To cope with the surge in cases, the Indira Gandhi Institute of Child Health has had to expand its space for respiratory cases from one room to an entire unit. UNICEF is supporting the hospital with ready-to-use therapeutic food (RUTF) to treat children with severe respiratory problems.

A severe rise in respiratory illnesses among Afghan children is pushing Kabul’s Indira Gandhi Institute of Child Health beyond its limits. According to Dr. Mohammad Aref Hassanzai, head of the hospital’s internal medicine department, 20 to 30 children are being hospitalised daily due to respiratory diseases.

“We are experiencing a significant increase in respiratory illnesses these days. In the ward where respiratory patients are admitted, we have fewer than 20 beds, but about 75 patients are currently hospitalised,” Dr. Hassanzai told TOLOnews.

The paediatric respiratory and pneumonia ward in the Indian-gifted hospital is overcrowded, with four to five children sharing a single bed. The lack of sufficient medical resources is alarming both healthcare professionals and parents.

“If a child in a household is suffering from pneumonia or any other respiratory illness, they must be kept separate from healthy children,” advised Dr. Zabihullah Darmal, emphasising the need for preventive care.

Families Struggle to Find Medical Help

Many families from rural provinces are travelling to Kabul in search of adequate medical care, only to find the hospital overwhelmed. Abeda, a mother who brought her five-month-old child from Sar-e-Pul, described the desperate situation. “The child was on oxygen in Sar-e-Pul. We brought him here, but since the house was cold, his breathing worsened, and eventually, we brought him to this hospital,” she explained.

Similarly, Sultana, who travelled from Kunduz with her two-month-old child suffering from pneumonia, expressed her concerns. “There are four or five patients in one bed. Our request is that each bed should be for one child because some diseases can spread from one child to another,” she said.

Doctors cite cold weather, air pollution, poverty, unemployment, lack of hygiene, and poor household practices as key reasons for the surge in cases.

The Devastating Impact of Pneumonia

Save the Children reported that over 1,000 children under the age of five have died from pneumonia in Afghanistan since the beginning of 2024. The organisation stated that these deaths account for 88 per cent of all fatalities caused by respiratory infections in the country.

In response, Save the Children has shipped 92 tons of medicine worth $590,000 to Afghanistan, aiming to treat 675,000 people, including children in remote areas who lack access to healthcare facilities. The organisation’s mobile health teams have treated 69,000 severe respiratory infection cases in children under five in the past three months across eight provinces.

“Many children in Afghanistan are losing their lives to preventable diseases. The arrival of this medicine means that over 400,000 children in some of the most remote areas of the country will be treated,” said Arshad Malik, Save the Children’s Afghanistan director. “We are grateful to the international donors who made this shipment possible, but more funding is needed.”

High Mortality Rates Among Afghan Children

The effectiveness of aid shipments in addressing Afghanistan’s healthcare crisis remains a pressing question. Dr. Nafeeullah Pirzad told TOLOnews that support from international organisations like Save the Children and UNICEF plays a crucial role in managing the crisis. However, Dr. Nematullah Rostami emphasised the need for a structured approach: “Aid should be assessed to identify the areas in which we need assistance. This will enable us to deliver aid transparently, inclusively, and swiftly.”

Previously, the World Health Organization (WHO) reported that in March 2024 alone, 140,816 people in Afghanistan suffered from acute respiratory diseases.

According to the US National Institutes of Health (NIH), Afghanistan has one of the highest childhood pneumonia death rates globally. Among 639 children studied in a hospital, the case-fatality rate was 12.1 per cent, with nearly half of pneumococcal serotypes covered by the 13-valent vaccine. Most deaths occurred within two days of hospitalisation, with newborns and malnourished children being the most vulnerable.

Respiratory illnesses, particularly pneumonia and acute respiratory infections, pose a significant threat to Afghan children. The primary causes include:

• Severe winter weather: Many families cannot afford proper heating.
• Malnutrition: Years of deprivation have left children highly vulnerable.
• Food crisis: Afghanistan faces an unprecedented food security emergency.

The impact is severe:

• In 2023, Indira Gandhi Children’s Hospital admitted a record number of pneumonia cases.
• In 2024, over 1,000 children under five died from pneumonia.
• 25-30 per cent of deaths in children under five are due to respiratory infections.
• Afghanistan’s child mortality rate is twice the global average.

A Glimpse Inside the Hospital

The grim reality of the crisis is evident at the Indira Gandhi Children’s Hospital. Cries of sick babies echo through the overcrowded paediatric ward. The hospital, designed to accommodate far fewer patients, has been forced to admit 40 children into a ward where two to three children share each bed.

Seven-month-old Ibrahim is among them. Suffering from pneumonia, he sits in his mother Gul Bibi’s lap, too weak to stop his tears. His mother recalls their arduous journey from Logar Province to Kabul, where they had to change taxis four times just to reach the hospital.

“This year, the winter is bitterly cold. We struggle to heat our home and keep our children warm. I have five children, and there is often not enough food to feed them. My child’s illness is an added burden on us,” she says.

Dr. Shir Mohammed, a paediatrician at the hospital, explains that severe malnutrition and respiratory infections often go hand in hand. “The overall economic situation is bleak. People are struggling to feed their children and keep them warm. They burn wood, clothes, tires, and plastic to heat their homes,” he says, emphasising how the fumes are harmful for children vulnerable to respiratory diseases.

Urgent Need for Action

To cope with the surge in cases, the institute, also known as the Indira Gandhi Children’s Hospital, has had to expand its space for respiratory cases from one room to an entire unit. UNICEF is supporting the hospital with ready-to-use therapeutic food (RUTF) to treat children with severe respiratory problems, thanks to contributions from the Asian Development Bank (ADB), the Afghanistan Humanitarian Fund (AHF), and Global Affairs Canada (GAC).

The situation in Afghanistan is dire, with children under five suffering the most. Health experts, international aid organisations, and the government are carving ways to work together to prevent further loss of life.

But aid does not address the real problem. One paediatrician says, “While international aid provides temporary relief, the country needs long-term healthcare infrastructure development and sustained funding to address the crisis effectively.”

“With pneumonia and respiratory illnesses continuing to claim young lives, Afghanistan faces an urgent health emergency that demands immediate and comprehensive intervention,” he says.

Experts highlight vaccination as a key preventive measure. Additional recommendations include:

• Wearing masks in public places.
• Covering the nose and mouth while coughing or sneezing.
• Washing hands regularly with soap and clean water.
• Keeping sick children away from healthy individuals.

UNICEF has been actively working to combat the crisis by prepositioning medicine in 850 health facilities across Afghanistan, particularly in districts cut off by snow. In one of the harshest winters in a decade, these efforts are proving to be lifesaving.