By Charlotte Greenfield and Mohammad Yunus Yawar

KABUL (Reuters) – In a bitterly cold bedroom at the start of winter in Kabul, 22-year-old Maryam sat with her son wrapped in a red sweater as he coughed days after being released from a hospital ward for a third time for suspected pneumonia.

Every time 10-month-old Rahmat’s parents bring him home from the overcrowded but warmer hospital, they say he’s getting sick again. The parents said they are spending everything they can, from their declining income to trying to heat the room, which drops below freezing at night.

“I’m afraid, it’s just the beginning of winter, what’s going to happen?” said Maryam, who said the family could only buy coal in small quantities and had to cut back on food to afford even that after her husband lost his construction job.

The family is one of many in Afghanistan who cannot afford adequate heating and often have to choose between food and fuel as an economic crisis grips the country.

Doctors and aid workers say thousands of children are being hospitalized with pneumonia and other respiratory ailments caused by the cold and malnutrition.

The crisis, aid agencies say, is likely to get worse. A ban on female NGO workers has led more than 180 international organizations to suspend operations in the crucial winter months, saying they could not operate in the conservative country without female staff to help women and children.

Even before that, more than half of the population depended on humanitarian aid after the economic shock caused by the Taliban takeover in 2021 caused Afghanistan’s GDP to shrink by 20% last year.

Afghanistan has been hit by cutbacks in development spending by foreign governments, the enforcement of Western sanctions and the freezing of the country’s central bank assets, which have severely hampered the banking system.

“Our patients have increased compared to the past, the main reason being the economy,” said Mohammad Arif Hassanzai, chief of internal medicine at Indira Gandhi Children’s Hospital in Kabul.

Hospital records showed that more than 6,700 children were admitted for pneumonia, cough, asthma and other respiratory illnesses in November, compared to about 3,700 in the same month the previous year.

Even before the winter months, the International Committee of the Red Cross (ICRC), which supports several hospitals in Afghanistan, said it had seen a 50% increase in the number of children under five admitted for pneumonia by 2022 compared to the previous year.

“People have died of pneumonia this year, including children,” said Lucien Christen, ICRC spokesperson in Kabul, adding that malnutrition contributed to children’s weakened immune systems.

Aid workers said pollution had also worsened this year as more people burned garbage and plastic for warmth.

In a hospital ward dedicated to pneumonia patients, babies lie in bed two or three, with worried parents and a handful of stretched medical staff supervising them. Some mothers held tiny oxygen masks in front of babies’ faces, while fathers crammed outside the hallways.

Suddenly a scream broke out. A month-old baby, Mohammad, stopped breathing and his lips turned blue. His panicked uncle, who was holding the child in a green blanket, was referred to a specialist emergency room two floors below. He ran downstairs, while the baby’s mother ran after him in tears.

In the high dependency unit, Mohammad was connected through his nose to an oxygen tube. The doctor said his condition was critical and would take five days to stabilize.

His mother stayed by the baby’s bedside. Her husband had lost his job and they couldn’t afford heating, she said. When she saw her son stop breathing, she said, “It felt like my own heart stopped.”

(Reporting by Charlotte Greenfield and Mohammad Yunus Yawar in Kabul; editing by Raju Gopalakrishnan)

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