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Like much of Afghanistan, the situation in Kabul has deteriorated significantly in recent years. Political turmoil and economic instability have encouraged internal displacements, bringing thousands of families to the capital.
Kabul’s suburbs are expanding, and temporary settlements of internally displaced persons are springing up all along the roads. At the same time, the urban middle class has become poorer with the economic crisis, and women’s lack of access to the job market has reduced income sources for many families. As a result, most of the capital population is now facing extreme poverty, with unemployment rates soaring to unprecedented levels.
Afghanistan has one of the highest malnutrition rates, with nearly 3.2 million children and 840,000 pregnant and nursing mothers suffering from severe or moderate acute malnutrition (WFP). According to the latest IPC report, 40 per cent of Kabul’s urban population is experiencing high levels of acute food insecurity, classified as Crisis or Emergency (IPC phase 3 and 4). Malnutrition rates, particularly among children, are on the rise, leading to long-term health implications.
To address the growing number of cases of malnutrition among children, Action Against Hunger opened a Therapeutic Feeding Unit (TFU) in Arzan Qimat, one of the most populated neighbourhoods of the capital. “Previously, there were no medical facilities specialised in malnutrition treatment in this district. The central and western part of Kabul boasts seven TFUs, while the eastern part, home to 300,000 people, is served by only one run by Action Against Hunger. We opened the TFU in February this year and started to receive patients the same day“, says Dr Ajmal, Capacity-building manager and acting head of the TFU.
The TFU is located within the Ahmad Shah Baba Public Hospital. It provides treatment services 24/7 for children under five years old suffering from severe acute malnutrition (SAM) with medical complications. “Even though most of our patients live in this district, many come from rural areas. The admission capacity of the TFU is 15 beds, and we are looking into increasing this number by at least 20 beds.”.
The TFU team comprises medical doctors, nurses, mental health experts and counsellors. Besides screening, isolation and treatment rooms, the TFU has mothers and child-friendly spaces where women can spend time alone, change their babies’ clothes and nappies, access hygiene items or find some privacy to breastfeed. Women can benefit from mental health corners and baby-friendly spaces to access optimal care practices, psycho-stimulation sessions, and in-person psychosocial support.
Since February*, 250 children diagnosed with severe acute malnutrition have been admitted to the TFU. On average, Action Against Hunger medical team admits 50 monthly patients who either come directly to the TFU or are referred by hospitals and clinics. Mothers with children undergoing treatment receive three meals daily and food baskets after discharge to cover the family’s nutrition needs.
“Children fall sick because of lack of food, leading to nutrient deficiency, poverty and displacement”, says Dr Ajmal. Sometimes, mothers prioritise providing food to their children over themselves, often sacrificing their own nutrition. It can lead to losing their breastfeeding ability, further exacerbating the challenges they and their children face. “That is why the food baskets we provide to the families are very important in enhancing the food security of the entire household – children and parents”.
Families who once had steady sources of income are now struggling to make ends meet. Despite relatively stable prices, purchasing food has become a daily struggle for many. Families are being forced to make choices between paying for food or other essential expenses like education and healthcare.
Khan Mohammed and his family had high expectations when they arrived in Kabul almost eight years ago. They dreamed of a better future, hoping to find work in the capital and establish a stable home for their five children. However, their transition to this new life was challenging.
“We moved to Kabul because there was no job opportunity in Paktia. In Spring it was still doable, but in winter we could not even find enough food for all of us”, says Khan Mohammed. “When we first arrived in Kabul, I could easily find different job opportunities, but today, the current situation and widespread unemployment have made finding work nearly impossible.”.
Khan Mohammed has been without work for two years now, and he worked as a driver in the past. The parents and children live in a small room provided by relatives, which serves as a kitchen and a bedroom.
His wife, Fatima**, is concerned for the future as her family navigates a challenging period with their baby boy’s illness, who was diagnosed with severe acute malnutrition. Soon after he was born last year, he began to show signs of malnutrition. Weakened by the difficult conditions, Fatima found it difficult to breastfeed her baby properly: “When he was born, I breastfed him for about two months. Then I started giving him local milk, which, I think, had a negative impact on him. After that, he became weak and was losing his weight.”
In June, after multiple consultations in several public and private hospitals, the child was referred and admitted to the TFU run by Action Against Hunger. Although the child’s condition has improved**, he will likely suffer from delayed development due to the late treatment. Concerned, the parents will return to the TFU for medical follow-up in the coming weeks. “The doctors gave him medicine and milk, and his condition has improved. I was told if he gets sick again, the TFU will admit him back”, said Fatima, worried about what to do next. The fact that the organisation covers all medical expenses is important for the parents. “During our time in the TFU, we received excellent care with all the staff dedicated to our service, providing not only milk, medicines, but also food for the mothers.”, recalls Fatima. Fortunately, the family lives just a few blocks from the TFU and can afford the trip to ensure proper baby follow-ups.
The story of Khan Mohammed and Fatima is not an exception but a new reality for many Kabul residents. The loss of a steady income, debts and economic shocks can push people perilously close to the poverty line. Rural areas are particularly vulnerable to hunger due to their limited access to medical facilities and poverty. The provinces like Ghor and Nuristan are dangerously close to a famine-like situation (IPC report).
Addressing the hunger crisis in Afghanistan requires a multi-pronged approach. Immediate humanitarian aid is essential to ensure residents have access to nutritious food and adequate access to medical care. Action Against Hunger urges increased attention to the dire situation in Afghanistan and calls upon donors to redouble their efforts to ensure that ordinary citizens do not bear the brunt of the current crisis.
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