The listless children in the overcrowded malnutrition ward lie two, or sometimes three, to each bed. Their wasted limbs can be glimpsed beneath layers of blankets and clothes to warm them against the oncoming winter.
Before Afghanistan was tipped into near economic collapse following the Taliban takeover, the malnutrition department at Kabul’s Indira Gandhi hospital treated on average four or six hungry infants at any one time.
It is now home to 20 and there are another 70 registered patients being treated in their own homes, said Raziya, one of the nurses. The hospital is short of beds and staff, who have quit because wages have not been paid for months.
“Our patients are very poor people. In the last three months more than 20 malnourished children have lost their lives,” she told the Telegraph.
The Taliban’s takeover has sent the country into spiralling crises which threaten lives and the modest gains of the past two decades of international aid.
The children being treated by Raziya are at the leading edge of a wave of approaching hunger set to engulf the country at a frightening rate.
Some 19m cannot feed themselves daily and that will rise to 23m by the end of the year, the United Nations warns. UNICEF, the UN’s children’s body, estimates there are 3.2m children who are acutely malnourished and 1.1m children who are at risk of dying.
Afghanistan’s humanitarian catastrophe did not begin with the Taliban’s shock takeover in August. The country is enduring its second severe drought in three years, Covid lockdowns hit the economy hard, and endless war drove hundreds of thousands off their land into camps or urban poverty.
But the Taliban’s stunning victory and the international community’s response have pitched the country into economic free fall.
International officials say few countries were so dependent on foreign aid. Two decades of lavish international funding had brought improvements to Afghanistan, with benchmarks in public health, and education rising but the nation-building efforts also fuelled corruption and failed to create a sustainable state or economy.
Three-quarters of Afghanistan’s government budget was paid for by foreign donors and international aid amounted to some two fifths of GDP.
Funding stopped overnight in August when Ashraf Ghani’s government fled and the Taliban took power. Hundreds of thousands of civil servants, former police and soldiers, teachers and doctors and nurses have gone unpaid.
Many of the Taliban’s leadership are on foreign sanctions lists, including Sirajuddin Haqqani, the interior minister, who has a $10m bounty on his head.
International banks are refusing transactions with Afghan banks for fear they will be breaking restrictions. Businesses do not know if payment of taxes and duties will now be counted as funding terrorists. Uncertainty has paralysed the economy. GDP is estimated to have shrunk by two-fifths and the prices of some staple foods has doubled in a year.
The destruction of the economy is hitting not just the poor, but those who until recently had comfortable foreign-funded jobs.
Farid worked for the Afghan supreme audit office until August, in a job paid by the World Bank. Now he sells vegetables from a hand cart in the street.
“The situation is getting worse day-by-day as there is no source of other income. Hunger and poverty are everywhere. People are starving as the prices of the food have raised dramatically,” he said.
Many families have resorted to selling their possessions to raise enough to eat. Col Rahmatullah was a security adviser at the defence ministry in Kabul before the fall of the government.
“I had a good life, but unfortunately everything changed in one day,” he said. “We lost everything. Now it’s been three months that I am jobless. We sold all the materials of the house at very low prices.
“Some days we don’t even have food to eat. My children ask me to bring food for them because they are hungry. I feel very bad when I hear this.”
The UN estimates it needs to provide more than $200m (about £150m) of humanitarian aid a month to avert disaster.
But such humanitarian aid will only keep people alive and will not dig the economy out of its hole.
The Taliban appear to have no plans to deal with the crisis, except calling for America to end sanctions and release $9bn (£6.7bn) of frozen foreign reserves.
Joe Biden’s special envoy to Afghanistan last week said the Taliban had only themselves to blame for the loss of aid.Thomas West said the US had warned the Taliban for years that critical non-humanitarian aid vital for the Afghan economy and basic services “would all but cease” after a military takeover.
Doctors fear 20 years of fragile improvements in infant and maternal mortality and life expectancy will collapse at the same time as the state built up over the past two decades.
Bahadur, who used to work for an aid charity in the Western city of Herat, said he was now reduced to earning what he could as a daily labourer. He, like many others, is trying to leave the country.
He said: “Things have got so difficult, there are no jobs, no ways to have any sort of income.I can see a very dark future here in Afghanistan. It is going to be very, very difficult and hard to survive in the coming days.”
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