KABUL (Reuters) - When foreign donors pulled the plug on Makai Sawash's small clinic run for and by amputees, she started selling homemade peat briquettes and wheelchairs to keep it going.
Working at her NGO in Kabul alongside landmine victims, Sawash laments the cash vacuum that has hurt many aid organizations in Afghanistan.
"Day by day, donor funds are getting weaker. NGOs are looking to the government for help, but it doesn't have the capacity," she said at the Kabul Orthopaedic Organisation.
The clinic, first opened in 1996 during Taliban rule and officially registered as an NGO in 2004 with the backing of USAID, provides help for the thousands of victims of war and poverty -- something the cash-strapped government cannot do.
As well as landmine and bomb victims, the clinic also provides physiotherapy treatment to women beaten by their husbands and to children crippled by cerebral palsy or polio.
Non-governmental organizations such as the one run by Sawash are now struggling to win donor support, more than a decade after the Taliban were driven from power by U.S.-led forces.
Almost 10 percent of NGOs in Afghanistan -- 175 in number -- were ordered shut at the start of the year by the Economy Ministry after they failed to submit annual reports due to inefficiency, corruption and oversight.
As a result, donations to Afghanistan's NGOs have waned, raising concerns about their ability to keep operating when most NATO combat troops leave at the end of 2014.
"We are very concerned, the country is at a critical stage," said Colin Alfred, Asia Education Advisor at Save the Children.
Dwindling aid will be the main point of discussion at an Afghan aid conference in Tokyo on Sunday.
Just under $4 billion is expected to be committed in development aid for the next year, though major donors and aid organizations worry that weak political will and graft could prevent funds reaching the right people at a critical time.
That amount is sharply down from its peak in 2010, when over $6 billion in development aid was pledged, more than half from the United States. The central bank has said the country needs $6-$7 billion per year over the next decade to foster economic growth.
"We are not blind and we all feel considerable fatigue among the taxpayers of Europe and beyond," the EU special representative to Afghanistan, Vygaudas Usackas, said this week, referring to the euro zone crisis and increasing war weariness.
A key contributor, the EU gives 1.2 billion euros annually in development aid.
But maintaining this support going forward will be difficult for the EU, Usackas said, if Afghanistan does not make progress in security, rule of law and financial management.
Progress in human rights, particularly for women, and holding credible presidential elections in 2014 are also essential if Afghanistan wants money to keep flowing in, he said.
Afghanistan remains one of the world's five poorest countries, and widespread problems such as poor governance and corruption keep investors and donors away.
Aid groups warn that fragile gains, such as education for girls -- banned by the Taliban -- and halving child mortality rates in 10 years, are at grave risk of being lost if financial support dries up.
Comparisons are frequently being drawn to the Soviets' humiliating defeat in their decade-long war against mujahideen fighters in 1989. Afterwards, Moscow continued to prop up the communist government of Mohammad Najibullah.
But when the Soviet Union collapsed two years later, the aid vanished, Najibullah was ousted in 1992 and civil war engulfed Afghanistan.
"The Najibullah regime collapsed not because of military defeat but because the Russians stopped financial support," Britain's development secretary Andrew Mitchell told reporters in Kabul this week.
"We need to learn many many lessons from the past including that one."
Some Afghans say their country has become too reliant on the West. With the World Bank predicting aid in 2025 will be around 10 percent of previous levels, Afghanistan must become more self-sufficient.
"Not becoming self-sufficient has been a mistake of the past 10 years," Economy Minister Abdul Hadi Arghandiwal told Reuters, rare criticism of how aid has been managed while U.S.-led NATO troops and Afghan forces battle a resilient Taliban.
For Afghanistan to one day stand on its own two feet, donors hope this weekend's Tokyo conference will win guarantees from Kabul to tackle corruption and ensure accountability.
Transparency International ranks Afghanistan as one of the world's most corrupt nations and despite President Hamid Karzai's recent campaign to tackle graft within government, a high-level corruption case is yet to be prosecuted.
Until these issues are tackled, Afghan NGOs will have to learn to fend for themselves.
"We all know that foreign funding will go down from 2014. NGOs can't sit around and wait for that day to come, we have to act," said Gulsom Satarzai, executive director of women's educational charity AWSE, which turned to light bulb making when its American donors pulled out.
After losing support from Washington's overseas development wing USAID as they cut spending, Sawash at Kabul Orthopaedic Organisation slashed her staff from 50 to 30, and looked for ways to fund the clinic herself.
As she spoke, men with prosthetic limbs molded muddy slabs into peat logs which are then sold to an array of customers, including NATO, to fuel stoves during the bitterly cold winter.
"We can't think that when the foreigners close their doors, we will shut ours too," Sawash says. "We need to have the independence to help each other."
Additional reporting by Hamid Shalizi and Amie Ferris-Rotman; Writing by Amie Ferris-Rotman; Editing by Michael Georgy and Jeremy Laurence