For Mohammad, prosthetic repairs now cost a 60 mile trip and a loan

Mohammad Rafiq, age 60, lives in a rural area of Kandahar province. He lost a leg when a mortar shell exploded in his home during Afghanistan's civil war.

He has worn a prosthesis for 33 years. Walking and looking after himself are difficult. Mohammad has no specific livelihood and relies on support from friends and family. He lives with his sons’ family.

About three months ago, he went to the rehabilitation center for a prosthetic repair and found that services had already stopped because of aid cuts.

By the numbers

• 33 years: how long he has worn a prosthesis.
• ~60 miles: the distance between his district and Kandahar city.
• ~3,000 AFN: the cost of the transport, for a two-way trip.
• 1–2 days: how long he sometimes has to stay in the city to get treated.
• Once or twice every two months: how often he now travels to the Kandahar city center.
• 1: the number of rehabilitation centers that served his district. There is no other.

Rafiq used to go to the center

Before the cuts, HI ran a physical rehabilitation center inside the district hospital in Spin Boldak. People with disabilities could get comprehensive care close to home.

He says this helped him improve his mobility, manage his daily activities and depend less on others. His most frequent repairs were small but essential: cotton wrapping, Velcro, socket padding and SACH foot replacements. Physical therapists also taught him exercises for back pain, including the bridging exercise and the knee-to-chest stretch.

A sudden stop

Rafiq says there was no slow decline. Services stopped abruptly.

"Around three months ago, I visited the rehabilitation center to receive P&O repair services, but I found that the services had already been stopped due to the aid cuts. […] It was very difficult for me because there is no other rehabilitation center available in our whole district, even though the need for these services is very high."

The new reality: a costly detour

Rafiq now has to travel to HI's physical rehabilitation centre at Mirwais Regional Hospital in Kandahar city.

The trip is hard on a person with a disability and costs about 3,000 Afghan afghani ($40, which is unaffordable for the many people in Afghanistan).

He sometimes has to borrow money to travel to the city only to pick up a basic item.

He can't always make the round trip in a day, so he sometimes stays one or two nights.

"Without rehabilitation services and mobility support, persons with disabilities become more dependent on others."

Who is hit hardest?

Rafiq says the burden falls unevenly.
Women with disabilities can't travel to Kandahar city without a family member accompanying them, and can't afford the fare.

Children have lost ground on nutrition. Nutrition services once offered at basic and comprehensive health centres (BHC and CHC), supported by other NGOs, are now limited to the district hospital, which can't cover community needs.

Older people with disabilities face the same barriers of distance and cost.

Decision-makers need to know

Rafiq says aid cuts have hit people with disabilities hardest, especially in rural areas. Closing rehabilitation and P&O services has increased health problems, dependence on family members, and financial strain. Rafiq hopes that comprehensive physical rehabilitation services continue to be funded and nutrition services expanded. Global Official Development Assistance (ODA) has experienced record-shattering cuts since 2024, driven primarily by major reductions from top donors like the United States and European nations. According to data from the OECD, international aid fell by 23.1% between 2024 and 2025 alone—the largest single-year contraction on record. With decisions to reduce budget, millions of people around the world are now without any support. Mohammad Rafiq's testimony is one of many that will be included in a HI report on the impact of funding cuts on persons with disabilities, which is to be released by HI in December. Disability inclusion projects are vital for the well-being, independence, and inclusion of disabled people, many of whom depend on foreign aid for their daily lives. In order to avoid exacerbating exclusion and inequality for persons with disabilities, donors must continue to support disability inclusion programs.