Discrimination and Social Exclusion for Vulnerable Groups in Afghanistan

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SOCIAL DETERMINANTS OF HEALTH
DISCRIMINATION AND SOCIAL EXCLUSION FOR VULNERABLE GROUPS IN
AFGHANISTAN
(Author)
(Institution)

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SOCIAL DETERMINANTS OF HEALTH
Introduction
Social determinants of health refer to environmental conditions where people are born, age,
work, play, live, worship, and learn, and those which affect their life quality, functioning, health,
and risks in life (Morteza et al., 2008). The social determinants of health are closely connected to
the social and economic situations and their dissemination amongst the populace that affect
group and individual dissimilarities in health status (Marmot, Friel, Bell, Houweling, Taylor, &
Commission on Social Determinants of Health, 2008). They are wellbeing stimulating factors found
in an individual’s working and living conditions (for instance the distribution of power,
influence, income, and wealth), rather than discrete peril factors (for example behaviourial risk
factors or heredities) which impact the peril for an illness, or susceptibility to sickness or injury
(Solar, & Irwin, 2010). In regards to some standpoints, the disseminations of social determinants
are molded by communal dogmas which replicate the impact of dominant governmental
philosophies of those governing a jurisdiction (Marmot, 2009). The World Health Organization
(WHO) points out, "This uneven dispersal of health-damaging experiences is not in any sense a
'natural' singularity but is the result of a poisonous amalgamation of poor societal policies,
discriminating financial activities [where the already wealthy and healthy become even better-
off and the underprivileged who are already more likely to be ill become even poorer], and bad
politics” (Frieden, 2010). Conditions in the different environments are usually known as the
place, and the patterns and nature in which people engage, and their well-being and security are
greatly determined by the area in which people live. Resources that usually improve life quality
may have a great influence on the outcome of the health of the population (Marmot et al., 2008).
Resources can include access to education, affordable and safe housing, public safety, local
health services, life-threatening toxins free environment, and healthy food availability.

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SOCIAL DETERMINANTS OF HEALTH
Vulnerable groups in Afghanistan include children, the elderly, internally displaced persons and
returnees, women, the kuchi nomads, and people living with disabilities. The groups are
vulnerable to shocks and external risks in Afghanistan but there has been no systematic
consideration on how they are socially excluded and discriminated. In fact, limited statistics that
are reliable are available. The objective of this paper is to analyze and discuss how social
exclusion and discrimination affects women, internally displaced persons and returnees, people
living with disabilities, children, kuchi nomads, the elderly and ex-soldiers in Afghanistan, and
how the negative impact of health on these vulnerable groups can be addressed.
Discrimination and Social Exclusion for Vulnerable Groups in Afghanistan
Women
Women in Afghanistan usually face different kinds of discrimination (Boserup et al., 2013).
Afghanistan is a nation of about 23 million which, after 23 years of war and devastation, five
years under the Taliban authorities, and three years of severe drought, has been left as among the
most underprivileged nations in the entire world. Globally, this country has the second highest
rate of maternal mortality. Actually, even prior to the Taliban took over control, Afghanistan had
a record of the highest rates of child and maternal mortality and an extremely low literacy rate
for women (Katzman, 2010). However women contributed socially, economically, and
economically in the wellbeing of their societies. In fact, women assisted to frame the 1964
Constitution and in the 70s, there were at least three women representatives in the Legislative
body. Up to the early 90s, females worked as medical doctors, teachers, and government
workers. (Klugman, Hanmer, Twigg, Hasan, McCleary-Sills, & Santamaria, 2014). They secured
occupations as professors, judges, poets, journalists, writers, and lawyers. After the Taliban's
upsurge to command, Afghan girls and women were thoroughly victimized against and

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SOCIAL DETERMINANTS OF HEALTH
downgraded, and their human rights were desecrated (Choudhury, 2007). For example, when
husbands die, women are not entitled to any inheritance from their husbands, a situation that
leaves them helpless, suffering, and with the sole responsibility to fend for themselves and their
children, hence making them susceptible to societal cut-offs as a result of cultural conventions.
Afghanistan has a record of 1 million widows, and in Kabul alone, there are between thirty
percent to fifty percent widows while ninety percent have children and ninety-four percent are
illiterate (Najafizada et al., 2014). Many women have resorted to begging while others send their
underage children to work so as to survive, with widows identifying child labor as a
supplementary income source. Living without husbands subjects women to intimidation and
violence, hence forcing them to stay indoors with limited job opportunities in case they have
some mobility. Reports show that more in Kabul alone, widows have a high chance to suffer
from malnutrition as compared to other women with husbands, while children in houses headed
by widows are five times more likely to suffer from malnutrition. The time spent fetching water
in rural areas could be used in activities that generate income as this is an important aspect for
widows who fend for themselves and their children. As a result, widows lead in incidence
poverty in all vulnerable groups.
Cases of physical torture of women have increased. Afghan women are beaten severely, cut
brutally, and acids are thrown at them, as witnessed throughout the country. Early marriages,
buying, and selling of women for marriage or prostitution purposes are high in Afghanistan
(Khan et al., 2010). The United Nations Assistance Mission in Afghanistan and the United
Nations Women emphasize the impossibility of carrying the movement of Afghan women rights
protection if violence against the women is not controlled completely through the appropriate
and tough implementation of the Elimination of Violence against Women law. The Afghan