The tragedy of Afghanistan’s malnourished children

Every few seconds a sick child is brought in to the emergency room of the main hospital in Lashkar Gah in a race against time to save the youngest casualties of Afghanistan’s hunger crisis.

Amidst the heart-rending sound of dozens of hungry babies crying, and desperate pleas for help from their mothers, nurses scramble to prioritise children who need urgent care. There are many such babies.

Lashkar Gah is a city in the capital of Helmand, one of Afghanistan’s most war-ravaged provinces and lies roughly 400 miles (644km) south-west of Kabul.

Jalil Ahmed is brought in hardly breathing. His hands and feet have gone cold. He’s rushed through to the resuscitation room. His mother Markah says he’s two and a half years old, but he looks a lot tinier. He’s severely malnourished and has tuberculosis. Doctors work fast to revive him.

Markah watches in tears.

“I’m helpless as he suffers. I’ve spent the whole night scared that at any minute he’ll stop breathing,’ she says.

Space has to be made in an already full intensive care unit for little Jalil. A doctor carries him there in his arms, as a nurse follows holding up the bottles of fluid and medicines that are being injected into his body through multiple tubes.

There’s no time for the staff to stop. They must quickly put another baby, five-month-old Aqalah, back on oxygen. It’s her third time in hospital. Doctors say that a few hours earlier, they thought she wouldn’t make it, but right now, she’s just about holding on.

One in every five children admitted to critical care is dying, and the situation at the hospital has been made worse in recent weeks by the spread of the highly contagious measles disease that damages the body’s immune system, a deadly blow for babies already suffering from malnutrition.

The hospital, run by charity Medecins Sans Frontieres, is one of a handful of fully-functioning facilities in a province that’s home to around 1.5 million people. It’s completely overwhelmed. It has 300 beds, but is seeing around 800 patients a day, most of them children.

There’s almost nowhere else for people to turn to. Cutting off the foreign money which ran Afghanistan has dealt a double blow. It’s triggered an economic crisis that has brought an already poor population to the brink of starvation, and it’s led to the near collapse of the public healthcare system that it almost entirely funded before the Taliban takeover.

Child malnutrition has long been a problem in Afghanistan, but data collected by Unicef (United Nations Children’s Fund) shows a massive surge in the number of children with severe acute malnutrition admitted to hospitals, from 2,407 in August 2021, to 4,214 in December 2021.

The increase can, in part, be attributed to it being safer to travel to hospitals now that the frontlines have gone, but also misses a large number of malnourished children not taken to hospital because their families cannot afford the journey. Even if they could, they’d need to travel for hours on rubble roads, and it would be hard to find a medical facility that’s not dysfunctional.

The Musa Qala and Gereshk district hospitals are overrun with malnourished children, but neither hospital has operational critical care. There are no female doctors. The hospital buildings are run-down, cold and dark. Electricity comes and goes. Night time temperatures drop to 4C.

In Gereshk a small heater hooked to a gas cylinder kept in the centre of the rooms provides barely any warmth. Mothers and babies sit huddled under blankets. The smell of disease hangs thick in the air.

At Musa Qala, when the breathing of another baby, one-and-a-half-year-old Walid, became irregular, he had to be carried through alleys and doorways to a decaying building next door which had the only oxygen cylinder we saw at the hospital.

The father of 10-day-old Zakiullah was sent out to find a saline drip solution in the market, because the hospital had no supplies.

Dr Aziz Ahmed who has worked at Gereshk hospital for more than a decade says they have few medicines and barely any staff, and yet have hundreds of patients coming in every day. They have to turn seriously ill children away because they don’t have the facilities to help them, and Dr Ahmed says some have died before they got to a fully functioning hospital.

He and the other staff didn’t receive salaries from August till October. From November, they and some other hospitals in the region have been receiving some payments through humanitarian organisations like Unicef, WHO (World Health Organization) and local charity Baran (Bu Ali Rehabilitation and Aid Network).

“The humanitarian family is just trying to provide a survival bridge for these children while the world figures out the politics, but we cannot fully fund the health system,” says Salam Janabi of Unicef.

“Don’t mix up children in politics. The moment here in Afghanistan is critical for children, and every decision the world makes, the politicians make, will impact them.”

When you travel through Helmand province, destruction caused by war can be seen in almost every area. The scale of it in Sangin town is particularly shocking.

There are swathes of land covered with debris and mud, where once homes and shops had stood. These areas are where foreign and Afghan troops encountered some of their fiercest battles and where British soldiers were posted.

Abdul Raziq is from a community that has lived on the frontline for decades.

“We are happy there is peace now, but we have no food, no work and no money. Wheat and fuel have become too expensive’, he says.

“Hundreds of children in my village are malnourished. In every house, you will find two or three. We have nothing to feed their mothers, that’s why they’re being born like this.”

In a mud home nearby lives Hameed Gul. Two of his daughters, Farzana and Nazdana, are malnourished. Nazdana is so ill he’s sent her to her grandparents because he’s unable to feed her. His 10-year-old son Naseebullah has already begun to work on the fields to help out.

The unending suffering of his family is the legacy of foreign actions, present and past. Hameed’s home was bombed in American airstrikes five years ago. Ten of his family, including his parents, six brothers and a sister were killed.

“We had no connection with the Taliban. My house was unjustly bombed. Neither the Americans, the previous government or the new one offered to help me,” Hameed says.

“We eat just dry bread. About two to three nights a week, we go to bed hungry.”

Everywhere we went, we asked what people had eaten that day. Most described sharing a few pieces of dry bread between whole families.

Children are the most vulnerable in this crisis of hunger. Afghanistan’s youngest generation is being left to die.

In many of the areas we visited, malnutrition deaths might not even get recorded or counted. The world might never know the scale of the tragedy unfolding in Afghanistan.