By Tamana Taban
Every morning, Rana Tawakol* spends an hour and a half walking to the clinic where she works in a remote and impoverished part of central Afghanistan. As the only child nutrition expert in her district, she knows that the advice she provides is crucial for her community.
Most of the children she sees are moderately malnourished, the legacy of poverty and a series of droughts that have compounded the difficulties of life in a region known for its harsh climate.
“Often, my heart truly breaks,” says Tawakol, 25, who’s the only expert in her field serving a district of 35,000 people in the province of Bamyan. “When I tell a mother to feed her child beans, chickpeas or lentils at least once a week, she replies: ‘Doctor, if we can just fill their stomachs, even with barley bread, that’s an achievement’.”
Bamyan has long been synonymous with poverty and hardship, but climate change is making life for its inhabitants even harder. Many rely almost entirely on farming, which has been badly hit by the droughts.
For the past two years Tawakol has dedicated herself to educating parents about how to keep their children healthy, and she sees the consequences every day. She sees up to 15 mothers a day, trying to explain to them in simple terms how and what they should be feeding their kids.
Many have only very limited awareness of nutrition, she says, though the biggest problem is poverty and a lack of access to the foods that make up a healthy diet.
“There is no variety in the food here. People eat the same thing all the time. When I ask mothers how many different meals they have in a week, most can only name three: potatoes, rice, and occasionally turnip soup.”
Earlier this year the United Nations’ deputy special representative in Afghanistan Georgette Gagnon warned of growing poverty compounded by a decline in aid after she visited Bamyan in May.
Malnutrition is rife in Afghanistan and is particularly dangerous for children. According to the U.N. children’s agency, 3.5 million children under five now suffer from malnutrition in Afghanistan. Its under-fives suffer some of the world’s highest rates of stunting, the permanent damage to both physical and mental development that is caused when young children do not receive the nutrients they need.
The situation in Bamyan is particularly bad. Mohsena*, a 34-year-old mother whose child suffers from malnutrition, says she cannot follow doctors’ advice because she cannot afford to.
“With bread, rice, and potatoes, children cannot grow strong,” she explains. “That’s all we have to give them. If there is anything to buy in the bazaar, it is beyond our means. We can’t even buy sugar, let alone fruit, vegetables, beans, milk, or yoghurt. When I cannot afford any of these, what am I supposed to do?”
Tawakol recalls how, when she first started working at the clinic, a mother brought in a child who was visibly weak and underdeveloped. When she asked about the family’s diet, the mother said there was often not enough food to eat.
“The economic situation is desperate,” she says. “Children who are at a critical stage of growth need proper nutrition for both body and mind. But here, it is the opposite.”
Tawakol sees twice as many malnourished children as healthy ones in her clinic. Most of them are stunted, she says, a condition that weakens the immune system, leaving children vulnerable to infections, as well as causing delayed puberty and depression.
She tries to offer practical help, showing mothers who come to her how to make the best use of milk and yoghurt in feeding their children. But there’s only so much she can do, and many families just don’t have access to the range of foods their children need.
“Our entire life depends on farming,” says Halima*, a 37-year-old mother of three. “In years when potatoes and wheat fetch good prices, we might manage to buy some beans, chickpeas or lentils. But in years like the last one, when our crops sold for half the price, only God knows our hardship.”
* names have been changed
