Inside Afghanistan’s child malnutrition crisis

“It’s the lucky ones who reach us.”

MSF’s inpatient therapeutic feeding center (ITFC) at Herat Regional Hospital.
Afghanistan 2021 © Sandra Calligaro
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Dr. Mohammed* works for Doctors Without Borders/Médecins Sans Frontières (MSF) at Boost Hospital in Lashkar Gah, Afghanistan, where 400 severely malnourished children under five years of age are treated every month. Many of them are also suffering from worrying complications such as pneumonia, diarrhea, or gastrointestinal problems. In the intensive therapeutic feeding center, MSF teams focus on treating the direct medical complications of malnutrition, in addition to preparing therapeutic foods to feed every child, three times a day. Below, Dr. Mohammed describes his experience working with the mothers and children who take long journeys to reach this urgently needed care.

Running out of beds

During the conflict and change of government, many people could not reach us. It was too dangerous and the roads were cut off.

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Sadly, I was personally affected by this. My mother became very sick during the fighting, but the route to the hospital was cut off by the clashes. It took days of driving for her to eventually reach treatment in Herat on the other side of the country. She died ten days after falling ill. It was a terrible time.

In Lashkar Gah, now that the security situation is more stable and people can travel again, we are seeing double the usual number of patients in the feeding center: In May, we admitted 250 children, but recently it’s been over 500 per month.

Our main concern now is that we’re running out of beds. At the moment, it’s two families—one mother and one child—to every large bed. We work hard to be flexible, but we can only admit the sickest. This means triaging patients is really important, and we make sure that those we can’t admit are seen elsewhere in the hospital.

Despite this, it is calm inside the feeding center. Although many mothers are anxious, they are happy that they are here and that their children are receiving high-quality medical care.

Inpatient Therapeutic Feeding Centre (ITFC) at Herat Regional Hospital
One of the rooms in MSF’s inpatient therapeutic feeding center at Herat Regional Hospital. The center is crowded and bed capacity is already full. Afghanistan 2021 © Sandra Calligaro

The lucky ones

The health care system has collapsed in Helmand, and people are now traveling from districts far in the north of the province to reach us. These are journeys that can take well over three hours. That’s very far when a child is very sick. The people who do reach us are the lucky ones.

There was one family who came from Musa Qala, which was under Taliban control as far back as last year, and from where only a few patients have ever reached us. Their story helps explain the crisis.

As medics, we don’t care about the political situation; we are here for our patients."

Dr. Mohammed
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The family was poor and struggled to find food while the young mother was pregnant. This is the situation for many families now—there are no jobs and everything in the market is very expensive. People also have very limited access to information on health or parenting, so when their child is severely sick, they sometimes don’t know what to do or where to go.

When the baby was born, the young mother became very weak and couldn’t breastfeed. The baby girl was malnourished from the very first day of her life.

Although we treat many patients for about three weeks, this child has now been with us in the feeding center for three months. She is still weak, but we hope she will improve with our care.

Kahdestan outpatient clinic, Herat
A malnourished child during a consulation at MSF’s Kahdestan Clinic. Afghanistan 2021 © Sandra Calligaro

Finding hope

Right now, in Afghanistan, many people are scared every day. But we deserve a good life, and we want to live in peace. My work with MSF gives me hope.

At Boost Hospital, we have more than 1,300 staff—it’s one of MSF’s largest projects in the world. The hospital itself has at least 700 patients arriving every day. Sometimes it’s 900, and most of them are children.

I have worked here since 2010 when the hospital first opened, and I am still very proud of what we do every day. We are providing something that would otherwise be out of reach for people here: life-saving medical care that is free.

As medics, we don’t care about the political situation; we are here for our patients.

* This staff member's name has been changed to protect their identity