A few weeks ago, around nine million were facing starvation in the Horn of Africa.
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Now it is approaching 13 million. The number going hungry is bigger than the entire population of Belgium – with some two million children under five malnourished, and, says the UN, at least 30,000 dead.
Countries across East Africa have been ravagedby one of the worst droughts in decades; in many places this has meant no rains at all for two years. Although Somalia and Kenya have dominated the headlines, Ethiopia, Eritrea and Djibouti are all suffering from the effects of their soil being reduced to arid dust.
With millions at risk of death the need is critical, but the sense of urgency has not reached everyone. An African Union donor conference which was supposed to take place on Tuesday has been postponed for a fortnight because the heads of state claim they need more notice to attend. They had already been given two weeks.
Islamic Relief's emergency programme manager for Somalia, Hassan Liban, said: "How many evaluations do you need? It's obvious that the situation is desperate and we need to get more food to people. The world has so much information but no support is coming.
"Today, in one of the camps in Mogadishu, we found a grandfather reciting the Koran to his one-year-old grandson, giving him the last rites. We asked why he wasn't taking the boy to the hospital and he said he would have to abandon a group of other desperately malnourished children he was caring for. We rushed the boy to the hospital but he died on arrival."
In the countryside – particularly in the south – it is far worse. There are reports of whole villages deserted, where people have abandoned homes for fear they would become their graves.
And in Kenya, with half a million refugees and an ongoing food crisis of its own, the number going hungry is now understood to be not far behind Somalia at 3.7 million.
Meanwhile, in Dadaab refugee camp, near the Somali border, the population is still soaring. If the stream of refugees from Somalia does not abate, it is expected to number half a million by the end of the year.
With such a concentration of people come serious problems. Crime is rife in Dadaab, and police report that armed bandits are attacking people for what little food they have.
Salado Ali Haron, 70, brought her three grandchildren to Dagahaley camp in Dadaab from Solagle in southern Somalia after their parents died of starvation. Her eyes are clouded with blindness, which meant she didn't see when a thief took the supplies her family had just been handed. "Because I'm very old and can't see well I put [our parcel] in front of us inside the distribution centre. A man said he would take it for me but I didn't know where he went. He just took it – took all the blankets, plastic sheets, maize and utensils. All he left me was just the wheat flour."
Thanks to the ballooning population, many newer residents are becoming malnourished a second time. A bureaucratic backlog means those arriving now will wait up to three months before completing the registration process that gives them ration cards and reliable access to food. In the meantime they are forced to survive on the one week's rations handed out on arrival.
Many of the most acutely malnourished never make it to camps such as Dadaab. There are reports every day of mothers and children perishing at the side of the road, unable to make those last few miles. In the town of Liboi, near the Somali border, aid agencies have now set up feeding and treatment centres for the thousands coming through every week. Unicef spokesman Chris Tidey said: "People are in pretty bad shape when they arrive in Liboi. Those that stop are the ones without the strength to keep going. If they didn't get help there they wouldn't make it all the way."
Even those who do make it to the camps are not yet safe; some are so weak they die moments after arriving. On Friday there were 10 freshly dug children's graves on the outskirts of Ifo camp – one of the main settlements in Dadaab.
In Somalia, where a child is said to be dying every six minutes, three new districts were declared famine zones last week. Almost five million people are now at risk of starvation, but help has been hampered by continued violence.
Yesterday the government declared that the Islamist extremist group Al-Shabaab had been driven from the country's capital, Mogadishu. But the al-Qa'ida-inspired rebels say it was just a tactical retreat, and the conflict is expected to continue. On Friday at least 10 Somalis were killed during a gun battle in Mogadishu, when troops and residents looted trucks of food meant for famine victims. The World Food Programme says aid cannot reach more than two million Somalis in the worst-hit southern areas because Al-Shabaab fighters have blocked access for most agencies. The few charities already working in these regions are getting increasingly frustrated that back-up has not been arriving fast enough.
The Vice-President of the United States, Joe Biden, is expected to arrive in Dadaab tomorrow. His presence will refocus attention on the world's biggest refugee camp, but Ethiopia is facing a similar – yet largely unreported – tide of the hungry, with more than 20,000 people arriving in Liben refugee camp alone last month.
A combination of a government keen to sweep the problem under the carpet and borders that remain more inaccessible to NGOs and journalists than neighbouring Kenya's means that the refugee situation in Ethiopia has been largely ignored.
Kenneth Lavelle, deputy programme manager for Médecins Sans Frontières, said: "In the last few months in Ethiopia there has been an extremely worrying situation for new arrivals. There are some reports from MSF teams in camps in southern Ethiopia that more than 50 per cent of children are malnourished."
Eblah Sheikh Aden, 35, sent four of her seven children back to Somalia when she realised the delays in getting help in Ethiopia's Kobe camp. "They were extremely sick and there wasn't food here. I couldn't watch them die and had to make a decision." It took her two days to walk to the camp, and another nine days to be registered and get food.
The rising cost of basic food is making survival even harder for farmers whose crops or livestock have perished. Last year in Turkana, north-west Kenya, it was 10 or 20 shillings for half a kilogram of maize, but this year it became 100. Once the farmers' herds are little more than sacks of bones, the livestock can no longer be sold – or only sold for a tiny sum, leaving them with nothing.
In the small country of Djibouti, where more than 160,000 – or a fifth of the population – are at risk of dying from starvation, the problem is less to do with drought than escalating food prices. With the majority of the population living in Djibouti city there is comparatively little farming, meaning rocketing food costs leave many priced out of making even the most basic meals.
The question now – both for the people who have found help and those clinging to hope at home – is what the future holds. If the rains fail again in October it may not be a question they want an answer to.
Additional by reporting Kitty Teague
12.4m people are at risk of dying from hunger in the Horn of Africa.
2m children under five are malnourished.
3.7m people are at risk of dying from hunger.
1.5m internally displaced Somalians.
651,885 refugees who have left Somalia.
250 children die every day, per 10,000 population, in southern regions of Somalia.
One child dies every six minutes.
3.7m people are at risk of dying from hunger of which...
3.2m are locally affected.
476,808 are Somali refugees.
77,777 are other refugees.
388,000 current population of Dadaab refugee camp, It is expected to rise to 500,000 by the end of the year.
4.8m people are at risk of dying from hunger of which...
4.6m are locally affected.
157,923 are Somali refugees.
80,500 are other refugees.
55% of children under five are malnourished on arrival at the Liben camps in Ethiopia.
100,000 people are sheltering in Liben in camps originally designed for 45,000.
165,264 people are at risk of dying from hunger of which
17,154 are Somali refugees.
1,510 are other refugees.
860,000 the approximate population of Djibouti.
SOURCE — UN, Médecins Sans Frontières, Unicef