Arzo is so weak she spends most of her day lying on a thin mattress in a dimly lit room under a ceiling fan that steadily circulates the polluted air of Pakistan’s largest city.
To pass the time, she watches makeup videos on her cellphone, the glow of the screen illuminating the faded freckles of a teenager whose skin now rarely sees the sun.
Arzo is a long way from her home in Afghanistan, where she lived with her parents before being smuggled across the border for medical treatment.
Her older brother and sister, Ahamad and Mahsa, now care for her in a rented room in Karachi, their temporary refuge from life in Afghanistan under Taliban rule.
“Don’t worry,” whispers Ahamad, as he kisses Arzo’s hand. “You will be fine. Don’t worry, we are with you always. I’m hoping you will be fine soon.”
CNN is not using Arzo’s or her siblings’ real names because they fear reprisals from the Taliban, and being discovered by Pakistani officials, who have deported more than 26,000 Afghans since announcing a crackdown on undocumented migrants in October.
Being forcibly returned to Afghanistan would mean certain death for the 15-year-old, her siblings say, because she needs medical care they say isn’t available in their home country.
The siblings don’t normally talk about why their little sister is so unwell – they don’t want to upset her. As they told CNN their story, Arzo silently wept.
A girl with ambition
Arzo dances barefoot in jeans to pop music with her sisters inside a home in Afghanistan. She smiles as she twists her hands in time with the beat.
Ahamad said the video was filmed six months after the Taliban seized control of the country in August 2021. Schools were closed but his sisters were confident they would reopen.
They didn’t. Instead, the Taliban gradually reimposed the repressive policies that shrank the role of women in society during their previous rule from 1996 to 2001, despite assurances they wouldn’t.
Women are banned from most workplaces, universities, national parks, gyms and going anywhere in public without a male chaperone.
Mahsa had already graduated high school, but Arzo still had three years ahead of her.
When their village school closed, their worried father sent his daughters to study English at an education center in Kabul, but that soon shut, too.
Back at home, Mahsa took up tailoring to pass the time. But Arzo drifted deeper into depression.
“Most of the time she said, ‘I hope we should move from this place, I don’t want to be here, there is no education and I want to become a doctor,’” Mahsa recalled Arzo saying.
One day in July, Mahsa walked downstairs to find her sister staring at her with bulging eyes.
“I asked her, ‘What happened to you?’ She said that she drank acid. I didn’t believe it, so I put my fingers in her mouth and she vomited up blood,” Mahsa said.
Doctors see rise in suicides
Experts say reliable statistics on suicide and suicide attempts aren’t compiled in Afghanistan, but rights groups and doctors say they’ve seen an increase under Taliban rule.
Dr. Shikib Ahmadi has been working six days a week and longer hours than ever, seeing patients at a mental health clinic in Afghanistan’s western Herat province. He’s using a pseudonym because he fears the Taliban will punish him for speaking to foreign media.
Ahmadi said the number of female patients at his clinic has surged 40% to 50% since the Taliban’s takeover two years ago. Around 10% of those patients kill themselves, he said.
Their lives restricted by the Taliban, girls and women are turning to cheap household items to attempt suicide, he said. Rat poison, liquid chemicals, cleaning fluids, and farming fertilizer – anything they think will ease their grief.
Ahmadi says he tries to tell them things will get better, that schools will reopen, that they can work at home while they wait, tailoring or doing something that gives them purpose.
But the truth is he doesn’t know if classes will ever resume, and his own hope is fading.
“I don’t see any good future for anyone in this country,” he said.
Another group of girls has just graduated from sixth grade – the end of their education under Taliban rules.
Ahmadi fears that will mean another wave of self-harm and suicide.
“Last year, everyone had a hope that next year the schools will be open. The government promised that they will open the schools,” he said.
“But since this year, the schools are not open, so people lost their hopes. I feel like the number of suicides will increase.”
CNN has contacted the Taliban for comment about the reported rise in suicide among women.
In a statement provided by the Taliban’s Ministry of Foreign Affairs to the Office of the United Nations High Commissioner for Human Rights in January, the group claimed that female suicide rates had fallen since they came to power.
“In the last 20 years, there were many case (sic) of women committing suicide, but by the grace of Allah, we do not have such cases now,” the statement said.
The claim is contradicted by multiple reports, including from UN experts, who said in July that “reports of depression and suicide are widespread, especially among adolescent girls prevented from pursuing education.”
The Taliban’s return
Arzo was born in 2008, seven years after the United States and its allies invaded Afghanistan and removed the Taliban leaders the US accused of harboring al Qaeda terrorists behind the 9/11 attacks.
Under the Western-backed Afghan government, a devastating civil war raged for years, but life had nonetheless improved for Afghan women. Many started school, earned degrees and became role models for girls like Arzo and Mahsa.
