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Lockdowns hurt child speech and language skills

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Lockdowns hurt child speech and language skill

Unfortunately lockdowns have taken children across the UK away from their language and socially-rich environments and consequently, children have fallen behind with their speech and language skills. In my profession of Speech and Language Therapy, The Royal College of Speech Language Therapy (RCSLT) reported the negative impact on those with speech, language and also swallowing difficulties this year. 

A survey undertaken by the RCSLT of adults, worryingly also showed a reduction during the March-June 2020 lockdown of over half of people accessing speech and language therapy. A large amount of appointments were reportedly cancelled by speech and language services. The survey for those aged 0-18 years shows this age group was impacted the hardest, with 81% of people seeing a decrease in their speech and language therapy service. For clients under 18 only 12% of clients received therapy after the March 2020 lockdown, leading to deficits. 

With face-to-face services unable to be delivered, what our clients were left with was virtual therapy, which was hard to access. There are several known factors that resulted in lockdown constraints; a strain on home broadband connection, no laptop or having to focus on homeschooling. 

In the March 2020 lockdown, I was still able to deliver services virtually to my primary school age clients, however only a small amount were able to attend virtually, due to lockdown constraints. Those that attended were regular, however some families did not return phone calls and some attended one session and then swiftly became no-shows.

Due to these constraints, our senior speech therapist team lead decided to discourage articulation therapy which focuses on the accuracy of our speech sounds. This therapy involves the use of visual and verbal feedback. It also entails physical contact, for example conducting an exam of the vocal tract to summarise its physical features and effect on speech. We were also discouraged from virtual therapy with reception to year 5 clients unless there was parental involvement. This was due to the fact that it was difficult to engage this age group in online therapy. Therapy entails preparation prior to the session, activities during the sesson and homework following the session, all of which are challenging tasks without an engaged parent. The therapist’s virtual time was given to those that were willing, and the remaining work time was allocated to developing new programmes, or writing annual review reports. 

The second lockdown showed some important changes. At this point I had changed roles from primary school to ‘birth to 5 years old’, and as a therapist, my process of assessment, therapy or gathering case history had adapted to the virtual world much better. Families were more acquainted with what to do, and many on my caseload kept their appointments. The other difference was face-to-face interaction was allowed in some cases with Personal Protective Equipment (PPE) which involved an apron, gloves and a mask. Further in January 2021, therapists were expected to resume face-to-face work mainly in day care centres, which were open. 

I made another personal switch at this point, to leave this role. I was now concentrating on another role: as a therapist in a special needs college for students with complex special education needs. College was not open at this date and our work was virtual. There was low engagement from my total caseload, and issues cited by families included difficulty making the therapy appointment time, online college classes, students unwilling to engage on Zoom/Team, etc. Again, my work time was dedicated to training and programme development, and annual review reports. At least, I was able to liaise with teachers, if not families and students.

What the RCSLT report shows is that lockdowns did hurt speech and language skills, and not just for children. All those accessing special education needs are behind and the RCSLT proposes a comprehensive build-back plan, citing speech and language as a basic human right. A BBC report also discusses the issue of our children falling behind. One of the concerns is the deficit in social skill development of under five year olds due to reduced communication opportunities. This is a valid concern, as speech and language difficulties have an impact on social development and mental health. Here are some statistics to fully highlight and digest this point. Children with a mental health disorder are five times more likely to have a speech and language problem. This shows that early deficits have negative impacts on development in the long term. What’s more, the RCSLT has also highlighted the socio-economic inequalities in the United Kingdom. The most deprived areas received the least access to speech and language services, during and after lockdown.

