A malnutrition treatment center in Kabul has fallen silent as U.S. aid cuts force a shutdown, leaving children without care and staff without jobs after Washington, once Afghanistan's top donor, froze all foreign assistance.
Entirely funded by Washington, the project had to shut down when the United States, until recently the largest aid donor in Afghanistan, froze all foreign assistance.
Cobi Rietveld, country director for the non-governmental organisation Action Against Hunger (ACF), which manages the clinic in the west of Kabul, said the many children who would have come to the center wouldn't be treated now.
"If they don't get treatment, there's an extremely high risk of dying," she told AFP.
Without new funding, the stuffed animals, toys and baby bottles were put away and the pharmacy locked when the last patient left in March.
"When malnourished patients come to our clinic, it's a big challenge for our staff to explain the situation to them and to tell them that they need to go elsewhere for proper treatment," said Chief Doctor Farid Ahmad Barakzai.
After four decades of war and crises, Afghanistan faces the second-largest humanitarian crisis in the world, behind war-torn Sudan, according to the U.N.
On average, 65 children suffering from severe acute malnutrition with complications were treated at the clinic every month.
They stay there for several days with their mothers, not only to be fed but to prevent them from spiralling into illness.
"Every infection a child can get, a malnourished child will get as well, with an increased risk of dying," said Rietveld.
Rietveld added that finishing their last days of work is "painful" for the staff because "they have to send them somewhere else where they don't have the same specialized treatment."
Child malnutrition in Afghanistan, where 45% of the population is under 14, is one of the most significant challenges because it affects entire generations in the long term.
Some 3.5 million children under the age of five suffer from acute malnutrition and the country has one of the highest rates of stunting in the world, according to the U.N.
Adults are also affected: 15 million Afghans are currently food insecure, including 3.1 million who are already on the brink of famine.
Last week, the World Food Programme said the United States had ended funding for its work in Afghanistan, having gone back on cuts to other countries.
"This is a country that's been through so many shocks," the World Health Organization representative in Afghanistan, Edwin Ceniza Salvador, told AFP.
"So with a fragile system, even basic care of screening, those are even not there," he said, underscoring that "of course, the most vulnerable are the most affected."
The funding crisis has also led to numerous layoffs in the humanitarian sector, in a country where the unemployment rate reached 12.2% in 2024, according to the World Bank.
Since the U.S. cuts, ACF has had to lay off around 150 of its 900 staff.
"I have crying people in my office," said Rietveld. "We listen, we offer support, but we can't get them a job."
Hit hardest by the layoffs were women, who made up the majority of the 40 staff at ACF's child nutrition centre and who face severe restrictions imposed by the Taliban authorities since their return to power in 2021.
They can no longer work in many sectors and are not allowed to study beyond primary school, unless they enrol in a religious school, leading the U.N. to label the system as "gender apartheid."
"For many of us, the only place we could work was in this health center," said 27-year-old nurse Wazhma Noorzai. "Now, we are losing even that."
To recover after the loss of U.S. funding, which made up 30% of the ACF's local budget, the organization is "in the process of writing proposals" and "discussing with donors," Rietveld said.
"But I don't think other donors can cover the gap."
