The rickety infirmaries of a ramshackle clinic in southern Afghanistan are just one sign of the catastrophic humanitarian crisis that has gripped the war-ravaged country since the Taliban returned to power a year ago.
Last month, the Musa Qala district hospital in Helmand province was forced to close its doors to all but those suspected of suffering from cholera.
The infirmary was soon overflowing with listless patients whose wrists were being pricked with IV fluids while they recovered on rusting gurneys.
Although the clinic has no facilities to test for cholera, within a few days about 550 patients presented, showing symptoms of an illness caused by a lack of basic sanitation: clean drinking water and an adequate sewage system.
“It’s very difficult,” hospital chief Ehsanullah Rodi, who has slept just five hours a night since the influx began, told AFP.
“We didn’t see that last year or any other year.”
The United Nations says the humanitarian crisis in Afghanistan is the worst in the world.
– hungry children –
Poverty in the country – felt most severely in southern Afghanistan – has been pushed to desperate new levels, exacerbated by drought and inflation since Russia’s invasion of Ukraine.
“Since the emirate (Taliban) came to power, we can’t even find cooking oil,” said a woman crouched on a stretcher next to her malnourished six-month-old grandson in Lashkar Gah, the provincial capital of Helmand.
“Poor people are crushed under their feet,” said the 35-year-old.
Her grandchild is being treated for the fifth time at Boost Hospital, a sun-scorched labyrinth of peeling buildings run jointly by the Ministry of Health and Doctors Without Borders (MSF).
Many of the beds in the malnutrition ward house two tiny, frail patients — some busily suckling milk syringes while others breathe heavily as they struggle to regain their strength.
“We can’t even find dry bread,” says Breshna, the mother of another patient, who estimates her age at 15 to 20.
“We haven’t had anything to eat for three or four days.”
Deputy head of nursing Homeira Nowrozi, who fights to be heard over complaining infants, said staff had “no rest”.
“We have many patients who are in critical condition,” she said, because parents could not afford to travel earlier.
“We don’t know how many deaths … we have in the districts because they didn’t come to the hospital.”
– A moral muddle –
Afghanistan’s plight began well before August 15, 2021, when the Taliban seized Kabul after US-led troops hastily withdrew and the government they supported collapsed.
However, when the Taliban came to power, the country of 38 million people was plunged into the abyss.
The United States froze $7 billion in central bank balances, the formal banking sector collapsed and foreign aid, which accounted for 45 percent of GDP, shut down overnight.
For the past year, potential donors have grappled with the conundrum of injecting new funds into the ailing nation, renamed the “Islamic Emirate” by the Taliban in keeping with their strong theocratic beliefs.
“How do you provide aid in a country where you don’t recognize the government?” asked Roxanna Shapour of the Afghanistan Analysts Network.
Importing humanitarian aid to deal with crises like the June earthquake – which killed more than 1,000 people and left tens of thousands homeless – is relatively easy because it is “not political, it is life-saving”.
Cash is also being flown to fund food aid and health care, but foreign aid for long-term projects that could transform the economy is more complex.
“If you walk in and say, ‘I’m going to pay all the teachers’ salaries,’ that’s great. But then what will the Taliban do with the money they save by not having to pay teachers’ salaries?” asked Shapour.
– Bad mood –
The deprivation is visible in Musa Qala — a dusty agricultural outpost with a shipping container bazaar serviced by children’s shopkeepers.
The local economy seems to be barely surviving on motorcycle repairs, the sale of faded poultry carcasses and cans of energy drinks kept lukewarm in dirty freezers.
The city witnessed some of the bloodiest chapters of the 2001-2021 war and is linked to Lashkar Gah by a makeshift path that climbs a dry river bed fringed by craggy rocks.
The road begins again further south at Sangin, a place where mud walls have been so badly ravaged by gunfire and artillery that they are crumbling back into the earth.
In a cruel irony, desperation and demands for humanitarian services have only deepened with the arrival of peace.
“Now we can visit the hospital day and night,” said Maimana, whose eight-year-old daughter Asia was being treated at Musa Qala.
“There used to be fighting and mines, the roads were closed.”
Sayed Ahmad, director of public health in Helmand, told AFP that the flood of new patients means there is “less space” and “less staff, so there are difficulties”.
Still, Ahmad – a soft-spoken doctor whose office is lined with medical records – insists “the overall situation is better” than under the previous government, when corruption was rampant.
He blames economic sanctions on the Taliban for some of their woes, saying “people’s needs and demands have increased.”
But analysts say the Islamists are far from blameless.
“The Taliban’s repressive social policies have made it more difficult to reach an agreement on the release of these frozen assets,” said Graeme Smith of the International Crisis Group.
“This is really all about the emotions of policymakers – and excluding millions of girls from secondary schools has really spoiled the mood.”
– Unable to rule –
The Taliban flag now flies openly over Helmand province, hanging from bullet-riddled buildings.
But after two decades of coveting control, they rule the nation at its most ruined.
A man in Lashkar Gah – who asked not to be named – made his own scathing remark about the Taliban’s ability to rule.
“The government clothes are too big for them,” he said.
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