Melissa Harris-Perry: I'm Melissa Harris-Perry, and we're back with The Takeaway.

Tedros Adhanom Ghebreyesus: "There has been a surge in cases of measles and diarrhea. Almost 50% of children are at risk of malnutrition, the resurgence of polio is a major risk, and 2.1 million doses of COVID-19 vaccine remain unused. 2,000 medical doctors and 1,500 registered nurses have left the country, and 600 private pharmacies have closed. Unless urgent action is taken, Afghanistan faces an imminent humanitarian catastrophe."

Melissa Harris-Perry: That's the Director-General of the World Health Organization, speaking this morning after the organization's return from a trip to Afghanistan. Public health experts and international aid organizations are warning that the healthcare system in Afghanistan is in danger of imminent collapse. The World Bank, the European Union, and other major international donors halted their donations to Afghanistan after the Taliban took control of the country last month.

The sudden loss of hundreds of millions of dollars could leave the war-battered nation with staffing and supply shortages. More than half a million Afghans have been displaced by the conflict, COVID-19 infections are rising rapidly, and healthcare facilities in nearly every province are closing. Joining me now is Deepmala Mahla, Vice President of Humanitarian Affairs for CARE, an international humanitarian organization fighting global poverty and world hunger. Deepmala, welcome to The Takeaway.

Deepmala Mahla: Thank you, Melissa. Pleased to be here.

Melissa Harris-Perry: We heard there from the WHO, but can you say a bit about what is happening on the ground even as we speak?

Deepmala Mahla: The situation, Melissa, is nothing short of dire. Let's remember the situation in Afghanistan, the humanitarian crisis, it did not happen on 15th of August. We are talking of communities which have been facing war for four decades. There are children who have known that the only way of growing up is in the middle of war, destruction, and being forced to flee from their homes. Amidst other things, the health system is really in inadequate shape, supplies are running out, fuel shortage is there, the coal chain is being compromised. The healthcare workers, they have not received their salaries, medicines are in shortage. The healthcare delivery system is on the brink.

Out of a country of 39 million people, at least 18.4 million are in need of humanitarian assistance. As we speak, Melissa, one million children are at the risk of falling into severe acute malnutrition. It is all very linked, and it's a catastrophe which the world has watched grow and deteriorate. The needs are only rising.

Melissa Harris-Perry: It's very helpful to hear you provide that longer timeline. I've been thinking, was this something that could have been predicted, this swift collapse of the healthcare system, but what I hear you saying is that it isn't necessarily swift, it's just that it's become more acute in recent weeks?

Deepmala Mahla: Absolutely. In the recent week, the existing humanitarian crisis has been exacerbated. Of course, we're talking about the health system. There are also high food insecurity, millions of people are going hungry. When people wake up in the morning, several of them have no idea where they will get food from. Forget about where, will they get food at all? Will they have safe water to drink? Will they have a safe place to sleep? When people are forced to flee and displace, just think about it. Why would somebody run out of their homes in ambiguity, uncertainty, amidst insecurity? Because that journey seems safer than their own home.

Yes, the humanitarian agencies have been predicting the deterioration, for example, in the food security situation in the rising projected numbers of people needing humanitarian assistance has been there. It is not something which has happened overnight, we could have prepared and responded better, but now there's no time for empty words; that time is long gone. Time to act, everybody together right now. There's too much at stake.

Melissa Harris-Perry: Okay. Let's talk about what can happen. I hear you saying empty words are insufficient, not enough, we don't have time for that. Talk to me a bit about what would be relevant. What are the kinds of interventions that are needed?

Deepmala Mahla: Absolutely. What we need right now is, as we say, all hands on deck. When we're talking of health system, it is related to food insecurity. Children who are into severe malnutrition, they need hospitalization. We are hearing from our partners on the ground, our colleagues, our teams - CARE has about 500 staff on the ground - there are children with whatever is left of hospitals, if you would give your hand to them they would not be able to grasp it because they're so weak. Poverty, drought, COVID-19, food insecurity, malnutrition, it all is coming together.

