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Somalis running from famine toward the Dadaab camp in Kenya must run one more gauntlet before they reach refuge.

Bandits hide in the thorny bushes dotting the sand, waiting to steal anything that refugees haven't lost already.

"When they come, they have nothing," said Rachel Wolff, director of media relations for World Vision. "They sometimes don't even have the clothes on their backs."

The drought stretched across the Horn of Africa to hit Kenya, Ethiopia, and Djibouti. But the crisis only reached U.N.-specified famine conditions in Somalia, where one-third of the children are extremely malnourished. UNICEF estimates that 14 children are dying each hour in some parts of the country.

Refugees are running from East Africa's worst drought in 60 years. Tens of thousands have died and the death toll may reach 750,000 before the end of the year. The worst part of the drought is in Somalia, and refugees are pouring out because aid agencies cannot get in.

World Vision, Lutheran World Federation, Samaritan's Purse, the American Friends Service Committee, and other aid groups work in massive refugee camps across the country's borders in Kenya and Ethiopia, and in northern Somali communities where the government is more stable, but few venture to southern Somalia's worst-hit regions.

And now Dadaab itself has been declared unsafe: With the kidnapping of two Spanish women working with Medecins Sans Frontieres, the aid organization has evacuated its four dozen staff to Nairobi. The U.N. halted almost all aid operations in the refugee camp, but they have since resumed.

Meanwhile, only a handful of humanitarian groups work in the famine areas in the middle of southern Somalia, said Ken Menkhaus, a Somalia policy expert and professor of political science at Davidson College. This area is controlled by Al-Shabaab, a militant Islamic group the U.S. has labeled a terrorist organization. Many of the aid groups allowed in are new local or Islamic aid agencies it can easily control, Menkhaus said.

Unni Karunakara, the international president of Médecins Sans Frontières, visited Somalia in late August and returned frustrated at the small number of aid agencies actually working in the country.

“There is a con, there is an unrealistic expectation being peddled that you give your £50 and suddenly those people are going to have food to eat,” Karunakara told The Guardian. “Well, no. We need that £50, yes; we will spend it with integrity. But people need to understand the reality of the challenges in delivering that aid. We don't have the right to hide it from people.”

Al-Shabaab probably gets some of any aid that groups bring to its territory, but relief agencies keep any deals secret to protect government relationships and keep donations flowing in, Menkhaus said. According to a recent report by the Overseas Development Institute, counterterrorism laws introduced since September 11, 2001 have undermined partnerships and increased operating costs for many humanitarian organizations.

"There's just this whole architecture of dissembling for good reasons. It's very utilitarian," Menkhaus said. "The ends justify the means: If we can all collectively say things that none of us believe then maybe we'll get some access and save some lives."

Aid groups have better access to Mogadishu, the country's capital, which is right in the middle of a famine area and controlled by a transitional government.

Aid groups can get food to Mogadishu, but still have a hard time getting it to the starving. Corrupt guards and officials take as much as half of it, Menkhaus said. Violence is also a problem: A car bomb attack by Al-Shabaab on Oct. 4 killed more than 70 people in a government compound. This week Kenyan troops openly entered Somalia, with Kenya's Internal Security Minister promising "to pursue the enemy, who are the Al-Shabaab, to wherever they will be, even in their country."

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