Genetu Dekebo's children were on the verge of starvation at the time she decided to seek treatment at Rophi therapeutic feeding centre in southern Ethiopia's Oromiya regional state.

"We could no longer find enough food and were eating one meal a day," the 35-year-old mother of four from Serraro woreda (district) in West Arsi zone, said on 26 May. "The children became weak [and] I saw my neighbour’s child die."

Five months earlier, Genetu had delivered her fourth boy, and she was yet to fully recover from the effects of that pregnancy. "We have been here for two weeks receiving treatment," she told IRIN at the centre. "The one with swollen legs is now much better."

Her children were among a few hundred at the tented centre, located in a remote area about 350 km south of the capital, Addis Ababa. The centre is managed by the medical charities Médecins Sans Frontières (MSF) Greece and the Missionaries of Charity.

"The problem in the [Serraro] woreda is quite extensive," Sally Stevenson, MSF-Greece country representative said. Her organisation was also conducting outreach programmes to try and stem the problem.

Recently, the charity conducted a rapid weight for height assessment in the area and found severe acute malnutrition prevalence at a dramatic 11.6 percent - nine percent above the threshold of two percent.

"We found very high rates of severe malnutrition here and in response, launched the interventions," she told IRIN, referring to MSF-Greece's feeding centres at Rophi and Senbete, and the outreach programmes. "We have over 600 children in the programmes."

In a catalogue of dozens of nutrition surveys in Ethiopia over the last few years prepared by the Ethiopian Disaster Prevention and Preparedness Commission (DDPC), only one result shows a higher rate of severe acute malnutrition. A rate of 15.4 percent was found among a population at a resettlement site in 2003.

Among normal rural populations, the MSF-Greece figure is the highest since the DPPC catalogue began in 2000.

"There are a range of compounding problems - lack of rain, a fairly food insecure area and increasing prices," Stevenson said. "In the outreach programme, we had over 200 children after only two days."

Gains at risk

Ethiopia, aid workers say, has been hit by drought and rising prices that have once again caused massive food shortages. For example, the costs of some cereals have increased between 50-90 percent since September, stretching the ability of some households to meet their food needs.

"The combined effects of drought, food price hikes, and insufficient resources for preventive measures resulted in an emergency that jeopardises significant child survival gains in Ethiopia," Bjorn Ljungqvist, the representative of the UN Children's Fund (UNICEF) in Ethiopia, said.

Up to 3.4 million people are in need of humanitarian aid, while an estimated 126,000 children are in need of urgent treatment for severe malnutrition. Among children under five years of age, six million face the risk of acute malnutrition - mostly in impoverished, drought-prone districts.

"Instead of a couple of thousand, we have 33,000 children in therapeutic care, which means they are admitted because of severe acute malnutrition," Ljungqvist told IRIN.

According to Ethiopia's national demographic and health survey, a significant number of children in the country suffer chronic malnutrition. UNICEF, in its 'State of the World's Children 2008: Child Survival' report, noted a 'dramatic achievement' of a 40 percent reduction in under-five mortality between 1990 and 2006.

The current situation, aid workers warn, could reverse these gains. "I was in Serraro last Monday [19 May]; children are severely malnourished and one died before I left the place," Miesso Nebi, director of the Centre for Development Initiative, a local NGO, said following a visit to Shashemene, a major town not far from Rophi.

Sheshamene general hospital had, over a three-week period, admitted 40 children suffering from severe acute malnutrition and other complications, and recorded 16 fatalities.

Another NGO, Concern Worldwide, found that drought had severely affected people in Ethiopia's rural south, forcing many to eat the seeds that they would have planted for this year.

"The only crop that is growing widely is 'enset', a banana-like plant native to Ethiopia and resistant to drought," the NGO said in a 26 May report titled 'When the rains don't fall'.

"Its root is ground up to make bread as well as a gruel or porridge. It may look healthier than the rest but it doesn't contain the nutrients people need to survive."

Even where some planting had taken place, the maize and beans had withered and died. "All around, the leaves of coffee and eucalyptus trees are turning silver as they burn in the scorching heat," Concern noted. "Some have dug up their fields already and replanted in the hope that the summer 'Mahar' rains won't let them down as the 'Belg' rains have."

Inadequate resources

In 2004, drought-prone Ethiopia launched an outreach strategy, in conjunction with aid agencies, to provide supplementary feeding for 5.8 million children under five, and 1.6 million expectant and breast-feeding mothers in 10 regions.

The strategy, however, did not stem the malnutrition crisis. "The families failed to give enough food to th eir children," Bjorn commented. "The children [ended up with] severe acute malnutrition."

The situation is compounded by inadequate resources. The UN World Food Programme (WFP), for example, is short of over 38,000 tonnes of corn-soya blend for both relief and targeted supplementary feeding programmes.

"Recent nutritional surveys carried out by regional offices of the Disaster Prevention and Preparedness Agency together with UNICEF and NGOs are showing alarming and increasing nutrition levels," WFP warned on 13 May.

UNICEF, on the other hand, asked for US$20 million for emergency nutrition alone, but has received only five percent so far.

"Resource shortfalls are stretching the capacity of the humanitarian community to respond fully to the current crisis including the need for more qualified staff," the UN Office for the Coordination of Humanitarian Affairs (OCHA) said.

"UN agencies and NGOs expect that the situation will continue to deteriorate without the immediate allocation of resources required to carry out life-saving interventions."

OCHA highlighted the situation in Oromiya, the Southern Nations, Nationalities, and People's Region, and the Somali Region, where drought, shortage of medical supplies, and a limited response have made matters worse.

"I am deeply concerned about the food security situation in Ethiopia, and the consequent increasing numbers of malnourished children, as a result of the current drought," John Holmes, UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, said.

"We will need a rapid scaling up of resources, especially food and nutritional supplies, to make increased life-saving aid a reality," he added. "As elsewhere, the rising global costs of fuel and basic staples are posing hardship for Ethiopia's people - especially the poorest."