However, in all of my roles, when parents were involved, the positive results that I witnessed were: increased one-on-one time with the parent, listening to their interaction with their child, and hearing their anecdotes of what they had done that day. This was an invaluable experience. Another positive result of this situation was, if the parents were available during the session it was a chance to show them therapy techniques. This is called ‘modelling’ and exposes the client and the client’s family to strategies to increase communication. This is an opportunity for speech and language education for the family. Going forward, this should be maximised to improve speech and language outcomes. What we don’t want to see is families going backwards in terms of engagement and education, as well as societal inequalities, and unnecessary funding cuts to education. In fact, due to the long term effects on human development, the government must continue to invest in education across the board, including speech and language services. If they don’t, the costs to our nation’s population and our future generation will be too high.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

Health

Racism at the root again: Inequalities in Health organisations

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Tigray People’s Liberation Front - Racism in Healthcare

Whilst many sectors have suffered at the hands of racist predispositions, Tedros Ghebreyesus, Director-General of the World Health Organisation states that racism is at the crux of the escalating humanitarian crisis in Ethiopia. He claims that, “Some are more equal than others” despite Ethiopia being the largest recipient of this aid. Ethiopia receives a grand total of $3 billion USD and has been the largest recipient for several years. Human Rights Lawyer, Khalil Yousuf, told Analyst News that there is a lack of “evidence to suggest that there is active racism” in the case of Ethiopia with many individuals from the country in the management.

Mr Tedros, an Ethiopian himself, believes that the lack of media coverage in non-Western regions has prevented better management and protection of human life. He suggests that the value of Ethiopian lives is deemed lesser than that of Ukrainians for instance. “Maybe the reason is the colour of the skin of the people,” speculates the WHO Director. There are currently 8.1 million people in a dire humanitarian crisis, suffering from continuous seasons of drought, political instability, and violence. 

Khalil Yousuf believes that it is not necessarily racism that has driven Ethiopia to a humanitarian crisis but its geographical and political isolation from western nations that render it inessential to their foreign policies. He stated, “Tigray is a long way away and not enough people who originate from there to warrant news, for example in the United Kingdom”. He further went on to acknowledge “Part of the problem with international aid is that it is not always given on the basis of need but there are a myriad of other factors which influence whether or not a country will give international aid and who they will give it to”. Influencing factors include political alliances, geographical relevance, budget, need to resolve transnational problems and if the provider and receiver have sufficient sources to transport aid from one place to another.  He insisted that neighbouring countries must play an active role to ensure that peace, security and health crises are resolved for the long term. 

This is not the first time WHO has been accused of racism. Earlier this year, Dr Takeshi Kasai, Regional-Director of WHO Western Pacific was accused of making derogatory remarks and behaving unethically towards staff. In an ongoing investigation, Mr Kasai was eventually removed from office. Hence, it is likely that racism exists in some form in organisations including WHO but the extent to which it shapes decisions is obscure.

Institutionalised racism is prevalent in many departments of the health sector and considerable evidence has been sourced from the United States, Australia, Germany, and Portugal amongst many others. Indigenous populations in Australia have to wait longer in elective surgery queues and are 20% less likely to receive proper care in hospital emergency departments. Hence, racial disparities certainly shape healthcare on micro and national levels and could also be permeating international health policies.  In Ethiopia, racism may be a negligible driving force of the humanitarian crisis with regional politics, ethnic disparities and corruption shaping the distribution and administration of aid. 

Contrastingly, the Ethiopian government accuses Mr Tedros’s personal affiliations with the Tigray People’s Liberation Front (TPLF) to be the root of his critique of the government’s administration of the aid. The ongoing violence and military operations occurring in the West African region have resulted in increasing cases of gender-based crimes, embezzlement, fraud, and abuses committed by insurgency groups. In 2022 TPLF was accused of severe violationsincluding rape and murder of at least 20 civilians. This instability is a key factor that has prevented Ethiopia’s journey to recovery and has only contributed to health issues with greater numbers of premature mortality, tuberculosis, respiratory infections, and HIV/AIDS. 

The exclusion of issues pertaining to people of colour in the media is likely sculpted by race and their economic and political irrelevance to the West; a central provider of aid and media. Hence, racism is a key factor shaping the humanitarian crisis, but war and food shortages barricade the narrow road to recovery. Ethiopia must rigorously seek political and military peace to see a notable difference in their health status.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Economics

‘Don’t forget them’: millions of Afghans face hunger, economic crisis 

International aid workers share stories of children and families struggling to make ends meet

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“Winter is coming.”

