Afghan medical staff checking a child at a Doctors Without Borders clinic.

A year ago, Kabul residents navigated blast walls and roadside bombs. Now, five months into Taliban rule, Afghans fear hunger.
Some Afghans, out of desperation to feed their families, tell Insider they have donated a kidney for money or donated dangerous amounts of blood.
The United Nations has warned of a humanitarian "catastrophe" in Afghanistan if the international community doesn't offer emergency assistance.

In November, Jahish Sahar Samir posted to Facebook an offer to sell 100 books – a collection of poetry anthologies and novels that had been years in the making – for a mere 4,000 Afghanis, or about $38.

On Dec. 4, Samir posted another offer: "One kidney for sale."

Immediately, the 27-year-old novelist and teacher was inundated with messages of shock and disbelief, discouraging his plan.

"No one could believe it," he said in an interview. "They all thought I was joking. None of them took it seriously."

But like many Afghans this winter, Samir was growing desperate.

Over WhatsApp, Afghans have shared pictures of signs that say "kidneys for sale."(When Insider tried the number provided, it appeared to not be working.) Meanwhile, long lines have been reported at blood banks, where a single draw can earn the donor about $47 – enough to feed a family for a few weeks. In some cases, people have reported donating their blood at a rate well beyond what's considered healthy and safe.

In cities, streets have been lined with televisions, refrigerators, carpets and other household items that residents are putting up for sale.

Before the Taliban took control of Afghanistan on Aug. 15, Samir taught Dari literature at a private school in Kabul and was a member of Kabul's Pen Society, a collective of poets and writers. But the school closed down and, since then, Samir has found it increasingly tough to find money to feed his family.

An UNHCR worker pushes a wheelbarrow loaded with aid supplies outside a distribution center in Kabul on Oct. 28, 2021.

"Life has become this daily challenge," he said. "The costs just keep piling up. Food, rent and finding ways to keep warm during the winter, it's all just so much."

A year ago, Kabul residents navigated blast walls and roadside bombs. Now, all across the country, Afghans fear hunger.

With the arrival of winter, the UN says nearly nine million people are at the risk of famine and up to one million children could die from the cold and hunger. Last month, the World Food Programme reported that 98 percent of Afghans don't have enough to eat.

'We're afraid of dying of hunger'

During the 20-year US-led occupation of Afghanistan, young people like Samir were held up as models of the well-read, ambitious generation that would eventually lead the country. But along with the rest of the country, they now feel abandoned by the international community, the propped-up Afghan government that fled under the cover of night, and now the ruling Taliban. Facing unspeakable hardship as winter has descended, they have been forced to resort to previously unfathomable measures to make money.

In the first weeks after the Taliban takeover, the number one issue on most people's minds was the economy. Half a million Afghans lost their jobs overnight, according to the International Labor Organization, while the foreign assistance that has bolstered the country for two decades also disappeared. When asked about the arrival of the Taliban, taxi drivers, money exchangers, and shop owners largely said the same thing: "We're afraid of dying of hunger."

With banks limiting withdrawals to $400 a week due to a shortage of paper money — printed in Europe — Afghans can no longer turn to family and neighbors for short-term loans. For Afghans abroad, unclear rules on remittances and changing policies from services like Western Union and MoneyGram have made sending money back home extremely challenging.

A money changer holds a stack of Afghan currency on a street in central Kabul.

"I go every day to Western Union only to be turned away because they can't send money to Afghanistan," one young Afghan-American said during a recent Twitter Spaces discussion on the personal effects of the humanitarian crisis in the country.

As the value of the currency has fallen at least 20 percent and prices of basic staples continue to climb, shops have struggled to stay open and keep their employees on their payrolls.

After the Taliban takeover, Samir put aside the novel he was working on and began selling energy drinks on Kabul's dusty streets. With many Afghans hunkered down at home, or lining up at the airport and hoping to board evacuation flights, business was slow. Most people didn't have the money to spend on energy drinks.

"It was challenging for me to find money," he remembers.

He next turned to something simpler and cheaper – shoe polishing. But even that didn't work.

Just a few weeks earlier Samir, who also dabbled in amateur photography, might have been seen wandering Kabul's streets taking pictures. But it was another world now.

The United Nations recently put out a request for $4.4 billion to address the humanitarian situation over the next year. USAID has also pledged $308 million "to support vulnerable Afghans" in 2022. The Under-Secretary for Humanitarian Affairs at UNOCHA, Martin Griffiths, said the money is needed to "stave off wide-spread hunger, disease, malnutrition and ultimately death."

Boys offer to carry goods with wheelbarrows to earn a pocket money near an aid distribution site in Kabul on Dec. 7, 2021.

