WARNING: SOME OF THE IMAGES AND VIDEOS IN THIS STORY ARE DISTURBING
(CNN) - Kamila is almost 3 years old, but she weighs only 5 kilograms. Her wrinkled skin falls off her skeletal limbs and stretches around her distended belly.
Kamila has been malnourished for eight months, Ella Bilqis's grandmother says of her, as she tries to calm her down in a sparse hospital ward filled with other emaciated children in Kandahar, southern Afghanistan.
Too weak to cry, the girl rubs her ears in pain.
"Her mother is sick and we are poor people," says Bilqis. "She tried to breastfeed her but she had no milk to give her."
Kamila's family is among the millions of Afghans struggling to survive severe food shortages during a harsh winter and economic crisis. Human rights organizations are calling for more foreign aid, arguing that the most vulnerable groups, women and children, are suffering.
In a statement to CNN, the Taliban ruler acknowledged the country's "economic problems" but vehemently denied there was a crisis, calling such claims "false."
"No one will starve because there is no famine and the cities are full of food," Taliban spokesman Zabihullah Mujahid said, contradicting graphic images of starving children.
Even before the Taliban took power in Afghanistan in August, poverty and food insecurity were widespread due to back-to-back droughts, economic decline, protracted conflict and the pandemic.
But three months after taking power, the crisis has rapidly worsened. Billions of dollars of foreign development aid have dried up, depriving the country of money that had been sustaining the economy, basic services and humanitarian workers.
As winter approaches, nearly 23 million people — more than half the population — face extreme levels of hunger, according to the United Nations. At least one million children under the age of 5 are at risk of starvation.
Conditions are so bad that some hospitals, short on fuel money, have resorted to cutting down trees to heat patient rooms, and aid groups warn the situation will only get worse if the international community doesn't act now.
Families desperate for hunger in Afghanistan sell everything
The unforgiving weather has exacerbated food shortages.
The vast majority of Afghans depend on agriculture for their livelihoods, but the country has lost 40% of its harvest this year due to drought, according to the World Food Program (WFP). As food supplies dwindle, the cost of staples like wheat and bread has skyrocketed.
"We only have water and bread, sometimes we have it, but sometimes there is nothing to eat," said Musafer, a worker and trader who goes by one name.
Earlier this month, he took his daughter to Ghor Provincial Hospital in the provincial capital Chagcharan.
Razia is almost 3 years old, but her ribs and spine protrude with frightening clarity as she hides her face in her mother's lap. This is her third visit to her hospital in just eight months, and she's not getting any better.
"There is no job, there is no income, there is no food to take away," Musafer said. "Every time I see her I get angry."
Richard Trenchard, the Food and Agriculture Organization's representative in Afghanistan, described the situation as "disastrous" in a November statement.
"All the farmers we've talked to have lost almost all of their crops this year, many have been forced to sell their livestock, have racked up huge debts and just don't have any money," he said.
Before the Taliban's takeover, poverty was common in many of the country's rural areas, but now, urban and middle-class residents have also sunk into despair.
Government workers and school principals, many of whom have not been paid for months, are among those queuing for food rations and medical care, the WFP warned. Across the country, families sell clothing, furniture, livestock, sometimes even entire houses, for food, the agency said in a news release.
A man guides his donkey through a parched field in Bala Murghab, Badghis province, Afghanistan, on Oct. 15.
The risk of famine was once restricted to rural areas, but now 10 of Afghanistan's 11 most densely populated urban areas face emergency levels of food insecurity, said Deborah Lyons, head of the UN Assistance Mission in Afghanistan. , in November.
In IDP camps, some of the poorest families with nothing to sell resort to offering their daughters as brides. It's the only way to keep their other children alive, several parents told CNN.
In the statement to CNN, Mujahid, the Taliban spokesman, said Afghans urgently need food and medical supplies.
He said the Taliban are "trying to increase this aid" and distribute it to the people, along with humanitarian groups.
saturated hospitals
Hospitals have been overwhelmed by hungry patients, even as medical supplies and staff are in short supply.
Afghanistan's national health program had previously been funded by the World Bank, but funding stopped in August, leaving 2,300 facilities without the means to buy medical supplies or pay salaries.
By the end of September, most of those hospitals and clinics had closed, and fewer than one in five were still open, according to a UN report.
Before the Taliban takeover, there were 39 hospitals in Afghanistan treating Covid-19 patients; now only three or four are still operating, said Dr. Paul Spiegel of Johns Hopkins University, who has just returned from Afghanistan as a consultant to the WFP.
