Acute respiratory infections double as Afghanistan’s children face the harshest winter in a decade
Amidst the worst winter in years, UNICEF is providing a lifeline to the sick and vulnerable by heating health facilities and prepositioning medicine in 850 health facilities in districts cut off by snow.
KABUL, AFGHANISTAN – Cries of sick babies fill every corner of the paediatric ward at Indira Gandhi Children's Hospital in Kabul. Way beyond its capacity, 40 children have been admitted in the ward. Two to three children share each bed.
Seven-month-old Ibrahim sobs in his mother's lap, with dried lips and tears rolling down his face. He is restless, and his mother, Gul Bibi, softly wipes his tears but fails to comfort him. Ibrahim has pneumonia; he is one among 50 children being treated for an acute respiratory infection at the hospital.
“Ibrahim has been sick for over a week now. He has a fever, cough, diarrhoea, and an ear infection. First, we took him to Logar Provincial Hospital. After they treated him there for three days, his condition was not improving. The doctors told us to take him to Kabul,” says Gul Bibi, cradling her son.
Gul Bibi travelled three hours from her village, Maikhail, in Logar Province, to Kabul, seeking urgent treatment for little Ibrahim. She had to change taxis four times to reach the hospital; each fare weighed heavily on her. Like most in Afghanistan, her family has limited resources and mainly depends on agriculture for income.
“This year, the winter is bitterly cold. We struggle to heat our home and keep our children warm. I have five children, and there is often insufficient food to feed them. My child's illness is an added burden on us," says Gul Bibi.
Severe winter weather conditions, with temperatures well below freezing in most of the country, have increased the number of acute respiratory infections. More than 25,000 cases were reported in December 2022 – double the number of cases reported in December in the last three years. Children under five make up 65 to 75 per cent of the total number of cases.
As Afghanistan faces a severe economic crisis, families are finding it increasingly difficult to afford adequate heating, causing cases of pneumonia to rise among children. Already weakened by years of deprivation, children across the country are increasingly vulnerable to disease and illness due to the deadly combination of rising malnutrition, an unprecedented food crisis, and crippling winter weather.
Per UNICEF estimates, around 900,000 children under the age of five are estimated to suffer from severe malnutrition and 2.3 million children from moderate to acute malnutrition.
"The overall economic situation in the country is bleak. People are struggling to feed their children and keep them warm. They burn wood, clothes, tyres, and plastic to warm their houses," explains Dr. Shir Mohammed, the paediatrician at Indira Gandhi treating acute respiratory infections. "Malnutrition, food crisis, cold weather, and air pollution are underlying factors behind the increase of acute respiratory infections in children."
While examining Ibrahim, Dr. Mohammed points to swelling on the child’s feet. Ibrahim looks healthy, but besides the respiratory infection, he is also suffering from a rare but severe form of malnutrition caused by a lack of protein in his diet. This form of malnutrition is characterized by swelling under the skin.
To cope with the increasing number of cases, Indira Gandhi had to expand the space previously dedicated to malnutrition cases from one room to an entire unit.
UNICEF supports the hospital by providing ready-to-use therapeutic food (RUTF) to treat children with severe acute malnutrition. UNICEF provides RUTF to hospitals and health centres across the country with support from the Asian Development Bank (ADB), USAID’s Bureau for Humanitarian Assistance (BHA), the Afghanistan Humanitarian Fund (AHF) and Global Affairs Canada (GAC).
Back at the ward for treating respiratory infections, Dr. Mohammed has received more children referred from the outpatient department which need to be admitted. Last week, a record number of 110 children with acute respiratory infections were admitted in the ward. While almost half of them are still receiving treatment for pneumonia and viral bronchitis, severe pneumonia cases were referred to the hospital's intensive care unit (ICU).
Dr. Mohammad Azim Latifi, an ICU specialist at the hospital, has been monitoring 10 children in the ICU, five suffering from acute respiratory infections and respiratory failure.
"All five children with severe pneumonia admitted here are under five. The increase in the number of ARI cases is adding a burden to our limited ICU capacity," says Dr Latifi.