“It’s the lucky ones who reach us”: Inside Afghanistan’s child malnutrition crisis
Doctors Without Borders' Inpatient Therapeutic Feeding Centre (ITFC) at Herat Regional Hospital. Only women, except the staff, are allowed to enter in the facilities. The gate is hidden by a large curtain, the "parda" (which means curtain). Afghanistan, 2021. © Sandra Calligaro
This is the number of severely malnourished children we are treating every month at Boost Hospital in Lashkar Gah, Afghanistan.
Every one of these young patients is under five years old. Many of them are also suffering from worrying complications such as pneumonia, diarrhoea or gastrointestinal problems.
I am a doctor here with Doctors Without Borders / Médecins Sans Frontières (MSF) and work in our intensive therapeutic feeding centre.
I can tell you that right now, we are very busy.
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.
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 10 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 numbers of patients in the feeding centre: In May, we admitted 250 children, but recently it’s been over 500 per month.
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 centre. Although many mothers are anxious, they are happy that they are here and that their children are receiving high-quality medical care.
The lucky ones
The healthcare system has collapsed in Helmand, and people are now travelling from very far districts 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.
The family were very poor and struggled to find food while the young mother was pregnant. This is the same 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 her child. The little girl was malnourished from the very first day of her life.
Although we treat many patients for around three weeks, this little girl has now been with us in the feeding centre for three months. She is still weak, but we hope she will improve with our care.
Children at Doctors Without Borders' Inpatient Therapeutic Feeding Centre (ITFC) at Herat Regional Hospital. Afghanistan, 2021. © Sandra Calligaro
Right now, in Afghanistan, many people are scared every day. But we deserve a good life, and we want to live in peace.
In this situation, my work with Doctors Without Borders gives me hope.
At Boost Hospital, we have more than 1,300 staff – it’s one of Doctors Without Borders' 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.
In the feeding centre, our team is working day and night to treat the direct medical complications of malnutrition, as well as constantly preparing therapeutic foods to feed every child three times a day.
One of the room of the Doctors Without Borders' Inpatient Therapeutic Feeding Centre (ITFC) at Herat Regional Hospital. The centre is over crowded : there is actually 84 patients for 60 beds. Afghanistan, 2021. © Sandra Calligaro
I have worked here since 2010 when the hospital first opened, and I am still very proud of what we do every day. We work hard to help very poor people who are very vulnerable to what is happening – like the young family from Musa Qala.
If you are reading this and you are someone who has ever donated to Doctors Without Borders, I would request that you please continue your support. 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