Imagine knowing a vial of medicine is all it could take to save a child but it may not get it to them in time. This is the heartbreaking reality for Aussie humanitarian doctor Dick Chamla.

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The crisis in Afghanistan has been ongoing for over 18 years. Humanitarian needs, driven by armed conflict, natural disasters and poverty, are on the rise. © Kate Geraghty/SMH


Drought, conflict and floods have destroyed parts of Afghanistan making it incredibly difficult to access hundreds of thousands of children in remote communities. 

“Half of the country is still under conflict,” says Dick, UNICEF Afghanistan Chief of Health. 

“We are among the few agencies in which we travel on the ground but insecurity is a really big challenge. We don’t know what will happen.”

A medical staff member shows mum Gul Zada how to feed her seven-month-old son, Qudratullah, Plumpy’nut® (ready-to-use food) in a UNICEF-supported healthcare centre. © Kate Geraghty/SMH

The lack of access has exacerbated already soaring numbers of child and maternal mortality and children suffering from disease and severe acute malnutrition. 

“We have heard of a child who had measles and simply because of issues around access, that child has stayed in the hospital until he died,” Dick, from Canberra, says. 

“The problem is, all of these are preventable if we are able to improve access and if we have the right policies.”
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Lack of access has exacerbated already soaring numbers of child and maternal mortality and children suffering from disease and severe acute malnutrition. © UNICEF Afghanistan/RaMin Afshar
 
“I am proud. I am here because
I am really helping people.”
UNICEF remains one of the few agencies working on the ground to provide not only immediate aid but also to negotiate access with government and non-state actors to reach children in need. 

We support 1,300 health facilities across all 34 provinces of Afghanistan, providing life-saving medical care and equipment to families in need. 

“We are having a huge difference on the ground,” Dick says, adding UNICEF has trucked-in safe drinking water to drought-affected regions and established temporary learning spaces and teacher training to get children back in school.

“We are the only agency which has offices in almost every region of Afghanistan and structures and mechanisms even in areas under Taliban.

“I am proud. I am here because I am really helping people.”
 
Among the two million children under the age of five who are suffering from acute malnutrition, 600,000 children are currently suffering from severe acute malnutrition - the most dangerous form of undernutrition in children. © Kate Geraghty/SMH

Roughly 13 million people in Afghanistan are food insecure - surviving on less than one meal a day. Across the country, 600,000 children are at risk of severe acute malnutrition. 

“Children are only victims of conflict. Every health condition I have seen here is preventable,” he adds.

“It is a huge dilemma as a health expert because I think, this person is dying and I can’t do anything. It is really heartbreaking, it is really, really heartbreaking.” 
 
“It is really heartbreaking, it is
really, really heartbreaking.”
More than 282,800 people are internally displaced and living in temporary camps. © Kate Geraghty/SMH

Before Afghanistan, Dick was in Bangladesh in 2017 at the time when the largest influx of Rohingya refugees fled torture and violence in Myanmar and sought refuge in Cox’s Bazaar. He says it was the first time he had seen an entire population with critical health needs.

“At one time we had the measles outbreak, we had high rates of pneumonia and diarrhoea all in the same population and at the same time. 

“And, we had the monsoon which caused yet another displacement of populations and the destruction of shelters, houses and toilets.”

Despite the challenges, Dick says UNICEF was able to address issues around mobility and the rising number of deaths - a feat he is particularly proud of.
Rumana, 2, was led by a community worker to safer ground in a camp in Cox's Bazaar, Bangladesh, which shelters over 800,000 Rohingya refugees. © UNICEF/UN0219084/Modola
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Later in 2017, Dick was also posted to Yemen to address the rapid cholera outbreak. In just one month, close to 70,000 cholera cases were reported with nearly 600 deaths. 

UNICEF was providing safe water to over a million people across Yemen and delivered life-saving medical equipment - including medicine, oral rehydration salts, intravenous fluids and diarrhoea disease kits. 

“I had never seen a cholera outbreak like this in any other country in recent history,” Dick says. 

“UNICEF was there, and I was there until we were able to address all the causes of cholera.”

“Now, here in Afghanistan, this is another area where I feel we have lots of challenges. It is hard work, but we will do it.”
 
Children sit in front of a house damaged by an air strike, inside the old city of Sana'a, Yemen. © UNICEF/UNI220712/Romenzi


Help #DeliverFutures


Our team of UNICEF humanitarian workers will go down roads with no names, through war zones and up mountains to reach children most in need of supplies.

UNICEF supports 1300 health facilities across all 34 provinces of Afghanistan, providing life-saving medical care for children in need. 

UNICEF health workers know how to bring a child back from the brink of deadly malnutrition. We have the global network to respond as soon as children need us in every region of the world. But we can’t do it alone.

What we’re doing is working. Every day, UNICEF donors make thousands of children like Adut smile because they’ve beat malnutrition. But emergencies are stretching our teams and resources to the limit. We've never needed your generosity more.

UNICEF provides children affected by emergencies with psychosocial support, safe water and adequate sanitation, child-friendly spaces for education and recreation, and other basic health, nutrition and protection services needed in the wake of a disaster. © Kate Geraghty/SMH

Four fast facts about Afghanistan

Where is Afghanistan?
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Afghanistan is located in Asia, bordered by Pakistan, Iran, Tajikistan, Turkmenistan, and Uzbekistan. 
What is UNICEF doing in Afghanistan?
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UNICEF works to promote and protect the rights and wellbeing of children and women in Afghanistan. Since 1949, we have been bringing basic services, including education, health, nutrition, protection, water, sanitation, and hygiene to those who are most in need, addressing inequities in each of these areas. UNICEF also provides humanitarian assistance during emergencies. Conflict and frequent natural disasters like flooding, avalanches and earthquakes take a devastating toll on the children and families of Afghanistan. We help provide children affected by emergencies with psychosocial support, safe water and adequate sanitation, child-friendly spaces for education and recreation, and other basic health, nutrition and protection services needed in the wake of a disaster. We also provide 'winter kits' (blankets, warm clothes, tarpaulins, among others) to children and families during the bitterly cold Afghan winter.
How bad is malnutrition in Afghanistan?
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In Afghanistan, the nutritional situation of children is alarming. Among the two million children under the age of five who are suffering from acute malnutrition, 600,000 children are currently suffering from severe acute malnutrition - the most dangerous form of undernutrition in children. Afghanistan is one of the countries with the highest numbers of children under the age of five suffering from severe acute malnutrition, alongside Yemen and South Sudan. 
What access do children have to education in Afghanistan?
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Afghanistan’s education system has been devastated by more than three decades of sustained conflict. For many of the country’s children, completing primary school remains a distant dream – especially in rural areas and for girls – despite recent progress in raising enrolment. UNICEF works with the Ministry of Education and other partners to improve the quality of education, build better education systems, and support environments that are conducive to learning and development. We also provide emergency education to ensure children continue going to school during disasters and conflicts. UNICEF and Save the Children co-lead the Education in Emergencies Working Group which supports the Ministry of Education in its disaster response. 

 
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