Beyond the burqa
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For more than 2 decades Dr. Sima Samar has defied Afghani laws that deny women their basic right to education and medical care. She has set up clinics and hospitals, and 21 000 children attend her schools.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/166/3/368/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/166/3/368/F1)

Figure. **Afghanistan's new minister of women's affairs** Photo by: Barbara Sibbald

But now this perennial rebel is part of the establishment. While in the midst of a cross-Canada speaking tour in December, Samar was appointed deputy prime minister and minister responsible for women's affairs in Afghanistan's transitional government. The appointments came as “a complete surprise.”

“I hope the women of Afghanistan accept me as their representative because I was selected, not elected,” said the 44-year-old physician. “I hope I will be able to live up to their expectations and be able to deal with at least some of their wounds.”

That seems assured, given Samar's track record. Since 1989, her Shuhada (Martyrs) Organization has brought education and health care to thousands of Afghani children and women. In addition to her schools, she runs 5 hospitals and 10 health clinics in Afghanistan and in the refugee camps around Quetta, Pakistan. Her literacy programs include the distribution of food and information on hygiene and family planning. She is also part of an international network, Women Living Under Muslim Law, which has links to 40 countries.

Samar travelled to Canada to accept the John Humphrey Freedom Award from Rights & Democracy (the International Centre for Human Rights and Democratic Development) in Montreal. The $25 000 award, which she contributed to improving education Afghanistan, honours the work of social activists.

For Samar, activism is a birthright: she is a member of the Hazara tribe, one of the most persecuted of Afghanistan's ethnic minorities, and she is a woman. She obtained her degree in medicine in 1982, becoming the first Hazara woman to do so, and after the Soviet invasion she was in the resistance movement until her husband, a professor at Kabul University, disappeared in 1984.

Samar then fled with her young son to Quetta, where she worked as the sole female physician in a hospital and at a refugee camp. The women there lived in abject misery, forbidden to visit male doctors or to leave their homes to work or attend school. Samar began by educating women about family planning. “Everyone had at least 9, 10 children,” she recalled during a speech to 450 people at the University of Ottawa.

Samar and other women established Quetta's first hospital for women in 1987, and it quickly had more than 400 patients a day. She also started training Afghani nurses, who could understood their patients' cultural needs and language. The persecution began in earnest: Pakistani police visited her every week, rumours spread that she was working for the Soviets, and a newspaper article said she had multiple relationships with men.

Undeterred, in 1989 she established the Shuhada Organization, a nonprofit group dedicated to the reconstruction and development of Afghanistan but with special emphasis on the empowerment of women and children. Samar and her medical staff now run 4 hospitals and 10 clinics in Afghanistan and another hospital in Quetta. Last year, the Taliban closed 2 of the hospitals.

Samar's vision goes beyond immediate medical needs. Dismayed at the 20 years of education lost because of war and the Taliban, the Shuhada Organization now runs 48 schools for 20 000 children in rural Afghanistan and another for 1000 girls in Quetta. “It's clear in the Koran that woman have to be educated, but they still harass us,” she says.

She usually found a way to dodge the Taliban. When its leaders decided that schooling had to end at Grade 6, she changed the classroom signs, but the education continued. “Today girls say they won't marry until they get their education,” says Samar. “That makes me very happy. Here it's nothing. There it's a revolution.”

But there is still a long way to go. “Just because some women have removed their burqas does not mean that there is respect for women's rights.” Only a democratic process in which women are actively involved can guarantee these rights, she maintains. 

The biggest challenge now, she said, will be to disarm the various political parties and individuals. “It used to be a whole district has 10 guns, now every family has 10 guns.” — *Barbara Sibbald*, CMAJ