Maryam watched her goats starve and her crops fail. She buried two of her children before she finally gave up hope and sought help from international aid agencies in southern Somalia.

She left her village with her remaining six children, making the long journey along the Jubba River to one of a clutch of makeshift settlements on the outskirts of Kismayo, the capital of Somalia’s Jubbaland state.

Three consecutive seasons of failed rains have doubled Somalia’s malnutrition rate. Maryam, 46, is among more than 300,000 Somalis forced to leave their homes since January alone.

Several international organisations have stopped operations in the Kismayo camp for internally displaced people (IDPs), largely due to aid cuts ordered by United States President Donald Trump last year.

“We are hungry. We need care and help,” said Maryam.

Haunted by the memory of her dead children’s swollen bellies, she says she will not return to her village, which is under the control of the al-Qaeda-linked armed group al-Shabab. Fighters there have started seizing the limited food supplies available.

But the camp is hardly better. In March alone, five children died of malnutrition, its manager says.

Since the early 1990s, Somalia has endured near-constant civil war, armed rebellions, floods and droughts. The war-torn country ranks among the world’s most vulnerable to climate change, which scientists say is leading to more frequent and more intense episodes of extreme weather such as droughts and floods.

Africa, which contributes the least to global warming, bears the brunt.

The recent cuts in foreign aid have not helped. They have had “a huge impact on our work”, said Mohamud Mohamed Hassan, Somalia director for NGO Save the Children.

More than 200 health centres and 400 schools have closed since last year.

Farmers, whose herds and crops have been decimated, describe one of the worst droughts ever recorded in a country where a third of the population already lacked regular meals. Even if the forthcoming rainy season is normal, it will take months for affected populations to recover.

“We cannot afford to actually address all the needs of these people,” said Ali Adan Ali, a Jubbaland official managing the displaced.

At a mobile health clinic supported by Save the Children, the only one still operating for multiple camps in the area around Kismayo, a woman named Khadija tried to feed a high-calorie solution to her severely malnourished one-year-old daughter.

She came to the camp after last year’s drought killed her livestock, but here also “we have nothing to eat”, the 45-year-old said.

A hospital in Kismayo is the only facility in the region capable of treating the most severe cases of malnutrition. But it is turning patients away due to a lack of space and staff.

Every bed is occupied by starving babies, some on ventilators with intravenous drips in their fragile arms. Cases have tripled since last year, and things are only getting worse.

The US-Israel war on Iran has increased fuel prices, affecting food and water supplies.

Those in the camp seek work in construction or cleaning jobs in Kismayo or sell firewood, but the options are limited.

Meanwhile, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) has had to steadily reduce its Somalia programme from $2.6bn in 2023 to $852m this year, especially since Washington slashed its donations. So far, only 13 percent of this year’s target has been raised.

“It’s a toxic cocktail of factors … Things are really, really desperate,” Tom Fletcher, head of OCHA, told the AFP news agency in an interview last week.

“Often we’re having to choose which lives to save and which lives not to save.”