Doctor Lynn Amowitz

DATE December 20, 2001 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Dr. Lynn Amowitz on a study of human rights violations
against women in Afghanistan and the state of women's physical
and mental health
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

My guest, Dr. Lynn Amowitz, has made several trips to Afghanistan in the past
year and a half conducting a study of human rights violations against women
and the state of women's physical and mental health. Her survey has taken her
to villages, refugee camps and camps for internally displaced persons. Dr.
Amowitz is a health and human rights fellow with the group Physicians for
Human Rights. She's done medical work in Kenya, Rwanda, Sierra Leone, Albania
and Kosovo. She also teaches at Harvard Medical School and has her own
private practice in women's primary care. Last month, she was collecting
information from women in a displaced persons camp in Dasht-e-Kala, a
mountainous area of Afghanistan. She was six miles away from the front line
where American B-52s were bombing.

Dr. LYNN AMOWITZ (Physicians for Human Rights): The day that I arrived, there
was very little noise and very little bombing going on. However, the second
day, we discovered that B-52s were flying over in the morning, and shortly
after that there were these ground-rattling and basically heart-rattling
sounds. And it turned out to be the cluster bombs and 2,000-pound bombs that
were being dropped on the nearby front line. The way that we would know that
a bomb was coming was that in these buildings that we were staying in, which
were sort of mud adobe huts, the plastic on the windows would suck in very
fast, almost as though a sail on a sailboat has caught the wind and it slaps
back and forth, and then you would hear this huge boom.

In addition, behind the place that I was staying, which was with one of the
humanitarian organizations, there was a large artillery piece that the
Northern Alliance were shooting, probably to the front line, although it was
never clear to me exactly where they were aiming. They said that what they
were shooting was about 30 kilometers away, and so my question was, `If I'm
between the gun and 30 kilometers away, can the Taliban shoot back?' And they
kept saying, `No, no, no. It's not possible. We took out their guns.' So we
had two sounds. We had one of the American bombing and then we had these huge
artillery piece noises that just shook your body. And they, for some reason,
always shot these off in the middle of the night every 20 minutes for about
six or seven rounds.

GROSS: Describe the camp that you were in at the time of the bombing.

Dr. AMOWITZ: I was in a rather large internally displaced camp in
Dasht-e-Kala, which was the city close to the front line. It was a very dusty
area at the base of these sandy hills. It was dry, parched, cracked earth.
You would see people who had dug into the ground to live in these camps and
then had covered these holes with thatch, and they were living in there with
all of their children. Primarily those living in the holes in the ground were
widows or those who were economically unstable or alone. There were some
tents that were passed out by Concern Worldwide, which was a humanitarian
organization which was primarily taking care of that camp, and they had just
received these tents.

But when you would go into the tents or you would go into these holes in the
ground, you might see one blanket, one teapot if they were lucky, one cup and
maybe a handful of beans, but nothing of real material value.

GROSS: Would you describe a little bit more those holes in the ground that
some people were living in? How big were they? Did you climb down into them?
What's the air like inside?

Dr. AMOWITZ: I did climb down into these holes, particularly to talk to the
women who were living in them or to talk to the children who were in them.
And what they are, they are about the size of a large dining room table, and
maybe they have built a sort of mud, flat table where they can sort of sit
around and have dinner if they are lucky enough to have anything, or they can
just sit and talk. The thatch is always airy. In other words, you can see
the sky and the clouds, meaning that if it rains or if it snows, in comes all
of the elements. And then you would see a pile in the corner, usually of a
blanket or a quilt, and then whatever belongings that they had. There is no
such thing as a store of clothes. There's no boxes. There's no paper.
There's basically nothing but a hole, dirt and maybe a couple of blankets.

GROSS: This was a camp for internally displaced people. These were people
who had to flee their homes in Afghanistan. What were some of the reasons
that people were in this camp?

Dr. AMOWITZ: In my interviews with these internally displaced, we found that
the majority of reasons that they left were because of Taliban atrocities. In
particular, these were the Uzbek ethnicity women, and the Taliban had been
incredibly grievous towards Uzbek and Hazara families. And a lot of what had
been happening in these areas was land seizure, as well as a scorched-earth
method where they would come in and completely bulldoze a community, destroy
the crops and set the people fleeing to wherever they could get to. And so
they would usually cross the front line and form these camps in order to find
safety, as well as food.

