As winter approaches Afghanistan’s eastern mountains, thousands of people displaced by the devastating 31 August 2025 earthquake in Kunar province are bracing for new challenges.

Kochai, a mother of five from Shomash village in Nurgal district, recalls the night the magnitude 6 quake struck.

“It was between ten and 12 o’clock when my uncle’s wife went to bed. I told her not to lock the door—my senses were telling me an earthquake might happen,” she says. Moments later, a loud boom shook the house.

“I grabbed my two small children and rocks started falling from every direction. As soon as we stepped out the door, the room behind us collapsed. I couldn’t do anything.”

She says the loss around her village has left her deeply traumatized. “Many people have died, and my heart feels blackened. I’m afraid to go back.”

The earthquake was one of Afghanistan’s deadliest in a decade, killing more than 2,200 people and injuring over 3,000 across four provinces, including Kunar and Nangarhar. Thousands of survivors now live in temporary camps after their homes were destroyed.

Emergency medical care on the ground

In the days following the disaster, Médecins Sans Frontières (MSF) delivered medical supplies to hospitals treating the injured. By early September, MSF had set up a 24-hour basic healthcare clinic and a health post in Patan camp in Kunar province. A mobile medical team also began visiting displaced families in Ari Gamba camp in Shomash from mid-October.

MSF teams initially provided trauma care and have since expanded services to outpatient consultations, vaccinations, antenatal and postnatal care, health promotion, and mental health support.

From mid-September to late-October, more than 7,500 people were treated—mostly for diarrhoea, respiratory infections, and skin diseases such as scabies, reflecting harsh camp living conditions.

Psychological toll and rising needs

Patan and Ari Gamba camps are among several temporary settlements sheltering roughly 8,000 people from the hardest-hit areas.

“We are seeing hopelessness among people from the earthquake-affected areas,” says MSF doctor Nahida Noor. “Many lost loved ones, and the sound and destruction of the earthquake remain in their memory.”

MSF provides both individual counselling and psychosocial group sessions, with nearly 250 participants each week.

But mental trauma is only one part of the crisis. With winter nearing, temperatures in the mountainous region will soon drop below freezing. For families living in unheated tents, the cold is already a serious concern.

“Winter is approaching and it will snow,” says Sayed Jalal, displaced in Ari Gamba. “Living in these tents is not possible. When it rained and hailed the other day, our children and women suffered greatly.”

Jalal says all their belongings were buried under rubble. “We were given a few blankets, but they cannot withstand the cold. The tents also cannot resist the cold.”

A race against time before winter

Health workers fear that the falling temperatures will bring a spike in respiratory infections, pneumonia, measles, whooping cough and other seasonal illnesses. The camps have no heating or electricity, and the surrounding terrain makes conditions even harsher.

“More will need to be done to ensure survivors can live safely until a permanent solution is found or until they can return home,” says Dr Esmatullah Esmat, MSF’s medical adviser in Kunar.

For thousands of families like Kochai’s, the struggle to rebuild their lives now collides with the onset of a bitter winter—threatening to deepen an already severe humanitarian crisis.