USAID fallout: In Nepal, when the aid workers stopped coming, the women and babies started dying

The Associated Press has found that the decision by the United States to slash its foreign aid funding last year has increased pregnancy complications and deaths in Nepal

GAUR, Nepal -- The young mother’s breath had grown ragged. Inside her mud home in rural Nepal, she hunched over in agony, pain pummeling her pregnant belly, her swollen legs scarcely able to support her.

Kabita Mukhiya was in the midst of an emergency, but didn’t know it. For weeks, she’d suffered at home, because there was nobody around to tell her to rush to a hospital. The aid workers who once regularly visited her village to help pregnant women had stopped coming, after foreign aid cuts by the United States shuttered a program aimed at saving mothers’ and babies’ lives.

Kabita was uneducated and impoverished, and she did not know what was happening to her body. In desperation, she turned at last to her aunt for help, who hauled her off to the hospital, where both women wept as the doctors said things neither could understand.

Which is why Kabita — confused and confined to her hospital bed — turned to something she could understand: prayer.

“Please save the baby,” she begged God through her tears. “Please save me.”

Then, through the chaos, came the words that Kabita finally grasped, but could not bear: It was too late. Her baby was dead.

This story was funded by a grant from the Pulitzer Center. The Associated Press is responsible for all content.

One baby at a time, the world is marching toward a grim milestone: Because of global cuts to foreign aid, the Gates Foundation has predicted that 2025 will be the first year this century where child deaths will increase.

For many experts, the health of a country is measured by the health of its smallest: Children under the age of 5. And while global child mortality data for 2025 won’t be available for several months, health officials are already bracing for a surge in deaths among the world’s youngest and most vulnerable.

The decision by U.S. President Donald Trump’s administration to dissolve the United States Agency for International Development — once the world’s largest humanitarian donor — gutted maternal and neonatal care, decimated nutrition programs for millions of pregnant women and children and left scores of birthing centers devoid of equipment, medicine and staff. The U.S. cuts, followed by foreign aid cuts from several other countries, forced 60% of women’s organizations to reduce their services, according to the World Health Organization.

The U.S. government has repeatedly insisted that no one — and, particularly, no children — have died because of its funding cuts. But the AP has documented the deaths of women and children from Myanmar to Nigeria .

A study published in The Lancet journal, meanwhile, said the U.S. cuts could lead to more than 14 million deaths, including more than 4.5 million children under age 5, by 2030.

“It’s heartbreaking to see what’s happening. It’s decades of progress being washed away,” says Rajat Khosla, executive director of WHO’s Partnership for Maternal, Newborn and Child Health.