Afghan Report: May 16, 2006

Speculation of ties between insurgents in Afghanistan and Iraq has resurfaced in the face of continuing attacks on military and other targets in Afghanistan. The fears are stoked by a growing number of suicide missions, videotaped testimonials, greater use of improvised weapons, and the neo-Taliban insurgency's claim of responsibility for the recent beheading of a hostage. Could the apparent shift in tactics in Afghanistan reflect what might be best described as "Iraqization."

The commander of coalition forces in Afghanistan recently acknowledged that "the enemy" has changed tactics in the past year. U.S. Lieutenant General Karl Eikenberry said in Washington on May 10 that attackers are increasing their reliance on improvised explosive devices (IEDs) and suicide bombings.

He attributed increased bloodshed -- particularly in the three southern provinces of Helmand, Kandahar, and Oruzgan -- to "very weak institutions of the state" rather than a "stronger enemy." Eikenberry ascribed the heightened violence to more than just Taliban and international terrorists. He also blamed purely criminal acts, tribal feuds, and drug traffickers.

The Afghan government refers more elliptically to "enemies of peace and stability." Self-described Taliban forces tend to claim responsibility for most of the violence, but some such claims have proven false in the past.

For the sake of discussion, the perpetrators of the violence carried out in the name of the Taliban might best be described as "neo-Taliban."

Keeping Up Appearances

While the neo-Taliban have acknowledged that there are foreign fighters among their ranks, there is no evidence to suggest concerted cooperation between Al-Qaeda and neo-Taliban -- at least not in southern Afghanistan. The south has not historically welcomed Arab influence or provided Arabs a foothold -- even throughout Afghan resistance to Soviet forces or the subsequent Taliban rule over much of the country.

Purported Taliban spokesman Mohammad Hanif was quoted by the Rome-based daily "La Repubblica" as saying recently that his movement has no "operational ties" to Al-Qaeda. But he added that the two movements have "tactical alliances based on given circumstances and territorial situations." That "tactical alliance" could be a reference to what Eikenberry described as training and facilitation provided by Al-Qaeda to Afghan insurgents.

Mohammad Hanif described suicide operations as part of the "various techniques in a war of liberation." When volunteers seek to conduct suicide missions, he said, "we support them...[and] view them as martyrs."

The Afghan government has tended to proclaim that suicide operations are not part of Afghan culture -- suggesting they are the work of foreign elements. But an increasing number of those individuals are reportedly Afghans.

Also mirroring suicide operations in Iraq, the neo-Taliban have begun recording the testimonials of suicide bombers -- along with their grisly crimes.

In at least one instance, the videotaped execution of an Afghan accused of spying for the United States was posted on an Arabic jihadist website. It was reminiscent of the work of the Jordanian Abu Mus'ab al-Zarqawi's group in Iraq. But it does not provide evidence of any operational relationship between al-Zarqawi's group and the neo-Taliban in Afghanistan.

In fact, according to spokesman Mohammad Hanif, the Taliban have no "specific strategy" but rather "adopt different tactics according to circumstances."

While links between the neo-Taliban in southern Afghanistan and al-Zarqawi's terrorist outfit in Iraq still appear remote, there is much to indicate direct cooperation between al-Zarqawi and Osama bin Laden's Al-Qaeda -- which operates in the Afghan-Pakistani borderland.

Postings on a jihadist website recently highlighted the desire within Al-Qaeda to link the Afghan and Iraqi theaters of fighting. A discussion on the website described Iran -- which sits between those two countries -- as an obstacle to connecting the Iraqi and Afghan fighting.

Cooperation, Not Coordination

U.S. General Eikenberry echoed the generally held view that there is no conclusive evidence of any mass migration of fighters from Iraq to Afghanistan.

The use and increasing sophistication of suicide bombings, beheadings, and improvised explosive devices -- including their increased sophistication -- might be attributed to training provided by Al-Qaeda elements to the neo-Taliban. It might also be ascribed to what Eikenberry called a major challenge in this technological age -- the sharing of operational tactics and weapons knowledge through the Internet. U.S. sources with knowledge of the explosive devices used in both Afghanistan and Iraq maintain that there is no evidence of shared materials.

