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The earthquakes that killed at least 2,200 people across eastern Afghanistan earlier this month were the first major disaster to hit the Taliban-led country since President Donald Trump’s administration suspended US foreign aid in January.
Washington did release a statement of sympathy, but there has been no official declaration of direct financial assistance from the Trump administration, which weeks before the disaster threatened to cut all assistance to Afghanistan.
Health workers, aid officials, and analysts say the US cutbacks have had a very real impact on the ability to deliver timely assistance to hundreds of thousands of earthquake survivors, including 212,000 children.
According to the UN, this year had already seen a 50% reduction in international aid to Afghanistan by the time the first 6.0-magnitude earthquake struck just before midnight on 31 August.
A weaker and slower response
“We had much less of a capacity to respond,” Arshad Malik*, Asia Regional Director, Save the Children, said of the crucial first hours following the earthquake.
“We had fewer teams, fewer supplies, and less flexibility to scale up quickly,” Malik said, explaining that the combined effect of all of these things was that the collective response from international NGOs was weaker and slower than in the past.
The number of injuries, more than 3,600, pushed the nation’s hospitals, still heavily reliant on foreign assistance, to their limits.
Officials in Nangarhar Regional Hospital, responsible for health services across five eastern provinces, said they treated more than 950 injured men, women, and children within the first 72 hours. Of those, 541 had to be admitted for in-patient treatment at a hospital that has a capacity of 650.
Hospital workers said the rush was so severe they had to send earthquake victims to long-dormant specialised wards. Fahimullah Dilawar, the hospital director, said this flood of patients, beginning at 3am on 1 September, arrived at a facility that lacks basic supplies for the treatment of patients, some of whom had lost as many as 20 family members in the disaster.
“More than anything, we need supplies, not just for the earthquake victims, but for all patients when we resume normal operations.”
When representatives from an international NGO and an Afghan-American nurse came to ask what was needed, Dilawar listed everything from stretchers to ultrasound machines to blood pressure gauges and pulse oximeters.
“More than anything, we need supplies, not just for the earthquake victims, but for all patients when we resume normal operations,” he stressed to the visitors, days after the disaster as The New Humanitarian waited to interview him.
Several workers told The New Humanitarian that the hospital faced extra pressure because the few clinics that did exist in the earthquake-affected villages were only capable of treating basic illnesses.
“They’re the kind of places you go if you have a bad fever or need some stitches,” said the hospital’s logistics director, Mohammad Attal Safi. “They certainly aren’t capable of treating the kinds of injuries that come from your house collapsing in on you.”
Access was a major issue for both local and international aid efforts. In the first days, “all the routes were completely inaccessible”, Malik said. “In some areas, our staff had to walk for hours to reach affected communities.”
But access, too, was affected by aid cuts.
Earlier this year, the UN’s Humanitarian Air Service scaled back its helicopter fleet. This left the entire burden of air lifts from Kunar and Nangarhar to the Islamic Emirate.
Hospital workers in Nangarhar said the vast majority of the injured had to be flown in by helicopter due to the distances, poor road conditions, and late hour of the first earthquake.
Years of cutbacks
Malik, who led Save the Children’s Afghanistan team at the time, said the easiest way to understand the impact of the aid cuts is to compare the earthquake response to that of past disasters, notably Pakistan’s first mass expulsion of Afghans in late-2023.
“When the returnee situation started, we were able to mobilise teams in less than 10 hours. We established our clinics and child friendly spaces on the ground very quickly,” Malik said, adding that the responses to the 2023 earthquakes in Herat and flooding in Baghlan saw similarly swift responses.
This time, however, mobile health teams were the only support available in some of the most remote areas, meaning “families with injured relatives were receiving delays of care or none at all” in those crucial initial hours.
Safeer Safi, a social worker from Kunar based in Nangarhar’s provincial capital of Jalalabad, said that unlike the returnee response, there was no central point to transfer and gather the victims immediately following the earthquakes. “There should have been a specific camp setting for the survivors to come and get aid,” he said.
Safi explained how survivors who remained in their already damaged villages were still in great danger, given the number of high-magnitude aftershocks: “Their houses are destroyed and the ones still standing are likely to collapse any day.”
