The drought that has gripped the Horn of Africa has led to a famine in Somalia and severe hunger crises in Kenya and Ethiopia. Here, people in Wajir, Kenya, roll water barrels across an arid landscape. Image by Sam Loewenberg. Kenya, 2011.
Halima Samow, 25, with her 2-year-old son, Mohammed, in the village of Sita Wario, in northern Kenya. A former nomad, she has been forced to settle here and now depends on trucked-in water and food to survive. Image by Sam Loewenberg. Kenya, 2011.
The drought that has gripped the Horn of Africa has led to a famine in Somalia and severe hunger crises in Kenya and Ethiopia. Here, people in Wajir, Kenya, roll water barrels across an arid landscape. Image by Sam Loewenberg. Kenya, 2011.
At the Argane watering hole, in northern Kenya, these camels traveled three days without water. The hump of the brown camel had collapsed, and the white camel was not expected to live much longer.
Adey Issack, one of the founders of the Kutulo Farm, a collective run by women in Wagberi, Kenya, said they would like to expand, but did not have the capital. Image by Sam Loewenberg. Kenya, 2011.
The children at the Kutulo collective farm seemed nourished and energetic, in contrast to other hungry children in the region. Image by Sam Loewenberg. Kenya, 2011.
In the village of Kursin, in northern Kenya, people filled water tanks at a cost of almost 25 cents each, a large proportion of their income. Image by Sam Loewenberg. Kenya, 2011.
Many children in the primary school in Kursin left because of the drought, and those who stayed were too weak from hunger to learn, said Esther Wanja, their teacher. Image by Sam Loewenberg. Kenya, 2011.
Idhey Sheikh, 28, with her 2-year-old son, Mohamed Ibrahim. By July, the family’s animals had died, milk had become too expensive and children were dying in the community every month. Image by Sam Loewenberg. Kenya, 2011.
The drought has taken its toll in Kursin, where livestock have died in the middle of the village. Image by Sam Loewenberg. Kenya, 2011.

This past summer I came across a camel that had lost its hump. After a long journey in search of pasture, the beast was swaying beside a brackish well, its ribs and hip bones showing. The hump hung flaccid off its back like a deflated balloon.

I was in northern Kenya, which is suffering through the worst drought to hit the Horn of Africa in 60 years. The toll of deprivation is everywhere. In the village of Kursin, emaciated livestock are collapsing in the middle of town; the local headmaster, Ismael Ali, told me they’ve “had a problem with dead carcasses around the school.” Attendance dropped sharply since the beginning of the year, as many families left the parched region with their flocks, some even crossing into war-torn Somalia in search of food.

American attention to the hunger crisis has focused on the dire conditions of Somalis, but they account for just about a third of the 13 million people affected. According to the United Nations, hunger afflicts 4.5 million people in Ethiopia and 3.75 million people in Kenya, which has about half of Ethiopia’s population. An estimated half a million Kenyan children and pregnant or breast-feeding women suffer acute malnutrition.

The drought has been mounting for a year, but it wasn’t until the crisis peaked over the summer that the news media and most international donors took notice. It’s a familiar cycle: first come the news media pictures of emaciated infants, followed by conferences on how to do better next time, visits from top-level government officials and large financial commitments from international organizations and even donors like China and the Ikea Foundation. The United States Agency for International Development and the Ad Council have even begun a celebrity public service campaign with the actors Uma Thurman and Josh Hartnett.

This is good news; the assistance is badly needed. Yet the mismatch in timing raises a question that bedevils aid agencies. Unlike earthquakes or hurricanes, droughts and food price increases take time to develop, and the resulting hunger crises are forecast well in advance. From water harvesting to livestock support to cash assistance, there are a plethora of steps that could have significantly ameliorated the current crisis. Why weren’t they taken?

This year’s drought followed two failed rainy seasons, leaving farmers and herders fragile. When coupled with skyrocketing food and fuel prices, catastrophe loomed. The Famine Early Warning Systems Network, financed by U.S.A.I.D., anticipated it as early as August 2010, and by January the American ambassador to Kenya had declared a disaster and called for urgent assistance.

