Pneumonia cases are soaring in Afghanistan and killing children unable to access healthcare facilities, leading humanitarian organisation for children Save the Children said on Monday. Since the Taliban takeover last August, unemployment levels have exploded throughout Afghanistan, leaving parents unable to provide for their families. The direct result has been a surge in malnutrition, producing a dramatic rise in pneumonia in children.
Nine-year-old Wazhma* lives with her family in a village on the outskirts of Kabul. Many people in her village have lost their jobs since the Taliban takeover last August and parents are forced to go without meals in order to feed their children.
When Wazhma became sick with a high fever and continuous cough that left her struggling to breathe, her parents tried home remedies at first but they didn’t work. They knew she needed to go to hospital but they didn’t have enough money. Wazhma’s father Samir* had to ask a friend for a loan.
When they arrived at the hospital, doctors said that Wazhma needed oxygen to help her breathe, but they could only give it to her for 30 minutes because they were so low on oxygen cylinders.
“I felt very ill, I was sleeping a lot and moving hurt my body," said Wazhma in a new Save the Children report. “I felt hot and tired. I was scared when I was at the hospital. I found it hard to breathe.”
Wazhma was one of the lucky ones: her limited access to the oxygen machine meant that she did eventually recover. But many Afghan children do not have the same chance.
“If my friend had not given us the money, I am not sure if Wazhma would have survived. She was struggling to breathe, it was frightening,” said her father Samir.
Children lie four in a bed
The Save the Children report, published this week, found that half of the parents they spoke to in Afghanistan claimed their children had pneumonia in the preceding two weeks.
The data also showed that almost 60 percent of those who couldn’t get healthcare said they had no money to pay for it while 31 percent acknowledged they would only visit a clinic if it was a life-threatening illness.
One doctor at a hospital in the north of the country said he had never seen so many cases of child pneumonia and severe malnutrition. Children have to lie three or even four to a bed, he told Save the Children. More than 130 children had died in or on their way to the hospital in December, he said. The majority were fighting for breath from pneumonia, and 40 were severely malnourished.
“The situation here now is absolutely desperate for the entire population, but especially for young children,” said Fiona McSheehy, Save the Children’s Acting Country Director, speaking with FRANCE 24 from Kabul. “The rising number of cases of pneumonia is frightening and all the more so because it is directly linked to high levels malnutrition.”
There is an obvious economic element too as parents do not have enough money and children are not getting enough to eat. “With the very high levels of unemployment since the change of regime last August and the lack of money, the price of basic food commodities have been pushed out of reach for so many,” McSheehy said.
NGOS such as Save the Children send their mobile health clinics around the country, reaching extremely remote areas to provide vital healthcare. “Pneumonia cases are increasing every day, the number of patients coming to our clinics has shot up by two or three times in recent months,” noted Dr. Sadat*, the team leader of one of their mobile health clinics. “They have nowhere else to go. It’s much worse than last year.
“Sometimes there are hundreds of mothers and children waiting when we arrive. They just can’t afford the food and heat they need to stay healthy. Malnutrition and pneumonia are a deadly combination.
“Every day we send several children straight to hospital for oxygen and emergency treatment. Recently, a baby didn’t survive. I called his mother to check up on him and she said he had passed away. It is the worst feeling imaginable. Often we can’t treat everyone, we are overwhelmed. I lie awake at night thinking of the children we can’t reach.”
One in two young children acutely malnourished
Before this latest surge in cases, pneumonia was already responsible for more than one in five deaths of children under five years old in Afghanistan. Pneumonia is the single largest infectious cause of death in children worldwide, according to the World Health Organization (WHO), whose their latest figures show that pneumonia killed 740,180 children under the age of 5 in 2019 and accounted for 22 percent of all deaths in children aged 1 to 5.
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UNICEF estimates that half the children under the age of five years old will be acutely malnourished in Afghanistan in 2022 due to the food crisis coupled with poor access to water, sanitation and hygiene services.
“These winter months are really make or break for millions of children in Afghanistan. One in two children under five will suffer from acute malnutrition this year,” said Salam Al-Janabi, UNICEF’s Afghanistan Communications Specialist, speaking with FRANCE 24 from Kabul. “At least a million young children will suffer from severe acute malnutrition in Afghanistan this year. This is treatable but it makes them vulnerable and then when they get other conditions, it can become fatal.”
In November 2021, UNICEF provided more than 10,000 front-line health workers with salaries and supported over 1,000 health facilities with medical supplies and winter heating materials. “But the need is immense. 97 percent of Afghanistan’s population is expected to be under the poverty line this year. And tens of millions of children are in need of food and very basic provisions,” said Al-Janabi.
Severe winter weather conditions make accessing health care all the more difficult. “You cannot imagine how bitterly cold it is here at the moment. Last week, I was in Paktia, 150 kilometres south of Kabul, and it was -15C at night. In another area, the snow was over our knees,” said Al-Janabi. “When we went into the hospital, it was freezing. The hospitals don’t even have enough money to put the heat on everywhere.
“For a lot of people, fuel is too expensive and the only thing they can afford for heating is animal dung. We are in the heart of freezing winter and children don’t even have shoes that cover their feet. The situation here at the moment is staggering, it is at breaking point.”
Unexpected twist in Taliban takeover
One unexpectedly positive twist in the Taliban takeover is that aid organisations have been able to access the whole country for the first time in years. “One of the things the teams are very excited about is that they are finally able to go into districts that they haven’t been able to access for 20 years because they were in the Red Zone,” said McSheehy. “We can now get to places in the drought areas where they have no access to clean water.”
“The situation here is critical, but it could be resolved if international financial institutions and the World Bank release money into Afghanistan to allow the economy to function again," she continued. "At the moment, there is really no light at the end of the tunnel for the Afghan population. This includes 20 million children who are being starved of their future. These kids are being penalised for a difference in opinion by the authorities.
“There is no time for waiting, there hasn’t been any time for waiting for the last month, the world has to act now. If the financial situation doesn’t change soon, people will die in the hundreds of thousands,” she said.
* Names have been changed to protect identities