DAVID FOLKENFLIK, HOST:
In Somalia, children are going hungry as their families are displaced by drought and the extremist group Al-Shabaab. A new survey conducted by Doctors Without Borders found a third of displaced families in one region are surviving on just a single meal a day. As NPR's Durrie Bouscaren reports, the humanitarian response is complicated by the Trump administration's decision to cut nearly all U.S. aid to Somalia.
DURRIE BOUSCAREN, BYLINE: It has been a brutal summer for Mukhtar Sirat Mahdi.
MUKHTAR SIRAT MAHDI: Between the death and the life, the child was very weak.
BOUSCAREN: Mahdi coordinates treatment centers for malnutrition in Somalia for the International Rescue Committee. The kids he helps are starving. He remembers one 11-month-old baby whose family had to leave their farm after years of drought. They're in a camp for internally displaced refugees.
MAHDI: In the camps, there's not enough food.
BOUSCAREN: The baby took six weeks to recover. Close calls like this, Mahdi says, are happening more and more.
MAHDI: It affects, you know, these children, even to the worst scenario, death, or if not, you know, death, it affects the future learning.
BOUSCAREN: Nutrition therapy works. Kids are given a fortified peanut product known as Plumpy'nut. But Mahdi says it's been a struggle to keep the center stocked. Thirty percent more children than expected arrived in the centers this summer. Aid workers had to scramble to find supplies. And, he says, the war in Iran delayed one shipment for months.
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BOUSCAREN: In videos of the nutrition wards shared by Doctors Without Borders, the beds are full of toddlers with thin arms and fearful eyes.
CHENOA SANKAR: When you sit down with people, at the end of the day, the main complaint is just that there is simply no food.
BOUSCAREN: Doctors Without Borders epidemiologist Chenoa Sankar organized a randomized study of malnutrition rates and camps for internally displaced people near the city of Baidoa.
SANKAR: We were just sort of seeing when we went there that a lot of children even over the age of 5 had distended stomachs and discolored hair so indicative of malnutrition.
BOUSCAREN: Half of children under 5 were acutely malnourished, she says, as were half of pregnant and breastfeeding women and girls.
SANKAR: Because of the extended drought and the multiple missed rainy seasons, there's just this huge influx of people coming in. And there is still no adequate food access in Baidoa itself. People are not able to grow what they previously were able to.
BOUSCAREN: The United States used to send about $770 million a year to Somalia. That aid was dramatically reduced this year after the Trump administration accused Somali officials of seizing food aid and destroying a U.S.-built storage facility. Other Western countries have also reduced assistance, leaving a patchwork of aid programs to fill the gap. NPR reached out to the State Department for comment. It did not respond. Sankar says families told her they were frustrated at how unpredictable assistance has become.
SANKAR: They would complain to me that, you know, somebody comes in. They do a distribution for three months or six months, then they leave and then there's no sort of indication of when they might come back.
BOUSCAREN: The U.S. also reports data on worldwide food insecurity. It's called the Famine Early Warning System. This month, it stopped reporting data from Somalia, Afghanistan and Yemen with no explanation. But UNICEF estimates that 1.9 million kids in Somalia are acutely malnourished. Spokesman James Elder visited the country this week to visit some of the 200 clinics closed by the cuts.
JAMES ELDER: When you close facilities, you create longer journeys for mums and their babies. Longer journeys mean later treatment. Later treatment means kids have more severe illnesses and a greater risk of preventable death.
BOUSCAREN: He says it's children who are paying the price.
ELDER: What I saw, what we are seeing is aid cuts closing the doors to healthcare, shutting down nutrition services and pushing all those basics - water, education, protection - further and further out of reach of people.
BOUSCAREN: And this, Elder says, pushes the cost of these programs down the road into the next generation.
Durrie Bouscaren, NPR News, Washington.
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