The staff is unpaid and the medicine is almost running out. Gereshk Hospital can only watch the baby die of a treatable disease

Shirin paid a heavy price for the conflict in Afghanistan and the sudden end of the Taliban's victory. Three years ago, her husband lost a leg when a roadside bomb hit his bus. Then in the summer, the victory of the militants brought peace to her corner of Helmand Province, but the Foreign Aid Fund stopped paying her as a hospital cleaner and maintained the family's livelihood.

They defaulted on rent, were kicked out of their homes, and they started to eat up food. Three weeks ago, Mohammad Omar died of a wound that never fully healed due to cold, hunger and confusion, making her a single mother of four children.

"He died because of lack of money. 50-year-old Schilling said: "We have suffered too much, but as long as we get paid, everything will be solved. "

But even if she did not receive a salary, she continued to work in the obstetrics department of the Gereshk District Hospital. "We need us here," she said, because a newly born girl was urgently sent for oxygen, she was going to transfer her mother to the recovery room and disinfect her bed for the next patient.

The ward needs a cleaner to ensure the safety of the new mother as much as possible. Even in the hospital, there is a shortage of cash and it stops slowly like this hospital. The operating room had to be closed last month because there was no money to fuel the generators—this rural corner of Helmand near the former camp fortress had no grid power supply—and there was no gas to sterilize their equipment.

Therefore, women whose lives depend on a C-section, car accident victims who need thoracotomy, and people with an inflamed appendix have to be taken away by taxi, and pray that they will survive an hour’s drive to Lashkar Gah, where Boost is. Hospitals supported by the charity Médecins Sans Frontières still have electricity and supplies.

There may be no bombs and gun battles on the roads, preventing many people in Helmand from seeking medical treatment, but the hospitals and clinics are no longer functioning normally.

"I can tell you many cases," said surgeon Karim Walid. "There was a woman who needed a C-section because of the position of the baby. She had no money, so we collected thousands of Afghans' cars around and took her to Boost."

The laboratory ran out of testing equipment for diseases ranging from malaria to HIV, for blood cell counts or blood sugar levels. “We are left with pregnancy and tuberculosis testing,” said the laboratory manager Bashir Ahmad Majar (Bashir Ahmad Majar).

In the end, even the midwife in the delivery room ran out of gloves. “We let those who can afford to buy it themselves,” said Malalai, a midwife who works with Shirin. For others, the hospital is heavily in debt. “I receive calls from the shopkeeper every day asking why I don’t give us the money owed to us.” Until early November, Haji Mohammad Barak, the director of Gereshk Hospital and the current provincial health care project manager. Barak) said.

He said that fortunately, during the air strikes in the last few days of the fighting, they managed to repair a hole in the roof of the inpatient ward, and then the money was completely spent. The bomb miraculously landed between the five hospital beds on the wall of the ward without causing any serious injury.

The Director-General of the World Health Organization Tan Desai visited Kabul in September and warned that the entire medical system was on the verge of collapse, prompting the United Nations to arrange for the payment of a month’s salary.

Gereshk's operating room has been reopened, the laboratory has been restocked, and the medical staff has promised to pay them another three months' salary. But these are temporary solutions that will be exhausted in the harsh winter of Afghanistan.

"We need something permanent; we can't just get a few months' salary and then everything will start again," said Malale, a midwife who is the main breadwinner of the family. "Don't leave us here without hope."

Western governments that support the health and education sectors were shocked by the unexpected and quick victory of the groups they sanctioned as terrorists in August, cutting off all funds and not making plans to support schools and hospitals built on overseas aid.

They worry about granting legitimacy to the government, which comprehensively restricts women’s rights to work and study, and is related to other human rights violations, including targeted removals and mass displacement.

But senior Taliban officials are not paying the price for freezing funds. "Don't be fooled into thinking that I will be sanctioned," said a senior Taliban official in Kabul. "I will always use my salary, my meals and money to keep my office warm."

What is at stake is the lives of ordinary Afghans. Tan Desai warned that the sudden cessation of international funding has caused health service providers to make terrible decisions about "who to save and who to die." Gereshk's reality is even worse.

Since the hospital is almost non-operational, they can only tell patients in serious need to go to Boost Hospital. It is the only fully functional medical center in the province, serving at least 1.5 million people and informally serving hundreds of thousands in neighboring provinces. On some days, more than 700 patients squeezed into an emergency room designed for half this number.

