The day before Ahmed Sheikh Jamale, a gaunt-faced Kenyan father, carried his two-year-old daughter to hospital, he buried his son. The rains have begun falling like belated tears in this bad borderland between Kenya and Somalia. But, with bitter irony, they have come too late.
Drought and war have produced the worst famine to hit Africa in two decades. It is now the biggest humanitarian disaster on the planet. Some 13 million people do not have enough to eat, the United Nations says, and 250,000 of them are facing starvation.
Wajir is the furthest north that non-Kenyan citizens are advised to travel. In the past few weeks this region of north-eastern Kenya and Somalia has become one of the most perilous places in the world for aid workers to operate
Virtually all international staff have withdrawn after a series of cross-border kidnaps. Aid distribution is now largely left to local staff who take extraordinary risks to keep the supply lines open.
And today, all across the region a new wave of Somali refugees are on the move, some turning up as far south as the Kenyan port city Mombasa.
But for Ahmed all the misery of the region is concentrated here - in one bed in the little hospital at Wajir.
On the bed lies his painfully malnourished daughter, Saadiya. She is fighting both malaria and pneumonia. With each rasping intake of breath her mother, Amina, lovingly mops her brow. All they can do is wait.
"We lost all our animals in the drought," laments Ahmed who - like many Somalis - is a farmer and entirely reliant on his livestock. "We now have nothing to feed our children. They keep falling ill." He is 75 and has lived through many periods of drought and famine. But this is the worst.
With the right care, Saadiya's chances of a full recovery are good. Her parents have made it to a clinic that specialises in acutely malnourished children which is run by Save the Children, one of three charities The Independent is supporting in its 2011 Christmas Appeal.
Delivering aid to Kenya's remote borderlands with Somalia has always been fraught. Even before famine struck to the north, the region was home to more than 250,000 Somali refugees - the result of two decades of internecine fighting. Like the tribal areas of Pakistan and Afghanistan, the border between Somalia and Kenya is little more than a line on a map and is filled with fiercely independent armed tribes.
In recent weeks Kenyan staff have been kidnapped by militants. Yet still the aid effort continues to help desperately hungry people.
Last month the Kenyan army crossed the border in an attempt to defeat the extremist Islamist militia al-Shabaab. The group, which is affiliated to al-Qa'ida, rules vast swathes of southern Somalia through a harsh interpretation of sharia law that justifies beheadings, stonings and amputations. Kenya has never previously gone to war outside its borders. Buoyed by its example, the Ethiopians have begun invading from the north in what looks set to be a significant ramping up of the conflict against al-Shabaab.
But the incursions have prompted revenge attacks on Kenyan soil - and led to a fresh influx of refugees from Somalia and Kenya. Thousands are on the move. Scores have been killed by grenade attacks and improvised explosive devices in the past few weeks, particularly in the border towns of Garissa and Mandera. Al-Shabaab has also expelled 16 aid agencies from its territory, making it all the more important that those groups who have been allowed to stay continue to reach millions of vulnerable people.
After months of drought, fresh rains have compounded problems. Roads to key villages in the Kenyan border regions are impassable. For much of the past month it has been impossible to truck in food, leading to a rise in cases of malnutrition among children.
"This hospital was built to take 27," explains Ruth Iravaya Mudasa, a nurse at the stabilisation centre in Wajir, where Saadiya was taken. "Last week we were getting 20 children a day." The hospital itself is clean but worryingly crowded. In some wards as many as four children share a single bed.
The Independent accompanied Save the Children on a flight to Wajir to deliver animal vaccines. Many of the few livestock that survived the famine succumbed to disease once the rains fell. Wajir is a sprawling settlement of thatched huts close to the border with Somalia. Its inhabitants are mainly farmers who have watched most of their herds die. Keeping the remaining livestock alive is vital to their future.
Rob MacGillivray, a Save the Children veteran with more than 20 years' experience in delivering aid to conflict zones, is increasingly worried about what he sees on the Somali border.
"The delivery of aid has been extremely compromised as a result of insecurity in north-eastern Kenya," he explains. "We have had to use more imaginative means to ensure the protection of vulnerable people. It's in this context that the value of local staff and partners really comes into its own."
Without those staff on the ground, he explains, it would be all but impossible for Save the Children to reach those in need. One local aid worker in Wajir, who asked not to be named, said: "Life has become so unpredictable. We're just hoping for a light at the end of the tunnel."
