The situation is similar across Afghanistan. The Taliban have concentrated resources on eliminating opposition to their rule. There has been little investment in the economy, infrastructure or projects to provide for the basic needs of people who have endured 20 years of war. Hundreds of millions of pounds of international aid, funnelled through the United Nations and non-governmental organisations (NGOs), has filled the gap. Now, with almost all foreign workers quitting Afghanistan for their own safety, the future of their work is uncertain.
The UN has even said it may pull out of Pakistan, which would cause huge disruption to the aid programme. Since the missile strikes, UN workers in Islamabad have been told to restrict their movements and take, or prolong, holidays. At the moment most aid work in Afghanistan is continuing with local staff. But it is unclear how long they can continue without support of expatriate specialists on the ground.
"In the short term, things are carrying on without too much disruption," said Sarah Russell, of Unocha, the UN body that co-ordinates aid to Afghanistan. "But it won't be sustainable over months, so it is very difficult to say what will happen."
The first problems will come when local staff need to be paid. The aid agencies employ tens of thousands of Afghan staff and their wages, paid in dollars, have been brought from neighbouring Pakistan, where most agencies have their headquarters.
Engineer Abdul Azim, an administrative officer for the Merlin British relief agency, said he was in daily contact with local staff by radio but added: "They will need money and we must provide it somehow. It is a problem we have yet to solve." Merlin, which was running basic healthcare clinics in two western provinces of Afghanistan, has pulled back all its expatriate staff. Westerners working at their office in Peshawar, in Pakistan, have been sent to Islamabad, Pakistan's capital, where it is thought there is less of a threat to their security. Peshawar is packed with recently evacuated aid workers.
There will also be problems reassigning workers when projects start to finish. New priorities need to be set and teams reorganised. Much can be done by radio but if there was an emergency, such as another earthquake, the situation would be grim.
Afghanistan depends on aid for much of its healthcare, sanitation and water supply. Thousands of people rely on food aid. Some face starvation this winter if they do not receive help.
The UN has appealed for $150m (pounds 91m) for aid for this year. So far only a third has been raised and questions are being raised over how willing donors will now be.
"It will be interesting to see what the Americans come up with. If they are feeling guilty then they may pour in a load of funds. Alternatively, people may just think Afghanistan is a basket case full of mad mullahs and give nothing," one senior aid worker said. A big issue for the Americans will be the Taliban's attitude to opium-growing. One of the projects that will be hit by the recent strikes is the UN Drug Control Programme (UNDCP), which, backed by American funding, is trying to reduce the amount of opium - the key ingredient in heroin - grown in Afghanistan. Last year the opium crop in Afghanistan totalled 2,500 tonnes, making it, with Burma, the world's biggest producer. The UNDCP is trying to get farmers to grow alternatives.
But since the missile strikes a key UNDCP office in the eastern city of Jalalabad has been closed and work restricted elsewhere. Expatriates responsible for monitoring the spread of the crop have been pulled out. The missile strikes are the second important blow to the aid operation in the country. Last month disagreements over a plan by the Taliban to relocate all the NGOs in Kabul to the dilapidated buildings of the former polytechnic led to the forced expulsion of almost all aid workers from the capital.
Most European Union aid is already suspended. The renewed fighting in the north has also caused serious problems for organisations helping the earthquake victims.
As ever, those who may suffer most are those least able to afford it. Many of the bigger projects are run through government departments.
The UN Children's Fund has been working with the Taliban Ministry of Rehabilitation and Rural Development to provide safe water supplies and sanitation.
In the absence of foreign workers the ministry provides a crucial management structure although, controversially, the Taliban take much of the credit for any improvements. But most projects merely operate at the local, community level where the lack of overseas input will cause more serious difficulties.Reuse content