"Afghanistan's health system is very dependent on donors, and the donors withdrew their support," said Emerson Gono, project coordinator of Doctors Without Borders Helmand. The impact of the cut was tragic and felt immediately.

"We are overwhelmed by the workload. People come from the whole province and even other provinces," he said. "We are far beyond our capabilities, because we will not reject the critically ill patients we see."

It may be difficult to imagine that the healthcare system is "in a state of collapse," but you can see the labor costs caused by capital cuts in Boost Hospital, the fragile bodies of sick and malnourished children, or being pushed to the morgue.

On a sunny and fresh morning last week, the hospital's medical staff wrapped up the small body of a 6-year-old boy and took it away. He just lost the battle against bacterial meningitis, he should have survived.

"We gave him a very strong antibiotic, but it was too late," said the chief Afghan doctor in the ward, and MSF asked not to be named. The clinic in the Garmsir district was where the boy sought help for the first time. He could not test his blood, mistakenly mistaken his illness for poisoning, and tried to treat him accordingly.

Outside, a 12-year-old diabetic patient who was paralyzed from the waist down was basking in the sun. His bedsores had reached his bones and he was left in the intensive care unit.

Nurse Alyssa Tianna Ranger said that Zabihullah's family was caught in a cycle of poverty and poor medical conditions. The family had to go to Lashkar Gah to obtain insulin for his treatment because the local clinic could not provide this medicine, and because it was difficult for the family to provide him with a good diet and control his blood sugar, sores developed easily and quickly.

"The cost of coming here is very high for our family," said his mother Marzia, whose son smiled in spite of pain. "Before he was diagnosed three years ago, we were already very poor. The situation is worse now, but we have no choice."

Like many of the poorest people, they have been hit by many crises. Taliban control has plunged the economy into free fall: it has shrunk by at least a third. The government does not pay wages, internationally funded jobs have disappeared, and food prices have soared. This effect is particularly reflected in the severely crowded malnutrition wards, where the number of children with bone pain has soared. Autumn usually brings some respite, because summer dehydration is more serious and hot, but this year it will not.

When other diseases-stomach diseases, respiratory diseases-ravage their petite bodies and make them unable to eat, children without nutritious food are extremely vulnerable.

Nazdana came here to keep the three-year-old Khalida alive because the clinic in her hometown of Yakhchal village could not stop the vomiting that was wasting her child.

In order to get the travel money, she weighed the life value of the two daughters and made a marriage contract for the girl's five-year-old sister. The wedding will not last 10 years, but Nazdana prepaid 15,000 Pakistani rupees (£63) in a dowry of 600,000 rupees, which is enough for the trip.

"I spent some money to come here the next day," she said. In a functioning health system, Khalida should eventually be discharged to local clinics for care, which distribute feeding supplements such as calorie-rich "plump nuts". Without these operations, some children will fall into a cycle of malnutrition and see them return to the ward time and time again.

As the international community weighs whether to re-commit long-term funding for the healthcare system, they may pay particular attention to the decision to let senior Taliban officials oversee all administrative positions in clinics and hospitals.

Most people were fighters a few months ago, and Gereshk District Health Commissioner Mohammad Nasim admitted that he has no background or expertise in this field. "This is the decision of the Islamic Emirate. I don't know why they chose me for this position," he said, using the name of the organization. "It's time for me to serve the people."

But the officials they replaced also had problems; several health care sources said they found that Ahmad Alghazi, the head of the new Taliban in the province, was more serious than his predecessor under the leadership of the government of the Republic. It is easy to work together and the level of corruption is lower.

In an interview, he promised that female medical staff will continue to hold their posts, female patients will be able to get medical care without a guardian, and that the polio vaccination campaign that the Taliban sometimes opposed in the past will continue.

But he also warned the West not to cut off hospitals when needed, thereby giving up goodwill. "The international community should give priority to the needs of the poor. They see too many problems," he said. "This is a good opportunity to support the health sector because there is no corruption now. It will not exist forever."

The dean of Boost Hospital, where he worked, simply pleaded with donors to put the lives of Afghan patients before the dispute with the new government.

"I hope the international community will not confuse health and human rights with political issues," Faizullah Mohammadi said. "We desperately need your support. As fellow human beings, I ask you not to let Afghanistan face this disaster alone."