Severe funding shortfalls are obstructing relief efforts in eastern Afghanistan, where a powerful earthquake has killed at least 800 people and injured more than 2,800.

Humanitarian officials warned Monday that dozens of health clinics have been forced to shut down and critical UN air support was suspended, leaving rescuers struggling to reach remote mountain villages.

The 6.0-magnitude quake struck shortly before midnight on Sunday in Kunar province, flattening entire communities and overwhelming a fragile health system already weakened by years of conflict, poverty, and natural disasters.

Since the Islamic Emirate took power in 2021, Afghanistan has endured three major deadly earthquakes alongside droughts, floods, and mass deportations of Afghan migrants from neighboring countries.

“The actual delivery of response has been badly hit by the funding cuts this year,” Kate Carey, deputy head of the U.N. Office for the Coordination of Humanitarian Affairs in Afghanistan told Reuters. “The number of people we have on the ground is much less than we would have had six months ago.”

Humanitarian aid to Afghanistan has plummeted, falling to $767 million this year from $3.8 billion in 2022, according to U.N. data. The decline stems from multiple factors: shifting donor priorities amid crises in Ukraine, Gaza, and Sudan; frustration over Islamic Emirate restrictions on women; and U.S. aid cuts to USAID programs, initiated in January under President Donald Trump’s administration.

The impact has been stark. Forty-four health clinics serving more than 360,000 people in Nangarhar and Kunar provinces have closed this year due to funding shortfalls, according to the World Health Organization.

The World Food Programme’s humanitarian air service, which once provided helicopters to ferry medical teams and supplies into inaccessible areas, was grounded earlier this year because of budget cuts.

The Islamic Emirate meanwhile has appealed for emergency support. So far a few countries including India, Switzerland and the UAE have pledged emergency aid. The UAE also confirmed it would send rescue teams.

Aid groups meanwhile say Afghanistan’s humanitarian crisis is being compounded by international isolation. Sanctions on IEA leaders have crippled banking channels, and billions of US dollars in Afghan central bank reserves remain frozen.

Sherine Ibrahim, Afghanistan Director of the International Rescue Committee, told Reuters that the cuts threaten to paralyze relief operations. “Although we have been able to act fast, we are profoundly fearful for the additional strain that this disaster will have on the overall humanitarian response in Afghanistan,” she said.