You can see, feel, hear the distress in Badakhshan’s Provincial Hospital in Afghanistan.
Warning: This article contains content some readers may find distressing.
The halls are heavy with the sound of crying babies. The rooms, full of malnourished children, many two to a bed. Their frail, fragile bodies expose their wasting bones, with some so weak they’re dependent on oxygen tanks to breathe.
Afghanistan is facing an unprecedented crisis of hunger. More than 4.7 million women and children require urgent treatment for malnutrition, according to the UN. And 90% of children under the age of five are in food poverty.
The hospital team in Badakhshan, in the northeast of the country, are doing all they can to keep the children alive. But increasing numbers are dying.
In the last three months alone, roughly one baby died every three days here. Fifty-three have passed away so far this year – that’s a 50% increase on the same time last year.
Faisal is 12 months old. He’s severely malnourished and has acute diarrhoea too. But like many on this ward, he has other serious complications.
Among these is hydrocephalus, a condition that causes water to gather around his brain. His poor mother is so exhausted, she’s lying on the floor by his bed.
As she sits down to speak with us, she reveals she has already lost three children to malnutrition.
“I am worried about him and what might come next,” she tells me.
“I’ve already lost three of my children. My first daughter died at eight years old. Two more of my children passed away when they were two-and-a-half years old.”
The ward is full of lost-looking eyes, dimmed by hunger.
A horrifying thing to watch
Asma is 13 months old. But she weighs little over nine pounds (4kg) – less than half of what she should.
Doctors fear she might not survive the night. But she’s put on oxygen and by the morning, she thankfully starts to improve.
“I’m really afraid,” her mother Khadijah says as her eyes fill.
“Of course I’m afraid, I’ve cried so much. I’m so thankful to the doctors, they’ve kept my baby alive. I’m so grateful to them,” she says.
But it’s touch and go for her daughter, and there are long periods when her chest fails to rise and fall.
It’s a horrifying thing to watch – imagine as a parent sitting day and night, wondering whether the next breath might be her last.
There is a stream of desperate cases coming through the doors here.
Today, there are 20 babies to just 12 beds. Sometimes, it is even more crowded.
There are suddenly two new arrivals. One of them, little Masouda. Her family travelled 13 hours to get here – spending what little they had left.
She, too, has to be quickly placed on oxygen and she’s painfully thin. Doctors tell us they fear she won’t make it.
The team are doing an incredible job during a hugely demanding time. But they need more staff, more medicine, more equipment.
Hospitals and health clinics across Afghanistan have suffered major funding cuts. The US, which was Afghanistan’s biggest aid donor, this year pulled almost all of its funding to the country. And the Taliban’s restrictions on women and girls have proved a major barrier for many international donors.
It’s having a direct impact on children’s chances of survival.
Daniel Timme, chief of communication at UNICEF, said: “The nutrition situation for children in Afghanistan is very serious and the numbers speak for themselves. Over 3.5 million children under five are acutely malnourished, including 1.4 million suffering life-threatening forms of wasting.
“It must be clear to everyone: when funding drops as we are seeing it now in a context with such high levels of malnutrition, preventable child deaths rise.”
A vital lifeline
In rural areas, poverty is as extreme as the landscape, and help for families with malnourished children is getting harder to reach.
Layaba Health Clinic is a vital lifeline.
The waiting room is full of mothers looking for medical assistance for their babies. Some women here tell us the Taliban’s restrictions on them working and earning money have also played a part, making it harder for them to feed their families.
“They are to blame,” one woman says with surprising candor.
“Every girl had her own dreams. I wanted to be a doctor. I took my responsibility for my children seriously. And I wanted to support my husband too.”
Another woman tells us she earned more than her husband as a teacher, but now finds herself unable to contribute financially.
The Taliban’s response
In an exclusive interview with Sky News, the Taliban’s spokesman, Zabihullah Mujahid, said the malnutrition crisis was the product of decades of conflict.
“We have had to start from zero to rebuild and restore our national resources. The Islamic Emirate is making every possible effort to address these challenges.”
Mr Mujahid said his government had a five-year plan to “tackle malnutrition, unemployment, and other pressing social issues”.
In response to the complaints of the women we spoke to, he said that men in the “vast majority” of Afghan families were the breadwinners and claimed the Islamic Emirate had made “significant efforts to promote vocational opportunities for women”.
But under the Taliban, women can no longer train to be doctors, nurses and midwives. And in remote villages, community workers like Harira are often the only lifeline – a project part-funded by UNICEF.
She goes door-to-door carrying baby scales, carrying out check-ups, trying to teach families about what to feed their children and when needed, get them to clinics and hospitals for treatment.
It saved Ramzia’s son’s life.
She had measles when she was pregnant and her son Faisal was very underweight.
“His legs and hands were as small as my fingers. Now he’s much better,” Harira says – beaming as she delights in the weight he has now put on.
“I was afraid I’d lose him,” Ramzia says. “He was so weak. But Harira came here and taught me how to feed him and give him milk when he needed it.”
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Reeling from death, fighting for life
Keeping children alive in this climate is a battle.
Nasrullah and Jamilah, who live on the outskirts of Fayzabad, are holding their two-month-old twins.
But they’re also in the throes of grief – on a journey to the grave of the baby they lost only a month ago. Her name was Shukriya. She was 18 months old.
“She was our child, we loved her. I will never forget her, so long as I’m alive. We really tried, we went to the doctors for check-ups, for ultrasounds, for blood work – we tried our very best. But none of it could save her.”
Both parents say they feared their twins could also face the same fate. Shukriya’s grave is covered with one of her babygrows. It is haunting to see. And there are other little graves next to hers.
Deaths aren’t documented in a lot of these communities. But locals tell us more and more children are dying because of malnutrition. A silent, searing loss that is spreading.
