The BBC is investigating the death of Afghan mothers after US aid cuts

When Shanaz fell into contraction, her husband Abdul called for a taxi and took her to the only medical facility that had access to them.

“She hurts quite a bit,” he says.

A 20-minute drive away, the clinic was located in Sheshpol Village, northeastern Badakhshan province, Afghanistan. It was where their two older children were born.

Abdul sat next to Shanaz and comforted her by running through the gravel truck for help.

“But when we arrived at the clinic we realized it was closed. I didn't know it was closed,” he said.

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Sheshpol's clinic, one of more than 400 healthcare facilities to be closed in Afghanistan, one of the world's poorest countries, after the Trump administration cut almost all US aid earlier this year, and made a dramatic and rapid movement after the demolition of the US Agency for International Development (USAID).

A one-storey structure with four small rooms, white paint peeling off the walls, and the Shesh Pol Clinic has USAID posters everywhere with information and guidance for pregnant women and new mothers.

It's not very visible, but in the mountainous region of Badakshan, lack of access is the main reason for historically high maternal mortality rates, and clinics were an important lifeline and part of a wider programme implemented during the tenure of the US-supported government in the country to reduce mother and newborn deaths.

There were midwives trained to help with about 25-30 delivery times a month. They had medication and injection stock and also provided basic healthcare services.

Other health facilities are only too far from Abdul's village, not without the risk of Shanaz traveling on bumpy roads. Abdul also had no money to pay for longer trips – borrowing the cost of a taxi to 1,000 Afghans ($14.65; £12.70) is about a quarter of his monthly income as a worker. So they decided to go home.

“But the baby was here and we had to stop by the side of the road,” Abdul said.

Shanaz delivered their baby girl to the car. Shortly afterwards, she died and suffered heavy bleeding. Hours later, their baby also died before she was named.

“I cried with tears. If the clinic had been open, my wife and children could have been saved,” Abdul said. “We were struggling, but we lived together. We were always happy when we were with her.”

He doesn't even have a picture of Shanaz holding his grip.

If the mother and baby were treated in the clinic, there is no certainty that they would have survived, but without that, they would not have maintained their chance.

For decades, the United States has been the largest donor to Afghanistan, and in 2024 US funds surprised 43% of all aid coming to the country.

The Trump administration justified it to withdraw it by saying, “There are many credible and long-standing concerns that funds govern the country… have benefited terrorist groups, including the Taliban.” The US government added that at least $11 million has “sucked and enriched the Taliban.”

The report, referenced by the US State Department, was made by the Special Inspector for the Reconstruction of Afghanistan (SIGAR). A USAID partner said $10.9 million of US taxpayers have been paid to a Taliban-controlled government in “tax, fees, obligations, or utility.”

The Taliban government has denied helping the money is in their hands.

“The allegations are not true. Aid is given to the United Nations and through them to the NGOs in the state. They identify who needs the assistance and distribute it themselves. The government is not involved.”

The Taliban government's policies, particularly restrictions on women in the world, mean that after four years of power, it is still unrecognised by most of the world. It is also the main reason why donors are walking more and more away from the country.

The US claims that no one has died because of aid cuts. The deaths of Shanaz and her baby are no longer recorded anywhere. Neither is a myriad of others.

The BBC has documented at least half a dozen directly devastating accounts in areas where the USAID-supported clinics have been closed.

Right next to Shanaz's grave, the villagers gathered around us pointed to the other two graves. They told us both Daurat Begi and Javar, a woman who died during the birth in the last four months. Their babies survived.

Not too far from the cemetery, his wife, 36-year-old Guruyan, met his wife, Khan Mohammad, whom he gave birth five months ago. Their boy, Safiura, passed away three days later.

“When she got pregnant, she went to the clinic for a medical check-up. But in the middle of her pregnancy it was closed. During the birth, she suffered a lot of pain and blood loss,” Khan Mohammad said. “My children are always sad. No one can give them the love of a mother. I miss her every day. We lived a sweet and loving life together.”

Maidamo's sad-stricken father, Ahmad Khan, showed the room in mud and clay house, and about five hours drives from Shesh Pol, Kaugani, another village where Ahmad Khan, whom she is giving birth to baby Kalima, was closed.

“If the clinic had been open, she might have survived. And even if she had died, we wouldn't have regretted knowing that Medic did their best. Now we left with regret and pain. America did this to us,” he said.

In another house with a few lanes, Bahisa tells us how horrible it was to give birth at home. Her other three children were born at the Kaugani Clinic.

“I was very scared. There was a midwife, medication, injections in the clinic. There was nothing at home, no painkillers. There was no unbearable pain. Life felt like I was leaving my body.

Her baby girl, named Fakiha, passed away three days after she was born.

The closure of clinics in the village has resulted in a surge in cases in the maternity wards of major regional hospitals in the rural capital Faizabad.

It is dangerous to reach it through the dangerous landscape of Badakshan. We were shown a horrifying photo of a newborn baby who had been born on our way to Faizabad, and his neck was squealed before he went to the hospital.

We visited the hospital in 2022, and while it was stretched, the scene we saw this time was unprecedented.

Each bed had three women. Imagine going into work, or simply going through a miscarriage and not having a bed for yourself.

That's something Zura Shewan had to endure after suffering from a miscarriage.

“I was bleeding so badly and didn't even have a place to sit. It was really tough. By the time the bed is free, women can bleed,” she said.

“There are 120 beds in the hospital. We currently accept 300 to 305,” said Dr Shafik Hamdad, director of the hospital.

The patient load is swollen, but hospitals are also facing rapid cuts in funding.

“Three years ago, our annual budget was $80,000. Now we have $25,000,” Dr. Hamdard said.

By August this year, as many mothers' deaths had been recorded as they were in the whole of last year. So at this rate, maternal mortality could increase by 50% compared to last year.

Newborn deaths have increased by about a third over the past four months compared to the beginning of the year.

Razia Hanifi, a midwife at the hospital, says she is exhausted. “I've been working for the past 20 years, and this year is the toughest due to overcrowding, lack of resources and lack of trained staff,” she said.

However, there are no reinforcements due to restrictions on women from the Taliban government. Three years ago, all higher education, including medical education, was banned for women. A year ago, in December 2024, training for midwives and female nurses was also banned.

In a modest place, I met two female students who were in the middle of training when the training was closed. They didn't want to be identified for fear of retaliation.

Anya (name changed) said that when the Taliban took over, they were both taking part in graduate courses at the university. When they closed in December 2022, they began nursing training with midwives as it was the only path to getting education and work.

“When that was also prohibited, I was depressed. I was crying day and night, and I couldn't eat. It's a painful situation,” she said.

Karishma (name changed) states: “Afghanistan already has a shortage of midwives and nurses. Without training, women are forced to give birth at home.

We asked Taliban government Suhail Shaheen how to justify a ban that effectively suppresses access to health for half the population.

“It's our internal issues. These are our problems, how we handle them, how we consider them, how we make decisions, this is something internal. It depends on the leadership. They make decisions based on the needs of society,” he said.

Access to health services is severely restricted by waves of crushed blows for women in Afghanistan, their rights to health, and their lives themselves.

Additional reports, photos, videos: Aakriti Thapar, Mahfouz Zubaide, Sanjay Ganguly

The image above shows Shesh Pol's daughter and son and Abdul.