But everything changed in 2021 when the US and its allies started pulling out of Afghanistan, creating space for the resurgence of Taliban fighters, who’d retreated to rural areas of Afghanistan and Pakistan.
Back in power in the cities, the Taliban reimposed their radical Islamist ideology, carrying out extrajudicial executions, arbitrary arrests, and unlawfully detaining anyone considered a threat to their leadership, according to rights groups.
In the chaotic aftermath of the takeover, women were initially told to stay at home because the fighters were “not trained” to respect them. Restrictions were gradually tightened, and now millions of girls and women are largely confined to their own homes with the threat of punishment if they don’t comply.
Ayesha Ahmad, an associate professor in global health humanities at St. George’s University of London, was conducting in-depth interviews with women in Afghanistan who had fled domestic violence when the Taliban moved in.
“I will never forget the day of the takeover, the frantic calls and communications and the absolute terror that they were feeling because they knew what the reality would be, and they were right,” she said.
Now many more women are vulnerable to violence, she said, and some see suicide as the only escape, despite the cultural stigma and shame it would bring on their families.
“Suicide is a sin in Islam, and in this context of religious extremism, women are not going to be seen as a victim,” she said.
With little sympathy from the Taliban leaders who created this situation, Afghanistan’s women are looking outside their country for support.
Heather Barr, associate director of the women’s rights division at Human Rights Watch, said Afghan women worry the world is beginning to accept that what’s happening to them is normal.
“Everyone’s kind of shrugging and saying, ‘Well, it’s Afghanistan.’ It should be intolerable to all of us. Because what happens in Afghanistan, and how the international community does or doesn’t respond, has huge implications for women’s rights globally,” she said.
“We have to be saying to our governments that this can’t be seen as normal. This can’t be treated as just one more country with a domestic issue.”
Ahamad wasn’t in Afghanistan in July when his sister drank the acid.
He had already fled to Pakistan, fearing retribution from the Taliban for his work as a journalist before they took power. He told CNN his father and uncle took Arzo to a local doctor, who gave her some medicine and told them to go to Kabul if her condition worsened. It did.
In Kabul, a doctor said the acid had damaged her esophagus and stomach and she was unlikely to survive surgery. So, they decided to take her to Pakistan, where Ahamad was waiting with a doctor. Ahamad then took Arzo to Karachi, where another doctor inserted a feeding tube into her stomach.
That was three months ago. Since then, Ahamad says Arzo has steadily lost weight and now weighs about 25 kilograms or 55 pounds.
“Her situation is not good at all. The doctors installed the pipe to her stomach for feeding so she can gain weight and be ready for the real operation,” in January, Ahamad said.
“Maybe she won’t gain weight,” he said. “And maybe they won’t do the operation.”
Mahsa sits on the bed, her needle piercing fabric with enough precision to keep her mind focused on the task. She would like to return to study, but right now caring for her sister is all that matters.
“I can’t sleep at night because she is in pain,” Mahsa said.
The siblings know they’re taking a huge risk by speaking out – they fear the Taliban’s reach in Pakistan and for their parents, who are still living in Afghanistan.
But they’re desperate.
Neither can work, the siblings say, and they don’t have the $5,000 needed for Arzo’s surgery, as well as money for the room, food for themselves and the cans of powdered milk and juice they need to keep her weight from dropping.
They don’t want to think about what happens if the last of their money runs out, or if the Pakistani police come knocking on the door.
Since October, when Pakistan’s government announced it was no longer tolerating the presence of undocumented Afghans, nearly 400,000 have returned to Afghanistan, according to the UN’s High Commissioner for Refugees (UNHCR) and the International Organization for Migration (IOM).
Most left voluntarily, driven away by the fear of arrest, according to a joint statement from UN agencies.
In October, the UN’s OCHR urged Pakistan to halt the removals, warning that those who returned were at “grave risk of human rights violations.”
The most vulnerable included “civil society activists, journalists, human rights defenders, former government officials and security force members, and of course women and girls as a whole,” spokesperson Ravina Shamdasani told journalists in Geneva.
Pakistan has defended its Illegal Foreigners Repatriation Plan (IFRP), saying in a statement that it’s “compliant with applicable international norms and principles.”
Ahamad wants a safe place to go with his sisters, where they can rebuild their lives, resume their studies, and start to work as they’d always planned to do.
He knows that returning to Afghanistan is not an option for his sisters, especially Arzo, who cries with despair at the suggestion.
“If she returns to Afghanistan, she will face the same fate. It would be better to live in a peaceful country and continue her education and proper treatment,” Ahamad said.
For now, they live within the four walls of a room heavy with grief for the girl who used to dance barefoot but now struggles to find the strength to lift her head.
“I don’t cry in front of her, but I kiss her and cry while she sleeps at night, for her future, for her treatment, so she can survive this sickness,” said Ahamad.