That’s how Ammar Ammar, spokesperson for the International Committee of the Red Cross in Afghanistan, describes the situation in Afghanistan. The current hunger crisis, the result of a collapsing economy and drought, will only get worse if the country doesn’t get help, he says, especially in the colder months when people also have to stay warm.

“It’s not Game of Thrones here, it’s reality.”

Almost a year after the Taliban takeover of Afghanistan, the world has become silent about the plight of the country and its people, who are facing one of their worst humanitarian and economic crisis in decades.

After the fall of Kabul, the international community declined to recognize the Taliban regime. Countries paused foreign aid and imposed sanctions. The United States also froze billions in Afghan state assets.

A country that had become reliant on external aid was left on its own. In the process, millions of Afghans were abandoned, too.

On a recent lunch break in Kabul, Ammar saw two girls, one about six years old and the other about three. One of them was lying down on the sidewalk, while the other was squatting next to a big nylon bag. They’d been collecting pieces of scrap metal on the streets to make ends meet. 

“You could see that they were exhausted,” Ammar said. “You are going for your break and at the same time you can see two kids on the street, where they have no break at this age. It strikes you.”

And there are thousands of children like them.

“We are doing a massive job,” Ammar says. “But the sad reality is we can’t help everyone at the end of the day.”

A woman in Qala-e-Naw, the capital of the Badghis province recently told the UN-run World Food Programme (WFP) in Kabul how she made ends meet after her husband died five years prior. 

“In the past, she said, she had a fair life, just getting by cleaning and washing for other people. After the economy collapsed, families have no money anymore to pay her and her work dried up,” said WFP spokesperson Philippe Kropf in an email. As a result, she borrows money to buy food, going further into debt.

“She told me she has not been able to buy cooking oil for weeks. She eats bread with tea and sometimes rice,” he said.

Afghanistan abandoned


A young man told Kropf that “his family went to sleep many evenings without anything to eat in the past months.”

“They borrowed food with neighbours, but increasingly the neighbours have nothing to share,” he added, noting the young man had only completed second grade and was trying to find labour jobs to make ends meet. “But these jobs are getting rarer and rarer because of the collapse of the economy, too.”

The man participated in a training program to gain skills such as tailoring or mobile phone repair to earn a livelihood. The program trains 200 men and women over six months, during which participants receive food assistance for their families. 

“After the training, (the young man) hopes to either open his own little shop, sewing clothing for men and children or to find work in a tailor shop and work for a salary,” Kropf said.

Prospects of famine remain

With the country reeling from recent droughts, and facing high inflation, a difficult situation is becoming even worse.

“For the first time, urban residents are suffering from food insecurity at similar rates to rural communities, marking the shifting face of hunger in the country,” Kropf said, noting some people are seeking help from WFP for the first time in their lives.

“The scale of the crisis in Afghanistan is immense, and needs continue to outpace available funding,” he added. The WFP needs nearly US $1 billion by the end of 2022 to help 18 million people – nearly half the population of Afghanistan.

Of that, the group urgently needs US $172 million to secure 150,000 metric tonnes of food to support 2.2 million people in remote parts of Afghanistan, which can get cut off by ice and snow in winter.

“We need these even more urgently because of the long lead-times for food commodities that we need to buy internationally,” Kropf said, including vegetable oil and specialized nutritious foods. “We need to get them into (the) country and then drive them into the mountains.”

The lack of funds in state bank accounts means civil servants aren’t being paid regularly, companies are shutting down and ordinary civilians face restricted access to their own savings.

Prospects of famine remain, said Ammar, noting that the main indicator is farming, which most people depend on to make ends meet. Farmers say climate change is resulting in less food production, resulting in extended periods when people don’t have adequate access to food.

Need for international aid

At the end of June, a 5.9 magnitude earthquake hit southeast Afghanistan, killing      over 1,000 people and causing damage the International Rescue Committee described as “catastrophic.”

