With famine continuing to ravage Somalia and a crush of refugees taking a toll on Kenya, Ethiopia and other countries even as they also manage the East African drought, the United Nations this week appealed for $1.2 billion more to help the region.

Valerie Amos, the United Nations' undersecretary-general for humanitarian and emergency relief, said that from Mogadishu to the Dadaab refugee camp in Kenya -- now the world's largest -- it is clear that relief efforts are working, but more is needed.

Speaking upon her return from Somalia and Kenya, Amos described Dadaab as "more a city than a camp," with new arrivals from Somalia arriving, and dying, each day.

"I met one woman who had lost all four of her children on the journey from Somalia to Kenya," Amos recounted. "There's a tremendous amount of work going on in Dadaab to keep the camp and refugees in supplies. In the weeks ahead, we also need to step up our efforts to ensure the host communities in areas accepting refugees are being helped, as well."

The Horn of Africa is suffering from its worst drought in 60 years, putting about 12 million people at risk of starvation across the region. So far, though, famine has only been declared in Somalia, a failed state without a functioning government.

Kenyan villages also under stress

U.S. Agency for International Development maps (pdf) tracking food insecurity that contrast conditions in Somalia with those in its neighbors are stark. More than 184,000 people have fled Somalia so far this year to neighboring countries like Kenya, Ethiopia, Djibouti and Yemen. The exodus has swelled the number of Somali refugees in the region to more than 800,000.

While addressing the needs of the refugees is critical, aid workers say, so is tending to the settlements around camps like Dadaab.

Rod Charters, the sub-regional emergency coordinator for eastern and central Africa at the Food and Agriculture Organization, recently spent about 10 days in Dadaab and the North Eastern Province of Kenya.

"It's quite shocking," he said. "In this day and age to have thousands and thousands of people having to move is, to me, very shocking." Looking at ways to support neighboring communities in Kenya, which he said "are not only suffering from the drought but also considerable stress from the refugees who are coming from Somalia into Dadaab," is a top priority.

More than 400,000 people, mostly from Somalia, are registered at the Dadaab camp. According to the United Nations, more than 70,000 new refugees arrived in the last month.

Meanwhile, the U.N. refugee agency announced Tuesday that child mortality rates at a camp for Somali refugees in Ethiopia have reached "alarming" levels. An average of 10 children under the age of 5 years have died every day since June at the Kobe camp. Acute malnutrition, compounded by a measles outbreak, is believed to be the cause.

U.N. officials say donors have committed more than $1 billion to the response so far. The United States has pledged $222 million in recent weeks.

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