Ravaged by war and in the grip of a terrible drought, the people of Afghanistan are in desperate need of foreign help. The BBC's Damian Grammaticas travels to the central highlands to assess the situation and asks whether the next US president will need to rethink America's strategy against al-Qaeda and the Taleban.

　　In the hospital in Bamiyan a nurse is examining Mohammed Hakim. He is almost two years old, but his tiny figure is shriveled and weak, little more than skin and bone.

　　Every month, 20 severely malnourished children are being admitted to this hospital. Their wasted figures are a warning.

　　After decades of war and neglect and now the worst drought in a generation, one in three Afghans - 11 million people - needs aid.

　　Sitting on a bed in the hospital's therapeutic feeding ward and cradling her listless son on her lap, Fatima told me her family only has enough food to last a month.

　　"Everyone in my village needs oil, needs flour, needs everything," she said. "When the winter snow comes we will be cut off."

　　"How will your son survive?" I asked Fatima. "I will pray to God to help him," was her answer.

　　Dr Ghulam Nadir, acting director of the hospital, says: "Here in Bamiyan around 8-10% of children are suffering severe malnutrition, but we cannot admit all of them because of a lack of space in our hospital."

　　He says he needs three wards to deal with the malnutrition cases he is seeing, but he has just the one ward, so all but the most severe cases are turned away.

　　Bamiyan's hospital gets no money from Afghanistan's central government. It has to rely on aid agencies and the Aga Khan Foundation for funding.

　　The hospital has a generator for electricity, but can't even pay for the fuel to run it 24 hours a day.

　　It is all evidence of a glaring discrepancy in the foreign investment that has been put into Afghanistan.

　　Currently nearly $100m a day is being spent on the war, yet since 2001 just $7m a day has been spent on Afghans themselves, according to the Agency coordinating Body for Afghan Relief, an umbrella organization representing 100 aid agencies working in Afghanistan.

　　'Afghan tsar'

　　Across the country a food crisis is looming just as the fighting is spreading.

　　And Afghanistan is now the top foreign policy priority for the next US president; both candidates promising to bring a new focus to the campaign here.

　　John McCain wants an "Afghan tsar" in the White House coordinating policy, who will be a national security expert.

　　Barack Obama wants to spend an extra $1bn a year on non-military spending. But improving security is the main issue for both men.

　　"As president, I will make the fight against al-Qaeda and the Taleban the top priority that it should be," Barack Obama told his audience during a recent speech on his foreign policy.

　　"This is a war that we have to win. I will send at least two additional combat brigades to Afghanistan," he said.

　　And John McCain wants to send even more US soldiers, three more combat brigades is what he is promising.

　　"I know how to win wars. If I am elected president I will turn around the war in Afghanistan just as we have turned around the war in Iraq, with a comprehensive strategy for victory."

　　Moonscape

　　US commanders on the ground say they need more troops. But is the focus on security what Afghanistan really needs?

　　To reach one of the parts of Bamiyan worst affected by drought we drove for two and a half hours deep into the central highlands.

　　The parched Saighan valley should have a river flowing through it

　　The province is home to 380,000 people spread across 14,000 sq km of mountains, but it has just 3km of tarred road.

　　Ours was a bone-shaking drive over a high mountain pass. For some of the way a dry riverbed doubled as a rough track.

　　The Saighan valley should have a river flowing through it. It is barren and parched. The earth is rock-solid and dry. The hills all around are like a moonscape, eroded away so you can see the layers of rock in browns and oranges, and greys and pinks.

　　Syed Shah, who is 80, and his brother Abdul Mukim showed me their fields. The two men say they have never seen it so bad.

　　They have 30 members of their family to feed, and they have lost three-quarters of their wheat crop.

　　"We have seen a little foreign aid here, but nothing very much," Abdul told me. "Now, because of the drought everyone is just thinking about how they can survive the winter."

　　One hand pump to supply water is the only outside help their village has had out of all the billions of dollars spent on Afghanistan. And now the brothers told me the Taleban are back and active in the neighboring district.

　　Just last week they tried to blow up a vehicle using a roadside bomb.

　　Heading for failure

　　From 2001 to 2004 Ashraf Ghani was finance minister overseeing efforts to reconstruct Afghanistan.

　　He says his country's current predicament is a product of a lack of investment, compounded by corruption and inefficiency. So Ghani believes the US needs a new strategy.

　　"You need to win the people over if you want to break the back of an insurgency. That approach is yet to be embraced and practically applied in Afghanistan," he said.

　　"So what would you say to the next US president?" I asked him.

　　"I would say Mr President if we win the people, we will win this conflict.

　　"If we focus on the wrong objective, body count, number of insurgents who are killed, bombardment, kinetic action, it is not going to be the answer," he said.

　　In Bamiyan the warehouse that the provincial government has ready to stockpile grain for the winter lies empty.

　　Bamiyan's governor has been told by the central government she will receive only half the 10,000 tones of food the province requires.

　　It's no wonder that after seven years many Afghans believe the international involvement here is heading for failure.

　　Unless ordinary Afghans start to see more benefits from the foreign presence in their country the next US president may find the war here can't be won.

　　PHOTO CAPTION

　　Mohammed Hakkim was severely malnourished

　　Source: BBC