The World Health Organization is among the agencies that have resumed airlifting essential medical supplies to Afghanistan; the four supply shipments so far should cover 1.5 million patients, the WHO said in November.
The Jar-e-Sakhi internally displaced persons camp in the Qala e Naw district of Badghis province, Afghanistan, on Oct. 17.
Meanwhile, the UN Development Program provided $15 million to Afghanistan's health sector in November, helping pay the salaries of more than 23,000 health workers, according to a UN press release.
But many aid workers and doctors on the ground warn that it is not enough.
At Ghor Provincial Hospital, up to 100 mothers and children arrive each day seeking treatment for malnutrition, as well as a host of other illnesses such as measles, diarrhoea, cold and flu, said Faziluhaq Farjad, head of the malnutrition ward at the hospital.
All of these problems are related, he added: Malnourished mothers and children become more susceptible to disease and infection. They often have to travel long distances to reach hospitals and arrive even weaker, he said.
Faziluhaq Farjad, head of malnutrition at Ghor Provincial Hospital in Chagcharan, Afghanistan.
But the hospital's supply of equipment and medicine is rapidly dwindling: the malnutrition wing has only milk left to sustain its patients.
"Nearly 70% of the cases are serious and this happens in the city. Imagine how bad the districts are," Farjad said. "If no one pays attention, things will get a lot worse."
One of Farjad's patients, 1-year-old Nasrin, is so severely malnourished that she spent almost half her life in the hospital, said her father, Abdul Rauf, who works as a day laborer.
"Every 20 days, every 10 days, we are in the hospital," Rauf said. "This is my life and we spend it like this."
ask for international help
Efforts by foreign governments to limit Taliban funding are having the unintended effect of starving the Afghan people, say aid organizations, which are calling on donor countries to change their strategy. Spiegel, the doctor who visited Afghanistan for the WFP, urged foreign countries to reconsider their decision to freeze Afghan assets after the takeover, including funding for government-run hospitals.
"The US, UK and EU have to make some decisions quickly or it will be too late and there will be a tremendous amount of needless death," he said.
He acknowledged the desire of foreign governments to avoid legitimizing the Taliban and holding them accountable, but said existing sanctions are not nuanced enough.
"The goal of change is a good goal, but is it worth tens of thousands of deaths?" he said.
The European Union pledged a €1 billion ($1.12 billion) aid package in October, and the World Bank's board recently pledged $280 million to the United Nations Children's Fund and WFP. The United States has also contributed nearly $474 million in humanitarian aid, separate from development aid, this year.
Turkey's Disaster and Emergency Management Presidency provides food aid to Afghan families in Kabul on December 7.
But even the international funds that have been pledged are only a fraction of Afghanistan's $9.5bn of frozen assets. And those funds are being channeled to international organizations already working in Afghanistan, according to statements by the US and EU governments, meaning the money is not accessible to Afghan banks or the Afghan public.
Several US lawmakers, mostly Democrats, have also urged the Biden administration to turn over frozen Afghan funds to the UN as humanitarian assistance.
Pressed on Monday about the impact of the sanctions on Afghan civilians, Ned Price, a spokesman for the US State Department, said Washington had warned the Taliban before the takeover that taking control would jeopardize foreign aid from the United States and other countries.
He said that before the United States can consider any future relationship with the ruling Taliban, the Islamist group must make certain human rights commitments, including forming an inclusive government. The United States remains committed to helping the Afghan people, Price said, noting the humanitarian aid provided so far.
Facing mounting pressure, the administration said on Wednesday it would lift some restrictions on the kind of aid humanitarian organizations can provide to Afghanistan, allowing more support for education programs, including paying teachers' salaries.
An Afghan teacher receives humanitarian assistance in Mazar-i-Sharif, Balkh province, Afghanistan, on December 15.
Martin Griffiths, the UN Emergency Relief Coordinator, said Afghanistan will not get through the winter on emergency aid alone.
"The need for liquidity and stabilization of the banking system is now urgent, not only to save the lives of the Afghan people, but also to enable humanitarian organizations to respond," he said in a statement on Sunday.
For Afghan families on the ground, there is nothing to do but wait for help to arrive. After 15 days of treatment, Nasrin was released from the hospital weighing just over 6 kilograms. The family returned home, where four more hungry children are waiting.
"I ask the international community to help all the poor who suffer from poverty and hunger," said Rauf, Nasrin's father. "If you don't help us, I will lose my children."
