“Since the deportations were announced, we live in constant anxiety,” said an Afghan refugee and father of two girls visiting a Doctors Without Borders/Médecins Sans Frontières (MSF) clinic in Balochistan, Pakistan. “We avoid going out due to fear of arrest. Families are afraid to sleep at night, not knowing if there will be a raid. The children are traumatized.”
Deportations are causing a climate of fear
The government has now announced a halt to deportations of Afghan refugees who have "proof of registration” cards, which was to begin on July 1, but this will not ease the fears of Afghans, especially for those without this documentation.
MSF teams are witnessing how the harsh reality of deportation is causing a climate of fear among Afghans in Pakistan. For many, the threat of deportation has turned accessing essential medical care into a perilous choice. The direct impact on people’s health is stark.
“I cannot come to the clinic for treatment because I will be arrested and deported,” said one refugee during a call with an MSF health promoter who was inquiring about his regularly missed doctor appointments. “I have to skip my visit.” For women, the cultural practice of having a mahram (a close male relative) to escort them in public spaces presents an additional barrier: Even if a woman chooses to take the risk and venture out for medical care, she may face difficulty finding someone willing to escort her due to the pervasive climate of fear. MSF teams in the Balochistan province say men are often too afraid of being harassed or arrested at checkpoints to accompany their female relatives to health facilities. This forces Afghan women to choose between breaching a deep-seated cultural practice or, more often, to forgo critical health care altogether.
"We are profoundly concerned about the welfare of people impacted by these deportation policies," said Xu Weibing, MSF’s head of mission in Pakistan. "For decades, many of these families have known no other home but Pakistan. Now, they live in constant fear."
Forced returns are separating families
The stories MSF teams have heard from Afghan refugees in Pakistan illustrate the trauma and hardship caused by forced returns. When people are deported, they are effectively being shuttled from one dire situation to another, while also being separated from their family.
“Many people who are forced to return to Afghanistan lose their livelihood and home, and have unmet health care needs, including those with non-communicable diseases that require ongoing treatment,” said Stephen MacKay, MSF operations manager in Afghanistan and Pakistan. “The Afghan health care system is chronically underfunded, under-resourced, and already struggling due to dwindling international aid. It is under increasing stress, and the potential influx of hundreds of thousands more people will only exacerbate the pressure on the health system.”
The pervasive anxiety of deportation is causing immense psychological distress among communities.
"We have nothing to go back to," said an Afghan woman seeking treatment at an MSF facility in Balochistan. "Many people who returned [to Afghanistan] have told us there is nothing left. I have no relatives there, and nowhere to go."
The deportation campaign has forced more than 1 million people to return to Afghanistan since November 2023, including more than 274,000 who were returned the first half of this year alone.
MSF in Pakistan
MSF has been working in Pakistan since 1986, providing medical care to people affected by conflict and disasters. We currently have projects in the Khyber Pakhtunkhwa, Punjab, Balochistan, and Sindh provinces, offering services including maternal and child health, nutrition support, and treatment for infectious diseases.
