This year, over 1.5 million Afghans have already come back. No-one had anticipated such high figures. All these people need food, shelter, drinking water and jobs. The country is nowhere near able to handle this. Many have simply exchanged one calamitous situation for another and are desperately searching for any means of survival - also in the South, where the persistent drought creates further complications. Many Afghans have lost their livestock to this four-year-long drought. The Kutchis, Afghan nomads, have been hit particularly hard because they depend on camels, donkeys, goats and sheep.

'Sand devils' they call them. Small whirlwinds that sweep across the dimensionless plain, sucking the sand into twenty-metre-high spirals and blowing it away. Coupled with a strong rising wind, they are a real source of hardship to the Afghans in Zhare Dasht - which is not just the name of the region but also of a new accommodation for 60,000 Afghans due to be transferred here by the UNHCR from the Pakistan-Afghan border.

The Yellow desert

'Zhare Dasht' is Pashtun for 'Yellow Desert'. The area lies in the Sanzari district, over an hour's drive to the west of Kandahar in the south of Afghanistan. Since mid-August this has been the operational area of an MSF team based in Kandahar. It is the site of the latest of the four projects which MSF is implementing in the south of Afghanistan with a team of seven international and over 70 Afghan staff members.

Combat medical crises

MSF has been active in this region since 1995. Over the years, various immunisation programmes have been carried out as well as projects to combat malnutrition and prevent outbreaks of cholera, malaria, meningitis, typhoid, measles, dysentery and other contagious diseases. This is a difficult logistical environment because of its isolation; a difficult cultural environment because of the conservatism; and a difficult political environment because of the years of Taliban domination. Working from Kandahar, the Taliban took control of virtually the whole of Afghanistan until they were driven out by the US-backed Northern Alliance at the end of 2001.

A new reality

This period did not pass unnoticed by MSF. In October 2001, the project in Kandahar came to a standstill because the Taliban commandeered the MSF office. The international staff had already been evacuated but the national staff could not continue the work without office assistance. After the Taliban was ousted and a caretaker government was installed in Afghanistan the team could slowly but surely return and re-start the project. The office was restored to normal, missing supplies were replenished and, in the months that followed, MSF assessed the scope for new projects. The situation had changed significantly.

Devastating drought

Hundreds of thousands of Afghans had taken to the road; not only internally, but also in neighbouring Iran and Pakistan, which had taken in millions of Afghans since the Soviet invasion in the early eighties. Now a new group of Afghans were on the move: fleeing the bombing and the inevitable ethnic tensions, and also the drought in the South. The drought in particular led to many problems with disastrous consequences which, in recent years, have been consistently under-addressed by the media - who were more interested in the political aspects of the story. 

These hildren are playing with selfmade toys - all toys were forbidden under the Taliban. At the start of 2002, Pakistan and Iran exerted increasing pressure on the Afghan refugees to return to their homeland. Many Afghans did so. The sudden, relative freedom in their country had inspired optimism, but the host countries had also given them a push. As a result, so many people returned that UN organisations such as the World Food Programme (WFP) and the UNHCR could barely cope.
 

Misplaced optimism

At the start of 2002, Pakistan and Iran exerted increasing pressure on the Afghan refugees to return to their homeland. Many Afghans did so. The sudden, relative freedom in their country had inspired optimism, but the host countries had also given them a push. As a result, so many people returned that UN organisations such as the World Food Programme (WFP) and the UNHCR could barely cope. This year, over 1.5 million Afghans have already come back. No-one had anticipated such high figures. All these people need food, shelter, drinking water and jobs. The country is nowhere near able to handle this. Many have simply exchanged one calamitous situation for another and are desperately searching for any means of survival - also in the south, where the persistent drought creates further complications.

Many Afghans have lost their livestock to this four-year-long drought. The Kutchis, Afghan nomads, have been hit particularly hard because they depend on camels, donkeys, goats and sheep. The harvests have been meagre for years in the South. Some experts say that the groundwater level falls by two metres per year. Dry riverbeds, encroaching desert and wells that need to be dug ever deeper - sometimes to a depth of 60 metres- are making life so hard in this part of the country that many Afghans have become completely dependent on international aid. According to the latest estimates, some 400,000 Afghans are wandering around in the South, searching for food and shelter. The UNHCR reckons that next year over one million Afghans will also return from neighbouring countries to face an uncertain future.

Ethnic and political tensions

Politics also plays a role. Since October 2001, over 60,000 Afghans have been living around the town of Chaman on the southern Pakistan-Afghan border. Half of them had fled from the drought and the war in the South. Many of these are Kutchis. The other half comes from the North.

These are Pashtuns, trying to escape the ethnic tensions that erupted shortly after the war against terrorism began. Uzbeks and Tajiks took revenge on the local Pashtuns because they suspected them of supporting the Taliban. The Pashtuns fled towards the South, where their tribe is in the majority, and ended up in the border area along with the Kutchis, looking for help and protection.