Malik said it was important to keep in mind that “the aid cuts didn’t begin with Trump”, and that the response was hindered by the effects of years of ongoing cuts.
In 2023, only weeks before earthquakes in Herat led to the deaths of at least 1,482 people, the International Committee of the Red Cross announced it was terminating a project that had been funding 25 government-run hospitals across Afghanistan.
Malik said this year alone saw the closure of 422 local clinics, including 80 in the eastern zone. More than half of those were in Nangarhar and Kunar, the two provinces most affected by the earthquakes. These cuts, said Malik, had a direct impact on the ability of health workers to respond to all subsequent disasters, including this month’s earthquakes.
As Western support dries up, others try to fill the void
Some Western nations – Australia, Ireland, the UK, and Germany – did provide assistance, but the United States, which contributed 43% of international aid to Afghanistan last year, notably abstained.
Regional countries – from as far away as Bangladesh – did send monetary support, supplies, and search and rescue teams, but they struggled to fill the gap.
Andreas Krieg, associate professor at King's College London, said the earthquake response showed that although Western nations still make up the largest donors to Afghanistan – particularly through international bodies like the UN and the World Bank – their generosity seems to have its limits. Krieg said Western capitals remain cautious in their dealings with the Taliban-led Islamic Emirate government and are “keeping most of their support outside the Taliban’s reach”.
This, Krieg added, has opened the door for the likes of the United Arab Emirates, Qatar, Türkiye, Iran, India, and China. These countries – also some of the Islamic Emirate’s closest allies – may not be matching Western dollars, but “they are present in ways Western governments no longer are,” he said.
“If we were recognised by the world, we would have had on-time rescuers and a lot of people would have been alive today.”
“They build airports, send convoys of food, run hospitals, supply electricity, and keep trade routes open,” while Western governments have “pulled back from long-term state-building” efforts, he said, adding that, most importantly, these countries are all willing to talk directly to the Taliban.
Safi, the Kunari social worker, said the disaster response would likely have looked very different if more countries were willing to engage with the Islamic Emirate.
“If we were recognised by the world, we would have had on-time rescuers and a lot of people would have been alive today,” he said.
Safi acknowledged that regional countries were stepping up, but he said it’s still not enough. Survivors, he said, will need longer-term assistance, which requires a serious ongoing commitment from the international community.
“They should have been given better grants for aid rather than cooked food and water bottles. They are not going to feed them forever. The people need proper, forward-looking solutions,” Safi said. These solutions, he suggested, range from better housing, to compensation for destroyed crops, to vocational training to help them secure alternative income sources until their crops can be restored.
Aid with a message?
Although Western aid “still dominates” in terms of sheer scale, the willingness of other countries to sit down directly with Taliban officials has resulted in a situation where “the West pays the bulk of the bills, but the day-to-day political and practical presence of neighbours and Gulf states is reshaping how Afghans actually experience assistance”, Krieg said.
This reshaping was on clear display when Qatar sent its first of several aid deliveries on 4 September. Doha’s shipment of two fully equipped field hospitals, food parcels, shelter materials, and assistance for 11,000 affected families was handed over by Maryam al Misnad, the minister of state for international cooperation.
The optics of the move weren’t lost on domestic and international observers.
“It was the first time a female Arab government minister has met with the Taliban on their home soil,” said Krieg. “It sends a message that in an Islamic country like Qatar, it is absolutely acceptable for women to lead policy.”
It was especially significant given the fact that the Islamic Emirate has repeatedly tried to hinder the work of female Afghan aid workers – something the UN has consistently warned could impede assistance efforts, including the response to natural disasters.
It also followed reports that a senior Afghan government adviser had reportedly been arrested after suggesting that female nurses should be sent directly to quake zones to show the value of female education to those who support the Islamic Emirate’s ban on government-run education of women and girls beyond the sixth grade.
A picture of Qatari and Taliban officials walking side by side with al Misnad went viral on Afghan social media – something Krieg said was likely not by accident: “The Taliban were eager to receive the aid and hence were compelled to take the photo opportunity.”
*The original draft mistakenly identified Arshad Malik, Asia Regional Director, Save the Children as Abdurahman Sharif, senior humanitarian director for Save the Children, both of whom had worked in Afghanistan.
Edited by Andrew Gully.
