DENAN, Ethiopia -- Two months ago Ayan Abdi struggled to tell her newborn twins apart. Tragically, she has no difficulty now.
The skin of her malnourished son Nemo stretches tightly over his tiny skeletal frame, while his sister Asma still retains some of her rounded features. Ayan, who earns $7 a month selling firewood, is so weak from malnutrition herself she can produce only enough breast milk to feed her daughter.
Millions are at risk of famine in eastern Africa after a potentially devastating drought wiped out this year's crop. Aid organizations warn that unless urgent supplies of food, water and medicine are delivered to the region, more people could die than perished in the drought of 2000 -- which killed nearly 100,000 in Ethiopia alone.
"People will die because we are already too late with our help," said Abdullahi Ali Haji, the government's health officer for this area of eastern Ethiopia. "This is our warning that without immediate help a famine will soon follow."
Preliminary assessments show those affected by the drought include an estimated 3.5 million in Kenya, 1.75 million in Ethiopia, 1.4 million in Somalia and 60,000 in Djibouti.
Poor rains over the last nine years have left many families living on a knife's edge. This year the rains failed completely. Food prices are up as much as 50 percent, while the value of prized livestock has plummeted, hitting hard the nomads who rely on cattle, sheep, goats and camels for food and income.
The warning signs of famine appear long before it takes hold in this corner of Ethiopia, about 870 miles southeast of the capital, Addis Ababa. The bones and rotting carcasses of cattle mark the landscape. Children, whose immunity systems are hopelessly compromised by insufficient nutrition, are beginning to fall sick.
The handful of malnourished children that used to be brought to Haji's hospital in Gode, about 50 miles southwest of Denan, has now turned into steady trickle.
The two doctors assigned to cover 1 million people in the region are totally overwhelmed. They have just a handful of drugs to combat widespread measles and diarrhea from drinking dirty water.
"As ever, women and children will bear the brunt of this disaster," said Bjorn Ljungqvist, the U.N's Children's Fund country representative.
Aid agencies do not have money to buy food from districts with surplus harvests to feed those hit by the food shortages, said Peter Smerdon, spokesman for the World Food Program.
"WFP is short $44 million now to feed 1.1 million people because of the drought," Smerdon said in Kenya on Tuesday. "Without new donations, WFP will run out of food to distribute in drought affected areas by the end of February."
Efforts to help the region's hungry have also been troubled by a low-level conflict between the Ethiopian army and separatist rebels in the area. In recent months, trucks carrying food aid have been attacked and, in some cases, burned.
Violent clan disputes, a spillover from the feuding warlords in neighboring Somalia, have deterred aid workers and the U.N. from entering the region.
"We have received nothing," said Aden Abdi, who has nine hungry mouths to feed in the wind-blown town of Kelafo. Water wells are empty and the nearby Wabe Shebelle River, which at this time of year can be as much as 65 feet wide, is now easily traversed by foot.
"We have been forgotten," the oval-faced woman sighed, sitting outside her one-room stick shack where her family struggles to survive on $8 a month. "No one cares if we live or die, as long as they don't see."
In Kenya, however, British International Development Secretary Hilary Benn met President Mwai Kibaki on Tuesday and pledged $5.3 million to help alleviate the crisis, according to a statement released by the president's office.
One-third of the money will go to dealing with food shortages and the remaining two-thirds will go to providing water in drought-stricken areas, the statement said.
In Ethiopia, one aid group has been working on a project to help cattle herders develop ways of coping with drought in the region.
The project, developed by the U.S.-based aid agency CARE with funding from the U.S. Agency for International Development, will help cattle herders negotiate access to land when a crisis develops, provide a market so they can sell part of their herds and supply emergency food and water.
"We hopefully are going to get away from these emergency responses in the region," said Carey Farley, a program manager for CARE, from the Kenyan capital of Nairobi.
Connect with the Southeast Missourian Newsroom:
For corrections to this story or other insights for the editor, click here. To submit a letter to the editor, click here. To learn about the Southeast Missourian’s AI Policy, click here.