Four hundred soldiers and police officers are trying to hunt down an armed Belgian extremist for three days, without result. Belgium put the highest security threat on the man, a radicalised far-right soldier, who succeeded in stealing heavy weapons from a military depot where he worked. He left a note before disappearing that he is on a mission and might not come back alive, creating fears of a terrorist attack.
‘I’ve already sold my daughters; now, my kidney’: winter in Afghanistan’s slums | Global development
The temperature is dropping to below zero in western Afghanistan and Delaram Rahmati is struggling to find food for her eight children.
Since leaving the family home in the country’s Badghis province four years ago, the Rahmatis have been living in a mud hut with a plastic roof in one of Herat city’s slums. Drought made their village unliveable and the land unworkable. Like an estimated 3.5 million Afghans who have been forced to leave their homes, the Rahmatis now live in a neighbourhood for internally displaced people (IDP).
There are no jobs. But the 50-year-old has hospital fees to pay for two of her sons, one of whom is paralysed and the other who has mental illness, as well as medicine for her husband.
“I was forced to sell two of my daughters, an eight- and six-year-old,” she says. Rahmati says she sold her daughters a few months ago for 100,000 afghani each (roughly £700), to families she doesn’t know. Her daughters will stay with her until they reach puberty and then be handed over to strangers.
It is not uncommon in Afghanistan to arrange the sale of a daughter into a future marriage but raise her at home until it is time for her to leave. However, as the country’s economic crisis deepens, families are reporting that they are handing children over at an increasingly young age because they cannot afford to feed them.
Yet, selling her daughters’ future was not the only agonising decision Rahmati was forced to make. “Because of debt and hunger I was forced to sell my kidney,” she tells Rukhshana Media from outside her home in the Herat slum.
Afghanistan is on the brink of “a humanitarian crisis and economic collapse”, according to the UN. The agency’s ambassador to Afghanistan has said it is “experiencing the worst humanitarian crisis of its contemporary history”. Drought, Covid-19 and the economic sanctions imposed after the Taliban seized power in August 2021 have had catastrophic consequences on the economy. Dramatic rises in inflation have resulted in soaring food prices.
The kidney trade has been growing in Afghanistan for some time. But since the Taliban took power, the price and conditions under which the illegal organ trade takes place has changed. The price of a kidney, which once ranged from $3,500 to $4,000 (£2,600 to £3,000), has dropped to less than $1,500 (£1,100). But the number of volunteers keeps rising.
Rahmati sold her right kidney for 150,000 afghani (£1,000). But her recovery from the operation has not been good and now, like her husband, she is also sick, with no money left to visit a doctor.
More than half of the country’s estimated 40 million population face “extreme levels of hunger, and nearly 9 million of them are at risk of famine”, according to the UN refugee agency, UNHCR. For a growing number of Afghans, selling a kidney is their only way to get money to eat.
“It has been months since we last ate rice. We hardly find bread and tea. Three nights a week, we can’t afford to eat dinner,” says Salahuddin Taheri, who lives in the same slum as the Rahmati family.
Taheri, a 27-year-old father of four, who scrapes together enough money for five loaves of bread each day by collecting and selling recycled rubbish, is looking for a buyer for his kidney. “I have been asking private hospitals in Herat for many days if they need any kidney. I even told them if they need it urgently, I can sell it below the market price, but I haven’t heard back,” Taheri says. “I need to feed my children, I have no other choice.”
In the past five years about 250 official kidney transplants have taken place in the hospitals in Herat province, with a very limited number being a family member donating their organ, says Asif Kabir, a public health official in the province. The cost of a kidney transplant is 400,000 afghani, plus the price of the kidney, according to Kabir.
But the true number of kidney operations may be far higher. A doctor working in one of the hospitals where most of the transplants take place, who spoke on the condition of anonymity, says: “Recently the number of people who want to sell their kidney has increased in Herat and most of them live in the displaced camps, in Herat’s slums. The customers also go to the displaced camps to find a cheap kidney.”
Sayed Ashraf Sadat, a civil society activist in Herat, was a member of a delegation assigned by president Ashraf Ghani to investigate the illegal kidney trade in May 2021.
“We found that the hospitals were not working according to the law. People are working inside and outside the country to encourage people to sell their kidneys. These people get them visas and send them to the other side of the border. There is more demand for kidney transplants outside Afghanistan. Countries like Iran need kidneys, and poor Afghans are forced to sell them.”
Sadat says the investigation he was part of identified two hospitals in Herat where kidney transplant operations take place; one of them said it had completed 194 operations and the other said 32, but more than 500 people were claiming to have sold their kidney, 100 from a single village in Herat. “This shows the kidneys were taken outside Afghanistan,” says Sadat.