GROSS: I've read excerpts of some of the interviews that you did with women
in this camp, and some of them talked about how their husbands were shot. One
woman said, `The Taliban shot my husband right in front of my eyes.' Young
men were forcibly conscripted to fight with the Taliban. I was wondering if
there was much rape that was reported, and I ask that because rape is often
one of the human rights violations that you report on a lot in times of war
and civil war. But also I'm curious because it's the Taliban, because they
have such a strict moral code, I wonder if there was any rape that accompanied
that.

Dr. AMOWITZ: From our survey that we did a year ago, we found a very small
number of women that admitted to rape. Now this is a very difficult number to
get at because women, particularly in this society, would not necessarily ante
up to having been raped because of the stigma associated with it. We also
didn't necessarily gear this survey to specifically look at rape, as we did in
Sierra Leone. However, we did get some cases--and in my interviews with these
women in the IDP camp in Dasht-e-Kala, there were some reports of women
stating that girls, particularly young girls, were taken repeatedly from areas
or villages from the front yard, so they were taken by the Taliban. It is
also interesting to note that when I asked what language the Taliban spoke,
they said that they didn't know what the language was, meaning that these were
probably foreign Taliban or not Afghan Taliban. And it also turns out that
lately there have been some reports surfacing that particularly among Arab,
Chechen and Pakistani Taliban, that rape was quite common and does go against
their sort of strict moral code. But these were not the Afghan Taliban.
These were the recruited al-Qaeda Taliban fighters or foreign fighters, as the
IDPs put it.

GROSS: I imagine most of the women were looking forward to the possibility of
returning home. Do you think that they'll be able to do that now that the
Taliban have been ousted from power?

Dr. AMOWITZ: To go home is definitely what they want. Whether that is
logistically possible is difficult to say. First and foremost, there are
seven hundred million acres of mine land in Afghanistan. So going back to an
area where the deminers have not been able to go to is a problem. And while I
was there, two of the men in the village went back--or in the IDP camp went
back to assess whether it was safe to go home. When they stepped into their
homes or their huts in the village, they were actually blown apart by land
mines. So first they have to deal with the land mines. Second, you have to
pay to cross the river in the area that I was in, and the river crossing was
getting incredibly expensive. At first it was $5 at the beginning of the
week. By the end of the week, it was almost $100. And many of these
internally displaced don't have that type of money to cross the river, and so
they would try to cross the river on their own without using the pontoon. And
many of the children were drowning in this swift-running river.

GROSS: Who was collecting the money at the checkpoint?

Dr. AMOWITZ: These were all Northern Alliance.

GROSS: What's your impression of what they were doing? Do you think that
they were just, like, extorting money from people?

Dr. AMOWITZ: You know, the Northern Alliance, I don't think, are good guys
either, but there's also a breakdown between the upper-level Northern Alliance
commanders and the sort of infantry and local leaders. And those guys have
very little structure and command, and tend to do whatever they want to do.
At this river crossing, it was run by the Northern Alliance. And, you know,
you also have to remember not to ever say that they're doing the right thing,
but these people are the people that are from the villages as well. They're
just as poor as the internally displaced. The only difference is, is that
they have a gun and so they're able to lobby for money. So they were charging
for the river crossing. It's also interesting to note that when I was
interviewing some of the internally displaced in other camps, there was a
point where a Northern Alliance group came through one of the IDP camps and
force conscripted the boys out of the camp as well. So it wasn't just the
Taliban.

GROSS: If you're just joining us, my guest is Dr. Lynn Amowitz. She's a
health and human rights fellow with Physicians for Human Rights. She also
teaches at Harvard Medical School.

Let's take a short break here and then we'll talk some more about your
experiences in Afghanistan.

This is FRESH AIR.

(Soundbite of music)

GROSS: My guest is Dr. Lynn Amowitz. She's a health and human rights fellow
with Physicians for Human Rights. She was in Afghanistan last month at a camp
for internally displaced people in Afghanistan. And at the time, she was
about six miles away from B-52 bombing.

Let's talk a little bit about the health conditions in the camp that you were
in. What were the biggest medical problems you witnessed?

Dr. AMOWITZ: Most of the medical problems in this camp were primarily upper
respiratory infections. This area in particular in the northeast is consider,
quote, "food secure," meaning that food has been able to get there on some
regular basis, although it was a month before I had gotten there that they had
gotten their last shipment of food. But if you walk the camp, you didn't see
children that were severely malnourished. And Medecins sans Frontieres, or
Doctors Without Borders, had been doing malnutrition surveys in the camp. And
the children made mild malnutrition, which almost half of children in
Afghanistan make criteria for anyway, and half of children in Afghanistan are
stunted from chronic malnutrition. But for the most part, what you saw were
upper respiratory infections.

