An Afghan family is covered with blankets outside the Directorate of Disaster, in Herat, where about 2000 internally displaced people have gathered. Photo / Petros Giannakouris, AP
OPINION
If you knew the sale of one of your children would prevent the rest of your children from dying, would you do it?
For a moment, let's put aside the shocking reality that in Afghanistan you can even purchase a child, a practice now increasing in response to thedire hunger situation in the provinces where my emergency response staff work.
David Beasley, chief of the UN's World Food Programme, recently pleaded on the BBC for world and business leaders to step up and donate. "For the wealthy it comes down to a decision to donate. For Afghan parents it's a choice of which child to sell for food."
The situation in Afghanistan is so bad that my dedicated national emergency response staff have now set up an in-office staff fund to prevent families selling their daughters.
They know those girls, often incredibly young, who are to be married to older men or sold into servitude and vulnerability. Although these practices took place before the Taliban came to power, it has now worsened due to the hunger crisis.
My staff recently heard of one father who tried to leave his children at a mosque.
This is happening because the food assistance programmes are being outpaced by the growing numbers of people facing starvation.
Afghanistan is now facing its worst hunger crisis in living memory. The latest stats show more than half of the 40 million population faces acute levels of malnutrition and children are dying. Almost nine million people are on the edge of starvation. In this context, untold numbers of children will be begging, married off into violent homes, forced into dangerous and exploitative work and pulled from school.
Winter is now what everyone fears, as things will get much worse, fast. Soon snowfalls will prevent access to remote areas which could then be cut off for up to four months.
World Vision has been on the ground for 20 years, undertaking a range of humanitarian and development work, but the activity that is most critical at this moment is providing emergency nutrition via 15 mobile health clinics. Of the 3600 children aged under five we treated in Herat and Ghor provinces in October, 808 had moderate acute or severe acute malnutrition while 2694 received treatment for acute respiratory infections.
Medical staff measure the arms of children as an indicator of how malnourished they are. The weakest go to specialist nutrition wards in hospitals. Those wards are filling with children, sometimes several to a bed, and deaths are increasingly commonplace.
We also distribute food from the World Food Programme to those living in the remote and mountainous provinces in Western Afghanistan. These areas are marked "emergency" red on a map managed by global food security experts who have assessed the food situation.
In fact, most of Afghanistan is now red - and just one step away from "famine" black.
The situation was bad before the Taliban took control of Kabul in August.
Drought, very probably worsened by climate change, and ongoing conflict that had displaced tens of thousands, created the initial conditions for this crisis. But an already bad situation has significantly worsened.
International funding that supported crucial sectors such as health and education and development has largely been suspended; there has been an implosion of the health system due to the World Bank halting normal funding for salaries and running costs of hospitals and clinics; and sanctions, counterterrorism measures and restrictions placed on cash flows to Afghanistan have resulted in a funding and liquidity crisis.
In response to this crisis, thousands of people are trying to leave Afghanistan to escape the crisis or to find work and send money home.
Left unaddressed, this crisis could end up on Europe's doorstep in the way the Syrian conflict did back in 2015, when conflict and food aid cuts provoked mass migration.
Just as it took a massive international operation to help thousands evacuate Kabul following the Taliban takeover, it is going to take something similar among those humanitarian INGOs and UN agencies still in Afghanistan, to feed people over the coming months. They are ready to scale up.
In less than one month people across the world will be sitting down for Christmas dinner and unwrapping presents only to be confronted by images on their televisions of starving and emaciated children in impoverished Afghan villages.
There will be an outpouring of hand-wringing and generosity. But by the time you see TV pictures of starving children, it will already be too late. Getting food trucks through the mountain passes will be next to impossible. Those living in remote areas will die invisible deaths.
Children weakened by malnourishment will already be dying from the cold. When famine was finally declared in Somalia in 2012 many of the 260,000 people who eventually died had already done so. The scale of this crisis may be worse.
We must not let that happen again.
The time to act is now. The time to unblock life-saving funding is immediately. The time for giving is today.
• Asuntha Charles is national director of World Vision Afghanistan.