MSF Urges Pakistan to Halt Forced Returns of Afghan Refugees, Warns of Health Crisis

Islamabad/Kabul — Médecins Sans Frontières (MSF), also known as Doctors Without Borders, on Tuesday issued an urgent appeal for Pakistan to suspend the forced deportation of Afghan refugees under its Illegal Foreigners Repatriation Plan (IFRP), warning that the policy is not only obstructing access to vital medical care but also pushing vulnerable families into a spiral of fear, malnutrition, and avoidable tragedy.

In a detailed report released on July 29, the international medical humanitarian organization condemned the sweeping nature of the repatriation drive, which has been progressively expanded since its launch in November 2023—initially targeting undocumented Afghans, then later encompassing holders of Afghan Citizen Cards and even Proof of Registration (PoR) cards. On July 10, Pakistani authorities further escalated the measures by ordering the immediate arrest and accelerated deportation of all Afghan nationals without valid visas, effectively criminalizing a population that has sought refuge in Pakistan for over four decades.

Fear as a Barrier to Medicine

MSF emphasized that Afghan refugees in Pakistan are now living under a persistent shadow of arrest, detention, eviction, and livelihood loss—a climate of intimidation that has profoundly deterred many from seeking even emergency medical attention. Refugees have told MSF teams that they are deliberately delaying or completely forgoing hospital visits due to the fear of being detained during identity checks at clinic entrances or checkpoints.

“Refugees told us they are scared to step into a health facility because they believe it could be their last step before deportation,” the organization stated, warning that this avoidance has led directly to preventable and worsening health outcomes, including rising rates of acute malnutrition, pregnancy complications, and untreated chronic illnesses.

A Personal Tragedy

To underscore the human cost of the policy, MSF shared the devastating account of Najib, an Afghan refugee who was arrested during a police raid despite presenting a valid Proof of Registration card. His wife, three months pregnant at the time, began experiencing severe bleeding shortly after his detention—an outcome Najib directly attributes to the trauma and stress of the arrest. Although he rushed her to a hospital the following day after his release, the delay proved fatal.

“I finally decided I had to go to the hospital, but I was terrified that they would arrest me again,” Najib said. “I rushed her to the doctor, but we were too late. My wife had already had a miscarriage.”

Alarming Malnutrition Rates

The organization’s mobile clinics in Quetta, the capital of Balochistan province near the Afghan border, provide stark statistical evidence of the crisis. In early 2026, one-third of all children screened at these clinics met the criteria for global acute malnutrition. Among them, 7.6% were diagnosed with severe acute malnutrition and 25.7% with moderate acute malnutrition. Strikingly, nearly 90% of all malnourished patients treated were Afghan refugees the vast majority being women and children, groups already disproportionately affected by displacement.

MSF also noted that the deportation policy has systematically undermined refugees’ ability to earn a livelihood, destroying small businesses and informal employment, which in turn has diminished families’ purchasing power for food and medicine, further exacerbating the malnutrition crisis.

A Regional and Humanitarian Ripple Effect

According to the UN Refugee Agency (UNHCR), more than 2.5 million Afghans have returned from Pakistan under the repatriation plan since 2023, with a significant portion deported involuntarily. The UN has also identified over 70,000 Afghan refugees who would face acute, life-threatening risks—including persecution, torture, or death if compelled to return to Afghanistan. MSF echoed these concerns, urging Islamabad to immediately exempt all individuals with international protection needs from deportation and to establish formal, transparent mechanisms to identify at-risk groups, including women and girls, children, the elderly, people with disabilities, refugees requiring urgent or long-term medical care, and those awaiting resettlement in third countries.

Overwhelming a Fragile Afghanistan

The organization further warned that the mass returns are placing unsustainable pressure on Afghanistan’s already crumbling healthcare system. Between 2023 and 2026, an estimated 6 million Afghans have returned from both Pakistan and Iran, while concurrent funding cuts, economic collapse, and the Taliban government’s restrictive policies on women and girls have drastically reduced the country’s capacity to absorb and support returnees. MSF assessments conducted in informal returnee settlements in Kandahar province revealed limited access to clean water, inadequate shelter, rampant undernutrition, and poor sanitation conditions that dramatically raise the risk of disease outbreaks such as cholera and measles.

Call for Voluntary, Safe, and Dignified Returns

“Pakistan has shown immense hospitality by hosting Afghan refugees for over 45 years, often with limited international support, and we acknowledge that burden,” said Marko den Hartogh, MSF’s head of mission in Pakistan. “However, the current policy of mass deportations—conducted under the guise of repatriation has created a climate of terror that makes a mockery of any claim that these returns are truly voluntary. We call on the Pakistani government to halt all involuntary returns, and we urge all host countries to suspend forced deportations to Afghanistan until returns can be guaranteed safe, voluntary, and conducted with full respect for human dignity.”

MSF reiterated its call for the Pakistani authorities to ensure that Afghan refugees can access healthcare without fear of arrest or detention, and appealed to the international community to step up financial and logistical support for both Pakistan and Afghanistan to manage the humanitarian fallout of this mass displacement. The organization stressed that without immediate action, the current trajectory will not only deepen the suffering of millions but also fuel a public health catastrophe spanning both sides of the border.

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