When the rains failed in Somalia, a war zone with few roads or hospitals, the consequences for people who live off the land were inevitable. But one year on, few expected the scale or the pain of the disaster now unfolding

Niman Adan Gabus is two years old. He was one of 363,000 Somali children suffering from acute malnutrition. Niman will now survive after he reached help at Hargeisa group hospital.

Those who don’t reach the main hospitals are likely to die, says William Babumba of the International Federation of Red Cross and Red Crescent Societies. “We have mobile clinics, which are very effective, but severely malnourished children need to reach hospital and this is very difficult, very few can,” says Babumba, in charge of the Somalia region. “It is difficult to know exact numbers but we have heard reports that we may have already lost around 10,000 people to the drought.”

Shukra Awal Ali, five, seen here last week, is one of six daughters in a family that had no food to eat that day. In the worst-hit villages, one cup of rice is being cooked each day, stretched to feed six people or more. Gathering firewood to build cooking fires is a struggle. Even so, people are sharing what they have with others who have nothing to eat. Mothers have reported eating just one square meal a week so that their children have food.

“Drought didn’t come overnight. It was a build up of various factors,” says Babuma. “The rains failed in 2015, then the situation really became a concern in 2016. Now things have escalated. Now we have 6.2 million people across Somalia who are urgently in need of food, so at least one in two people in the whole country are affected.”

The UN has estimated that up to half a million children will suffer acute malnutrition in the country this year. Many who survive will face related health problems throughout their lives.

Hamda Mohamed Ibrahim, 25, of Dacawaley village in Somaliland, has lost two children to malnutrition in the past 18 months. Now she is worried about losing another.

Sarah Awal Ali, 44, collects water at a local well in Somaliland. People have to walks for miles, sometimes for hours, to find water. Outbreaks of cholera are being reported where water points are becoming polluted or insanitary.

For people who live pastoral lives, the death of their animals is a massive blow. The drought has left swaths of countryside dotted with the corpses of cattle.