The first jolt threw Dr. Abdul Mateen Sahak out of bed. The second sent him to his phone. It was right before midnight, last Sunday, and the steep, mountainous valleys of eastern Afghanistan had just been hit by a powerful 6.0-magnitude earthquake, closely followed by the first of many aftershocks.
At his home in Jalalabad, roughly 50 kilometres away from the epicentre, Dr. Sahak and his wife stormed out of their bedroom to find their eight children already in the hallway.
"I immediately thought about Herat," the Afghan physician in his late forties told me, referring to the earthquakes that devastated the country's western province in 2023. "I could tell that the impact would be huge as well."
A native of the Jalalabad area, he knew first-hand what this new disaster would mean for the country's northeast, where extended families all live under the same roof in remote, hard-to-reach locations.
Within seconds, their homes built of mud and loose stones would crumble. Roads would disappear under the rubble. Families would be buried alive as they slept.
The first calls
Dr. Sahak, who leads the local World Health Organization ( WHO ) emergency office, immediately turned to his health-cluster WhatsApp group, a thread that links hospitals, clinics and aid organisations across the region.
Reports began trickling in from Asadabad, the capital of neighboring Kunar Province, the hardest-hit area along the Pakistani border. There, the quake had been felt very strongly, the city's main hospital informed him. Some residents would likely be injured.
By 1am, the calls grew more urgent: "We received multiple injuries from different areas and the situation is not good. If possible, provide us with support!"
Racing the monsoon
Dr. Sahak asked his WHO team to meet him at the organization's warehouse in Jalalabad. As he and his colleagues drove through the dark, rain began to fall - the monsoon that would complicate everything, from helicopter landings to ambulance runs, in the first hours of the response.
Soon, the aid pipeline clicked into place. A truck was loaded with medical supplies at WHO's depot, then transferred at Jalalabad's airport, five kilometres away, before a Defence Ministry helicopter lifted pallets toward Nurgal District - the epicentre of the earthquake, midway between Asadabad and Jalalabad.
"Fortunately, we were able to quickly reach the most affected area," Dr. Sahak said.
Into Nurgal District
His initial field team came down to just four people: himself, a technical adviser, an emergency focal point and a security assistant.
Within hours, they drew in Afghan partners from two local NGOs, assembling a force of 18 doctors, nurses, and pharmacists - "six of them were female doctors and midwives," he said. That first day, WHO managed to airlift 23 metric tonnes of medicine to Nurgal District.
Meanwhile, the casualty figures kept climbing. "There was news that 500, maybe 600 people died. There were thousands of injuries and thousands of houses destroyed," Dr. Sahak recalled.
Five days later, the official toll is far grimmer: more than 2,200 dead, 3,640 injured, and 6,700 houses damaged.
He and his team reached Nurgal District on Monday afternoon aboard an armoured vehicle. "Many roads were closed because big stones were falling from the mountains," he said. On the lanes that remained open, crowds were slowing down traffic - thousands of civilians rushing in, most of them on foot, to help the victims.
'Where is my baby?'
Once there, Dr. Sahak, a seasoned humanitarian worker, was unprepared for the scale of devastation. "We saw bodies in the street. They were waiting for the people to come in to bury them," he said. Volunteer rescuers streamed in from neighbouring districts to clear rubble, carry the injured, and tend to the dead.
Among the survivors was a 60-year-old man named Mohammed, whose house had been destroyed.
I could not bear to look this man in the eyes. He was tearing up
"He had a total of 30 family members living with him…22 of them had died in the earthquake," Dr. Sahak said. "This was shocking for me. I could not bear to look this man in the eyes. He was tearing up."
At the local clinic, its walls cracked by the tremors, medical staff treated a rapidly growing number of patients beneath tents pitched outside.
Dr. Sahak met a woman with multiple injuries - pelvic fracture, head trauma, broken ribs. She struggled to breathe and could not stop crying. "She kept saying: 'Where is my baby! I need my baby! Please bring me my baby!'" he recalled. Then he paused. "No, no, she lost her baby. All of her family."
Women on the frontline
In a country where strict gender rules govern public life, the earthquake briefly broke down barriers.
"In the first few days, everyone - men and women - was rescuing the people," Dr. Sahak said. Female doctors and midwives can still work in Afghanistan, but only if accompanied to hospitals by a male relative. He did not see female patients being denied care either.
In the first few days, everyone - men and women - was rescuing the people
The deeper crisis, he added, is the exodus of female professionals since the Taliban's return in 2021. "Most of the specialist doctors, particularly the women, left the country…We have difficulty finding professional staff."
The impact reached his own home. His eldest daughter had been in her fifth year of medical school in Kabul when the new authorities barred women from higher education.
"Now unfortunately, she is at home," he said. "She can do nothing; there is no chance for her to complete her education."
A family's fear
From the outset, the WHO's task was to keep clinics running by providing technical guidance, medical supplies, and clear instructions. It also meant offering words of encouragement to the medical staff. "We told them: 'You are heroes!'" Dr. Sahak recalled.
As he cheered on local doctors, his family back in Jalalabad had been worried sick, following the news. He had spent a career running hospitals and leading emergency responses across Afghanistan, but this disaster struck too close to home.
That first night, when he finally returned to his wife and children, it was his 85-year-old mother who greeted him first. "She hugged me for more than 10 minutes," he said.
She gently scolded him and tried to make him promise he would not go back to the stricken areas. But in the poor eastern districts of Nurgal, Chawkay, Dara-i-Nur and Alingar, tens of thousands of people were relying on the WHO to survive. The next morning, he was back on the trail.
Ledger of life and death
By Friday afternoon, when I spoke to him, the figures in Dr. Sahak's ledger told the story of the emergency: 46 metric tons of medical supplies delivered; more than 15,000 bottles of lactate, glucose and sodium chloride distributed - intravenous fluids for trauma and dehydration; and 17 WHO surveillance teams deployed to track the spread of disease, which the agency expects soon because of the destruction of drinking water sources and sanitation systems.
WHO has asked for $4 million to deliver lifesaving health interventions and expand mobile health services. About 800 critical patients had already been rushed to the hospital in Jalalabad. Others were taken to the regional hospital in Asadabad, which Dr. Sahak and his team visited on Tuesday.
A mother's words
Outside the health facility, they noticed two survivors driven by the sun into a narrow strip of shade along a wall - an older woman and her daughter, both recently discharged, both alone.
They were alive, but their remaining 13 family members were dead
"They were alive, but their remaining 13 family members were dead," Dr. Sahak said. There was no one left to collect them. The daughter, in her twenties, seemed devastated: "She was unable to speak." Tears streamed down her face.
Moved by their plight, Dr. Sahak asked the hospital to keep them in a bed for a week or two. The director agreed. That night, back home, he recounted the scene to his family. "All of them were crying, and they were even unable to have dinner," he said. By then, even his mother no longer begged him to stay.
"Please go there and support the people," she told him.
