NEW DELHI – Ahead of its first democratic elections in early October, Afghanistan is facing an acute food and malnutrition crisis and continues to suffer from the highest number of maternal and child deaths in Asia.
According to a study by the UN World Food Program (WFP), some 1.4 million Afghans are affected by continued drought and crop failure, adding that more than $50 million is needed to tackle the severe situation facing the country.
Widespread food insecurity is heightened by several years of severe drought coupled with decades of civil conflict.
"For almost five years, since 1999, the situation of drought remains the same. And due to drought there is no cultivation," rues Dr. Roya Mutahar, national nutrition officer of the Afghan health ministry.
Elaborates Dr. Hedayatullah Stanek Zai, the ministry's director general of policy and planning, "Food is available but its prices are so high, it becomes difficult for people to purchase it."
He adds that, "This condition has not improved since the past five years and the water table is continuously reducing."
One of the reasons for the crippling food shortage is a radical change in the pattern of cultivation, from wheat – the country's staple commodity – to poppy.
Says Dr. Ahmad Shah Salehi, the ministry's external coordination director, "Most farmers are not producing wheat, but are moving towards poppy cultivation. Poppy is more profitable for them since it needs a small piece of land without too much water."
Zai attributes the growing food insecurity to a multiplicity of factors ranging from limitations on population movement due to prevailing insecurity in some parts of the country to poor transportation, seasonal obstacles like harsh winters, a dramatic depletion of productive assets at the community and household level and lack of employment opportunities.
Predictably then, according to Afghan health officials, the country suffers from an extremely high 45-59 percent prevalence of chronic malnutrition, high mortality rates among children under five years (257 per 1,000 live births), high maternal mortality rates (1,600 per 100,000 live births), and the widespread prevalence of micronutrient deficiency diseases.
The rugged, mountainous country has the highest maternal and child mortality rates in Asia, with nutritional surveys suggesting that mothers, infants less than six months old, and young children between six and 24 months face the greatest risk.
"Today, apart from Afghanistan, there is not a single Asian country, with the highest mortality rates in the world," says Dr. Patric Webb, chief of nutrition, WFP.
"The population's poor micronutrient status is the result of lack of diversity of food in the diet and over-reliance on the staple food – wheat," remarks Zai.
He adds that iodine deficiency disorders are highly prevalent, particularly in the mountainous provinces of the north, northwestern and central highlands of Afghanistan.
"The prevalence of clinical cases of goiter is reported to be between 20 and 63 percent, reaching up to 70 percent in particular areas. This is due to the low access to iodized salt in the country," he says.
Data provided by the Afghan health ministry shows a prevalence of 50-70 percent anemia among young children and mothers and up to 20 percent night blindness among women.
Adds Zai, "Over the past few years outbreaks of scurvy have occurred repeatedly in the winter months with severe clinical signs observed in ten percent of the population in some of Afghanistan's remote districts."
Studies show access to health care is very limited, with only three percent of Afghanistan's Gross Domestic Product (GDP) devoted to health.
A skewed ratio of doctors results in most of them being located in urban areas, leaving remote, rural regions devoid of access to health services.
Around 75 percent of households in Afghanistan use unsafe water sources for drinking.
Analysis of the 2004 National Risk and Vulnerability Assessment reveals that 37 percent of the Afghan population – almost 6.5 million people – are unable to meet their minimum food requirements, so they constitute the top priority for assistance.
The Crop and Food Supply Assessment 2004, conducted by UN agencies and Afghan government ministries in July, shows a whopping 70 percent of crops have failed in the country's worst affected areas, like southern, western and southeastern Afghanistan.
While spotlighting the deficiencies, government officials concede that some development has taken place in Afghanistan after the fall of the Taliban regime.
Remarks Dr. Mutahar, "But the credit for this goes to the United Nations and not the United States of America."