The prospect of a coordinated operational alliance between Al-Qaeda in Afghanistan and Iraq clearly concerns NATO and other countries with troops in Afghanistan.

But that nightmare scenario would seemingly require Iranian cooperation to provide a transit route. Contributors to jihadist websites have pinned their hopes on a further deterioration of relations between the West and Iran. Such a development could prompt Tehran to cooperate in the effort to link antigovernment fighters in Afghanistan with those in Iraq.

In the absence of Iranian assistance, Al-Qaeda and its neo-Taliban allies are seemingly limited to shared tactical knowledge and training with al-Zarqawi's terrorist group in Iraq. For now at least, they would appear unable to synchronize their operational capabilities -- if such a desire exists. (Amin Tarzi)

New Afghan Foreign Minister Rangin Dadfar Spanta said on May 15 in an exclusive interview with RFE/RL's Radio Free Afghanistan that his country is ready to play a role in reducing tensions between its ally, the United States, and neighboring Iran over Tehran's nuclear activities.

Afghan Foreign Minister Spanta said today that his country wants a diplomatic solution to the ongoing crisis over Iran's nuclear program.

"We want the tensions between [the U.S. and Iran] to be decreased and disagreements to be resolved in the framework of international laws and also the expectations of the International Atomic Energy Agency (IAEA)," he said. "In this regard we have said that Afghanistan is ready, if it can, to have a role in reducing the tensions."

A Mediator?

Spanta, however, said that there has been no demand for his country to mediate in the ongoing crisis over Tehran's refusal to halt its uranium-enrichment program.

"We have not been entrusted with mediation, we just wanted to have a role in this regard," Spanta said. "If someone will eventually ask to convey a message from one country to the other, then we would definitely do so."

Iran's Fars news agency recently reported that Afghan President Hamid Karzai is due to travel to Iran next month with a high-level delegation.

Afghan Foreign Minister Spanta on May 15 confirmed in his interview with RFE/RL that he will accompany Karzai during his trip to Iran, though he didn't give a date. Spanta said cooperation between Kabul and Tehran in different fields -- including railroad building -- will be discussed.

Mutual Trust

He added, however, that the nuclear issue is not on the agenda for talks with Iranian officials. "[The nuclear crisis] is not directly on our agenda but we hope that this issue will be solved between Iran and Western countries as soon as possible," he said. "Any tension in the region will affect Afghanistan, economic developments, and peace in our country."

Spanta said Afghanistan enjoys very good friendly ties with its Western neighbor, Iran, which are based "on the principle of cooperation and mutual trust."

Regarding ties with Afghanistan's eastern neighbor, Pakistan, Spanta said that he is hopeful that the two countries can overcome "misunderstandings." Spanta did not elaborate but he blamed Pakistan for not doing enough to catch Taliban leaders who, he says, have taken refuge on its territory.

Fighting Al-Qaeda, But Not Taliban?

"I'd mainly like [to emphasize] that although Pakistan has arrested several Al-Qaeda leaders, there has not been any significant action to arrest Taliban leaders," he said.

Spanta was quoted on May 13 by a German paper ("Bild am Sonntag") as saying that Al-Qaeda leader Osama bin Laden is living in Pakistan close to the Afghan border, but that Pakistani authorities are only making "half-hearted" efforts to catch him.

The claim was rejected by Pakistani officials as "absurd."

Spanta told RFE/RL that "representatives from the international community" have told him that leaders of terrorist organizations active in Afghanistan are based outside the country.

"Because of comments by representatives of the international community, with whom I have talked in recent days," Spanta said. "They all believe that the main center of terrorism and main terrorist leaders are outside the borders of Afghanistan, in one of the neighboring countries, and they've also said so and I just confirmed the reality they had expressed."

Spanta also said that he has invited his Pakistani counterpart to visit Afghanistan to discuss "issues of mutual interest." (By Farishta Jalalzai with contributions from Golnaz Esfandiari.)

After years of hardship, students from Kabul Medical University received their diplomas at a ceremony in the Afghan capital on May 5, including 90 women, who became the country's first post-Taliban female medical graduates. The 460 students in the university's 16th graduating class studied curative, pediatric, and dental medicine. The graduation was also attended by the dean of the university, professors, and dignitaries from the ministries of Public Health and Higher Education.