GROSS: Well, you've reported that a lot of women in their mid-30s in
Afghanistan already have six to eight children.

Dr. AMOWITZ: That's correct.

GROSS: What effect does that have on them physically?

Dr. AMOWITZ: Physically to have six to eight children in a short span of
years is very hard on any woman. I mean, you know, if you ask any woman in
the US how bad was their pregnancy, they always have a horror story. These
women just seem to grin and bear it. The problem is, is that Afghanistan has
one of the highest maternal death rates in the world. Every 30 minutes a
woman dies in childbirth. And then again, it also has one of the highest
infant/child mortality rates in the world. So I think a lot of these women
are counting on the fact that they're going to lose a portion of their family
in a very short amount of time and that having more children assures that you
have children for your future as well. They do quote that one in five
children will not see the age of five, which is a huge number of children
dying every year. About 85,000 children a year die.

GROSS: I was thinking, too, that, you know, under the Taliban, there was a
period when women doctors weren't allowed to practice. But then I think women
doctors were allowed to have women patients. Correct me if I'm wrong on that.
But it must have been very difficult for women under the Taliban to talk
openly to their doctors about medical problems they were having?

Dr. AMOWITZ: I think if women were able to see women, it was not such an
issue. The problem arose if a woman under the Taliban needed to see a male
doctor, then it became much more difficult. And meaningful diagnosis was
almost impossible given that they were not allowed to be completely examined.
So if you complained of a cough, a male physician could only listen through
traditional dress to your lungs, but couldn't listen to your heart. So if you
were an older woman and you were having heart problems and that's what was
giving you the cough, then it would be undiagnosed. They were able to access
medical care. However, in the Physicians for Human Rights survey that we did,
we found that the main reason that they couldn't access care was not because
it wasn't available. We also found that there was an increase in the access
and quality of care, largely because of the international community. But the
reason that they couldn't access care was because financially they couldn't
afford it. And this was, of course, directly due to the fact that women were
not long allowed to work under the Taliban.

GROSS: Did women feel comfortable in your interviews with them talking with
you openly about their experiences under the Taliban and about their
gynecological health care and what they were able to get and what they were
unable to get?

Dr. AMOWITZ: The women definitely felt comfortable with me. I had spent a
lot of time prior to actually going into Afghanistan of trying to integrate in
the Afghan communities, learning to speak a little bit of Dari, learning the
rules of the road, you know, what to do and what's not appropriate when you go
into somebody's house. But I also used local data collectors. I felt that me
going in and asking questions of these women would not be appropriate if I
could use local data collectors. And so I used local women in each area that
I was in to help me collect this data. When I did the interviews, some of
them, as, you know, trying to get as many as we could, I did have a translator
who I sort of trained to ask the questions and I would, you know, ask her to
translate the question for me. But I never had any woman that I perceived as
feeling uncomfortable. And I got horrendous stories told to me, as well as
very personal things, including things like, `I tried to commit suicide,'
which is something that you wouldn't tell a stranger.

GROSS: Well, in fact, you report that a lot of women tried to commit suicide.
What was the suicide rate and the attempted suicide rate that you found?

Dr. AMOWITZ: The attempted suicide rate ranged from 9 percent to 16 percent,
16 percent being in the Taliban-controlled areas and 9 percent being in the
refugee camps in Pakistan and the non-Taliban-controlled areas. But you have
to remember, if this woman was able to say, `Yes, I attempted suicide,' then
that's a woman who failed the attempt. So that number is probably much
higher, because those who succeeded I would never be able to capture. Some of
the other staggering statistics that we found about mental health was that
more than 70 percent of women made clinical criteria for depression, and that
means that they had depression that needed to be treated. And as well, more
than 70 percent of women felt as though their life would be better off if they
were dead, so that they hadn't moved towards wanting to try and kill
themselves, but they were thinking that life would just be better if they
end it, and this is a crisis among women in Afghanistan.

GROSS: What does depression mean in a situation like Taliban-controlled
Afghanistan, where, if you're a woman, you have every reason in the world to
be depressed? You have no rights. You can't leave the house unless you've
totally covered up. I mean, you basically don't exist in society. So it's
not like, `Oh, it's just a chemical imbalance that you're facing or a period
that will pass.' I mean, there's every political and social reason to be
depressed. It's not something that you'd necessarily want to go to a doctor
for. You'd want to go to a different political leader.

