BOSTON, Massachusetts — Besides Pakistan, Afghanistan is the only other country in the world where polio is endemic. The country’s vaccination efforts often meet logistical challenges like navigating religious customs, reaching isolated neighborhoods and closing gender disparities in vaccinations. To combat these challenges, local women have been volunteering for years with little to no compensation. Despite constant threats from the Taliban, these female frontline workers (FLWs) continue to assist Afghanistan’s polio vaccination campaigns through education and resilience.
Gender Disparities in Afghanistan’s Polio Vaccinations
Gender plays an important role in Afghanistan’s polio vaccination campaigns. The country’s social and cultural landscape shapes vaccine distribution, which often leaves women without polio protection.
Women’s vulnerability to polio is based on several factors, such as gender dynamics in the community and religious customs. In many Afghan communities, boys take priority in health care and vaccination distribution over girls.
Traveling to vaccination clinics can be difficult. In 2021, the Taliban banned women in Afghanistan from taking solo road trips beyond 45 miles, requiring that a male relative accompany them. This ruling makes transportation especially difficult for women in rural areas who must also account for travel costs and wage loss.
Female FLWs Bridge the Gender Divide
The unique position of female FLWs allows them to avoid several barriers to vaccination. Under the current community law, women vaccinators can enter houses with only women and children. Volunteer Hosna Reza told UNICEF: “You can almost say it’s become ‘normal’ to see women going door-to-door in Kandahar during polio campaigns. Few people ask what we are doing anymore.”
While reaching out to the community, female FLWs also educate women and mothers. Featured in a UNICEF article, Sakina Abdul Ghafar combats misinformation in her community by leading polio and health education sessions. Her hope is to ensure positive perceptions about the polio vaccine and dispel rumors. Other female FLWs offer other health care information to women in their communities in comfortable settings, providing information over tea and during breaks.
Under Constant Threat
Despite their necessary work in polio vaccine distribution, multiple female FLWs have been assaulted or murdered. In March 2021, an unidentified gunman in Jalalabad, Nangarhar Province, killed three FLWs. The three women were part of a five-day nationwide polio vaccination campaign aiming to vaccinate 9.6 million children in Afghanistan.
The Taliban poses another reason for concern. Since June 2012, the Taliban’s targeted killing of polio workers in Pakistan, near the Afghan border led many women to quit their positions. The Taliban has since changed its statement, expressing its support for house-to-house polio vaccination campaigns. In a UNICEF statement in October 2021, the Taliban allowed a nationwide campaign to resume its efforts.
Still, female FLWs face no shortage of harassment from strangers or fellow male volunteers. In balancing the benefits and the drawbacks of their volunteer work, many female FLWs have understandably left their positions in Afghanistan’s polio vaccination campaigns. But many volunteers also refuse to back down.
– Anna Lee