During the days of the Taliban, women were not allowed to study medicine at Kabul Medical University, not even under the cover of the all-encompassing burqas.

More than four years after the fall of the Taliban, however, the radiant faces of 90 women could be seen in the university's auditorium, speaking happily about their graduation. Some of them are now mothers, having had to interrupt their medical studies during the five years the Taliban held power in the capital.

Committed To Helping

Abeda Fahim says she now feels free and prosperous. Despite a lack of modern medical equipment throughout the country and the poor state of education, Fahim says she has a firm commitment to serve her patients.

"I am committed to serve the children, the women, and the people of my country," Fahim says. "I want to do something that at least can cure part of the pain felt by the women of our country."

Fahim is optimistic about her future career, but admits to being nervous about finally working as a doctor. She says she is reluctant to go to the provinces to work, since she feels she does not yet have enough practical experience in medicine.

Most of the graduates share the same concern. They want to stay in Kabul and are urging the Public Health Ministry to provide them with jobs in hospitals in the capital, or at least in the main cities of the country.

Kabul Medical University President Obaidullah Obaid says he shares the concerns of the students and has conveyed that message to health officials.

"I am committed to serve the children, the women, and the people of my country," said Abeda Fahim, one of the women who graduated on May 5. "I want to do something that at least can cure part of the pain felt by the women of our country."

"I suggest that a two-year training program should be provided for the 460 young graduates, to train them here [in Kabul]," Obaid said. "This will help them get enough experience in all fields of medicine. And once they go to the provinces, they will not face any problems. They will not be able to work as they must when they are dispatched to the remote parts of the country unless they are provided with practical work here at the hospitals."

About two years ago, the Public Health Ministry decided to send new graduates of medicine to work in the provinces. The ministry says there are not enough vacancies for young doctors in Kabul hospitals at the moment.

Recalling Hard Times

Tears roll down his cheeks as Khyber Tabesh, diploma in hand, recalls the seven years of study, many of them under strict Taliban rule, that led to his graduation from Kabul Medical University.

"I am really happy today," Tabesh said. "This diploma means a lot to me. I feel like I have gained a superb victory in life."

Tabesh, a lifelong Kabul resident, enrolled in the medical school in 1997, a year after the Taliban took control of the city. He says studying medicine during the Taliban years was difficult beyond words.

"It was a nightmare," he said. "No student in the world could bear what we suffered during our studies. I can't put it into words. It was unbelievable what we, the Afghan medical students, experienced. It was more of a strangulation."

Tabesh says the Taliban would measure the length of the beards of the medical students, "and if they found out that they had been trimmed, they would punish us harshly."

And at the start of each day, the Taliban members who worked as Islamic teachers for the university would visit classrooms to make sure that students were wearing properly tied turbans, which varied in length from 7 to 9 meters.

Living conditions in the dormitories were also unbearable -- no hot water or heating, and little electricity. The food was also poor, mostly what the students referred to mockingly as "Titanic soup" -- a watery gruel in which stones and sand would often be found.

Grave Robbers

Proper study materials were also rare. The Taliban prohibited medical students from working with human cadavers, saying such studies were against Shari'a law and were an insult to the dignity of human beings. As a result, some students resorted to digging up graves and using the stolen bones for their studies.

"We lacked the very essential things in that time," Tabesh said. "The first semester, we had anatomy classes. It is a very difficult subject, and you need to have materials like bones and skeletons to study with. But the Taliban did not allow us to work on the human body, so we needed to buy bones from other boys who were in the higher grades at the university. We could not even afford to buy an anatomy atlas textbook. And since we had to use human bones [dug from graves], sometimes [the chemicals used to clean the bones] produced allergies. It was unbelievable."

Tabesh recalls the dean of the university during the Taliban days chasing students with a long stick.

