Access to water is a serious concern—many families can get no more than ten litres per person each day to cook, wash, and drink, below the minimum amount recommended even in the immediate aftermath of humanitarian emergencies. Work is hard to find, and without reliable sources of income, many families do not get enough to eat and cannot afford life-saving health care.
Life in close quarters in unhygienic conditions means that illness spreads easily, particularly among young children. Some of these slum areas have no health clinics at all; others are served by health workers once or twice a week.
Such mobile clinics often lack the expertise to address gynaecological concerns. Many women do not receive antenatal and postnatal care, and most give birth at home without skilled attendants, dramatically increasing the risk of maternal and infant death in a country that already has one of the world’s worst maternal and infant mortality rates.
The constant concerns about getting enough to eat, the threat of eviction, and the trauma of displacement take their toll. Women report that violence against women in particular occurred more frequently than before they had been displaced.
Education, which many families see as critical to a better future for their children, is often unavailable for displaced children. They may be refused enrolment or threatened with expulsion if they cannot produce a national identification card, a document that most Afghans do not have and which in practice they can obtain only in their home province. Some are turned away for wearing dirty clothes, an unavoidable circumstance given their families’ limited access to water. Informal schools are frequently the only option for displaced children, but such schools do not always offer a full curriculum and may employ staffs who lack basic qualifications to teach.