“Mothers and children will die.” The reason?

 “Mothers and children will die.” The reason? The wholesale slashing by Washington of U.S. humanitarian aid, until recently the single biggest source of development support for ordinary Afghans.

That support had been critical for the survival of health and other development projects in the country, flowing in via the U.N. and its partners. But, as of August this year, funding cuts have led to the suspension or closure of 422 health facilities in the country. The reductions include 21 family-health clinics in Daikundi. Officially known as Family Health Houses, the clinics provided care to women and children in areas where communities have no access to other health facilities.

Nationwide, more than 100 such clinics have closed as a result of the cuts. The impact in many cases has been devastating. In April, Ali Hassan rushed his pregnant wife Mariam to their local Family Health House in Taiko, when she complained of pain and believed she was close to giving birth. It was only after waiting for the midwife for several hours that they realized that the clinic had been closed. The midwife had been laid off.

Desperate for medical attention, they headed for a district hospital around five hours’ drive away. It was too far. Both Miriam, 38, and their child succumbed shortly after they reached the hospital. “There was a chance we could have saved both mother and child … or at least the mother [had the clinic been open],” Sediqa, a midwife at the district hospital, told TIME.