Since the food crisis began in the Horn of Africa, Somalia and Kenya have dominated the headlines. But more than a third of the nearly 13 million now going hungry in East Africa are in Ethiopia. With its own rural population facing starvation, the country is struggling to cope with a fresh influx of 78,000 refugees in seven months.
The newcomers are mainly women and children; many are so weak they die on arrival. In the past month, the health charity Merlin says it has witnessed more than 50 dying in the Gode area, near the border, having arrived too weak to be saved. Unlike in Kenya, where provision for refugees was initially adequate but has been overstretched for months, Ethiopia was little prepared for arrivals on such a scale.
At the beginning of March there were 38,000 refugees across two camps. Now the two original camps are at double their capacity, with 40,000 living in each. A third camp has filled within three weeks with more than 24,000 people, and now a fourth has been opened as a home for the 15,000 or so arriving from a makeshift centre near the border. Kristen Knutson, a public information officer for the UN in Ethiopia, said: "There was a much lower service provision in Ethiopia than Kenya. There wasn't much infrastructure in place; then suddenly you had this enormous increase in the number of refugees coming."
Roads are poor and getting aid into the camps is a struggle. In Kobe camp – one of four at Dolo Ado – the water supply has almost dried up as lorries battle across near impassable tracks. Now the water ration there – which is needed to do all washing, cooking and drinking – has gone from 10 litres per person a day to three. But there is some hope for supplies now. A cargo plane was sent from the UK by Oxfam and Unicef on Friday to bring five kilometres of piping to Dolo Ado, as well as emergency food and medical supplies.
On top of the physical difficulties involved in getting help to the hungry, the Ethiopian government has also obstructed foreign aid organisations. In recent years, regional licences and permits have been taken away from those who spoke out on hunger in the region, stopping urgent help in its tracks.
Charities say the country is sick of being portrayed as a "basket case" in the foreign media, which meant that until this year they could be stopped from operating if they chose to reveal the scale of the disaster.
The UN's Ms Knutson said: "This year, it's been a sign of the seriousness of the situation that the government has made it easier for agencies to open their operations."
Bereket Simon, Ethiopia's Minister of Communication, said he wanted the country's recent problems to be seen in the context of a growing economy over the past decade. But he admitted: "We see the reality as it is. There are 4.5 million in need of aid. We have been trying to respond promptly, as well as the international community, but we are aware response has been largely inadequate."
Today, the head of the African Union (AU), Dr Jean Ping, is expected to visit the camps in Liben. The AU will not meet for crisis talks on the situation for another 11 days. The urgently needed meeting was supposed to take place weeks ago, but leaders claimed that two weeks' notice was not enough.
More than half of the children under five who arrive at refugee camps in Liben are malnourished. Alice Gude, a nurse for Médecins sans Frontières, described the condition of the children who have been coming daily to one of the charity's clinics there. "The state they arrive in is shocking: you get used to seeing skinny children, but it gets me when they have the look of an old man's face, typical of marasmus [severe malnutrition]. The saddest thing is to hear the refugees' distress when they arrive and realise that the response is still slow in preparation for these arrivals."
Last weekend, the UN refugee agency announced a measles outbreak in the camps. The congestion there means that people are particularly vulnerable to communicable diseases; a situation made worse by immune systems weakened from malnutrition. A mass-vaccination programme has been started for all children under 15.
Many do not manage to get to Dolo Ado at all and are instead incapacitated just across the border, too weak to continue. The first people who crossed from Somalia into Morodile and Godere received old sacks, plastic sheets and rugs donated by the local community. The charity did not last long, though; now there are so many there that the majority are living out in the open with little protection from dust storms, scorching sun and cold nights.
Merlin has set up mobile clinics on the border to help the growing cases of malnutrition – not to mention other health problems made worse by overcrowding, a lack of proper toilets and sleeping out in the open.
Ethiopia's own people are also facing serious problems. Pastoralists whose livestock have died in the drought have left their homes to find help that has been hard to come by. Even in the towns and cities people cannot escape hunger, with food prices up more than 250 per cent.
On the surface, it is difficult to see why 119,000 Somalis have chosen to flee to a place like this. But a quick look across the border confirms why. Somalia's capital, Mogadishu, is where many of the rural starving who could not make it to Ethiopia or Kenya have flocked to. The city, already beset with conflict and unrest, is now facing a cholera epidemic. The World Heath Organisation said on Friday there had been more than 4,000 cases of diarrhoeal disease reported in the city's Banadir hospital this year, with children under five accounting for 75 per cent of cases.
It took Hadija Isaac Abdu more than a week to get her family safely across the border and out of Somalia. Their maize and sorghum crops had failed and their cattle had been decimated at their home in Qansah Dere. First they drove a car, but when it broke down they had to walk for seven days. By the time the 30-year-old arrived in Ethiopia with her husband, his first wife and all their children, her baby son was critically ill. "There was not enough food on our way, and the walking took so long. We didn't have any milk for him. He lost his appetite and he wouldn't eat any more."
Despite his high fever and severe malnutrition, Mrs Abdu's son is one of the luckier ones. He is being treated at a stabilisation centre in Kobe, one of four refugee camps now stretched beyond capacity in Dolo Ado.
If parents like Hadija Isaac Abdu do not get help in Ethiopia they have very few choices left. "I don't think we will be back in Somalia in the near future," said the mother. "In Somalia, there is nothing of what we need: a little bit of food and peace."
