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The Afghan Humanitarian Crisis

There is mass hunger and need in Afghanistan, and the UN is under great pressure to get supplies through.

Matt Bivens

November 16, 2001

TERMEZ, Uzbekistan

From the heights of this border town the view into Afghanistan is cruel. One can walk right up to the barbed-wire border fence and look out through the second, taller, electrified barbed-wire fence, past the machine-gun-bearing Uzbek soldiers, across the (presumed) minefield, out over the expanse of the Amu Darya River–cold, windswept and gray–and beyond that to the empty steppes.

Termez seems even crueler when one sees its river port filling up with tons of United Nations emergency aid–blankets, essential drugs, therapeutic milk for the emaciated–all on the wrong side of the barbed wire. Only late this week did it finally start moving to those who need it. Will it arrive in time?

Life has long been cheap in Afghanistan. Life expectancy is 46, every fourth toddler dies and millions this summer were already dependent on UN food. But as harsh as the past has been, America's new war in Afghanistan has created a dramatically new situation–one that is equal parts hope and fear. Hope, because world attention and charity is focused on Afghanistan like never before; fear, because the month-long US bombing campaign has disrupted crucial UN food-supply networks that are only today starting to be reactivated. It was not until Friday, for example, that the UN World Food Program could announce it was finally meeting its targets for tons of aid shipments rolling into Afghanistan.

It's possible, then, that 2001 will be the year Afghanistan broke free of the famine that in recent years has regularly claimed tens of thousands of children's lives.

It's also still very possible, however, that hundreds of thousands of Afghan civilians, as always mostly women and children, could be dead from malnutrition by spring. All depends on how much aid can be trucked into Afghanistan in the next few weeks.

The American bombing of Taliban-controlled Afghanistan eventually prompted the successful Northern Alliance offensives–and with them a breakdown in public order, one that has turned the Taliban from grudging UN partners into a hostile force. This had until late this week left truck drivers, the backbone of any major aid effort, unwilling or unable to do their job.

Given that the UN says seven and a half million Afghans are dependent on UN aid to survive, what happens if that aid can't get in? A week ago, Kofi Annan was complaining that only half of the food aid Afghanistan needed was getting into the country. UN workers remained grimly upbeat–as diplomats, they had to be. But the more outspoken aid workers at private charities were quick to note that feeding just half of the 7.5 million hungry could work out to 3.75 million starvation deaths by spring.

"Aid is not getting in. We are on the cusp of a massive humanitarian crisis, the like of which we haven't seen for decades," said Dominic Nutt, a spokesman for Christian Aid, last week. Now the UN food trucks are rolling again, finally. And actually, the UN has more financial resources at its disposal to help Afghanistan than it has had for years. But the situation remains precarious. The breakdown of law and order and the bombing still hinder aid workers–who now must race against snow to reach thousands of Afghans in communities accessible only by treacherous mountain passes.

Nor do the recent military victories of the Northern Alliance automatically improve matters. John Davison of Christian Aid, a British charity helping feed Afghanistan, says the alliance's march forward has in the short term simply made a confused and volatile situation worse. Granted that the demise of the Taliban regime is in the long-term interest of Afghans. But in pursuing this goal so far, Washington has been surprisingly cavalier about the short-term danger of mass starvation–hardly a reasonable moral calculus on our part.

Happily, it looks like we might pull it all off. The Taliban are in retreat, and on Friday the World Food Program announced that, having performed "logistical miracles," it was finally trucking food into Afghanistan at a pace that could, if sustained, block mass starvation. (Though WFP officials and NGO aid workers are quick to add that getting that food to the people who need it most remains a big question mark). But even if we are finally succeeding, it owes more to luck than to planning. For three weeks we ignored UN and aid agency pleas to temporarily halt the bombing a few weeks, so food could be rushed in before the crippling snowfalls. For weeks, we staked everything on the fighting spirit of the Northern Alliance at a time when no one seemed sure if they would ever move at all. It has all along been a helluva gamble with the lives of millions–one we barely seemed conscious of taking.

Matt BivensMatt Bivens is an emergency medicine physician practicing in Massachusetts and a national board member of Physicians for Social Responsibility.


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