Dr. AMOWITZ: I mean, you're absolutely right that depression is
multifactorial or there are many reasons that you can be depressed. And we
did try to get at this in our survey, and we asked, `How much of your
depression is due to Taliban policies?' It was interesting that in the
Taliban-controlled areas, 70 percent of women said that their depression
symptoms were related to those policies. But that also leaves 30 percent who
said no, it had very little to do with their depression. And then in the
non-Taliban-controlled areas where the Taliban didn't exist and none of these
policies were part of their every day, 30 percent of women also blamed the
Taliban.

When we went back to look at this, we found out that some of these reasons
were that it had been 23 years of war, they had destitute poverty, the drought
for the past three to four years had ruined their crops and they were not long
able to work and to have a financial status at all, that they had lost family
members, that they felt internationally isolated. So there were many reasons.
So, yes, you can't fix depression primarily by treating it with a medication.
Some of this is what we would call situational, that the situation is so bad.
But that just shows you that if you're going to treat these women, that you
not only have to treat the emergent ones, so those who really feel like life
is not worth living, but you also have to work on all of these other basic
human rights, like food, shelter, security and emergency provisions.

GROSS: In the United States, we've really focused on the burqa as a symbol of
the oppression of women by the Taliban in Afghanistan. What did you find
about how women in Afghanistan feel about the burqa?

Dr. AMOWITZ: Women in Afghanistan don't completely understand the Western
obsession with the burqa. And actually, what the women in Afghanistan call it
is a chadri. A burqa is a general term for any type of veil, but the Afghan
chadri is the one that everybody knows, the blue with the mesh in the front.
What they told me when we surveyed them was that 90 percent of women in the
northern areas not controlled by Taliban chose to wear this or wore this on
their--every day. In the non-Taliban-controlled areas, about half of the
women said that they really didn't care about the issue of whether they were
punished for wearing this or not, also because half of them chose to wear
this. My sense of this is, look, if you take off the chadri or you take off
the burqa, it doesn't change their risk for tuberculosis, it doesn't change
the fact that they will get education or health care, and it doesn't change
the fact that they'll die in childbirth, and that all of these issues are far
more reaching than simply talking about what they choose or don't choose to
wear.

GROSS: What insights did you get about how much the oppression of women in
public life carried through at home with their husbands?

Dr. AMOWITZ: When we interviewed these women, we also had a chance to
interview the husbands or a male relative. And what we asked the men, similar
to what we asked the women, were, `What were your opinions about women's human
rights?' you know, `Should women have equal education, participation in
government, occupation and all of these rights that have been taken away?'
Ninety percent of men in both Taliban-controlled and non-Taliban-controlled
areas supported women's human rights. So we have this grand feeling that they
definitely support them, and that what the Taliban were saying were the voice
of the people was not true. And we did see this. Herat was not taken by the
Northern Alliance. Herat was actually taken by those in Herat who rose up and
said, `OK, had enough. Taliban, go. We want our city back.'

GROSS: Dr. Lynn Amowitz is a health and human rights fellow with Physicians
for Human Rights. She teaches at Harvard Medical School. She'll be back in
the second half of the show. I'm Terry Gross, and this is FRESH AIR.

(Announcements)

GROSS: Coming up, classical music critic Lloyd Schwartz reviews DVD
recordings featuring conductor Pierre Boulez, and we continue our conversation
with Dr. Lynn Amowitz, who has traveled several times to Afghanistan for
Physicians for Human Rights.

(Soundbite of music)

GROSS: This is FRESH AIR. I'm Terry Gross. Back with Dr. Lynn Amowitz.
She's a health and human rights fellow with Physicians for Human Rights. Her
current work for the group is in Afghanistan. She was there last month and
hopes to return in January. She's also done medical work in Kenya, Rwanda,
Sierra Leone, Albania and Kosovo. Dr. Amowitz teaches at Harvard Medical
School and has a private practice in women's primary care.

You've made several trips to Afghanistan. Give us an overview of when you
went and what your missions there have been.