No man's land

The first group, a few ten thousand, were lucky. Though Pakistan had officially closed the border, it was still allowing a lot of Afghans through. These were taken to various official refugee camps on the Pakistani side of the border where they received the help they were entitled. MSF runs official programmes in two of these camps: Rhogani and Lande Karez. Another group of around 25,000 Afghans were less fortunate when they attempted to cross the border at Chaman in February 2002. They were stopped and since then have been stuck in a piece of no man's land, practically on the border but just on the Pakistani side. They have been living in a chaotic camp where it took a long time to get aid started. MSF was present there from the outset to provide the people with medical support (vaccinations, basic healthcare and the like) and to tackle the presence of malnutrition among the children. Then there is a third group of some 35,000 Afghans on the Afghan side of the border, dispersed over five camps around Spin Boldak, near Chaman. As they are still in Afghanistan, they are not official refugees but internal displaced persons. MSF is running a clinic here.

Under pressure

The Afghans in the official camps are the best off. The 60,000 in the no-man's land and around Spin Boldak have much more to endure. The Pakistani and Afghan authorities want to get rid of the Afghans and have exerted so much pressure on the UNHCR to move them that there is now a plan to transfer them to Zhare Dasht. New accommodation is gradually being built there in the middle of the desert. There are no facilities for miles, so everything needs to be built from scratch. Though MSF believes that everyone has the right to cross a border and apply for refugee status if they have good reasons to do so, MSF have also started setting up medical facilities in Zhare Dasht in order to assist those who are being relocated.

MSF staff have been working with this group since last October and simply cannot abandon the people to fate, especially since there are no other organisations or facilities to provide medical support. The first group - around 500 - arrived on August 15. By September the numbers had swolen to 5,000.

The UNHCR is transporting them in trucks from the border area to Zhare Dasht, where they are registered by the International Cathoilic Migration Commission (ICMC), an aid organisation called in by the UNHCR. Registration entitles them to food support, a piece of ground with a tent as well as various items such as a tarpaulin, wheelbarrows, spades and jerry cans. After the registration, they are given a medical examination by an MSF team. The children are vaccinated against measles and polio.

They are also given vitamin A and are being screened for malnutrition. The ones who are malnourished are admitted to a special programme that devotes extra attention to them so they can quickly build up their strength through a special feeding programme, combined with medical supervision.  It takes a lot of water to support 60,000 Afghans. Each person needs, on average, 20 litres a day to cook, drink and wash a little. Water consumption in the western world is over 200 litres a day. Twenty litres is considered the absolute minimum. But it is nowhere near enough to spray the soil and maintain the crops. Much more is needed for that. No-one knows how much water is under the ground and how long the water level can meet the demand. The success of Zhare Dasht will depend on the long-term availability of water.

Building a new life

In this dry plain the Afghans must try to build a new life. Some may want to return home to the North, but they are still distrustful. They feel it is still dangerous and want to stay in the South for the time being. The Kutchis can do nothing without livestock. Where could they go without the means of subsistence? They could build up a new life in Zhare Dasht. There are various organisations in the area. UNICEF is starting schools, the WFP is distributing food and MSF has started a large clinic at a central point. In addition to initial medical registration, this clinic will provide medical assistance to the Afghans currently living in Zhare Dasht: basic healthcare, monitoring of the therapeutic feeding programmes for the children, support for pregnant women and new mothers, tackling of dehydration and an ambulance to take patients to Kandahar if they cannot be treated in the clinic.

Dry as bone

But the success of Zhare Dasht depends on the availability of water. Many wells have been dug but most of them are useless because they are too shallow. People are really just muddling along. The wells are going to be worked on again and efforts will be made to dig deep enough so that they can cope with the demand for water. The earth is dry as a bone, but fertile. Inevitably, water is spilt now and then at the wells that are actually working. Grass is shooting up. But it takes a lot of water to support 60,000 Afghans. Each person needs, on average, 20 litres a day to cook, drink and wash a little. Water consumption in the western world is over 200 litres a day. Twenty litres is considered the absolute minimum. But it is nowhere near enough to spray the soil and maintain the crops. Much more is needed for that. No-one knows how much water is under the ground and how long the water level can meet the demand. The success of Zhare Dasht will depend on the long-term availability of water.

Still much to be done

In the meantime, people are getting by in this vast dry plain. Winter is approaching. This means sub-zero temperatures in the south - but no snow. Just as well, you might say. But this is exactly what would help the south to pick itself up. Snow or rain, it makes no difference. Snow brings melted water and water is what the south needs. Apart from national stability and security, water is the only solution for the hundreds of thousands of Afghans who are still dependent on aid. But the prognosis is grim. And the longer the drought continues, the more Afghans will flee the area. This is why MSF is working there: to help the people, but also to make sure this group is not forgotten. A new government and an international military presence do not necessarily mean that the problems are solved. On the contrary.