But it is not only the Kenyan badlands bordering Somalia that have felt the massive displacements caused by war and drought in the Horn of Africa. Across the region a new wave of Somali refugees is on the move. Large numbers have flooded into the Kenyan capital, Nairobi.
In the capital, slums already filled to bursting point with desperately poor Somalis are having to take in yet more arrivals as they seek shelter with relatives away from the refugee camps to the east.
Mukuru, a corrugated-iron shanty town with 300,000 inhabitants, is one of a number of slums to the east of the city centre that are often referred to as "little Mogadishu" because of the number of Somalis who call them home.
Recent downpours have turned the town's already narrow roads into streams of mud. Somali elders with henna-dyed beards sit listlessly chewing qat as children chase each other among the piles of litter. The slum itself is a hive of activity. Young men collect towering piles of glass bottles for recycling, women working with a single sewing machine put together colourful dresses in sheds connected by a tangle of wires to the high-voltage cables hanging precariously overhead.
But while few of Mukuru's inhabitants are idle, the area is still a place of grinding poverty. "We are getting new arrivals from Somalia every day," says Isabel Muthoni, the head of Okoa Mtoto, a local charity that is supported by Save the Children for its pioneering work within slums, which present a very different set of challenges for aid workers. "Some of the houses have as many as 20 people in them. In the refugee camps at least they get food, here they have nothing."
At the Shauri Moyo Refugee Centre, where new arrivals are encouraged by the police to register, migrants from Somalia, Ethiopia and the Great Lakes region wait patiently in the midday sun. Hudson Wanjala, a local immigration official, says the recent invasion of southern Somalia by the Kenyan military has led to an upsurge in new registrations. "Two months ago we had maybe 50 people a day, now it is 200."
Locals suspect many of the Somalis who have chosen to register have been living without papers in the slums for months or years but have felt compelled to collect the right paperwork after a crackdown by Kenyan police, sparked by the recent military offensive.
Tensions already run high between native Kenyans and the immigrant Somali population but there are fears things could deteriorate if al-Shabaab's promises of carrying out a large-scale attack in Nairobi are realised. In late October, militants carried out a series of grenade attacks in the capital, killing one and leaving more than 30 injured. A large attack could spark violent conflict across the city. "We are afraid that if this war continues, Kenyans may start looking at Somalis as the enemy," says a local police chief, who asked to remain anonymous. "Many of the refugees that come to these areas are in hiding, they are terrified of what might happen to them."
Those in the aid community are also worried that the Kenyan military invasion has been couched as an intervention to create humanitarian space inside Somalia, dangerously affecting the perception of neutrality.
"That created a clear link between military action and delivering humanitarian aid and I think we need to debunk that," explains Rob MacGillivray. "NGOs work exclusively within a neutral environment and are totally impartial in any conflict. The priority for Save the Children is to protect the most vulnerable people, many of whom are caught up in a conflict not of their own making. We will continue to do whatever it takes to get aid to those who need it."
Back in Wajir, there is a renewed emphasis on ramping up the supplementary nutrition programme after the increase in malnutrition cases. Treating a child in hospital is significantly more costly than ensuring they don't fall ill in the first place. Save the Children is currently providing food to more than 200,000 under-fives across north-eastern Kenya. Without this lifeline, Sadiya Ibrahim would have no means of feeding her family. Breastfeeding her 18-month-old daughter Farhi, the fresh-faced mother of three explains how the recent famine has left her entirely reliant on handouts. "We come from a very poor background and we lost all our animals," she says. "The whole village lost their flock. The only way to get food is with the outsiders."
Farhi was also brought to Wajir suffering from malnutrition. After four days' treatment she has improved.
"Soon she will be better," says Sadiya, a smile breaking out across her face. "Soon, inshallah, we will go home."
Appeal partners: Who we're supporting
Many children will be suffering this Christmas because of severe poverty, serious illness, abuse or neglect. Our Christmas appeal aims to help readers to make a donation which will help some of the most vulnerable children both here in the UK and in the world's poorest countries. Money raised will be divided equally between three charities:
Save the Children
Save the Children works in 120 countries, including the UK. They save children's lives, fight for their rights and help them fulfil their potential. Save the Children's vital work reaches more than 8 million children each year - keeping them alive, getting them into school and protecting them from harm. www.savethechildren.org.uk
The Children's Society
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Rainbow Trust Children's Charity
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At The Independent we believe that these organisations can make a big difference to changing many children's lives.
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