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Children play at a makeshift refugee camp on the outskirts of the Dadaab complex. Image by Sam Loewenberg. Kenya, 2011.

The outskirts of the Dadaab refugee complex are jammed with dome-like huts made of sticks, refuse, plastic sheeting and discarded cartons from aid packets. Toilets are scarce, and water is delivered periodically by truck. More than 60,000 people are occupying these makeshift encampments built atop a harsh arid landscape in the far east of Kenya, just over the Somali border. The ragged domes in the desert look like something from the post-apocalyptic world of Mad Max.

The Dadaab refugee complex is already the largest in the world, with more than 380,000 residents - four times the capacity it was built for, when the three encampments that form the complex were built in the early 1990s. The camps no longer accept new admissions, so tens of thousands of new refugees, most of them women and children, that are fleeing Somalia in the wake of the drought that has gripped the horn of Africa are left to set up makeshift housing in the no-mans land that surrounds the official camps. Simply put, there is no place for them in Dadaab itself.

The famine-like conditions in Somalia have led to an increase in the number of refugees coming over the Kenyan border from around 5,000 per month in 2010 to an estimated 30,000 in June. The refugees must make a perilous journey from their conflict-ridden country and navigate for days through forbidding terrain, usually on foot. Most of those who arrive are badly malnourished, and aid workers say that many children did not survive the trip, while others died as soon as they arrived.

Hawa, 40, came here from the Buale district in Somalia after a 23 day trek on foot with her seven children. She left, as did all of her neighbors, because there was not enough food. When fighting arrived in her locale, her husband disappeared, and she fled with the children. Her one year old son, Abdu Noor, is recovering in a hospital run by Medecin Sans Frontiers from severe malnourishment. Now, the rest of her family has settled in a makeshift hut in the outskirts of the official camps, living rough and scrambling for basics like food and water.

Coming here, she had hoped for a safe haven, says Hawa. "What I found is that there is little difference between Somalia and a refugee camp."

The recent surge of refugees has led to a flurry of new media and diplomatic attention, but in truth the conditions in the camps have been bad for years, with four families forced to settle on a plot built for one. Things really began to get bad in January of this year, but despite warnings from aid groups and relief agencies and government drought monitors, the response from international donors was tepid.

"We raised the alarm quite early, but for me, the response was inadequate", says Dr. Edward Chege, the director of the hospital run by Medecíns Sans Frontières in the Dahagely refugee camp. The number of severely malnourished children - meaning they are close to death — at the hospital has swelled from 20 in January to more than 130 now. They expect the number of patients to increase in the coming six months, says Dr. Chege.

Malnutrition rates for small children in the outskirts is around 30%, and about half of those are severe. That is twice as high as the malnutrition rates in the official camps, but even 15% is already at crisis levels. It is usually children under 2 that get the worst of it. That said, aid officials say they are seeing severely malnourished children up to 10 years old, which is extremely unusual and shows the severity of the crisis.

At the reception area where new arrivals are registered and receive a food ration, a man with visible strain on his face, Abdikarim, is comforting his family. He came from Mogadishu with his 2 boys and 3 girls. They arrived at the border in the back of a truck and then walked the 100 kilometers to the camp. They had no food for three days, he tells me. A mother, Hawo, has a distracted, yet urgent, gaze, as she describe how she left four of her children and her husband in Mogadishu, and came here with only her 10-year-old daughter, Farhiyo. The journey took them five days, with little food or water.

"This is the most problematic and challenging refugee situation in the world," said Antonio Guterres, the chief of the UN refugee agency (UNHCR), which runs the camps, who made a visit to the camps earlier this month to press the Kenyan government to allow UNHCR to expand the existing camps.

Guterres' visit appears to have been a success. Late last week the Kenyan government announced it may allow the opening of Ifo II, a new camp that had originally been slated to get underway last November but that been blocked by local officials who wanted a greater say in how the camp was designed and set up as well as compensation for use of the land. Central government officials said they were concerned about security, having in mind sensitive Kenyan ethnic, territorial, and electoral politics.

The Ifo II camp is designed to hold 40,000, so it will take off some of the pressure, but with the camps already at four times their capacity, with 70,000 in the outskirts and the numbers increasing daily, it won't be nearly enough. UNHCR says it has other camp sites that could hold several hundred thousand more people, but they have yet to be built, and at this point it seems unlikely the Kenyan government would be willing to allow such a large expansion.

Kenyan Prime Minister Raila Odinga says that new feeding programs should be done in Somalia, not Kenya. Whether that is viable is questionable. The al-Shabab Mujahideen, an Islamist militia group, had prevented the World Food Program and other international relief agencies from working in Somalia since last year, but have recently said they would be willing to lift the ban. Relief groups say al-Shabab's promises mean little unless there are concrete safety measures in place.

Meanwhile, the aid machinery is in full swing, with official visits already under way from rich country ministers and heads of state, and aid agencies courting journalists and donors in a bid to raise emergency funds. Millions of new dollars have been pledged in the last week. But given that these camps have been in a badly overcrowded state for more than a decade, and the current drought was forecast from the beginning of the year, it makes one question what took so long. And with no end in sight for the Somali conflict, and climate change leading to droughts in the region that are harsher and longer term, opening new camps, wherever they may be, is at best a short term solution. The original camps were supposed to be short-term too — and that was 20 years ago.

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