“This earthquake is a catastrophe for the people affected, but the response to the wider crisis in Afghanistan remains a catastrophe of choice for the international community,” said David Miliband, the group’s CEO and president in a release at the time.

“While humanitarian aid has averted famine for now, policies of economic isolation, the halting of development funding, and the lack of support for Afghan civil servants are unraveling the two decades of development progress that western leaders vowed to protect.” 

He noted that families across the country face unemployment, leading to lower demand among local businesses which in turn leads to further job losses. He called for the international community to urgently provide funding to the country as well as “the phased and closely monitored unfreezing of assets.”

The question of frozen assets

Advocates for Afghanistan have criticized U.S.’s decision to freeze a portion of the country’s assets and decried a proposal for the U.S. to use some of them to support families affected by 9/11.

Afghanistan’s assets rightfully belong to Afghanistan, said Zubair Iqbal, a scholar at the Middle East Institute in Washington. 

However, while unfreezing the funds would help bring immediate help to alleviate Afghanistan’s crisis, the country will need more support in the long-term, said Iqbal, who previously worked at the International Monetary Fund for more than 30 years.

The solution is to grant foreign aid to Afghanistan in a sustainable way to allow recovery, while managing its spending through an independent entity, he said.

Concerns around a proposal in the U.S. to use some of the Afghan assets to support families affected by 9/11 prompted a group of Afghan women to write an open letter to U.S. President Joe Biden in February.

“Taking funds from the Afghan people is the unkindest and most inappropriate response for a country that is going through the worst humanitarian crisis in its history,” the letter reads. “It is the squeezing of a wounded hand.”

Freezing the assets from the Taliban was the right decision, said one of the signatories in an interview, but they belong to the Afghan people and must be released to address the humanitarian crisis. 

“My expectation from the international community is to put serious attention on Afghanistan,” said Roshan Mashal, former deputy director of Afghan Women’s Network, who left Afghanistan after the takeover and is now a fellow at the University of Texas at Arlington. 

She called for coordination on how countries engage with the Taliban and to support the country’s people, as millions of Afghans face hunger and economic crisis.

“Don’t forget them,” she said.


All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Health

Learning From The Lancet’s New Study on Alcohol Consumption

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A new study in The Lancet, one of the world’s oldest and most prestigious medical journals, calls for “stronger interventions, particularly those tailored towards younger individuals…to reduce the substantial global health loss attributable to alcohol.” This study sought to elucidate the effects of alcohol consumption in varying populations. Its data comes from the Global Burden of Disease investigation, which began in 1990 and has used information from 204 countries and territories to “understand the changing health challenges around the world.” Regarding research on alcohol consumption, the authors wrote, “No study to date has examined the variation in the theoretical minimum risk of alcohol consumption by geography, age, sex, and time, conditioned on background rates of disease.” In other words, the new study is groundbreaking in its thorough and holistic analysis of the health impacts associated with drinking alcohol. 

Ultimately, the researchers’ data was intriguing. They found that for individuals between 15-39 years old, consuming alcohol only confers risks, i.e. there are no health benefits associated with drinking alcohol. Furthermore, the authors write, “The recommended level of alcohol consumption in existing low consumption recommendations is too high for younger populations.” In other words, following existing guidelines is not enough to protect people between 15-39 from the health risks associated with alcohol consumption. Interestingly, the study found that consuming small amounts of alcohol, such as one or two 3.4-ounce glasses of red wine, can yield some health benefits for individuals over 40. These include reducing the risk of cardiovascular disease, stroke, and diabetes. 

In their discussion, the researchers emphasized, “These findings highlight the need for tailored guidelines that discourage alcohol consumption among young people, as well as alcohol control policies and interventions that are targeted especially towards young males.” The scientists pointed out young males because they are the group that currently struggles the most with alcohol overconsumption. Overall, the authors in the study clearly caution against drinking alcohol if one is below 39. Even for older individuals, limiting alcohol consumption is essential to avoid health risks. 

