Somalia is on the brink of a "hidden famine" which threatens to leave more than half of the country's population in need of emergency assistance by the end of the year.
The entire Horn of Africa, including Ethiopia, Djibouti and parts of Kenya, is gripped by a food crisis. A deepening drought and rocketing food prices have put about 14 million people at risk – three million more than in 2006 when the last major drought hit the region.
But the situation is most severe in Somalia. A continuing conflict, pitting Ethiopian and Somali government forces on one side and a variety of Islamist militias on the other, is having a devastating effect on relief operations.
Twenty aid workers have been killed this year, most of them in the past two months, in what humanitarians fear is an "orchestrated campaign" of terror.
Some aid groups have suspended operations and many are considering pulling out altogether. "What we are seeing is alarming," said Mike Fark, head of mission in Somalia for Médecins sans Frontières (MSF). "But at a time when the population's needs are increasing, our ability to provide assistance is being diminished."
The United Nations had estimated that up to 3.5 million people, out of a population of about 8 million, would need emergency assistance by the end of the year. But that figure is expected to rise. The rains failed in many parts of southern and central Somalia – in some areas it was the fourth consecutive season they had not come.
The number of severely malnourished children at feeding centres has doubled in the past three months. The MSF says malnourished adults are also turning up in far greater numbers.
Getting food into Somalia is becoming impossible. About 90 per cent of the World Food Programme's (WFP) deliveries are supposed to come by ship. But piracy off Somalia is scaring off shippers. European navies have been escorting WFP shipments since November, but since the last Dutch escort in June no other country has offered to help.
The food already in the country is either too expensive or cannot be safely delivered to those in need. Roadblocks set up by militia groups regularly attack aid convoys. Five drivers for the WFP have been killed this year.
Peter Smerdon of the WFP warned that if enough food was not delivered over the coming months "we could see scenes similar to the 1992-93 famine in which hundreds of thousands of people perished". With aid workers and journalists unable to access most parts of the country, Mr Smerdon warned Somalia could suffer a "hidden famine".
A peace agreement, reached in Djibouti last month between the government and leaders of the opposition Alliance for the Reliberation of Somalia, was supposed to lead to a cessation of violence. But the deal was not backed by hardliners on both sides. In the weeks since the agreement, violence, including attacks on aid workers, has increased.
Al Shabaab, the militant armed group of the former Union of Islamic Courts, has been blamed for many of the deaths. But in recent weeks, diplomats and analysts have begun to suspect the involvement of groups and individuals linked to the UN-backed and European Union-funded Somali government.
At present, an African Union force of fewer than 2,000 is able to do little more than protect government institutions. The UN's special envoy to Somalia, Ahmedou Ould-Abdallah, will today urge the UN Security Council to deploy peacekeepers. But analysts fear a repeat of the UN's troubles in Darfur if a peace agreement which includes all the main actors is not in place first.
Where aid is needed
Around 2.6m are in need. This will rise to more than 3.5m by December.
Around 4.6m in need. A further 5.7m receive food aid, but will need more.
In the Karamoja region, just over 700,000 need food.
More than one in 10 need assistance.
In the arid north-east, 900,000 are relying on food aid.Reuse content