Alissa J. Rubin / New York Times News Service

JALALABAD, Afghanistan — It is doubly miraculous that the young woman named Gul Meena is alive. After she was struck with an ax 15 times in the head, she held on long enough to reach medical care and then, despite the limitations of what the doctors could do, clung to life.

“We had no hope she would survive,” said Dr. Zamiruddin, a neurosurgeon at the Nangarhar Regional Medical Center in the eastern city of Jalalabad who, like many Afghans, uses only one name. After she was brought in, he worked for more than six hours in the hospital’s rudimentary operating theater, stitching her many wounds.

For weeks afterward, she was often unconscious, always uncommunicative and, but for the hospital staff, utterly alone, with no family members to care for her. That is because, if the accounts from her home province are true, she is an adulterer: Though already married, she ran away with another man, moving south until her family caught up with them.

Locals say that the man who wielded the ax against her, and also killed the man with her, was most likely her brother.

That she reached a hospital and received care at all is the second part of the miracle: The villagers, doctors and nurses who helped her were bucking a deeply ingrained tradition that often demands death for women who dishonor their families.

An entrenched culture

Such “honor killings” of women exist in a number of cultures, but in Afghanistan they are firmly anchored by Pashtunwali, an ages-old tribal code prevalent in the ethnic Pashtun areas of the country that the government and rights advocates have fought for years to override with a national civil legal system. This year, six such killings have been reported in Afghanistan’s far east alone, more than in each of the past two years, and for every one that comes to light, human rights advocates believe a dozen or more remain hidden.

Gul Meena’s story, as best it can be pieced together from relatives, tribal elders and others, gives insight into that deeply entrenched tribal culture. But it is also a story about a society struggling to come to terms with a different way of thinking about women.

The Americans and Europeans have put a special emphasis on programs to help Afghan women and raise awareness of their rights. Now, as the Western money and presence are dwindling, women’s advocates fear that even the limited gains will erode and a more tribal and Taliban culture will prevail, especially in the south and east of the country, where Pashtun tribal attitudes toward women are strongly held.

It is a credit to many people — villagers, doctors, the police, rights advocates — that they chose to help Gul Meena, overcoming centuries of distaste for dealing with so-called moral crimes. The doctors at the Nangarhar Regional Medical Center who first treated her and cared for her for weeks were aware of her likely transgressions and chose to ignore them. However, the doctors, who say Gul Meena is about 18, were also bewildered about what to do with her.

“She has no one; no mother has come, no father, no one from her tribe has come,” said Dr. Abdul Shakoor Azimi, the hospital’s medical director, as he stood at the foot of her bed looking at her. “What is the solution? Even the government, the police, even the Women’s Affairs Ministry, they are not coming here to follow up and visit the patient.”

Gul Meena first arrived in the area, in a village called Kandi Bagh in a rural stretch of Nangarhar, about two months ago, traveling with a man named Qari Zakir. The villagers asked few questions, although the two had traveled south from Kunar province with just a single bag. That is hardly the profile of a married couple hoping to set up housekeeping in a new place.

“Everybody avoids such cases and doesn’t want to get involved in others’ troubles,” said Hikmat Azimi, 27, who lives in Kandi Bagh and works as a teacher at a nearby agricultural institute.

The last time anyone saw Zakir was about a week after their arrival, on the night before he was killed. He was seen buying a large bag of fruit, it seemed in honor of Gul Meena’s brother. He had turned up a few days earlier, according to villagers’ accounts related by Col. Nasir Sulaimanzai, the head of the Nangarhar police investigative division. Her father had also come but then left, Azimi said. The next morning, a distant relative of Zakir’s who lived in the area knocked on the couple’s door. When no one answered, he climbed over the wall that surrounds most Afghan homes and was met by a scene of carnage: Zakir lay on a bed, dead. Gul Meena lay on a separate bed bleeding profusely. Her brother had vanished.

“I shivered when I saw it,” said Azimi, one of the villagers called in to help. He and others borrowed a car and drove her to the hospital in Jalalabad.

For days as Gul Meena lay in the hospital, government entities in Jalalabad held meetings and discussed what to do with her. Her situation was not helped as people learned more specifics. According to villagers and tribal elders as well as her relatives in Kunar province and just over the border in Chitral State in Pakistan, Gul Meena was married, as was Qari Zakir. So the couple had broken fundamental moral codes as well as Afghan law.

‘We will come after you’

According to Gul Meena’s relatives, her family moved to kill her in part because of pressure from her husband’s family. “Her husband’s family came to them and said, ‘If you don’t do this thing, we will come after you,’” said a close relative of Gul Meena who asked not to be named. “Her mother agreed to let them kill her in order to protect her sons.”

Sulaimanzai, the provincial police official, was recently assigned here from Kabul, and he sees the tribal code as the root of the problem in a case where Afghan civil law should prevail.

“What is destroying us is this useless, unofficial justice, these tribal jirgas. The tribal elders, the jirgas, always violate the provisions of the law,” he said. “Many things in this case need investigation: why did she run away from her husband’s house? Maybe he was old, maybe he was impotent, maybe he didn’t feed her,” he added. “They should bring her to the court. We have laws in this country.”