“For example, a kidney is purchased for 300,000 afghani (£2,100) inside Afghanistan, and it is sold for more than £7,500 to £11,000 outside the country,” says Sadat.
“We found evidence that some are encouraged to sell their kidneys, taken outside the borders, and their kidneys are sold for 200,000 to 400,000 afghanis ,” says Sadat. “It seems that the doctors are involved in the illegal trade. But unfortunately, our investigation was stopped due to a worsening security situation.”
Two months have passed since Rahmati’s kidney operation, and the money has already gone to pay off medical debt. Her recovery from the operation continues to go badly.
“I am so sick. I couldn’t even walk because the wound has been infected. It is very painful,” she says, adding that the recipient of her kidney only paid for the operation fee, two nights in hospital and her first medicine bill.
On the day of the transplant, Rahmati was sick and the doctors refused to operate. “I couldn’t breathe properly, so the doctors took me down from the hospital bed, but I returned. I told them ‘I am happy with my own death, but I can’t tolerate seeing my children hungry and ill’,” she says.
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Airlines should start paying for CO2 sooner
Airlines flying from one European destination to another should start paying for all their carbon emission from 2026, a year earlier than planned, according to a draft report by Croatian centre-right MEP Sunčana Glavak seen by Reuters. The Commission earlier proposed to phase out free CO2 permits by 2027. “We must support innovation in the sector and the use of sustainable aviation fuels,” she said.
Death threats and phone calls: the women answering cries for help one year on from Poland’s abortion ban | Poland
One year ago, on the night Poland introduced one of the most restrictive abortion laws in Europe, the phone started ringing at the country’s most high-profile family planning organisation. Over the course of the evening, volunteers took calls from more than 20 panicked women who suddenly found their next-day appointments for abortions cancelled.
One of the calls was from hospital staff at a loss over what to do about a woman who broke down after being told that her termination would not go ahead. “She went into a frenzy, got into the hospital lift and was going up and down, up and down, without stopping for an hour,” says Krystyna Kacpura, director of the Federation for Women and Family Planning (Federa).
Staff at Federa were used to helping women navigate a hostile healthcare system in which legal terminations were already virtually impossible. But the new legislation put in place an almost total abortion ban in everything but name, allowing women to terminate only if the pregnancy was the result of rape or incest, or if it represented a threat to life or health. At the time the legislation was brought in, about 1,000 legal abortions were carried out in Poland every year, 98% because of foetal abnormalities. This option was now closed to women. It was, says Kamila Ferenc, a lawyer for Federa, a devastating blow.
Since its announcement, at least 34,000 women in Poland have managed to get abortions despite the ban, and hundreds travelled abroad for later abortions, facilitated by groups such as Abortion Support Network and Women on Web.
But now the women calling Federa for help are often in serious distress, many further into their pregnancy because they have discovered a problem at a second-trimester scan. Pregnancies are more likely to have been planned. “In the past, it was rare for us to receive calls from individuals in this state. This last year, it has been 80% of our work,” says Ferenc in Federa’s Warsaw office. “Every call is very emotional.”
In the past year staff and volunteers at Federa, like many other women working as advisers, lawyers and activists in the pro-choice movement, have faced death threats, intimidation and legal challenges. Many have said they are exhausted by their increasing workload as they struggle to help women trying to access safe abortions.
Ferenc says she is not afraid of the people who send bomb threats to her office or superimpose bullet holes on pictures of her face. “I’m more scared that one day prosecutors will launch an investigation against us,” she says. In the past, few Poles faced trial on abortion-related charges. The state largely turned a blind eye to illegal abortion services, with pages towards the back of newspapers filled with euphemistic adverts for private clinics offering “restoration of the menstrual cycle”. That changed when the new law came in.
Justyna Wydrzyńska, of pro-choice groups Abortion Dream Team and Women on Web, became the first Polish abortion activist to face the prospect of trial in September, after a man notified the police that his wife ordered abortion pills online. The case is ongoing.
Ferenc believes the latest changes did not fully appease the ruling Law and Justice party’s (PiS) religious base. “Before, abortion was not a topic, no one wanted to talk about it. Now the anti-abortion groups on whose support PiS is relying are demanding blood.”
Marta Lempart – who is fighting 86 court cases under various charges – heads the pro-choice Polish Women’s Strike movement and says the new laws have targeted the women most at need of healthcare and support.