Although the United States began stockpiling emergency food in the region, that wasn’t enough. On June 7, the warning network announced, “This is the most severe food security emergency in the world today, and the current humanitarian response is inadequate to prevent further deterioration.” At that time, there were 7 million people in jeopardy. Now, the number is 13 million.

A common misconception is that hunger crises are about a lack of food. Yet there is food in Kenya and Ethiopia, and even in many parts of Somalia. The real issue is poverty. The people affected are poor to begin with; when things turned bad, they had no recourse. In April the World Bank reported that 44 million people worldwide were pushed over the edge by skyrocketing food prices.

Such a perspective is largely missing in our food-aid program. It’s like a health insurance system that waits until someone has a full-blown illness before he or she can get treatment. By the end of June, with the crisis in full swing, the United States had committed a total of about $64 million to Kenya, much of it in the form of food supplies (this doesn’t include relief for the Somali refugees). But food aid loses at least half of its value, according to the Government Accountability Office, because we ship actual food instead of sending cash for local purchase, like most countries. And only $5 million was allocated to agriculture, nutrition, water and sanitation — about $1.33 per hungry person — things that would have helped people during lean times.

Blame politics. Medium- and long-term planning is often the first thing to be cut from an aid budget. After the food price crisis of 2008, when hunger riots erupted around the globe, President Obama got the Group of 8 to promise $22 billion for agricultural development and food security. But many of those commitments have not been met. Meanwhile, this summer Congressional Republicans voted to cut the foreign food aid budget by a third, and more cuts are planned.

And, of course, there is the matter of optics: donors want to see dead babies before they provide significant assistance, one frustrated aid worker told me.

Blame also lies with the Kenyan and Ethiopian governments. In the northern district of Wajir, for instance, by July the central government provided only about half the food assistance that local governments requested, while Ethiopia, according to the BBC, misused aid for political purposes. It is an old story: sending emergency aid is clumsy, and often fraught with problems. As I was leaving a village that depended entirely on delivered water, I passed the water truck the villagers were waiting for, broken down by the side of the road.

Aid officials say they realize that prevention is better than reaction. “We know how to do this,” Rajiv Shah, the head of U.S.A.I.D., told me during a trip he made in July to Kenya’s Dadaab refugee camp. “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.”

Our shortsighted response also highlights a misunderstanding about foreign assistance and prevention. “We are not investing in relatively obvious solutions,” said Christopher Barrett, an expert on food aid at Cornell University. Those mundane but vital interventions include shoring up the water supply and helping to bolster markets and transportation so that economies continue during lean times. The best assistance, people in Wajir told me, would be a decent road to the south, which would cheapen imports and give them a market for their animals.

DRIVING through Wajir’s sandy, arid landscape, we turned the corner to an amazing sight: a green oasis — a farm, a greenhouse, a well, a water pump, a windmill. Running around were the first happy, healthy-looking children I had seen. This is the Kutulo Farm, a women’s cooperative in Wagberi, where they grow kale, cabbage and peppers. They received money for the well from the European Union, but otherwise have done everything on their own. They would like to expand, said Adey Issack, one of the founders, but have no access to credit.

Programs like the Kutulo Farm are significantly cheaper to start and maintain than sending mounds of food aid at the last minute, in large part because they leverage the skills and knowledge of local residents to do the work. The current crisis is a painful demonstration of how well such an approach works: those few communities that received small, well-designed assistance are weathering the drought relatively well.

While recent rain has eased the pressure, much of it will be lost because of a lack of water-collection facilities. And experts warn that so many in Kenya are weakened and destitute that the cycle is expected to start up again in May. In other words, droughts cannot be stopped. But the economics that link drought and famine can be upended, so that next time, the people of Wajir, and dozens of countries around the world, might be able to avoid untold, and unnecessary, suffering.

Samuel Loewenberg is a Nieman Foundation global health reporting fellow at Harvard. The Pulitzer Center on Crisis Reporting provided a travel grant for the reporting of this essay.

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Sky-rocketing food prices, drought, conflict, and an insufficient response have left populations in the Horn of Africa on the brink of famine.

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