In Afghanistan, hunger is spreading and driving babies to death's door

Will Zubair survive? At a month and a half, he weighs barely two kilos and struggles in his survival blanket under the gaze of his mother who hesitates between anguish and hope. He was the fifth hungry Afghan child to arrive at the MSF clinic in Herat that day.

There are the cries of the children, most of the little ones under the age of 2, the heat of the intensive care rooms, the dozens of busy caregivers, the mothers exhausted from being worried.

Do they know that more than one in five children who arrive at the clinic of the NGO Doctors Without Borders (MSF) in Herat, the largest city in western Afghanistan, will not survive? All victims of the infernal cycle of misery: mothers do not have enough to eat and do not have enough milk to give to their babies, who are wasting away dangerously.

The clinic, located right next to the public hospital, has increased in recent months from 45 to 75 beds, to help local authorities deal with the collapse of the health system following the return of the Taliban to power in mid-August. . The NGO receives about sixty new patients there every week.

"Mothers often come from very far" to the public hospital next door. But it is "no longer supplied" with equipment and drugs, and "the doctors and nurses are no longer paid", explains the head nurse of the clinic, Gaïa Giletta.

Zubair's mother, Shabaneh Karimi, traveled 150 kilometers and spent two nights in the establishment. But after she came out, her baby was left weak and sick. When she returned to the hospital, she was sent to MSF.

At the clinic, Zubair is quickly examined and placed in intensive care, where he joins a dozen children. Perfused, his face buried under an oxygen mask almost as big as his little skull, he managed to make it through the night, and even found the strength to cry out.

Initially, the doctors only gave him a few hours to live.

- 'Will it survive the winter?' -

"He's still alive, but it's still complicated for him," explains Gaïa Giletta. Because he did not escape the vicious circle of malnutrition: very weak, he caught a lung infection.

"Financially, we are not in a good situation", modestly slips Zubair's mother. Her husband left a few days ago for Iran to work as a day laborer.

According to Unicef, 3.2 million Afghan children under the age of 5 will suffer from severe malnutrition this winter, and one million of them could die for lack of treatment.

In the next room, Halima* watches over her 9-month-old twins. In them, severe malnutrition has caused edema that could be fatal. "I got worried when I saw their face swell up," their mother said.

Initially, "I tried to breastfeed them, but I didn't have enough milk," she says. She soon ran out of money to buy them powdered milk. Her husband, a drug addict she says, does nothing for his family.

A terrible news comes to darken the picture even more: the twins are the last victims of the measles epidemic. They are placed in solitary confinement.

After two months in the clinic, Ali Omar, 5 months, is better: he now weighs 3.1 kg. But the outing is approaching, and his mother, Sonita, worries: "Will he survive the winter if there is no milk and the house is not heated?"

Before leaving the centre, MSF gives mothers sachets containing a mixture of peanut butter and vitamins, the equivalent of a meal for a baby over 6 months old.

"The problem is that sometimes mothers, once at home, share the sachet between their children", explains Gaïa Giletta. At the risk of tipping the baby back into malnutrition.

- Selling a kidney -

“The readmission rate (of babies who have already come) is very high,” laments Christophe Garnier, MSF project coordinator in Herat. Malnutrition, already well anchored in a country undermined by 40 years of war, has worsened in recent years after severe droughts, he underlines.

And last summer, the Westerners left, the Taliban regained power, and everything came together, precipitating the country into a serious humanitarian crisis.

With MSF, the Taliban are "very collaborative" and "sincerely worried about the situation", notes Mr. Garnier. For him, "the major change is probably the international sanctions".

In response to the seizure of power by the Taliban, their enemies for 20 years, the United States froze the reserves of the Afghan Central Bank, drying up the banking system, deplores Mr. Garnier who pleads for a thawing of these assets. And international aid, which financed 75% of public expenditure, has been interrupted.

Unemployment has soared, food prices have doubled, and suffering is visible across the country, especially in camps for the displaced.

There are three near Herat, where 9,000 families have fled wars and droughts.

"When you're hungry, you can't think of anything else," says Muhammad Amin, a "grey beard" from the camp, where a bit of bread and tea often make up the daily menu.

For lack of work, Muhammad Amin thinks of going to a clinic to try to sell one of his kidneys. “Of course, I thought about the consequences but I think that it could help the children”. One of his neighbors evokes the fate of a relative who became disabled after selling a kidney for some 150,000 Afghanis (1,413 euros).

In these camps, MSF carries out prevention work with mothers who are sometimes totally destitute.

That day, a medical assistant from the NGO puts a graduated tricolor bracelet on the arm of each baby to detect malnutrition. A baby is in the red: at six months, he seems to have two. “I only had milk for 40 days,” says her mother.

She is invited to go to the clinic in Herat, where she and her child will be able to benefit for a time from a luxury that is now inaccessible to many Afghans: having three meals a day.

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*some people did not wish to give their surname