Interestingly, The Lancet study corroborates many religions’ guidance regarding alcohol consumption. Chapter 5:91 of the Holy Quran, for example, says, “O ye who believe! wine and the game of chance… are only an abomination of Satan’s handiwork. So shun each one of them that you may prosper.” Similarly, Proverbs 20:1 advises, “Wine is a mocker, strong drink is a brawler, and whoever is led astray by it is not wise.” For people that associate with a particular religion, it is heartening to see scientific research confirm one’s religious texts and commandments; it often affirms and strengthens one’s faith. For anyone, regardless of whether or not they practice any religion, seeing scientific research support religious teachings is an important reminder that religion and science are not at odds. In the media and popular culture, we often see religion portrayed as diametrically opposed to science. This is far from the truth, however, and it is critical to not let such prejudices cloud our view of others.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Health

Abortion care-A Fundamental Right Under the Kenyan Constitution

Abortion care – A fundamental right under the Kenyan Constitution.

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Kenya Abortion Laws

By making abortion legal for victims of sexual abuse and women with pregnancy complications, Kenya is making health care accessible for women. AnalsytNews spoke to Dr. Anne-Beatrice Kihara about abortion laws.

Over a decade ago, Kenya set out on a course to provide constitutional reproductive rights to women. By replacing the colonial constitution with a new democratic text, it secured the rights of privacy and abortion for women in the constitutional framework. Although the country is still a long way from translating the articles into a legal language of implication, they are helping to save the lives of women.

The long struggle for the right to abortion in Kenya yielded results when a minor, PAK and her health care provider, Muhammad Saleem, were released of charges by the High Court in the Kenyan city of Malindi after Saleem was detained by the officials along with PAK under the accusation of performing an illegal abortion for the said minor.

The ruling in the PAK and Saleem Muhammad case established abortion as a legal right for women experiencing pregnancy complications and has been hailed as a victory for women’s rights to privacy in the country. 

While the Roe v. Wade case ruling has been overruled in the U.S, Kenya still holds its position as one of the few countries that legalises abortions under certain conditions.

According to Article 26(4) of the constitution of Kenya, Abortion is permitted if in the opinion of a medical expert, “there is a need for emergency treatment”.

Similarly, if the pregnancy complications are putting the “life or health of the mother in danger,” the mother can undergo a procedure with the assistance of a certified care provider. 

Kenya also provides post-abortion treatment for women under Article 43 (2). 

With 41% of Kenyan women experiencing sexual violence, in 2019 the high court in the FIDA- Kenya case gave the victims of assault the Right to Abortion.

As elections are fast approaching in Kenya, the issue of abortion is once again making headlines. The recent Roe v Wade ruling, and organised online campaigns against the Reproductive Health Care Bill and Surrogacy Bill by the right-wing are shaping up to become a growing threat to women’s right to abortion in the country.

According to the President of the International Federation of Obstetricians and Gynecologist (FIGO) Dr Anne-Beatrice Kihara (obgyn), although the laws in Kenya do not provide “abortion on demand,” they do take into consideration the “life and health of the mother”She told The Analyst in an interview that “The foetal viability in Kenya is after 20 weeks of conception.” Thus, safe abortion services can be provided in the 2nd trimester at gestation when the fetus  is not viable,” she added. 

“Although the laws in Kenya do not provide ‘abortion on demand,’ they do take into consideration the “life and health of the mother.”

The lack of safe abortion options could lead mothers to opt for unsafe choices. The consequences could be dire, Dr Kihara explains. There are short-term effects on a mother’s health such as “hemorrhage, sepsis, fistula formation, etc.” In the long-term they also develop “chronic pelvic inflammatory disease, infertility, and mental illness.”

A mother who has had an unsafe abortion could develop “chronic pelvic inflammatory disease, infertility or mental illness.”

