Malnutrition among children in one of the world’s largest refugee camps has surged over the past year as concerns grow at worsening conditions at the site in Kenya. Médecins Sans Frontières said its health facility in Dagahaley, a camp in the Dadaab refugee complex, has treated 33% more patients – mainly children – for malnutrition over the past year, while the rate of malnourishment in the camps grew by 45% in the last six months of 2022. “We’ve had to put up an extension ward to accommodate these numbers of children,” said Kelly Khabala, MSF’s deputy medical coordinator. “When you look at the living conditions in the camp now, they are not acceptable.” Dadaab, in northern Kenya, opened in 1991 as a transit zone for refugees escaping civil war in Somalia. However, due to protracted conflict in the Horn of Africa and a catastrophic hunger crisis in the region, by September it was home to more than 233,000 refugees – more than three times the number it was intended to accommodate. The number of arrivals is projected to increase by more than 100,000 by April. Humanitarian organisations say the influx of new refugees has strained food and water and sanitation resources. MSF, which has worked in Dadaab for nearly three decades, warns that the increase could “tip the crisis beyond the levels humanitarian organisations can manage”. Around 800 families currently live outside the Dadaab complex without access to basic amenities. MSF has also raised concerns over rising cholera cases in the camp and across northern Kenya, including Garissa and Wajir. Since an outbreak was declared in October, 716 cases have been reported, according to MSF. Medics report that the outbreak has stretched on much longer than the smaller, sporadic breakouts the camp has experienced in recent years. Northern Kenya and Somalia have been hard hit by the worst drought to hit east Africa in 40 years. The region is braced for its sixth consecutive failed rainy season this year. Millions are facing hunger and destitution. Humanitarian agencies say they are concerned over how they can meet people’s needs in the face of dwindling refugee funding.