Though there has been an organ trade in Afghanistan for a decade or more, it was usually an option for the poorest and most desperate people that was largely hidden from public view – discussed only in hushed tones. Now, Afghans who had a degree of economic stability less than a year ago are also thinking about becoming donors.

In 2020, at least 47 percent of the population lived below the poverty line, despite billions in annual foreign aid. The current crisis has hit the entire population, even those who once had steady jobs and reliable incomes.

The 'One kidney' village

A few years ago, one village in the outskirts of Herat, Se Shanba Bazar, became known locally as "the one kidney village" because so many people there had become kidney donors.

For men who could not find work in Herat city – in western Afghanistan – or across the border in Iran, selling a kidney became a last, desperate option for men to support their families, earning in excess of $3,000, some of those who were interviewed said.

In 2021, Tolo News reported that, since 2016, at least 200 kidneys had been sold illegally every year in the province of Herat. At the time, donors were receiving upwards of $3,200.

A nurse checks the weight of a child in a makeshift clinic organized by World Vision near Herat on Dec. 16, 2021.

Up until last year, the main cause for people selling their kidneys was poverty caused by the 20-year war. Today, according to interviews, the main cause has been the twin crises of unemployment and access to cash that have come since the Taliban takeover. One difference, people said, is that now women are coming forward as donors.

"We do kidney transplants here every week," said a receptionist at Afghan Arya hospital in Herat. "It's a deal between the buyer and the seller. People sell their kidneys to make money. Poverty is real and huge here."

One activist in Herat, who spoke on the condition of anonymity to avoid being targeted, said she was aware of three men and two women who underwent the surgery in the last week.

'I just kept going back to put food on the table'

For years, Ali Reza's job in a local salt factory in Mazar-e Sharif, in northern Afghanistan, earned him more than $150 a month, which was just enough to provide for his seven-person household.

But after the Taliban took over the city on August 14 – one day before they claimed Kabul – everything changed. Within weeks, the city that was once a hub for local and global business, became a center for the evacuation of vulnerable Afghans.

Thousands of people were leaving the country from Mazar on a daily basis. Among them, were the very businesspeople who had helped sustain the city's status as Afghanistan's economic hub in the North.

As business owners left the country, their offices, factories and shops began to shut their doors, many with no forewarning, leaving tens of thousands of people without a reliable income. The salt factory Ali Reza worked in for years, was one of the first businesses to shutter once the owner left the country shortly after former President Ashraf Ghani fled and the Taliban took control of the government in Kabul.

Initially, Ali Reza did like millions of Afghans before him, and turned to day labor as a source of income in hard times. But with the United Nations warning that male unemployment may double to 29 percent by 2023, the competition even for menial, physically-grueling work, is high. At one of Mazar's busiest roundabouts, every day brought long lines of men advertising their desire for work.

"There were hundreds of people lined up and only a few got work each day," he said.

As Mazar's harsh winter crept closer, Ali Reza grew desperate. Finally, a friend told him that people had started selling their blood to private blood banks.

He was conflicted. With some skills and a few years of schooling, donating his blood seemed shameful. But the need to feed his young kids and elderly mother trumped his reservations and wounded pride.

A man waits for work in Kabul on January 5, 2022.

It turned out that his blood type, O, made him a universal donor. Since October, Ali Reza has sold more than 1,500ccs of blood at a rate of 5,000 Afghanis or $47, which is enough to provide for his family for about three weeks.

"The nurses kept saying they don't have enough O donors, so I just kept going back to put food on the table," he said.

Already, he is donating at a dangerous rate. The Red Cross recommends donors wait at least eight weeks between donations, and that they should not donate more than six times per year. Ali Reza has already donated three times since October.

He says that if the economic situation doesn't stabilize, more people will be forced to follow him in selling their plasma, "Things have to get better, or more and more Afghans will have to sell parts of their body."

Elsewhere in Mazar, another local man, Nematullah, has made a similar calculation.

In the last two months, he has twice donated his blood. Unlike Ali Reza, the 32-year-old has no formal education to fall back on and once construction work dried up in Mazar, he too found himself unable to feed his family.

In prior years, he was able to travel to neighboring Iran for construction and interior design work, but the COVID-19 pandemic, the declining value of the Iranian riyal and Tehran's increasing crackdowns against undocumented migration from Afghanistan have all made that much more difficult.

Now, he is relegated to waiting for the phone to ring when plasma is needed.

"A relative of ours works at a private hospital, he put my name on the blood donation list," Nematullah says of the competition for donating blood among cash-strapped Afghans in Mazar and other cities.

He said he has heard about kidney donation.

"Of course, I'm thinking about it, if the situation doesn't get better," he said.

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Facing hunger, some desperate Afghans are selling their kidneys for money