"I remember him boasting that no man could ever be as cruel as he was," Tabesh says. "It was pretty dreadful." (Mustafa Sarwar)

The U.S.-based charity Save the Children claims that Afghanistan has the world's second-highest infant mortality rate -- behind only Liberia. Maternal mortality in Afghanistan is also among the world's highest, and, according to the organization's report -- released on May 9 -- some 16 percent of Afghan women die during pregnancy or childbirth. Save the Children says that in countries such as Afghanistan where women have little or no access to basic prenatal and postnatal care, childbirth is often a death sentence for a mother and her baby.

Golandam recently gave birth in her mud house in a village in the eastern province of Nangarhar.

There was no doctor or midwife to assist the young mother. Golandam and her newborn baby died of complications from the childbirth.

A neighbor spoke about her plight with RFE/RL's Afghan Service.

Tragic Deaths

"Most families are concerned about [the health of pregnant women and their babies during delivery]," she said. "My poor neighbor -- even though she had already given birth to three children -- she died while giving birth to the fourth one. When the time of delivery came we went there, she went through a difficult delivery, the placenta remained in the womb, she lost her life and left three children behind."

Golandam's case is not unusual.

Nongovernmental organizations estimate that every 30 minutes a woman dies in Afghanistan from causes related to being pregnant. Only 16 percent of pregnant women in Afghanistan receive prenatal care.

Sixty of every 1,000 Afghan newborns die, on average, and one child in four dies before reaching the age of five.

Save the Children's senior health adviser, Regina Keith, tells RFE/RL that one of the main reasons for the high fatality rates among mothers and their newborns is that many women give birth at home without any professional help.

No Help With Childbirth

"One of the reasons is that so many of the births in Afghanistan occur at home," Keith said. "In other words, we know that if you have a skilled attendant delivering your baby, the likelihood of that child dying, for example, from not being able to breath or [from] infection is [lower]. So, one of the factors is the number of women accessing health [care] for delivery or within the first week of [the] life [of the baby]."

Nadera Hayat Borhan, an official with Afghanistan's Health Ministry, says most infants die of diseases that can be prevented by simple immunizations and sanitary practices.

"Most of the children's deaths occur because of diarrhea and respiratory infections," Borhan said. "Unfortunately, more than 70 percent of our children die of preventable and treatable diseases."

Illiteracy, poverty, and a crippled or even nonexistent health system are among the factors contributing to the high death rates of infants and mothers in Afghanistan.

Most hospitals and health facilities lack equipment and professional staff. It is estimated that there is only one doctor per 50,000 inhabitants.

Cultural Obstacles

Cultural practices in the deeply conservative and patriarchal Afghan society also contribute to the fact that Afghanistan remains one of the worst places for a woman to give birth.

Especially in rural areas, men often do not allow their female relatives to be treated by male doctors.

Keith says the situation can be improved through simple and affordable solutions including increasing awareness about the importance of proper hygiene and breastfeeding for infants.

"We need to invest more in ensuring that girls and women can have access to more effective education; that they are properly nourished, because we know that one of the biggest causes [of death] is low birth weight," Keith said. "So the health of the mother is really important. Access to health care, access to decision-making responsibilities so that they can do that."

She says such measures have led to better health indicators for mothers and children in northern Afghanistan. Other measures are also being taken.

Health workers are being trained -- including many women nurses and midwives -- to serve in remote areas.

New Hope

In April, a modern pediatric hospital, the French Medical Institute for Children (FMIC), was founded by two French charities (La Chaine de L'Espoir and Enfants Afghans) and was officially inaugurated.

Children from all over Afghanistan are being treated at the hospital, which has about 100 beds, four operating rooms, a laboratory, a pharmacy, and a radiology unit.

More than 120 children have already undergone operations at the hospital and in early April a team of French doctors performed the first open-heart operation, on a young Afghan girl aged 13.

Dr. Fatima Mohpatali is the director for professional support at the FMIC. She tells RFE/RL that the best way to tackle maternal and child mortality in Afghanistan is to develop local abilities.

"People are trying both the NGO community, [the government], the universities -- all are trying," Mohpatali said. "But to reach up to the international standards it requires time and it requires resources. The best way to reach that level would be to develop the capacities of [the] local community here and that is what many NGOs are trying."

She says Afghanistan still has a long way to go before the critical situation for mothers and children improves. (By Golnaz Esfandiari with contributions from Radio Free Afghanistan correspondent Sultan Sarwar.)