Dr. AMOWITZ: Over the last 18 months, I've made five trips to the region.
Three of those were in Afghanistan. The first four trips were for completing
this large-scale population study of health and human rights issues among
women as well as the opinions of human rights among women and men in both
the Taliban-controlled areas and non-Taliban-controlled areas, meaning that I
had to get into Taliban-controlled areas to do part of this study. The last
trip was changed because of the situation. Originally it was to go and to
talk to the internally displaced, since I didn't have a chance to do that
previously. But the situation changed a few days after I actually crossed the
border, and so I had to modify what I was doing. But the one thing that I
wanted to find out was to figure out who were the most vulnerable and what
type of programs could be made to try and help those most vulnerable, meaning
widows and women, who need the most help in getting back to their villages.

GROSS: Did you travel alone during your trips through Afghanistan?

Dr. AMOWITZ: On each trip I did travel alone. It was somewhat easier to
travel alone given the circumstances, particularly in Taliban-controlled
areas, because you don't really want to gather a lot of groups of people and a
lot of attention.

GROSS: You wore a burqa?

Dr. AMOWITZ: I did not. I did wear a chador, or a head scarf, an Afghan
dress, only because it made it easier to go through the villages and to go
through the markets to get what I needed.

GROSS: Why was it easier that way?

Dr. AMOWITZ: If someone comes from you from behind, they don't necessarily
know that you're Western, although in some areas where women are supposed to
wear a chadri or the burqa it was important to have that. I was actually
asked by the Taliban officials in the area not to wear it and thought that was
a reasonable request, given that I wanted to downplay my existence there.

GROSS: They asked you not to wear it because it would be inauthentic for you
to wear it or what?

Dr. AMOWITZ: Because it would be inauthentic, was their reason.

GROSS: Mm-hmm. So did you feel like you called a lot of attention to
yourself as a woman who wasn't as covered as the Afghan women were?

Dr. AMOWITZ: Well, I didn't necessarily go into the villages or into the open
areas of the market areas unless I absolutely had to. I stayed with families
in the areas that I was in, mainly because it was safer, it was also a way to
get to know the community better by staying with families in the area. So I
didn't go out to make myself visible, only when I was accompanying the data
collectors or doing my own survey.

GROSS: You know, I think for women traveling alone, there are two opposite
extremes you get concern with. One is that people will be very patronizing
towards you because you're a woman alone, and the other is that people will
try to prey on you sexually because you're alone. But I imagine traveling
through Afghanistan there's, like, a totally different option, which is that
you're a woman, you have no rights, you're not supposed to be out alone in
public. You're just like a different kind of creature, a fairly unacceptable
creature. I mean, tell me if I'm exaggerating here, but what was the
experience for you of just being a woman trying to go about your business?

Dr. AMOWITZ: First of all, I never felt safer than when I was in Afghanistan
alone.

GROSS: Why?

Dr. AMOWITZ: It was just an incredible experience to walk and feel as though
I was respected, and I'm not sure why that was. Perhaps they just thought I
was completely crazy and that the best thing to do was just to stay away from
me because I may do something, you know, unpredictable. I did meet with
Taliban officials in every area that I went to to get permission to do this
study, and I never had a problem. Now the one place I definitely felt unsure
about being alone was on the Tajik side of the border crossing in Afghanistan,
and that was because it was young Russian border guards who wanted to deny my
access despite the fact that I had all the necessary paperwork. And so they
wanted me to stay in their, quote, "hotel" overnight, and then they would let
me pass in the morning, at which point I pulled out my sleeping bag, sat in
front of the gate and said, `Sorry, I'll just sleep here for the night and
you'll let me across.' By the time I had done this, they were just so
flustered after five hours of going back and forth about this, they let me
across. And I truly felt so much safer on the other side, even though I
crossed the border at night alone into Afghanistan, into an area that I hadn't
been in previously, because I knew that the Afghans would respect me.

GROSS: Now you said in all of the villages that you were in Afghanistan, you
had to get the permission of the Taliban to do your research. I'm surprised
that they didn't feel threatened by the research that you were doing.

Dr. AMOWITZ: You know, I think part of the problem is they don't read, and so
I would offer up the survey, which had all of the questions on it, I would
explain what was on the survey, and then I would say, you know, `If you want
to read this survey to figure out what's going on, you're welcome to do so.'
And I think losing face in front of a Western woman and saying, `I'm sorry, I
don't read,' since the majority of the Taliban are uneducated and illiterate,
was not an option for them. And so they would hand back the survey and say,
`OK.' On the other hand, the Taliban were never one group. It was a very
mixed group. There were those who were fanatical and then there were those
who were Taliban because it was the way to assure that you would get food and
a government position and an ability to stay in your village. So depending on
who I met with, dependent on what kind of access I could get--and fortunately
for me I met with those who had no problem with what I was doing.

