Since January 2025, Pakistan and Iran have been forcibly deporting Afghans back to Afghanistan. About 1.86 million Afghans have been forced to leave Iran, while 314,000 have returned from Pakistan. The large-scale repatriation of Afghans raises numerous health concerns, as many returnees face serious medical risks resulting from the difficult journey back to Afghanistan. With a health system that is already under immense pressure from the lack of resources and funding, it is expected that the returning Afghans will further exacerbate the health system crisis.
The journey from Pakistan and Iran back to Afghanistan is physically and mentally difficult. According to the World Health Organization, “Commonly reported health issues among returnees include trauma, malnutrition, infectious diseases such as acute watery diarrhoea and acute respiratory infections, and mental health problems.”
The scene at the Pakistan border is a tough image: “toddlers with sunken cheeks and dehydrated skin, elders bent over in coughing fits, heavily pregnant women staggering through the dusty campus, some giving birth amid chaos.”
Zohra, an expecting mother, who crossed the border said “The journey was long and hot. I thought I would lose my baby on the road.”
There is an enormous human cost to forcing Afghans to return to Afghanistan. Zaher Qayumi is an Afghan father who was forced to leave Iran with his five children. All of his children are sick with diarrhea, dizziness, and heatstroke. Amid all the chaos, Qayumi says there are no public health services anywhere during the journey back to Afghanistan to help anybody.
There is a catastrophic health crisis at the Iran and Pakistani border with returning Afghans. Children and elderly are the ones who are hit the hardest and suffer.
Once Afghans reach the end of their journey and are back in Afghanistan, their health problems are continuous after enduring days of heat and being without adequate water and food. However, with the stark aid cuts in Afghanistan, Afghans still face challenges accessing basic services due to the fact that out of the $2.4 billion aid plan, only 12% is being funded for humanitarian services. Unfortunately, Afghan returnees are placed into an even more vulnerable position following their journey.
Currently, the healthcare system is not ready to meet the needs of Afghans because of the fact that many local clinics have closed with aid cuts and larger hospitals are overcrowded, understaffed, and underfunded. Halima Bibi returned from Pakistan recently and is concerned she would not find her insulin medication in Afghanistan. Bibi lives in the Nangarhar province where hospitals are overflowing with patients and doctors do not have the time or resources for chronic disease management.
Afghanistan is enduring a worsening health care collapse amid earthquakes and the continued assault on women’s rights. The physical and psychological toll on Afghans is deep, lasting, and demands urgent global attention.
Sources: Health Policy Watch