profit sector’s motives (perceived as ‘make as much money as you can, no matter what the quality of the product or service is’), and (2) the for profit health sector is not organized making it hard to invite ‘representatives’ to the table.

The plan was a heroic attempt to bring some order in all this, and a strategy for action. Yet how this is going to be funded is unclear. This was also true for the next presentation about Afghanistan’s mental health strategy; maybe an even more complex and more costly undertaking.

Everyone agrees there is a huge problem but the boundaries of what constitute ‘illness’ and what is the result of cultural practices that some of us would call domestic abuse are fluid.

The strategy development process was long and arduous and full of disagreements and conflict. The proponents of the need for action fought many battles and lost often to primary health care advocates. All sides claimed that their investments pay off. But the investments will have to come from outside as the government cannot pull this cart on its own. Someone is calculating the cost. It will stun people no doubt.

That women are anxious, throw themselves in wells, burn themselves or are seriously depressed is not because they are mentally ill (although one could argue they become that way – ill from worry). Afghanistan, especially the rural areas, is not a healthy place for women.

One of today’s ANSO reports (the organization that reports faithfully on the multiple ‘security incidents’ each day) illustrates this all too well: the bodies of two women were brought to the capital city of Helmand province this morning. They were, allegedly, members of a women’s tailoring cooperative – funded through the US government which made them, in the eyes of the insurgents, ‘collaborators,’ a death sentence that was swiftly executed. Or may be it was simply a family feud – such reckoning goes mostly unpunished.

There are safe houses for women who escape, but they are well hidden and thus not easy to find. The women who make it there need psycho social support yet there are few professionals who are trained to provide this and no government services or legal recourse to help them. The mental health strategy tries to insert some services so that women who come to the health center can find an attentive ear rather than a man to escort them back to their tormentors (husbands, brothers, uncles as well as mothers-in-law).

One of the people who spent much energy on this mental health strategy is Inge Missmahl. She attended the meeting as one of the architects of the strategy. She and her ministry counterpart must have been very happy to hear the words ‘strategy accepted,’ at the conclusion of the meeting, coming out of the mouth of a senior government official.

My friend Charles had sent this link that shows Inge speaking on TED. I felt privileged to meet her in person.

We talked about life and death in a way that would be unthinkable in the US. We had Ted over for dinner. Much of the evening we brooded over whether his school for young girls and boys can survive – with survival also referring to people living rather than dying, or to be more precise, being shot by angry fathers, uncles or brothers.

Two of what we refer to as ‘his girls’ have first names that mean ‘bad omen.’ How’s that for a vision of your baby girl? Yet both of these bad omens are now in the US studying to become the Afghan intelligentsia. But with the Taliban talking to Karzai and maybe even with the Americans, what good will that do to girls? Most of Afghanistan’s male and female intelligentsia is now living someplace else. They know on which side their bread is buttered.

Having Ted for dinner is an emotional roller coaster ride. On the one hand there are the stories of the blossoming of female talent and self-confidence, which I have witnessed myself, and on the other hand the threats, the abrupt ending of promising school careers for (forced) marriage, and always, always the possibility of an angry man with a gun storming into his home and wrecking havoc.

Over a delicious leg of lamb dinner accompanied by a bottle of Mateus Rose that Ted brought us, we pondered the future of the SOLA school. Ted’s is beginning to come to the conclusion that investing in brick and mortar in this place is increasingly unattractive as the situation in Afghanistan (though not quite in Kabul) deteriorates. Could the school be someplace else?

Axel and I invoked the Quaker belief that one day ‘way will open,’ even if that opening is right now obscured from view. Ted’s trip to the US may help open the way, or it may not. We will add some of our connections to the ones he already has. After all that is how the world works, even, or especially, for these young Afghan girls and boys whose families have placed all their hopes in a better education for them, even for the two bad omens.

My biggest regret today was that I don’t understand Dari as well as I should to follow the conversations during this morning’s alignment meeting with several of the Midwives’ Association’s stakeholders. It is hard to coach people when you don’t understand exactly who is saying what. The only thing I could do was reacting to signs of derailment and requesting a quick whisper translation before intervening.

M. facilitated several pieces of today’s agenda. She was nervous, and had probably been sweating all through the weekend, but she performed just fine and none of the nervousness showed. It is always like that – nervousness is mostly noticeable inside, not on the outside. I am pleased with the results of our gentle pushing – we are all one experience wiser. We will do an after action review later this week, before I leave. There were many teachable moments, even after the fact.

I continue to see the consequences of the awkward dynamics between men and women, especially older men and younger women. The longer I am in this country the more I believe that Afghanistan’s troubles partially stem from the unequal and uncomfortable relations men and women have with each other outside the home. The inability of professional women, especially young ones, to tactfully challenge their male colleagues means there is nothing to put the brakes on their behavior except the man’s own willingness to observe what he is doing or ask for someone else to do that. Luckily A. is like that.

It also means there is little room for women to experiment as a way to learn how to facilitate conversations with dominant men in the room. I learned the trade by challenging (or gentle confrontation) and then I noticed the response and compared it to the effect I had intended. Over time this is how one learns and expands one’s repertoire. The main thing is that I, as a woman, can do this sort of experimenting without risking life and limb. It’s not clear how that could happen here.

The pattern I have observed is that when men violate agreements, dismiss or belittle women as full partners, the women, unable to confront this, exit behind their chadoors and into their private spaces where they talk with their sisters, increasing the upset through mutual reinforcement.

A few young women in this country have dared to challenge men in public, older and powerful men, but the consequences have been deadly. And so there is little incentive to change the situation. As a result the vicious circle is reinforced over and over, unbreakable it seems: the women remain unable to engage directly with the men who they criticize (at best) and despise (at worst). I sometimes joke that this is a 1000 year project. But for Afghan women this is no joke.

My grey hair comes in handy, as does my (birth) nationality and the fact that I am a creature that doesn’t fit into any of the clearly delineated gender roles. I am direct, sometimes very direct. I don’t know really how that goes over except that it doesn’t appear to have damaged my relationships. I say ‘appear’ because the indirectness makes it impossible to gauge the impact of one’s behavior on others.

And since appearances are so important here, I treat ‘what appears’ as ‘what is.’ I don’t know how else I could do my job.