Objective: Although the more than 6 million Afghan refugees represent the largest single group of refugees worldwide, little information is available about their health status. Research Design: Case series assessing the health and socioeconomic status of female Afghan refugees and their families and the nutritional and developmental status of their children. Setting and Patients: Fifty-one female Afghan refugees and their children accompanying them at a maternal child health clinic in Quetta, Pakistan. Results: All families had suffered serious losses from the war. Thirty-three women (65%) had lost at least one live-born child, most commonly to gastroenteritis, ''hunger,'' or neonatal tetanus. Thirteen children had been killed by bombardment, mine injuries, or gunshot wounds. The nutritional status of the children was markedly poor: z scores were less than -2 for weight in 67% of children and also less than -2 for head circumference in 50% of children. Serial z scores for weight in 23 children showed marked decline in 15 children (65%). Sixty-nine percent of children were overdue for vaccinations. Developmental milestones were significantly delayed. Conclusion: Afghan refugee children and their mothers are extremely needy and vulnerable and may be considered among the hidden casualties of war.