GROSS: I know you have a baby, and I think on at least one of your trips you
took your baby with you to Afghanistan, yes?

Dr. AMOWITZ: Yes, I--well, not into Afghanistan. I tried to get a Taliban
visa in August of this year. My baby was six months old at the time--I'm
sorry, seven months old at the time, and I was still nursing her and felt like
there was no reason that I couldn't take her. So I took her along. She
turned out to be a lot of fun in the refugee camps and actually put women at
ease. But, you know, if you ask these women, did they think it was
extraordinary that I took my baby, they would have just laughed. I mean, here
they are living in a refugee camp in Pakistan trying to find food for their
family and, you know, I'm just bringing my baby, who I just take home at the
end of the day. You know, I don't live in this situation.

GROSS: Still, though, by taking her with you, you were exposing her to a lot
of the contagious illnesses in the camps, whereas the people who were forced
to be there have no choice. You did have a choice.

Dr. AMOWITZ: I did have a choice, but she was nursing and, therefore, she had
all of my antibodies, so every single shot that I've ever had, which is a lot,
she was getting antibodies from this. When I had this discussion with my
pediatrician, she felt as though that the risk was very small, given that she
would primarily be with me and, you know, we would not be there on a prolonged
period of time.

GROSS: Did it help to know that you're a doctor, and if something went wrong
you could, like, diagnose it and treat your baby?

Dr. AMOWITZ: Oh, gosh, no. I'm still a mother and I don't do pediatrics.

GROSS: So you were as insecure as any of the rest of us would have been?

Dr. AMOWITZ: Oh, absolutely. I cannot go to the pediatrician with my
children. I also have a five-year-old, and when they need to go to the
pediatrician, I send my husband with them.

GROSS: Were people any more welcoming or any less suspicious of you when you
had your baby with you?

Dr. AMOWITZ: I think that's probably the case, that, you know, here's a
Western woman, or the yellow-haired, green-eyed woman, as they called me
there, bringing her baby, then she can't be doing anything awful. I mean, the
suspicion in these areas if you are Western, and particularly American, is
that you are somehow intelligence. And by bringing my baby, that sort of put
them at ease. Also, in August the previous year, I was there finishing a
study in Afghanistan and was pregnant with her at the time, and then all of
the women figured out that I was pregnant even though I didn't think I was
showing at the time. And that also seemed to put them at ease, that if I, you
know, would come even though I was pregnant, that I could be doing very little
that was bad.

GROSS: My guest is Dr. Lynn Amowitz. She's a health and human rights fellow
with Physicians for Human Rights. We'll talk more after a break. This is
FRESH AIR.

(Soundbite of music)

GROSS: If you're just joining us, my guest is Dr. Lynn Amowitz, and she's a
health and human rights fellow with Physicians for Human Rights. She teaches
at Harvard Medical School. We're talking about the trips she's made to
Afghanistan in the past--What?--18 months?

Dr. AMOWITZ: Eighteen months, yes.

GROSS: Why do you do the work that you do?

Dr. AMOWITZ: Huh. Everybody has asked. I do it because I'm afraid that if I
don't do it, nobody else will. And I have all of these sort of mishmash of
skills that seem to fit with the type of work that I do in talking to women,
in conducting scientific studies to better understand the situation in all of
these countries that I go to. And I am truly afraid that if I didn't go, who
would do it? And that it wouldn't get done and that these issues wouldn't be
dealt with.

GROSS: Some of the places that you've been to in addition to Afghanistan and
Pakistan are Sierra Leone, Rwanda, Kosovo, Albania, Kenya. What was the most
kind of awful and surprising situation you found yourself in?

Dr. AMOWITZ: I think Rwanda was probably the most horrible of the situations
that I've been in. I landed just after the Hutus and Tutsis had stopped
fighting--or the genocide of the Tutsis had stopped, and the bodies were still
on the side of the road, and at that time I was helping UNICEF to establish an
orphanage in Goma, Zaire, and each day I would walk from where I was staying
to this orphanage, and along the way I would always pick up one or two or more
dead or dying babies that had been abandoned by their mothers. A lot of these
babies, in retrospect, were probably babies that were born out of a rape that
happened in Rwanda. And every day I would try and resuscitate these babies,
and every day seven or more in this orphanage would die. It was just
horrendous. And I, you know, didn't go into pediatrics because I can't handle
taking care of sick kids. I have too much motherly instinct and I end up in
tears, and I just spent the entire time that I was there in tears.

