Help is needed on all fronts. One in three Afghans don't know where their next meal will come from, UN Secretary-General Antonio Guterres said at the beginning of September. By next year, 97% of the country's nearly 40 million inhabitants could be living in poverty.

"The situation in the country is getting worse every day," Simone Pott, of the German aid organization Welthungerhilfe, told DW. Villages in the north of the country suffered greatly in fighting even before the Taliban took power two months ago. Schools and health clinics have been destroyed. "The situation for people, for families, is quite difficult," she says.

Physician Tankred Stöbe experienced this suffering firsthand. He was in Herat, western Afghanistan, at a Doctors Without Borders clinic just a few weeks ago, where he saw severely malnourished children and people coming to the clinic from other parts of the country because their crops had failed. "We treated an 18-month-old child who weighed only 3.5 kilograms and was practically dead," Stöbe tells DW. The clinic staff was working at its limit, treating 400 patients a day instead of the 200 it was designed to handle.

Aid organizations such as Doctors Without Borders (MSF), the Catholic Caritas and Welthungerhilfe often attempt to help in such situations. But all of these large organizations have faced problems since the Taliban took power in mid-August. Caritas and Welthungerhilfe have withdrawn all their international staff.

Stefan Recker currently manages Caritas' Kabul office from Germany. He says he wants to return as quickly as possible, but the security situation doesn't allow for it. "Street robbery in remote areas is a problem in a way it wasn't before the takeover. In Kabul, there have even been kidnappings of wealthy Afghans." Caritas leaders fear Recker would also be a kidnapping risk if he returned.

Collapsing economy

Caritas, Welthungerhilfe and MSF cite Afghanistan's collapsing economy as one of the biggest problems. Syed Moosa Kaleem Al-Falahi, head of the Islamic Bank of Afghanistan, one of the country's leading financial institutions, told the BBC recently that the Afghan banking system is on the verge of collapse. Long lines are already forming outside banks with people trying to withdraw their savings as cash runs short. Even before the Taliban took power, Afghanistan relied heavily on foreign funds. Now those funds are frozen due to sanctions.

This has had serious consequences for the health sector. MSF's clinic has been flooded with patients as government clinics have closed, Stöbe said. "Doctors haven't been paid for months. The Afghan health system has always been bad, but now what little there was is crumbling away. We are trying to absorb it, but we can't." 

MSF had planned to close its COVID-19 clinic, but, now that another hospital has closed, the organization has instead decided to increase the clinic's size.

Women living in fear

Women in Afghanistan are suffering not only because of the economic decline, but also because of the Taliban's takeover. In many places, girls are no longer allowed to attend secondary school or study at university. Aid organizations are also feeling the effects. "We have many young unmarried women working for us," says Recker of Caritas. "They are afraid of being forced into a marriage with a Taliban fighter." As a result, they no longer come to the office and try to work from home. Though the danger is greater for women, men also live in fear. According to Recker, Caritas has introduced a special shift system so that not all local employees have to come to the office and they can work from home as much as possible.

Welthungerhilfe is also seeing changes for women. "In the north of the country, there are many households headed by women," says Simone Pott. These families in particular face major problems, she says, because the women cannot go out without male accompaniment and also have no income.

Looming over all these developments is the upcoming winter, which aid organizations fear will make the situation even worse. Welthungerhilfe is currently planning so-called winter aid. Blankets are to be distributed along with hygiene kits for women with sanitary pads and water. But here too the organization faces logistical problems. "How do we pay for the blankets seller? How do we get these things across the borders," says Pott. "It's a real logistical challenge. We're in talks every day and struggling to figure out how to do this."

Negotiations with Taliban

Welthungerhilfe could have international staff on the ground to help soon. According to Pott, the organization has written confirmation from the Taliban that Welthungerhilfe will be allowed to provide humanitarian assistance in all provinces. "We are looking very carefully at the conditions that would allow staff to return," Pott says. "We are planning to return in the next few weeks." But he warns the situation in Afghanistan could change at any moment.

For Caritas, the situation is still too unstable to send international staff back to the country. This is mainly because the Taliban is a heterogeneous group, Recker says. "The leadership, who are also negotiating in Doha, say one thing. But the foot soldiers, who have their own interests, do another." That has led to local staff being insulted and threatened, even though the leadership say Caritas can work in the country. More radical subgroups won't necessarily follow that line. Recker says the situation "would have to become more coherent” for their staff to return.

For the people on the ground, this means continued suffering. Even if the aid organizations are eventually able to have international staff on the ground again, there is a problem of liquidity. Because of sanctions and the banking crisis, even large organizations cannot pay their local staff's salaries. Recker believes the United Nations should be the solution. "The UN could act as a bank for us in Afghanistan. That means the United Nations would bring money to Afghanistan in its planes. In principle, we could pick it up there and use it to finance aid programs. But behind that are negotiations that take time."

One-time payments are supposed to provide relief. The EU announced billions in aid for Afghanistan ahead of a special G20 summit. "The will of the international community to help is there," Pott said.

Stöbe is more critical. As long as the sanctions are in place, he said, one-off payments are no use. In the end, it is the people of Afghanistan who will suffer.