'Every anguish passes except the anguish of hunger’: Afghans on the brink of poverty and malnutrition as bleak winter begins

Afghanistan children
5 min read
17 November, 2021

Life for Afghans has never been easy. ‘Every anguish passes except the anguish of hunger’ states an old Afghan proverb; and now with winter at the doorstep, nearly 19 million Afghans risk hunger and acute malnutrition.

According to UNDP, by mid-2022, 97 percent of the population could sink under the poverty line unless an adequate and urgent response to the economic crisis is launched immediately. The most vulnerable and at-risk are children, particularly those under the age of five.

The news of eight orphaned siblings between the ages of 18 months and 8 years left to fend for themselves, and ultimately succumbed to starvation in Kabul sent a wake-up call to the international community on the harsh reality of this unprecedented food crisis.

"With approximately 3.2 million children under five at risk of severe malnutrition by the end of the year, how will their basic human right to health be ensured?"

Away from the capital, in rural areas – where nearly 70 percent of the population lives – the situation is no better. However, acute food insecurity began before the Taliban took over. Many farmers whose orchards had become the frontline of the conflict between the Taliban and the Afghan National Army, had to abandon their crops and became internally displaced (around 665,000 civilians according to OCHA).

“In the last year alone, I had to move nine times because of the war. I used to sell 1 kg of pomegranates for 150 Afghani (around $ 1.60) now I sell 7 kg for 100 Afghani (around $ 1.09),” 54-year-old Mohammed tells The New Arab as he stands in his beautiful orchard of pomegranates in the province of Kandahar.

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An acute drought last year worsened the situation. The reduced snow in the mountains affected farmers who rely on the melting of the snow for their crops and livestock.

The farmer from Kandahar province in his orchard with his pomegranates
The farmer from Kandahar province in his orchard with his pomegranates [Gaja Pellegrini Bettoli]

At the Mirwais Children Hospital in Kandahar, Dr Mohammed Sadiq, who has been a practising paediatrician for 38 years, escorts The New Arab to the ICU paediatric ward and explains how the economic crisis has dramatically affected children. “The number of children who reach us for severe malnutrition has increased 100 percent in the past month. We have 32 beds for 63 patients, we had no other solution but to place two children in each bed.”

The rooms of the ward are stuffy and crowded with worried and loving mothers who sit on the floor or on the bed next to their children. Some mothers boil a cup of tea while sitting on the floor next to the beds.

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“We work very long shifts because we are understaffed and have not been paid for the past three months,” Taiba, a 24-year-old nurse in the ward tells The New Arab.

She has no time to stop and sit to speak: while talking, she checks the children’s temperature, fixes their beds, checks their vital signs, rushing from one side of the room to the other.

Most of the mothers are fully absorbed in tending to their children and prefer not to speak. One mother however shows her baby. Her name is Malika. “My daughter, Asmar, is only one-year-old. At first, she started vomiting, then she had diarrhoea and she kept getting weaker. I did not know what to do so I came with my husband from my village to Mirwais hospital.”

The entrance to Mirwais Pediatric Ward in Kandahar [Gaja Pellegrini Bettoli]
The entrance to Mirwais Pediatric Ward in Kandahar [Gaja Pellegrini Bettoli]

Dr Sadiq explains that while the dramatic increase in the number of patients has given some the impression that acute malnutrition has become a problem only recently, that is not the case he states.

“One of the reasons why Mirwais – a.k.a. the ‘Chinese hospital’ because it was funded by China – is so overcrowded now is because we are the only clinic equipped with certain facilities in the region. Furthermore,  now that the war and air raids have stopped the roads are safe. This means more families from the villages are able to travel to our hospital with their children and his has also caused an increase in the number of patients.”

The physician highlights the fact that acute malnutrition and starvation are two separate conditions. It takes several months for a child to become malnourished; it is not a condition that develops over a few weeks.

Despite the enormous difficulties, Dr Sadiq manages to keep a jovial and welcoming attitude as he goes around the beds, reassuring mothers and checking on the improvements in his little patients’ health.

"According to UNDP, by mid-2022, 97% of the population could sink under the poverty line unless an adequate and urgent response to the economic crisis is launched immediately"

The paediatrician comments that fortunately, for the moment, the hospital is supported by funds from the ICRC. “The current government has met with the staff at the hospital and has essentially told us to manage the clinic as we see fit.”

However, the conditions vary significantly from one hospital to the other. At the Indira Gandhi Children’s hospital in Kabul, the situation appears to be significantly worse.

The New Arab is told by a doctor, who prefers to maintain his anonymity, that there are no medicines. “We only have about five percent of our medical stock left. Patients need to purchase their own medicines from the pharmacies outside the hospital and bring them with them.” Salaries here have not been paid for nearly four months.

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The Afghan economy which was already weak under the previous government and dependent for about 40 percent of its GDP on international aid (according to the World Bank) has now come to a screeching halt with Western powers’ aid suspension.

According to the World Food Programme, the UN assistance programme has received funding only for about one third, requiring funds of up to $220 million per month to meet the task which makes the figure of the $1 billion pledged at the Geneva conference in September a ‘drop in the ocean’.

As the doctor accompanies us to the exit of Marwais Children’s Hospital, mothers enter carrying their children wrapped in blankets.

They are the lucky ones, as they will receive treatment and in most cases will survive. With approximately 3.2 million children under five at risk of severe malnutrition by the end of the year, how will their basic human right to health be ensured?

Gaja Pellegrini-Bettoli is a freelance journalist based in Beirut and focusing on the MENA region. Her articles appear in Al Jazeera, Middle East Eye, Al-Monitor, E.U. Observer, France24, Opendemocracy and the Atlantic Treaty Association.

Follow her on Twitter: @gajapell