            As Dr. Kihara sees it, the overturning of the Roe v. Wade decision could create issues for health care providers who are ethically and morally obligated to provide healthcare to patients in need. They might face “stigma, discrimination, and criminalization for supporting the provision of information and services.” Resultantly there will also be more referrals of patients to other  US states for abortion services. This will result in failure to access emergency treatment, possibly more pregnancy related complications that will increase morbidity/mortality, she adds.

She argued that the issue should not only be dealt with at a medical level but at a social level with special attention paid to the “education, counselling of the girls with health promotion and prevention strategies; access to family planning and contraception programs”.

Dr Kihara further said there is need to “reduce the politicizing” of sexual and reproductive health services. 

Instead we need to focus on what could be the outcome of investing in comprehensive, quality and safe health services on individuals, the health system  and society at large. She suggested there is also need for “engagement of boys/ men taking responsibility for fatherhood  and as agents for change”. 

She further urged legislators to ponder over the “serious ramifications related to access, affordability, acceptability, quality and safety of services rendered” after the overturning of RoeVsWade. 

   While the US navigates it way through the confusions and controversies involve in the matter, abortion policies in Kenya can help them find a common ground that can ensure the safety and health of the mother and child. 


All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Daily Brief

Deadly Marburg Virus Spreads in Ghana

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  • The Marburg virus, a highly infectious disease currently spreading in Ghana, has killed two people and has more than 90 quarantined. The virus causes diarrhea, fever, nausea, vomiting, and death in many cases.
  • The World Health Organization has said that resources would be sent to Ghana to combat the outbreak, while warning that “without immediate and decisive action, Marburg can easily get out of hand.”
  • The virus has been linked to the Ebola virus, which spread through West Africa until 2016 after killing more than 11,000 people. The Marburg virus was initially spread to humans through fruit bats.
  • The virus has been detected in many other African countries over the past fifty years, killing hundreds of people with no vaccine or antiviral treatment yet approved.
  • Hopefully the world will come together to put an end to this virus in a timely fashion, and not let poorer countries suffer.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Crime

UN debate human rights in Afghanistan, concern for women especially

Human rights in Afghanistan and more specifically those of women are being discussed at the UN after Taliban takeover of the country.

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Since the recapture and overthrow of the Afghan government on August 15th 2021, the Taliban have slowly reverted to strict rulings for women in Afghanistan, raising issues of human rights in Afghanistan. Despite the several reassurances and claims that women’s rights would be protected under the new Taliban regime, the UN (Human Rights Council) believe it is now time to find solutions after many violations on women’s human rights have occurred. 

Various points were discussed during the debate but the general consensus amongst all the countries who participated, was that women in Afghanistan are facing human rights violations on a systemic level. The Taliban have triggered the removal of women from many occupations as well as dismantling previous structures to help girls receive adequate education. 

Many speakers expressed their concerns that the Taliban are slowly removing women from all public spheres of life, which would set up entirely male-dominated social hierarchies. These hierarchies are created from young ages, as girls are not allowed to participate in further education . If this is able to continue for the foreseeable future, although it may look grim for Afghanistan now, it may get worse. The lack of education for all girls may prove to be a bad decision for nature of the Taliban’s rule within the next decade. It was also mentioned that without the equality and participation of women in Afghanistan, the social and economic development of the country can only go so far. 

The UN were also able to debate what they may be able to provide Afghanistan after the removal of US troops from the nation. One solution suggested was more general rather than specific for women but emphasised the importance of continuing humanitarian aid as the country is also facing a poverty crisis. Some in the council blamed this poverty on the previous US occupations in Afghanistan, whilst also requesting that the US restore the damages and assets to the country. 

It was discussed that if these resources are provided by the UN in order to aid the Afghan people, it would still not be sufficient enough to allow the country to prosper because the involvement of women is fundamental both socially and economically. 

Although it may seem like little, council members believed that this debate was a spark in the quest of restoring the human rights of women in Afghanistan. Fawzia Koofi (First Woman Vice President of the Afghan Parliament) stated that the situation for women had previously become “unique and dire” and there are fears amongst society that this may occur again and without debates like this, then our fears may become true. 

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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