Inside, we were escorted by male and female Afghan prison guards to a small, sparsely furnished room. The prison was eerie. The brick walls were damp and peeling. Sheets hung randomly, trying to control the freezing cold air from wafting about, and old blankets and sleeping mats were piled high. The prison was overcrowded with approximately 400 men, four women, one person of unknown gender — the patient I’d be seeing — and an infant.
I volunteered to go to Afghanistan as part of a provincial reconstruction team to assist in nation-building. As a female nurse practitioner in the U.S. Navy, I would have the privilege of providing medical care to Afghan females, who rarely receive any.
The prisoner in question had been charged with heroin trafficking and was somewhat of a local celebrity. That’s because during interrogation the prisoner had claimed to be half-man, half-woman. My mission was to determine three things: whether she was clinically insane, her gender and whether she had been sexually assaulted.
The prisoner, Hachkas, was of slight frame and approximately 18 years old with short, black, uncovered hair, and dressed in men’s clothing. My first impression of Hachkas was she was female, an impression I eventually would confirm.
I learned that women in Afghanistan did not receive healthcare in the same manner as American women. For example, Hachkas never had experienced a gynecological exam. Later, as I ventured to local villages to provide medical care, the cultural knowledge I gained from Hachkas and the other women prisoners would become invaluable.
As I talked with Hachkas, I felt she was anything but insane. She said her government constantly was telling people to turn in their guns and drugs to help establish a “new Afghanistan.” She said she had taken the drugs from her family and was going to turn them in when she was arrested.
Hachkas said males who turned in drugs or guns didn’t get arrested, but she did, and she suspected her incarceration happened because she was female. She had been saying she was part male because a female in Afghanistan really didn’t have a voice. She said she couldn’t hide that she was female, but if she was half-male, half-female, maybe she could accomplish more in her life.
She spoke of a great Afghanistan, of what she wanted to accomplish to see Afghanistan rise out of the ashes. I thought she was an amazing young woman. To have her drive and determination is what I wish for all women.
Hachkas’ sex was externally and internally physically characteristic of being female. I found no evidence of sexual assault through my gyn exam, a finding she verbally confirmed.
My mission was complete. But was it really?
Hachkas always will be a part of my soul. She has propelled me to explore my own reason for being. Here was this woman in a land ruled by men, where women have little to say but much to offer. They all want a safe place to raise their children, a place where their children can grow up and raise the next generation. They want to be educated, to offer something to their world.
I fell in love with Afghanistan through the hope and sheer will of Hachkas. May she live in the hearts of all women. May her spirit continue to beat and may we all find peace in our world.
Deborah Lynn Redman, RN, MSN, FNP, is a nurse practitioner in the cardiology department at San Antonio Military Medical Center and a lieutenant commander in the U.S. Navy. Send comments to firstname.lastname@example.org or post comments below.