We have been driving around the world's largest refugee complex, late for an appointment with an NGO, as we are lost amid seemingly endless rows of ramshackle huts built of sticks and discarded packaging from aid organizations. The driver is making me nervous as he steers recklessly through women in hijabs, children with bare feet and men with donkey carts, moving through the narrow roads of desert sand. The hired guard, a moonlighting soldier, seems at ease, chatting loudly on his mobile phone as he cradles his machine gun in the other hand.
Realizing that we are lost, we park near a dried-out tree on the edge of the Hagadera refugee camp, one of the three in the Dadaab complex in eastern Kenya, when a man runs toward me shouting, urgently asking for help. What happens next seems to be a metaphor for the crisis that has overtaken this portion of the country, now the safe haven for the tens of thousands of people fleeing the world's worst hunger crisis, a famine that has gripped war-torn Somalia, the result of the worst drought in the region in 60 years.
The man, an aid worker named Maash, tells me that a woman who has just given birth is hemorrhaging and needs to get to a hospital right away. The woman, called Mrs. Hassan, has just arrived in the camps after walking for two weeks — she is one of tens of thousands escaping from Somalia into Kenya. With her is another new mother, who looks to be barely out of her teens, cradling a severely malnourished child. There is no ambulance available.
We get into the car and drive off toward the hospital, but after just a few minutes, we are stuck in the sand. The driver, a surprise substitution for my professional driver the day before, does not seem to have experience driving in the off-road conditions of the camp. Passersby try to help push us out while the wheel spins. Inside, the women sit quietly, their faces tight, showing little expression. I am scared. Our car is freed then gets stuck a second time. We dig the wheels out, push, and finally the SUV gets moving again.
Thousands of Somalis are facing similar health crises and are forced to fend for themselves. They face a grueling, dangerous journey with little food or water. According to Médecins Sans Frontières, 1 out of 3 newly arrived children suffers from acute malnutrition. Once the refugees arrive at the camps, they find they face an entirely new struggle: the camps have been closed since 2008 because of severe overcrowding. Filled up as the result of the Somali conflict in the past two decades, they are now four times their capacity. New arrivals are forced to end up on the outskirts of the camps, and there are more than 380,000 people in the camps and the outskirts. Newcomers, now arriving at a rate of 1,400 per day, are left to build their own shelters in the desert on the edges of the established camps. Their number has reached over 70,000. Despite the heroic efforts of NGOs working in the area, many people have little access to clean water, toilets, security or medical care. The U.N. refugee agency is starting to move people in the outskirts to a new tent camp, but that is not expected to be completed until November. Meanwhile, news reports from Somalia say that the Islamic militant group al-Shabab is preventing hungry people from fleeing the country.
One senior aid official in Dadaab says that while his organization is gratified to see promises of millions of dollars from the U.S., Europe, Saudi Arabia and other wealthy countries in the wake of the recent media coverage of the crisis, it is also very frustrating because in fact the crisis has been going on for many years and the drought was forecast a year ago. The chaos that is happening now is unnecessary, he says. "It is the procrastination by everybody in world; they wait until the situation gets out of hand."
The camps had been badly overcrowded for years, and since January had been receiving 10,000 refugees a month — already a huge number. But it was not until that monthly number surged to 30,000 in June that the media and the politicians took notice. "They only come in when they can actually witness the situation," said the aid official, a veteran of the camps, who was not authorized to speak on the record. "They want to see if it is really true that kids are malnourished."
The current wave of attention from the media and international donors is leading to commitments of millions of badly needed dollars, but this is a long-term crisis that the world has only just woken up to. "Unfortunately, when we get the support and response from donors, it is only after they see this in the media," said William Spindler, spokesperson for the U.N. High Commissioner for Refugees in the Dadaab refugee complex. If donors had reacted in a timelier manner, the relief agencies could have increased staffing, stockpiled more supplies, and set up reception centers closer to the Somali border — all things that would have alleviated the current chaotic crisis.
There is currently a massive backlog of refugees: more than 30,000 people who have to wait up to two weeks to get registered — meaning no housing and limited rations. The severely strained resources have led to a three- to six-fold increase in child deaths. "We are very aware that we are not responding to the needs as fast as we should be," said Spindler, who said that the problem stemmed from a combination of the overstretched U.N. relief agency and the particularly bad condition of the arriving refugees.
U.S. aid officials admit their frustration at the current chaos and say that longer-term development efforts are needed to prevent the same thing from happening again. "We know that it is one-tenth the cost to provide effective agricultural support and help communities gain food security than it is to provide food aid at a time of famine, and [yet] we are standing right here providing food aid at a time of famine," Rajiv Shah, the head of USAID, told TIME as he visited a refugee intake center. "So we are working hard but this change doesn't happen overnight." He was on a visit to Dadaab to announce a donation of $28 million to the refugee crisis. (The U.N. refugee agency has said it needs an additional $145 million to deal with the crisis.) Meanwhile, dozens of refugees are crowded outside the gates of the reception center waiting to enter.
In the end we make it to the hospital run by the International Rescue Committee. Despite the delays, Mrs. Hassan and the child receive treatment in time. The next day I get a text message from Maash, the aid worker. He says Mrs. Hassan is now in stable condition, and so is her malnourished baby. "Jst 2 thank u for da support. The mother n her baby r vry stable... . Am glad we saved lives."