Afghanistan: the only choice is to stay

Credits: INTERSOS/Nava Jamshidi

Afghanistan continues to deal with the consequences of four decades of conflict. Several factors combine to exacerbate the humanitarian crisis in the country: the economic crisis, drought and other climate change-related problems exacerbate the fragilities associated with protracted internal instability and international isolation. It is estimated that 23.7 million people will be in need of humanitarian assistance during 2024, more than half of the Afghan population. With the support of the European Union, INTERSOS is addressing the health and protection needs of the most vulnerable people.

Working in the country since 2001, INTERSOS has a long-standing working experience in Afghanistan with three operational offices: Kabul, Kandahar and Qalat, covering the needs of 3 provinces and 7 districts, concentrating its intervention on remote and hard-to-reach areas, where people’s needs are constantly increasing and where decades of conflict have compromised access to essential services. In a complex operating environment, in which it is essential to maintain the centrality of an approach based on humanitarian principles, our commitment is to remain in the country and ensure access to assistance for the entire population, particularly women and girls.

The humanitarian crisis in Afghanistan is one of the worst in the world. The United Nations reports that more than half the population faces severe food security problems, with children and women particularly vulnerable. The United Nations Development Programme (UNDP) has estimated that by the end of 2022, the number of people living in poverty in Afghanistan has grown to 34 million, an increase of 15 million compared to 2020. The situation is particularly severe in the most remote areas, where humanitarian access is limited and resources are even scarcer.

In a country that has continued to depend on humanitarian assistance for decades, many Afghans have been forced to reduce the quantity and quality of food consumption, abandon medical care, and sell family possessions. Child labour has increased, many people have had to borrow more and more money, and in some cases have gone as far as selling their organs.

To deal with this extremely complex humanitarian crisis, INTERSOS’ strategy is to prioritise the most urgent humanitarian problems such as widespread food insecurity and malnutrition, which mainly affects children and women, the lack of access to health care – some rural areas are in fact more than two hours away from the nearest health facility – and problems related to the humanitarian protection of individuals or groups exposed to various forms of vulnerability and exclusion, and therefore more at risk of suffering physical and psychological damage. 

Credits: INTERSOS/Martina Martelloni

Malnutrition and lack of care

According to the IPC – Integrated Food Security Phase Classification, which delineates food insecurity into five distinct phases (minimal/none, stressed, crisis, emergency, disaster/hunger) – an estimated 15.8 million people are now at crisis level, with millions suffering from acute malnutrition, particularly children under five, pregnant women and lactating women. Access to basic health care in the country is limited, due to the severe shortage of medical facilities and equipment, and the small number of health personnel.

Vulnerable groups, particularly women, children and displaced persons, are at greater risk of morbidity and mortality due to poor maternal and child care, difficult access to vaccinations and treatment for communicable diseases, with an estimated 17.9 million people in need of treatment. INTERSOS provides pregnancy health care and support for safe deliveries for women: our midwives, as part of the EU-funded project, assisted 7,920 women in giving birth.


Pregnant women attended antenatal care sessions


Individuals screened for malnutrition


Primary health care consultations


Child births attended

Credits: INTERSOS/Martina Martelloni


People reached through protection services


Children attending child-friendly spaces


Psychosocial Support (PSS) counselings

Gender-based violence and child exploitation

In addition, there are still very high numbers of displaced people, risks of gender-based violence, child labour and the presence of mines and explosive devices in Afghanistan. It is estimated that 20.8 million people in the country are in need of humanitarian protection services. In this regard, INTERSOS intervention offered support to those facing the greatest vulnerabilities due to conflict and displacement in southern Afghanistan.

With the support of the European Union, we reached 106,087 vulnerable people with activities ranging from case management for survivors of gender-based violence (GBV), to the protection of children and people with various vulnerabilities (Persons with Special Needs), including people with disabilities, chronic medical conditions, the elderly and women at risk. Through the establishment of family protection centres, INTERSOS provided psychosocial support (PSS), legal assistance and awareness-raising activities for communities.

The integration of protection services into health and nutrition activities aims to ensure a holistic approach to safeguard the dignity, safety and rights of the populations most at risk. In particular, INTERSOS addresses the growing challenges of health care and malnutrition among vulnerable populations in the provinces of Kandahar and Zabul. We provide essential services including primary and secondary health care, covering different needs, from sexual and reproductive health to nutritional support.