Children are in need of emergency aid. They are hungry. The anguish on the parents’ faces cannot hide their desperation. Such is the situation in Afghanistan. Children suffering from acute malnutrition, pneumonia and dehydration. 

Dominik Stillhart

I am livid. Pictures viewed from afar of bone-thin children rightly elicit gasps of horror. When you’re standing in the pediatric ward in Kandahar’s largest hospital, looking into the empty eyes of hungry children and the anguished faces of desperate parents, the situation is absolutely infuriating.

It’s so infuriating because this suffering is man-made. Economic sanctions meant to punish those in power in Kabul are instead freezing millions of people across Afghanistan out of the basics they need to survive. The international community is turning its back as the country teeters on the precipice of man-made catastrophe.

Sanctions on banking services are sending the economy into free-fall and holding up bilateral aid. Municipal workers, teachers, and health staff haven’t been paid in five months. They walk up to two hours to work instead of taking public transportation. They have no money to buy food; their children go hungry, get dangerously thin, and then die.

At the paediatric intensive care unit the International Committee of the Red Cross (ICRC) supports at Mirwais Regional Hospital in Kandahar, the number of children suffering from malnutrition, pneumonia and dehydration more than doubled from mid-August to September.

More broadly, severe and moderate global acute malnutrition is up 31% around Kandahar compared to the same period in 2020. Region by region the severity of child malnutrition can be up to three times the emergency rating. This is a serious food crisis even before the worst of winter sets in.

New support for hospitals

Amid a sea of heartache is one small silver lining: The ICRC on Monday began supporting 18 regional and provincial hospitals and the 5,100 staff who work in them to help prevent total collapse of the public health system in Afghanistan.

This support, slated to last six months, includes funding for running costs and medical supplies, and will ensure the continuity of nearly half a million medical consultations per month.

But it’s not enough.

Drought, failed harvests, and the economic collapse are all driving the increase in malnutrition. Rising food costs are pushing proteins and other staples out of reach. As the harsh winter sets with temperatures below freezing, the suffering will be immense as people lack the cash to heat their homes.

What can be done?

First, states must engage with Afghanistan. This is the only way to prevent a total collapse of essential services like health care and education. Political considerations should not interfere with humanitarian action. A political solution must be found to avoid irreparable humanitarian consequences.

And this is technical but important. Foreign assistance to Afghanistan is currently put in question as donors ask themselves how they can comply with their legal obligations stemming from relevant U.N. Security Council resolutions. Simply put, some donors feel they can either comply with the resolutions and their own law — thereby denying life-saving assistance — or provide such assistance through organizations such as the ICRC and others.

Suppliers and banking services will have similar impediments. The ICRC is calling for a clear carve-out for impartial humanitarian organizations engaged in exclusively humanitarian activities, and for its translation into domestic legislation. It is in everyone’s interest to see humanitarian activities operating smoothly in Afghanistan.

Amid what we know will be a tragic winter, the ICRC will step up its response to the most urgent humanitarian needs, but humanitarian assistance is only part of the solution. The existing and projected needs are beyond any humanitarian organization’s capacity to deal with or solve.

More than 22 million Afghans will face crisis or emergency levels of acute hunger between November and March 2022, according to the latest IPC report. The desperation can be seen in the huge crowds lining up in front of banks at 5 a.m. in the hope that they can withdraw a little bit of cash.

The empty eyes of hungry children are not something one soon forgets. It makes my plea to the international community even more urgent: that it rapidly finds creative solutions to save millions of Afghans from deprivation and despair. Ultimately, this is in everybody’s interest as it will help prevent Afghanistan from slipping back into conflict and violence, and help give Afghans more means to remain in their country.

Dominik Stillhart is the director of operations for the International Committee of the Red Cross.