Changes are being urged to plans for returning thousands of Afghan citizens from Pakistan to make the process more effective.
While Pakistan has delayed the expulsion of some 850,000 documented Afghan refugees to Afghanistan, a senior Red Cross official is appealing for the returns to occur "in a more staggered way" so Afghanistan can better absorb the enormous influx of people.
"It will be important to work with the government of Pakistan in 2024 to ask that if there are going to be returnees," that they arrive "in smaller numbers at a time just so it is more manageable on the Afghan side," said Alexander Matheou, regional director, Asia Pacific Region for the International Federation of the Red Cross.
Speaking in the Qatari capital, Doha, Matheou told journalists in Geneva on Friday that he had just concluded his fifth visit to Afghanistan since the autumn of 2021, shortly after the Taliban takeover of the country.
He said the challenges facing Afghan returnees from Pakistan was one of several pressing issues he discussed with de facto Taliban rulers.
"You will be aware that over half a million have crossed the border over recent months, and it is likely that we will see large numbers of new arrivals in the coming months," he said.
"I imagine this is probably the largest population flow in a short period of time in Asia since the population movement from Myanmar into Bangladesh in 2017," he added. "So, it is a significant event."
Returnees ill-equipped to start over
Since October, Pakistan has expelled more than 500,000 Afghan refugees who lacked proper documentation. In a second phase of expulsions, which has been temporarily halted, more than 850,000 Afghans holding identification cards issued by the Pakistani government are slated to be forcibly deported.
Matheou notes many of the returnees have lived in Pakistan for decades and are ill-equipped to begin a new life in a country that to them is unknown, without government or international support.
The humanitarian effort is, he said, " largely concentrated on trying to help people on arrival at transit stations near the border. He added that the real challenges start once people move away from those transit areas.
"When we interviewed the returnees themselves, it was also clear that most had no idea how they were going to settle in their point of destination or how they were going to build a livelihood with nothing," he said. "They largely expected to be living with distant relatives, which would actually make very, very poor people some of the poorest communities in the world, even poorer."
Children make up half of returning Afghans
Matheou described the returnees as being in generally poor health, especially the children, who account for nearly half of all returnees.
"The evidence of that was we visited clinics where they reported a real spike in cases of acute malnutrition coming from the arrivals from Pakistan.
"We visited routine immunization programs of the IFRC and the Afghan Red Crescent in the villages, and there it was clear looking at the children that as well as being anemic, you could see wasting and stunting among the children," he said.
Wasting in a child is a condition that increases the risk of death and requires intensive treatment and care.
While Afghanistan is a country with multiple challenges, Matheou said there have been a few positive changes since the Taliban came to power.
"There are still plenty of security incidents going on in Afghanistan every day or most days, but the security on the whole is better than it has been for decades, and on the surface it is peaceful, and this is clearly deeply welcomed by a war-ravaged population," he said, noting there is also a welcomed commitment to reduce theft and corruption.
Human rights crises remain
While security has improved, however, he said the country's humanitarian and human rights crises remains severe. That is most clearly manifested in the mental health crisis afflicting the population.
"Beneath those crises, there is an invisible crisis of hopelessness, depression, desperation that stem from a collapsing health service, mass unemployment, barriers to education, and frustrated boys, girls, men, and women who are stuck at home all day.
He said the IFRC has a staff in two to three of the provinces of Afghanistan, but the work of ministering to the physical and mental health needs of the population was done primarily through the Afghan Red Crescent.
Despite the Taliban ban on women's participation in work and education, he said, "We try to ensure that our work is gender balanced. We employ women in all our health, mental health, primary health services, as well as services for women-headed households."
He warned, though, the outlook for Afghanistan is bleak. If the Taliban does not change its discriminatory policies against women, he said it will be difficult to get the kind of funding needed to turn Afghanistan into an economically viable society.
"The future of where the next generation of doctors and nurses will come from, where the next generation of teachers will come from, and where employment generated for families to be economically independent and hopeful about the future is looking quite grim," he said.
