While Afghanistan has suffered from malnutrition for decades, the country’s hunger crisis has drastically worsened in recent months. This winter, an estimated 22.8 million people — more than half the population — are expected to face potentially life-threatening levels of food insecurity, according to an analysis by the United Nations World Food Program and Food and Agriculture Organization. Of those, 8.7 million people are nearing famine — the worst stage of a food crisis.

Such widespread hunger is the most devastating sign of the economic crash that has crippled Afghanistan since the Taliban seized power. Practically overnight, billions of dollars in foreign aid that propped up the previous Western-backed government vanished and U.S. sanctions on the Taliban isolated the country from the global financial system, paralyzing Afghan banks and impeding relief work by humanitarian organizations.

Across the country, millions of Afghans — from day laborers to doctors and teachers — have gone months without steady or any incomes. The prices of food and other basic goods have soared beyond the reach of many families. Emaciated children and anemic mothers have flooded into the malnutrition wards of hospitals, many of those facilities bereft of medical supplies that donor aid once provided.