GROSS: You have a report that's due out in January about rape in Sierra Leone
and you're not at liberty to discuss the findings yet because the report
hasn't been released yet. But I'm wondering, since you've studied rape in
various war-torn cultures, do you find that rape is regarded in places like
Sierra Leone, Rwanda, Afghanistan in the same way that rape is regarded here?
Is the language the same? Is the interpretation of rape the same? You know,
are the reactions to it by women who have been victimized similar to the
reactions of rape victims here?

Dr. AMOWITZ: I think the reactions of any woman who is raped is the same no
matter what society you're in. And I don't think that you can say that it's
different--that women that are raped here are any different than women that
are raped in Sierra Leone. The fact that it is rape, the fact that it
unravels your being, your society, your family--all of those issues are the
same. You're stigmatized, your family is stigmatized. Now in some countries
where family and extended family is more important, such as in Afghanistan or
Sierra Leone, then that becomes a big issue because it determines your
survival; whereas here, you don't necessarily lose your family or lose your
house, lose your belongings or lose your life because of the high rates of HIV
in Sierra Leone. So it is a different ending, but the feelings and the
feelings of trauma and lack of self-worth and all of those issues are very
similar.

GROSS: I want to get back to something we were talking about earlier, and
that is that when you crossed the border from Tajikistan into Afghanistan, you
felt more respected in Afghanistan than in Tajikistan and, therefore, you felt
safer, too. I'm not sure I understand the meaning of respect in that context
since it's also a culture that, at the time, was under the Taliban in which it
just seemed to me women had very little respect.

Dr. AMOWITZ: Yeah, I think that's a hard thing to understand. But basically
on the Tajikistan side, my sexuality was an issue, whereas my sexuality on the
Afghan side was not an issue. I did not worry that they were going to drag me
away or put me at risk for being assaulted on the Afghan side, and that they
would be somewhat standoffish, whereas there were no bounds on the other side.
There was no respect. And I don't really think on the other side, on
Tajikistan side, where the Russians are patrolling this border, that they have
much respect for anybody, whether it's a woman or a man. But certainly a
woman to them is a lot less secure, if you want to put it that way, than if
it's a man.

GROSS: If you're just joining us, my guest is Dr. Lynn Amowitz. She's a
health and human rights fellow with Physicians for Human Rights. She teaches
at Harvard Medical School.

You have private patients in your practice in Boston, but you've been around
the world working with women in war, women in refugee camps and displaced
persons camps. Do you ever think the women in your private practice are
spoiled because they're complaining of medical problems that would seem so
minor in comparison to the problems of women in war?

Dr. AMOWITZ: Never spoiled, but awfully lucky. I mean, I just sometimes have
to sit and say, you know, you have the right to complain about this because
something can change, whereas the women that I've treated in the past in these
other camps and in these other parts of the world, there is nothing for me to
do other than to say I understand and give a hug and that's it. I do have
some adjustment problems when I come back. The most notable one was coming
back during residency from Rwanda, and my first day back I ended up having to
be the resident in the medical intensive care unit. And the medical intensive
care unit was full of 80- and 90-year-old women and men who were being treated
for things that were never going to be treated and that they would probably
die. And I had an incredible difficulty adjusting to that situation and ended
up losing my perspective for a little while.

GROSS: Now what was particularly difficult about that?

Dr. AMOWITZ: In intensive care units, there's always sort of an interplay
between the residents and the nursing staff and the patients, who are usually
completely out of it. And the nurses who primarily take care of these
patients, you know, you go home, they're still there. And they take care of
these patients day in and day out. And there was an argument that started
between one of the nurses and I about how much potassium to give someone,
whether it was 20 milliequivalents or 40 milliequivalents, at which point I
just blew up and said, `Look, if you want to give 40, give 40. I just spent
six weeks picking up dead babies and trying to resuscitate them, and we are
trying to resuscitate a 90-year-old woman who has, you know, metastatic cancer
or cancer all over her body. What more do you want me to do?'

GROSS: And how would you feel about that now? Same way? Same kind of
difficulty adjusting?

Dr. AMOWITZ: No. I think I, you know, over the years have learned to
readjust better in this regard in coming back and realizing that, you know,
we're some of the luckiest individuals in the world with regard to medical
care. But I do have some readjustment problems when I come back for a couple
of weeks in just realizing or feeling as though what I'm doing here is not as
meaningful as what I'm doing other places. However, there's always that one
patient that reminds you what you're doing here is very meaningful. You know,
when I start seeing patients at home again and I am able to make a patient
feel better, then I realize that this is really my job, and this job helps
what I do in the field just as much as what I do in the field helps at home.

