The circumference of Nimo Abdi Duh’s upper arm measures just 12cm and, while the number means nothing to her, it does to the health workers treating her. Nimo, two, like so many children in the arid lowlands of Ethiopia, is suffering from malnutrition. “We have been affected by the drought,” says her mother, Shems Dire, looking anxiously on. “We don’t have milk to give to the children. My child is sick due to lack of food, and this happened because of the drought … Our cattle have been harmed by the drought. We have lost so many. “We pray to Allah for rain.” In a country already grappling with humanitarian strife brought on by civil war, aid workers and local officials say that another crisis is slowly unfolding, as severe drought plagues much of southern and north-eastern Ethiopia. By mid-March, it is estimated that more than 6.8 million people in the affected regions are expected to be in urgent need of humanitarian assistance. According to Unicef, almost 850,000 children in those areas will be severely malnourished this year due to a combination of drought, conflict and economic downturn. “We have had the failure of three consecutive rainy seasons,” says Gianfranco Rotigliano, Unicef’s country director. “If in April the rain comes, things will get better. But, if not, then we will have something that is comparable to what we saw in 1999 or 1993 to 94.” Those years brought drought-provoked crises to Ethiopia that saw millions go hungry, and some die from starvation. Now, to help get essential supplies to those who most need them, Unicef is appealing for £23.7m, for, among other things, water trucking, the rehabilitation of wells and child nutrition. If that money isn’t raised, Rotigliano warns: “As they say in west Africa, ce sera la catastrophe [it will be a disaster].” With an estimated 4.4 million people facing critical water shortages, the lowlands of Ethiopia’s south-eastern Somali region and parts of Oromia are thought to be most severely affected by the drought. Abdi Farah Ahmed, from the regional health bureau in Jijiga, Somali, says the lack of rainfall – which locally came on top of a locust invasion – caused crops to fail, livestock to die, and malnutrition to rise. Many people had left their homes, he adds. According to a survey in December, more than a fifth of under-fives in Somali are suffering from global acute malnutrition. Abdi Farah says the number of those suffering from severe acute malnutrition (SAM) was also rising. Last year, the average number of people admitted to regional healthcare services with SAM was more than 9,000, he says. “But in December 2021, the number of new SAM cases admitted at the health facilities was 11,588. This means a rise of 18.5% [on the previous month],” he adds. Zainab Wolie, a mother of seven children from Saglo village in the Somali region, says she had been hit hard by the lack of rainfall. She used to sell some of her goats to supplement her income, but she lost almost half of them to the drought. “We depend on our cattle. We lost many of them. Who knows, people may also die next? I haven’t seen such a drought before … Five years ago, there was drought in our area, but at least we had food. But now we don’t have enough food for our family,” she says. She is far from the only one to have suffered the loss of livestock. The land of Saglo is strewn with the carcasses of animals who died in the drought. Cows, sheep, goats, camels and donkeys have perished – and their owners are struggling to survive in their absence. “The situation is desperate,” says Ayes Mohammed, a mother of five from Gebiass village in Somali, who has lost 20 cows and 80 goats and sheep to the drought. “Goats and sheep do not make it. For the cows, there is still some hope if we get fodder soon. I worry about my children. I feed them borrowing food from the neighbours for the last 10 days. But today, I am glad that the government distributed food in our village. I got 20kg of rice and 20kg of sugar.” For Abdirahman Ali Hussein, a healthcare worker in the Korahey zone of Somali, it is clear that the government is not, however, going to be able to deal with the problem alone. The drought is also affecting parts of the Southern Nations, Nationalities, and Peoples’ Region in the country’s south-west, and Afar in the north-east, scene of much of the recent fighting between Tigrayan rebel forces and federal government troops. “The government is trying to supply everything but there is overload,” says Abdirahman. Health services were under severe pressure due to the increase in malnutrition and internal migration. “For example, for one health centre we’re [supposed to be] receiving 25,000 people,” he says. “But now with this drought sometimes you can see 40,000 to 50,000 people.” From nutritional support for children and breastfeeding mothers to essential medicines, food, and water, “we need to scale up everything”, he says. People “are suffering, and they need urgent support for everything”. Rotigliano, who was recently in the Somali region, urges donors to give money now before the crisis deepened even further. “When you have the pictures of the children who are, you know, three years old and they weigh three kilos, then everybody is putting the money upfront – but do we really want to get there?” he says. Sign up for a different view with our Global Dispatch newsletter – a roundup of our top stories from around the world, recommended reads, and thoughts from our team on key development and human rights issues, delivered to your inbox every two weeks: