SharecloseShare pageCopy linkAbout sharing”There’s no space inside,” shouts a beleaguered hospital worker as he tries to push back a frantic crowd of mothers and babies hoping to receive nutrition packs. “It’s like this every day,” he yells out to us over their heads, “it’s been like this for the last four or five months… It was bad last year too, but not like this.” The war in Afghanistan is over, but its economy is collapsing and at this hospital, in the remote, central province of Ghor, they’re struggling to cope with the fallout. International support, which propped up the previous government, was withdrawn after the Taliban takeover in August, whilst the country’s foreign reserves, totalling around $10bn, have been frozen – chiefly by the United States. Afghanistan has seen unemployment and food prices soar, whilst the value of its currency is plummeting and banks have set limits on cash withdrawals. For the women outside the malnutrition triage centre in Ghor, life has always been difficult, but now it’s getting even harder. “We have nothing, no food. My children are sick and we don’t have medicine,” pleads one mother. “Why aren’t we getting any help?” There are twice as many cases now compared with this time last year, one senior doctor tells us.Inside a small room, a nurse wraps a measure around the stick-like arm of a young baby. It indicates “red” – the child is severely malnourished. They’re witnessing a sharp rise in cases of malnutrition here and across the country, with both mothers and young infants in particular unable to get enough food. The UN has warned that one million children are at risk of dying due to starvation over the coming months. At the malnutrition ward, they’re running out of space. “Right now, we have two babies and their mothers in a single bed,” Dama, a nurse tells me. “At times we have three.” Temperatures can drop well below -10C at night, but there’s only enough wood in the heater to last for a couple of hours each day. Under the previous government, the hospital was also badly under-resourced, but at least the Ministry of Health was able to provide them with enough fuel. Now, with funds cut off, the Taliban’s government simply doesn’t have the money. Even the small pile of wood in the ward’s heater has been donated by an international charity. Someone has shoved an empty medicine box and a crisp wrapper inside the stove too, to try and provide a few extra minutes of warmth. Chaghcharan, the capital of Ghor province, is around 10 hours drive from the capital Kabul, much of it along a dirt road. The mountains along the way are picturesque, but there’s less snow on them than usual – a sign of the continuing drought that’s adding to the humanitarian crisis.The struggle to save Afghanistan’s starving babiesAppeal to help Afghanistan over starvation fearsAfghans facing ‘hell on earth’ as winter loomsAs we arrive at the province’s only hospital, staff are receiving their salaries for the first time in five months, thanks to the International Committee of the Red Cross. Medicine supplies, for now are still dangerously low, however. They have only about a week’s worth left, so most patients are told to buy their own from nearby pharmacies. “We don’t have anything… no medicines,” says Dr Safar, his voice cracking with emotion as he holds up a prescription he’s writing, “we are suffering, sometimes we are crying.”Many struggle to cover the costs of treatment. Gulfiroz, 20, is recovering from a Caesarean section. Her baby, Benyahim, is doing well, but the procedure has driven her family into debt. “We didn’t even have 10 Afghani (9c; 6p) for a taxi here,” her mother-in-law tells the BBC. “We couldn’t afford to buy her meat, just milk… We had to buy lots of medicines. We asked everyone we know to lend us the money.” At times hospital staff hold their own collections on behalf of patients, despite not having received pay checks for months themselves. Dr Parsa, the head of the hospital, has been paying out of his own pocket for six extra nurses, just to keep essential services running. Western governments are anxious about resuming funding, concerned they will be strengthening the new Taliban government. But Dr Parsa says his hospital needs support. “My message to the international community is: this is the worst situation we have ever faced… please send us humanitarian aid. Negotiate with the Islamic emirate [the Taliban government] and unfreeze their foreign reserves.” It’s not just a rise in malnutrition that hospital staff are witnessing, but also of cases of severe pneumonia as winter sets in. “We don’t have fuel, shawls or warm clothes,” says one elderly woman accompanying her baby granddaughter in the emergency ward. “We don’t have a real life… we’re displaced refugees.” Panorama reports on how life has changed for Afghan people under Taliban rule – watch on BBC iPlayer.It’s in the measles ward we come across the starkest example of the consequences of the lack of hospital resources. The hospital is struggling to cope with the number of cases of the infectious disease – vaccination campaigns were recently disrupted by both Covid and, until the Taliban takeover, armed clashes. The night before we arrived a baby boy died, because doctors couldn’t provide him with enough oxygen. “We needed pure oxygen in cylinders… they’re expensive,” says another doctor, Dr Musa. A cylinder would have cost them around $50. That can be the difference between life and death in Afghanistan. In fact, there are a few dozen empty cylinders just outside the measles ward. The hospital has a machine to produce its own oxygen, but there’s no electricity to power it. At the moment, there’s no electricity across the whole city, apart from private solar power in some residents’ homes. The city used to be powered by a fuel-run power plant, but there’s no money to turn it on. The hospital has its own generators, but they’re not enough. Dr Khatera heads the maternity unit, and is the wife of Dr Parsa, who is in charge of the whole hospital. Despite the billions of dollars of international support over the past two decades, she reels off a list of equipment and resources they have long been in need of. Now, the situation is even worse. The International Committee of the Red Cross is committed to providing emergency support for the next six months.Dr Parsa is grateful, but also deeply worried about the future. “If we don’t get international help, and this situation continues, my fear is the hospital will shut down. That would be the end of the health service in this province,” he warns. Additional reporting by Ahmad Fawad Zhwak and Malik Mudassir.This video can not be playedTo play this video you need to enable JavaScript in your browser.

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesHeaped in plastic bags in a small room in rural southern Afghanistan, the white crystals glisten. They are “export quality” methamphetamine, and will be trafficked to countries as far away as Australia. Once there, the 100kg (220lb) stored in this room will have a street value of around £2m ($2.6m). Outside, smoke billows from two barrels where new batches of meth are being cooked. Drugs are big business in Afghanistan, and under the Taliban, trade is booming. The country has long been linked with heroin, but in recent years, it has also emerged as a significant producer of crystal meth – another dangerously addictive drug. One source involved in the trade says that about 3,000kg of crystal meth are now manufactured every day by more than 500 makeshift “factories” in a single remote drug-producing district in the south-west of the country. The rise of meth has been fuelled by a discovery that ephedra – a common, wild herb known locally as “oman” – can be used to make one of the drug’s key ingredients: ephedrine. At a bazaar deep in the desert that serves as the central node of Afghanistan’s meth trade, there are huge mounds of the plant on sale, on scale not previously seen before. Previously, the Taliban were understood to charge tax on ephedra. But recently, they have announced a ban on its cultivation, in a decree that was not widely publicised. For the moment though, they’re continuing to allow the meth labs to function. One Afghan involved in the trade told us with a wide grin that the ban on ephedra had simply caused the wholesale price of meth to double overnight, while there were still warehouses full of supplies of the plant to use for future production. Dr David Mansfield is a leading expert on Afghanistan’s drug trade who has tracked the growth in meth production with the help of satellite imagery identifying labs involved in the process. He says the ban on ephedra comes at a time of the year when the crop has already been collected, “so the true impact will not even be felt until July next year when the ephedra harvest is due”.Dr Mansfield believes the amount of meth being produced in Afghanistan could outweigh the amount of the country’s other more established drug, heroin. Opium harvested from the country’s poppy fields is already estimated to be the source of about 80% of the world’s supply, and it too appears to be booming. In recent weeks, farmers across Afghanistan have been busy preparing their fields and planting opium seeds. “We know it’s harmful,” says Mohammad Ghani, while raking the earth outside the city of Kandahar, “but nothing else we grow makes any money.” What’s the Taliban’s record on opium production?How do the Taliban make money?Who are the Taliban?Afghanistan’s economy is collapsing following the withdrawal of international support in response to the Taliban takeover earlier this year, and for many farmers, opium seems like the safest option. Decreasing water levels, exacerbated by drought, are also forcing their hands, they say. “We have to drill wells, and if we grow okra or tomatoes, we won’t even make half of what the wells cost us,” says Mr Ghani.Speculation the Taliban might eventually ban opium cultivation has led to a rise in prices, which in turn, according to farmers, is encouraging them to plant more of it. For now, the trade is flourishing. Opium dealers, who used to pay off corrupt government officials and sell bags of the thick black paste in secret, have now set up stalls in markets. “Since the Taliban liberated the country, we have become totally free,” one wholesaler says, with a smile.The Taliban, however, are still sensitive about the trade. In Helmand province, they prevented the BBC from filming a large and notorious opium bazaar, describing it as a “restricted area”. BBCWe know it’s (opium’s) harmful… but nothing else we grow makes any money.Mohammad GhaniOpium farmerWhen pressed on whether the ban on media coverage was rooted in allegations some Taliban members were profiting from the trade, Hafiz Rashid, the head of the provincial cultural commission abruptly ended an interview and threatened to smash a camera unless the footage was deleted. In neighbouring Kandahar, we were initially given permission to film an opium bazaar, but on arrival told it would not be possible. Bilal Karimi, a Taliban spokesman in Kabul, told the BBC the group was “trying to find alternatives” for farmers. “We can’t take this away from people without offering them something else,” he said. During the group’s first stint in power, they did eventually ban opium. During their insurgency, however, taxes on it became a source of revenue, though in public they refute that. Some traders say that if the Taliban want to, they will be able to effectively enforce a ban on the drug again. Others are sceptical. “They’ve achieved what they have thanks to opium,” one farmer says, indignantly. “None of us will let them ban opium unless the international community helps the Afghan people. Otherwise we’ll go hungry and won’t be able to look after our families.” Dr Mansfield warns that increases in costs of food and agricultural products linked to the economic crisis will lead farmers and lab owners to ramp up the volume of trade, “just to maintain their income”. In parts of Afghanistan, the drug industry is deeply enmeshed in the local economy. Gandum Rez, a remote cluster of villages in Helmand, is only reachable by a dusty gravel track. But it’s at the centre of the global heroin trade. As well as a large number of market stalls devoted to the sale of opium, it’s home to factories, employing 60-70 people each, which process it into heroin. The drug is smuggled into Pakistan and Iran, and then westwards to the rest of the world, including Europe. According to one local source, a kilogram of heroin for export sells at around 210,000 Pakistani rupees (£900; $1,190). A former drug trafficker in the UK told the BBC that by the time a kilogram reached Britain and had been cut with various mixing agents, it would have a street value of around $66,000. Most of that profit is made by those transporting the drugs internationally, but the Taliban do levy taxes on producers. According to Dr Mansfield, the amounts earned by the group from drugs are often overstated, and less significant than other sources of revenue. But he estimates that in 2020, they received around $35m from taxes on drug production – money that they need.”The first time the Taliban came to power, it took them six years before they actually enforced a ban on drugs and that was just opium at the time,” he says.To do so now, given the state of the Afghan economy, Dr Mansfield says, would be seen as punishing a constituency that has previously given the Taliban “succour and support”. Taliban spokesman Bilal Karimi told the BBC that eradicating drug production would help both Afghanistan and the international community, “so the world should help too”. The country’s drug trade doesn’t solely revolve around exports. It has also had a devastating impact on the Afghan population, in which high levels of addiction are seen. By the side of a busy road on the outskirts of the capital Kabul, a few hundred men are huddled together in small groups, smoking crystal meth and heroin. “Now the drugs are made in Afghanistan, they’re much less expensive,” says one man, “before they used to come from Iran. A gram of meth was 1,500 Afghani ($15), now it’s 30 to 40 Afghani ($0.31 to $0.41).” Conditions are squalid, with some living inside sewage ditches. “Even a dog wouldn’t live the way we do here,” says another man. The Taliban often roughly round them up and take them to under-resourced rehab centres, they say, but most end up straight back here.For now, more drugs look set to hit the streets both in Afghanistan and abroad. You may also be interested in:This video can not be playedTo play this video you need to enable JavaScript in your browser.