“Polish women with unwanted pregnancies are now in a better situation than those with wanted pregnancies but who are facing complications, because there is a working system completely outside of public healthcare for the former. But the healthcare system does not provide a service to the latter at all.”
A further attempt to ban abortion completely and jail women who had terminations for life was rejected by the Sejm, the lower chamber of the Polish parliament, but the government has since announced it would begin compiling a database of all pregnancies across the country, a move defended as a digitisation of existing documentation but which women’s rights groups believe is another natalist policy designed to control women’s lives and a sign that worse is to come.
Meanwhile, an underfunded and overstretched Polish healthcare system, accused of failing to provide women with reproductive care, is emboldened by the new laws. “Women are falsely told by doctors that contraceptive pills give them cancer, or that an IUD is dangerous for those who haven’t had children yet,” says Ferenc. She has begun advising women to record their conversations with doctors. One woman said that doctors treating her breast cancer repeatedly told her the illness was caused by an abortion she had months earlier.
But Kacpura and others believe the legislation may also have had a chilling effect on doctors who are terrified of navigating the new law. She says, before the 2021 ruling, doctors would rarely contact her, but in the past year she has been answering their calls day and night. “No one [in authority] explained to the doctors what they should do,” she says. Sometimes, doctors call to pass on the numbers of patients they were not able to legally help. “I called one woman straight after she left the hospital. She was in an awful state, it’s hard to say what she would have done if we hadn’t reached her.”
Agata Bzdyń, a lawyer who represents a number of women who have taken their abortion refusals to the European court of human rights, points to reports that Bielański hospital in Warsaw, which she says “has a reputation for still providing abortions”, has been under pressure from the government to hand over documents on the number of terminations approved. Bielański did not respond to a request for comment.
Beyond the government, Roman Catholic lay groups continue to exert pressure for an outright abortion ban. The group Ordo Iuris (Order of Law) was one of the mobilising forces behind a citizen’s bill in favour of a total abortion ban, a move that was rejected by parliament but precipitated the ruling. Since 2016, the organisation has acted as official adviser to the PiS government in areas of reproductive rights and education. The organisation recently announced that it will provide legal representation to a man who is suing his wife for having an abortion, which Ordo Iuris argues violated the man’s right to family life.
The most shocking case of the past 12 months is that of a woman called Izabela, who died in November of septic shock while in her 22nd week of pregnancy. Doctors at the hospital in Pszczyna, in south-west Poland, did not perform an abortion, even though her foetus would not survive, according to a lawyer for the family. “For now, because of the abortion law, they can’t do anything,” Izabela texted to her mother shortly before she died. An investigation found “medical malpractice” led to Izabela’s death and the hospital was fined . She is survived by a husband and daughter.
Kacpura said she knows of several cases in the past year where the woman’s waters broke prematurely, as Izabela’s did, but doctors refused to perform a caesarean or induce birth. “A nightmare, because the foetus cannot survive but the heartbeat can continue for days, sometimes weeks, and the woman has to wonder whether she has already become a coffin.”
Bartłomiej Wróblewski, a leading PiS parliamentary force behind the change in the law, said: “It is not true that this law puts women’s lives in danger, because nobody challenged existing provision of Polish law to rescue endangered life and health of the mother, even when it leads to the death of their unborn child.” Echoing other governmental and anti-abortion voices, he stressed that in his eyes there was no connection between Izabela’s death and the new abortion restrictions, instead putting the blame on doctors.
But Izabela’s death horrified the country and sparked fresh protests. It may have proved a turning point. Several polls have found the majority of people in the country oppose the 21 January ruling.
Even those who are not pro-choice resent what they see as the Roman Catholic church overstepping the mark by creating political pressure for a ban, says Aleks Szczerbiak, professor of politics at Sussex University. “About 40% of people in Poland still attend weekly mass, but that is not to suggest they are happy for the church to have more control of their lives,” says Szczerbiak. He believes the change in law may have shifted perceptions of the issue in Polish politics.
Ferenc echoes this. “We thought there was no political chance to change [the law around abortion]. The paradox is that it has changed for the worse, but that means we have a chance to liberalise the law too,” she says.
A pro-choice citizen’s bill calling for abortion to be made fully available is gaining momentum. “We had an older gentleman come in whose wife told him to print the form from the internet and he got his friends to sign it, and then he came to deliver his 10 signatures,” says Lempart from her office on Wiejska Street, a few doors down from the Polish parliament. “Before, initiatives to collect signatures were mostly organised by groups and political parties. Now, I’d say 60% is just individuals collecting signatures.”
Organisers say the citizen’s bill has reached the 100,000 signatures needed for official recognition and more signatures are coming in every day.
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