The IoS give a day's pay for Africa
Nearly 13 million people are at risk of dying from hunger in the Horn of Africa as a result of the worst drought in 60 years. Two million children under the age of five are malnourished and 500,000 are severely malnourished. The Independent on Sunday is asking readers, their friends and families to join its senior staff and each pledge one day's pay to the Disasters Emergency Committee appeal. High-profile figures from the worlds of politics, sport and the arts are backing us. Together, The Independent on Sunday and its sister title, The Independent, have so far raised more than £117,000. Thank you!
They joined – how about you?
Laurence Llewelyn-Bowen Interior designer
"This devastating crisis can't be ignored. Jackie and I are pleased to support The Independent on Sunday's campaign. The level of suffering is beyond our imagination and it doesn't look as if this problem will go away soon."
Tony Blackburn DJ
"The problems last week are nothing compared with East Africa. I am happy to support what The Independent on Sunday is doing, and hope it will go some way to helping children."
Amir Khan World light welterweight boxing champion
"I'm a big supporter of Islamic Relief and all the Disasters Emergency Committee charities. This is the worst humanitarian crisis of my lifetime but the DEC charities have a huge amount of experience in these horrendous situations. They can save hundreds of thousands of lives in East Africa if we give them the support they need."
Jackie Kay Poet
"It's shocking that we have let things get to this stage when there was plenty of warning. Twenty years ago, we had terrible famine in Africa and we should have learnt the lessons. It's horrifying that every six minutes a child is dying. To me, it's the biggest thing happening but it's not getting the most attention."
Jonathan Agnew, BBC Test Match Special presenter; Tom Aikens, chef; Heidi Alexander MP; David Arnold, composer; Lord Avebury; Willie Bain MP; Tristan Baker, theatre producer, The Railway Children; Elena Baltacha, British No 1 women's tennis player; Greg Barker MP, energy minister; Tony Blackburn, DJ; Lauren Booth, Tony Blair's sister-in-law; Sir Peter Bottomley MP; Chris Bryant MP; Richard Burden MP; Rev Stuart Burgess, chairman, Commission for Rural Communities; Paul Burstow MP, health minister; Vince Cable, Business Secretary; Alastair Campbell, former No 10 communications chief; Nathan Cleverly, WBO light-heavyweight champion boxer; Max Clifford, PR consultant; Mary Creagh MP; Sarah Darwin, great-great-granddaughter of Charles Darwin; Richard Dawkins, biologist; James DeGale, boxer, Olympic middleweight champion; Esi Edugyan, author; Rev Jonathan Edwards, general secretary, Baptist Union of Great Britain; Yvette Edwards, author; Moira Elms, global partner at PwC; Mo Farah, athlete; Tim Farron MP, Lib Dem president; Andrew George MP; Helen Goodman MP; A C Grayling, philosopher; Kate Green MP; Bonnie Greer, author/playwright; Olly Grender, Lib Dem pundit; Harriet Harman, deputy Labour leader; Baroness Healy of Primrose Hill; Baroness Hughes of Stretford; Howard Jacobson, author; Cathy Jamieson MP; Jackie Kay, poet; Barbara Keeley MP; Stephen Kelman, author; Amir Khan, boxer; Jemima Khan, campaigner; Lord Knight of Weymouth; Derek Laud, New City Initiative; Andrea Leadsom, MP; Helen Lederer, comedian; Annie Lennox, musician; Jackie and Laurence Llewelyn-Bowen, interior designer; Stephen Lloyd MP; Tony Lloyd MP, chairman, Parliamentary Labour Party; Josie Long, comedian; Naomi Long MP; Caroline Lucas MP, leader of the Green Party; John McDonnell MP; Ian Mearns MP; A D Miller, author; Nadifa Mohamed, author; Penny Mordaunt MP; Ian Murray MP; Sheryll Murray MP; Pamela Nash MP; Sarah Newton MP; Fiona O'Donnell MP; Brian Paddick, ex-Met officer; Neil Parish MP; Alan Pascoe, former athlete; Lord Naren Patel; Lord Phillips of Sudbury; Alison Pick, author; Daniel Pinto, chairman of Stanhope Capital; Rt Revd Anthony Priddis, Bishop of Hereford; Hugh Quarshie, actor; Doug Richard, original Dragon's Den panellist; Kate Robertson, UK group chairman of advertising firm Euro RSCG; Mark Robinson, co-founder of Sandlanders Football; Jane Rogers, author; Linda Rolph, general secretary, Advance union; Amber Rudd MP; Stuart Semple, artist; Lord Shipley; Andrew Slaughter MP; Julian Smith MP; Caroline Spelman MP, Environment Secretary; Michelle Stanistreet, National Union of Journalists general secretary; Juliet Stevenson, actress; Rt Revd Nigel Stock, Bishop of St Edmundsbury & Ipswich; D J Taylor, author; Lord Taylor of Goss Moor; Glenn Tilbrook, musician; Keith Vaz MP; Frank Warren, boxing promoter; Graham Watson MEP.
Join up – and help the starving
To join our 'Give a day's pay for Africa' campaign, go to independent.co.uk/giveadayspay. All donations are welcome – to give £5, enough to buy high-energy food supplements to save five children a day, text INDY to 70000. And spread the word on Twitter using the hashtag #GiveadayspayReuse content