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The cost of speaking up

Health & Society
Peter Blackburn

Describing the horrors of life under the Taliban has led to doctor Muhib Shinwari fearing for his safety and having to look elsewhere for work. Leaving the country may now be his only option.

‘We are all beggars in the making now – they erase our hope and our way of life.’ Cardiology trainee Muhib Shinwari is putting his own career and safety at risk to tell the world what the Taliban has done to his home country of Afghanistan.

‘I think people around me need to be educated,’ he says. ‘They need to know. It is risking my job. And it could be worse than that... But I don’t see any other way.’

Dr Shinwari, who lives in Kabul, feels that everything with value is being decimated in his country. ‘We are heading toward the very worst impacts of this regime,’ he says.

It just feels like the future is more disaster.

Dr Shinwari

‘They are forcing people to not wear what they want to wear, forcing girls to wear hijabs, they check the colours of scarfs and assess beards. They are hurting Afghans.’

It isn’t just the rights of others Dr Shinwari is worried about. He and his loved ones have suffered directly. Dr Shinwari has been told he can no longer work at his local hospital because he is unwilling to stop speaking out. He is now trying to find work elsewhere.

And Dr Shinwari says his brother has been attacked and taken away on two separate occasions by the Taliban. On top of that, his sister, who is in the 11th grade at school, is no longer allowed to continue her education.

‘It’s very confusing and scary, it just feels like the future is more disaster,’ he says.

Needless deaths

Dr Shinwari had been training in Beijing until the COVID-19 pandemic hit. Having seen the impact of the disease and the relationship with cardiac problems he decided to fly back to Afghanistan and to offer help in a hospital in Kabul. But then the Taliban came.

In August last year Dr Shinwari spoke to The Doctor from a house in Kabul, in hiding, for fear of going to work not knowing what the Taliban might do to him. He eventually returned to his hospital.

Dr Shinwari says it was a tough environment in which to work – with most patients unable to afford care and only the most desperately unwell coming through the doors.

‘The people who are going to hospital are dying. They are having acute myocardial infarction or heart attacks or brain haemorrhage or things like that.

'Only those people who are in real need of care are there otherwise they tend not to go to hospital because of the economy and all the problems in the country. They just don’t have the money to pay.’

Dr Shinwari

Dr Shinwari adds: ‘Ten days ago we had a doctor who was suffering from an intracranial cerebral haemorrhage. He was a doctor admitted to our ICU but he could only afford to stay for two days.

'It was roughly 50 USD per night and then they took him to the public hospital because he couldn’t afford the care for more than two days. When he went to the public hospital, where there are real problems with care, he died there.

'He was only 28 years old. This is the situation of a doctor in a good profession – imagine the situation of everyone else, how they are struggling.’

Now, having told his hospital he isn’t willing to be made to be silent, Dr Shinwari is desperate to find a way out of the country – to use his skills to help patients in another country.

Trapped and ignored

Despite multiple efforts, however, Dr Shinwari has been unable to find other countries and health organisations willing to offer him work and a visa. He says: ‘It is so hard for Afghans in the current situation to go to other countries.

‘If you have contacts with professors or universities or whatever they can help you, but you need to show huge bank accounts with maybe 30 or 40 thousand dollars which isn’t realistic in Afghanistan.

‘Nobody wants to put money in the banks, the economy is a mess and even if you fulfil all the requirements of getting a visa they often just ignore you, deny you a visa or turn you down. They are not wanting Afghans. It’s quite a bleak situation for us.’

There have been many obstacles beyond finance, too. Some organisations have requested proof of significant experience working in academia and Dr Shinwari has also struggled to find mentors who will help navigate systems and bureaucracy.

Dr Shinwari says he had expected to find more ‘welcoming’ environments given the ongoing situation in Afghanistan but feels trapped.

‘The whole country is in a prison,’ he says. ‘People are trying to find illegal ways to get out of this hell.’

People are trying to find illegal ways to get out of this hell.

Dr Shinwari

When The Doctor asks what Dr Shinwari would say to the UK Government and to health organisations not offering help, he says: ‘I would be a professional coming to the host country – not just there to take benefits. I would be there to help the economy and the health system.

'Many countries are struggling for doctors – and we saw in COVID times how important it was to have a strong health system – but we don’t seem to be welcomed anywhere. It is a position many of my colleagues are in. Whoever can, will leave – nobody wants to stay here by choice.

‘We just want a chance.’

The BMA has voiced concern with the passage of the Nationality and Borders Bill, which will result in the UK failing to support individuals fleeing desperate situations.

It continues to push for the development of a single, fair, humane and effective refugee system, in keeping with its obligations under international humanitarian and human rights law.

The BMA, through the refugee doctors initiative, supports asylum seeker and refugee doctors who enter the UK providing a range of benefits to help them get their licences to practise in the UK.