How the children of Kabul are sacrificed to sexual politics of the West

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SIX MONTHS after nearly all the foreign aid agencies in Kabul shut down their operations in a confrontation with the Taliban authorities, the poor and destitute of the Afghan capital are paying the price.

The large sticker advertising the Duchess of York's charity, Children in Crisis, is still fresh and shiny above the entrance to the nursery department of the Indira Gandhi Memorial Hospital, Afghanistan's only dedicated children's hospital. But here the children are indeed in crisis, and the British charity is nowhere to be seen.

Last year its team arrived and began providing the filthy and desperately under-equipped nursery with drugs and medical equipment, including vital items such as incubators. "They worked with us for three months," remembers Dr Jelil Wardak, a surgeon at the hospital for the past six years. "But then they pulled out."

The confrontation with Afghanistan's Taliban authorities had been brewing ever since the Islamic fundamentalist army captured the city in September 1996. The Taliban's exclusion of women from education and jobs was repugnant to the West.

The women's issue brought intense pressure on governments and aid bodies to withdraw. But the crunch last July was over demands that the charities move to remote new premises. Since then the international community's position has hardened.

The European Union cut all funding and the Department for International Development, headed by Clare Short, warned that any charity returning to Afghanistan would automatically forfeit all British government assistance.

The department, which used to give pounds 8.5m a year for Afghanistan, stopped funding individual charities last year. It now says it is reconsidering the position.

Ms Short told the Commons last month that the humanitarian situation in Afghanistan, in terms of meeting basic physical needs, was "under reasonable control". But rudimentary health services have now collapsed in many places, and a hard winter has brought new problems with food supplies.

Now, with the temperature around freezing, most of the Indira Gandhi hospital has no heating. The Save the Children Fund has promised to supply fuel, but it is out of the country. The hospital has no drugs - Children in Crisis and other donors have packed up and gone. "Now the patients' relatives must buy what is needed from the bazaar," says the hospital's president, Jalal Nasruddin, "but most of them cannot afford them." The hospital has also lost the wherewithal to determine what the patients are suffering from. "When the agencies were working with us, we carried out 50 X-rays every day," says Mr Nasruddin. "Now we can only do five or six, strictly in emergencies, because we no longer have film."

Altogether some 40 agencies pulled out of Kabul, including the United Nations. Thousands of Afghans employed by the agencies were thrown out of work, bringing misery to them and their extended families. Many of them supported a dozen or more relatives on their salaries of US$70 to US$170 a month.

A water sanitisation programme was forced to close when the European Commission shut off funding. The departure of Children in Crisis and many other charities involved in healthcare has stripped the hospitals of drugs and left them floundering in the effort to help poor patients.

Today a handful of agencies, including the Red Cross, sustains a skeleton programme of food distribution and other initiatives. But the city pummelled to pieces during four years of bombardment is struggling to recover.

In a society where begging is taboo, destitute women in all-enveloping burqas prostrate themselves in the streets while their babies lie nearby. Young boys, shivering in thin clothes, roam the bazaars, begging for small change.

The bazaars are full of fresh fruit and vegetables, but catastrophic hyper-inflation puts them out of reach of the poor.

The hospital has an operating theatre, but lacks the equipment to carry out many common operations. "We cannot remove foreign bodies such as shrapnel," says Dr Wardak. "These cases have to

"be taken across the border to Peshawar in Pakistan for treatment." Whether the sick children are likely to survive the 12-hour trip over potholed roads, Dr Wardak is unwilling to venture.

The nursery's patients and their mothers are crowded into the one small room the department can afford to heat. The infants have septicaemia, jaundice and pneumonia.

A baby born with a neuro- abdominal condition has just been operated on by Dr Wardak, and is recovering in his mother's arms. The 10 mothers and their babies huddle round an electric fire and an old wood-burning stove that gives off evil-smelling fumes. "We desperately need proper heaters and heating oil," the doctor says. "The fumes from the stove are very bad, especially for sick children."

The confrontation that led to the departure of Children in Crisis and other agencies was brewing ever since Taliban became the masters of Kabul in September 1996, defeating and expelling the government forces. With their belief that women should be excluded from education, jobs and any other situation in which they might come in contact with men, the Taliban were never going to make a comfortable fit with aid agencies accustomed to having their Western assumptions about sexual equality respected and acted on.

Numerous crises erupted. As the United Nations' acting co-ordinator for humanitarian aid in Afghanistan, Bronek Szynalski, said in Pakistan last month: "Afghanistan is one of the most difficult places for the delivery of humanitarian assistance."

The last straw came in July, when Taliban demanded that many agencies move from their offices and homes in the city centre to an abandoned polytechnic in a western suburb. The agencies attempted to call the Taliban's bluff, threatening to leave the country if they were made to move. Infuriated, the Taliban sealed some of their offices and homes, effectively expelling them.

Six months later, with Kabul in the grip of bitter winter, it is hard to understand why the question of shifting premises was seen as a quitting matter when, as Mr Szynalski said last month, in the course of appealing for $185m for the UN's Afghan aid effort, "the needs are as great as ever before."

The polytechnic, next to the Hotel Intercontinental, is dirty and rundown, its grounds given over to grazing goats, but the structure is modern and sturdy and in relatively good condition by the standards of this martyred city. It even has electricity. Fleeing the country over such a matter tends to confirm the Afghan-in-the-street's cynical view. "Most of the agents are hypocrites," one student remarked. "They spent most of the money on themselves. Food, cars, houses - everything had to be the best. The people most affected by their leaving were the antique carpet dealers."