GROSS: Dr. Amowitz, I thank you so much for talking with us. I wish you good
health. Be safe. And I wish you good holidays. Thank you.

Dr. AMOWITZ: Thank you. It was my pleasure.

GROSS: Dr. Lynn Amowitz is a health and human rights fellow with Physicians
for Human Rights. She teaches at Harvard Medical School.

Coming up, Lloyd Schwartz reviews DVDs featuring conductor Pierre Boulez.
This is FRESH AIR.

(Soundbite of music)

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Review: DVDs featuring conductor Pierre Boulez
TERRY GROSS, host:

Post-September 11th terrorist anxiety touched the music world when Swiss
police investigated French conductor and composer Pierre Boulez. Music critic
Lloyd Schwartz says his favorite living musician is making musical news as
well.

(Soundbite of music)

LLOYD SCHWARTZ reporting:

Pierre Boulez made headlines recently, but not for his music making or Grammy
awards. The police in Basel, Switzerland, evidently dragged the 76-year-old
musician from his hotel room in the middle of the night, confiscated his
passport and detained him for three hours as a terrorist threat. There were
two versions of this story which broke a month after the events in question.
The British newspaper The Guardian reported that he was put on the police list
because threats were made, surely not by him, to a hostile music critic after
a particularly negative review. The BBC News reported that he made the list
because of a comment he made when he was an apostle of the avant-garde back in
the 1960s that opera houses should be blown up.

It's true, artists are dangerous, real subversives. They make us rethink our
knee-jerk responses. But they're not literalists. What they say needs to be
interpreted. We can see how Boulez wanted to revitalize opera in the new DVD
of his radical 1976 production with director Patrice Chereau of Wagner's epic
four-opera "Ring Cycle." Wagner's grandson, Wolfgang, the director of the

theater at Bayreuth, Germany, built especially to perform Wagner's operas, was
looking for a new view of this cycle to celebrate its centennial. Boulez and
Chereau gave him one of the great stage productions of the 20th century, not
the usual glorification of German mythology by Hitler's favorite composer, but
an exploding of conservative opera tradition, with a moral indictment of the
greed and hypocrisy of the industrial revolution and its effect on the 20th
century.

(Soundbite of music)

SCHWARTZ: Chereau's deliberately anachronistic images are visually stunning.
The Rhine is a hydroelectric dam. The Rhine maidens are prostitutes. In
their frocked coats and glamorous evening gowns, the gods look like a family
of wealthy 19th-century industrialists. A huge pendulum hangs in their
private chamber of Valhalla, reminding us their days are numbered. Men in the
chorus in shabby suits and ties look like German workers in the 1920s, a mob
out of one of Bertalt Brecht's political plays. The modern world is directly
implicated in this myth, which may be exactly what Wagner had in mind to begin
with.

But here, the usual Wagnerian heaviness is gone, along with the horned
helmets. Boulez makes the orchestra fluid and transparent. The singers are
subtle actors who actually look their parts, and they can sing with both
grandeur and conversational intimacy. Here's the first entrance of the
poignantly beautiful soprano Gwyneth Jones as the youthful, exuberant
Brunhilda, whose affection for the mortal Sigmund will precipitate tragic,
even cosmic consequences.

(Soundbite of opera)

SCHWARTZ: If ever a musical work was made for DVD, it's the "Ring Cycle." How
sparkling the images look, and how satisfying to replay a favorite scene
without having to wind back and forth searching through 14 hours of videotape.
Several other Boulez performances have also come out on DVD. Brilliant
concerts from Cologne and Frankfurt with the London and Chicago Symphony
Orchestras of 20th-century masterpieces.

(Soundbite of music)

SCHWARTZ: It's great not only to hear but to see the master at work. And the
cameras really focus on him. If he's ever arrested again, at least while he's
moldering in prison, there are still these documents of his dazzling
technique and cat-got-the-canary grin, and we can watch them whenever we like
in the comfort of home.

GROSS: Lloyd Schwartz is classical music editor of the Boston Phoenix. He
reviewed new DVDs of Pierre Boulez conductor Wagner's "Ring Cycle," and
Stravinsky's "Rite of Spring."

(Credits)

GROSS: I'm Terry Gross.
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.