However, we have great lessons where humanitarian assistance has quickly averted or changed the course of a catastrophe. Continued and sustained funding, support to Afghanistan is really important, because I often worry once the headlines fade people's attention also deteriorates. This is something which will need some concerted efforts over the coming few years.

Melissa Harris-Perry: It's my understanding that at least part of what is happening in these intersections of collapsing healthcare that you've talked about, is also other infrastructure problems. The idea that those COVID-19 vaccines are sitting there but are unused, that that isn't about just an unwillingness to distribute those vaccines, but that there is a real problem with the infrastructure to make it possible to get them to people.

Deepmala Mahla: Absolutely. For a successful humanitarian response, smooth supply chain and logistics are the backbone. One out of four hospitals that can treat COVID-19 have been closed only in the recent weeks. Then there are the issue of fuel shortage. The banking system, it is opening up but it is not fully functional. When there is not an efficient and smoothly running banking system, when fuel is short, this really hampers. When fuel is not there, electricity gaps are there, then the coal chain suffers. With all these multiplied complexities, the health system, the COVID response really gets very compromised.

Melissa Harris-Perry: Deepmala, can you talk to me a bit about how organizations like CARE, Doctors Without Borders, and other international aid organizations, what are the circumstances even for your workers right now in Afghanistan?

Deepmala Mahla: The circumstances are uncertain, but the organizations like CARE and the others that you name, CARE has been there since 1961, way before several of us were even born. That means we have strong relationships with the communities. We know the context, we know the area, we know the people, and over 98% of our staff are from Afghanistan. Not only from that country but from area. That gives us a strong understanding of what exactly the gap and needs are. It is very much possible. It is very, very much possible to respond to the humanitarian needs.

CARE, after a brief pause we have resumed our activities, but we need several enablers. Some of the main enablers are funding which is flexible, which is for emergency response, and longer-term. The banking system to be fully operational. Other infrastructure facilities like fuel and electricity to be there, and the most important thing: smooth uninterrupted, and safe humanitarian access. If aid workers are not safe, if aid workers are not able to reach-- Aid work by definition depends on aid workers.

If all these enablers are in place agencies like CARE can operate. We have been operating, we have resumed our activities. For example, earlier this week our teams were working in one of the provinces with farmers because there is a huge drought situation; a massive drought which really affected people's livelihood and health. Our teams have been working with them on legume production. So things are possible, very much possible. We just need some more enablers, some more continued attention, and some more support.

Melissa Harris-Perry: Tell me what the specific aspects of that enabling and support look like.

Deepmala Mahla: For example, if a community is in need, let's say a family needs vaccines, some COVID prevention commodities like soaps, for example, the funding is available. There is an aid agency like CARE and others to deliver it. What is the one thing which is needed? That we are able to go into that community and come back, we being safe and the community being safe. This is what I mean by humanitarian access. If this is interrupted by security or other factors, it means that the wonderful people who urgently need aid, either the aid will be delayed or they will not be able to get it.

This is one of the biggest enablers, that humanitarian aid agencies must be able to deliver aid timely, safely, and uninterruptedly. I cannot emphasize enough the importance of the banking sector and fuel and electricity availability. Without money, we will not be able to turn around this really, really imminent humanitarian catastrophe.

Melissa Harris-Perry: Can you say just one more word for us about the particular impact this is having on women and children?

Deepmala Mahla: Women and children are bearing the brunt of the crisis, the pandemic, the hunger situation. Majority of the people who have been forced to flee their homes, and usually it's not once it is multiple times, it is women and children.

Melissa Harris-Perry: Deepmala Mahla, Vice President of Humanitarian Affairs for CARE. Thank you for joining us.

Deepmala Mahla: Thank you for having me.

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