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."
"As aid workers, we're all beyond frustrated at the inability to reach children who are literally dying. That's horrific," Wolff said.
Diakonie Katastrophenhilfe, part of the social service arm of the German Protestant Church, flies medicine and medical supplies in to treat malnutrition and diseases in Mogadishu, according to ACT Alliance, an organization of NGOs affiliated with the World Council of Churches and the Lutheran World Federation. Norwegian Church Aid is also working around Mogadishu, according to the organization's website. The Adventist Development and Relief Agency is in the midst of a three-month food distribution project in the Mogadishu region, said spokesman John Torres.
World Concern is one of the few groups that aids internally displaced Somalis inside the southern border before they enter Kenya to become refugees. Communications director Derek Sciba said it is too dangerous to travel far, so workers stay within about 15 miles of the border near the town of Dhobley.
The robbers and bandits preying on refugees near the border also target food convoys, so those are impractical, said Josephat Ngaira, Kenya country director for World Concern. Instead, workers use a voucher system to give Somalis money to buy food and other items from local vendors.
The United Nations refugee agency announced October 4 that relief agencies in Dhobley had temporarily suspended aid to the area after late September fighting between Al-Shabaab and the transitional government that reportedly killed 30 soldiers and two civilians. Sciba said World Concern was working in Dhobley again within a week.
Once Somalis make it across the border to Kenya, they seek help in Dadaab, a 450,000-person collection of refugee camps near the border. Some head west instead, to the twin camps of Dolo Ado, at the Kenya-Ethiopia-Somalia border, and Dolo, a camp for internally displaced persons just inside the Somali border.
Aid workers at these camps give refugees food and shelter, but the camps are located in food crisis and emergency areas, surrounded by thorny bushes and animal carcasses, said Ngaira.
"As you look around, the first thing that goes through your mind is, 'Oh my—if this is a refuge, what are these people fleeing from?' Because this looks bad," said Harry Kraus, a doctor who works with African Inland Mission near Nairobi and recently traveled to Dadaab to perform surgeries. "Yet they're content to be in a place where they're not fleeing bullets and where they're getting a small ration of food."
Twenty agencies, including World Vision, Oxfam, and Finn Church Aid, signed an open letter calling for a cease-fire in Somalia and free passage for aid groups and seekers. Menkhaus said Al-Shabaab would probably not make such an agreement. Indeed, the group was blamed Tuesday for a car bomb in Mogadishu that seemed designed to disrupt talks between the transitional Somalia government and Kenya's defense and foreign ministers.
As the rainy season sets in, bringing diseases like cholera and measles, aid agencies expect the crisis to get worse before it gets better.
"This does not happen in one cataclysmic event like an earthquake, but it's happening over time," said Sciba. "Each family faces this one by one. It's like a slow moving freight train of tragedy."
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See last week's article, "Undoing the Famine Damage | If the famine in the Horn of Africa is manmade, human intervention can end the crisis."
Previous CT coverage of world hunger and drought in the Horn of Africa includes:
Famine in East Africa: Who Cares? | Several Christian NGOs are on the move, provided they can get the appropriate funds. (August 19, 2011)
Polling Evangelicals: Cut Aid to World's Poor, Unemployed | A Pew Research Center survey suggests evangelicals prefer the government spend on schools, the military, and police. (February 18, 2011)
Hunger Isn't History | The world produces more food than ever. So why do nearly a billion people still not have enough to eat? (November 7, 2008)