Catastrophe Is Emerging in the World's Most Vulnerable Places

For nine days, they trudged across the parched soil of southern Somalia, taking turns carrying their 3-year-old daughter on their shoulders. Abdullahi Abdi Abdirahman, his wife and their seven children sought escape from a landscape drained of life.

Another drought had killed their goats and sheep, turning their life savings to dust. So they pressed on for 140 miles toward Dollow, a dusty outpost on the Ethiopian border. They were drawn by the same things that had already attracted more than 100,000 other people: International relief organizations were clustered there, offering food, water and healthcare.

Yet when they arrived in late January at a camp on the fringes of town, they were horrified to learn that aid groups had abandoned the area. President Donald Trump had dismantled the U.S. Agency for International Development, or USAID, eliminating Somalia's primary source of assistance. From London to Berlin, governments had reduced funding for humanitarian aid. Relief organizations had been forced to choose where to focus their remaining money.

Dollow had not made the cut. Inside the camps, thousands of tents remained, but aid was disappearing. Families were losing cash grants for food. Health clinics were bereft of medicines and staff.

The following month, another shock unfolded, as the United States and Israel unleashed war on Iran. The closing of the Strait of Hormuz halted the shipment of oil, fertilizer and other critical commodities from the Persian Gulf. The cost of moving cargo soared. In Somalia, which depends on imports for 70% of its food, staple goods like rice and wheat flour doubled in price.

"Milk and meat are just a dream for us," said Abdi, 47. His family was subsisting on a daily meal of sorghum porridge and wild grasses plucked from nearby riverbanks.

"The children are hungry," he said. "It hurts."

As the conflict in the Middle East grinds into its third month, catastrophe is unfolding across the world's poorest, least stable countries. If hostilities continue beyond June, those confronting acute hunger will swell beyond 363 million people worldwide, an increase of 45 million compared with before the war, the World Food Program warned.

The danger is mounting absent the usual degree of international mobilization.

Four years ago, when Russia began its war on Ukraine, the global supply of fertilizers and grains was disrupted, prompting fears of hunger from sub-Saharan Africa to South Asia. But the pain was limited by $43 billion in humanitarian assistance marshaled by governments and multilateral institutions, according to data compiled by the United Nations. That campaign, which included emergency food aid, water and medical care, was led by $17 billion from the United States.

Last year, overall humanitarian funding dropped to $28 billion, and the United States contributed only $4 billion. Cuts are continuing.

"The system has been eviscerated," said Kate Phillips-Barrasso, who heads global advocacy at Mercy Corps, an American aid group that runs relief and development programs around the world. The organization led journalists from The New York Times on a reporting trip in Somalia.

"This is the era of indifference," she said.

Somalia is rife with calamity. In recent decades, the country has suffered civil war, famine, and the unpredictable attacks of al-Shabab, a militant Islamist group affiliated with al-Qaida.

Drought ravaged the most recent harvest. Some 6.5 million people -- roughly one third of the population -- were suffering hunger at levels deemed an emergency, the U.N. Food and Agriculture Organization warned in February. That included more than 1.8 million children under 5 facing acute malnutrition.

Those numbers have almost certainly increased given the war. Yet the World Food Program, the largest source of aid in Somalia, has only enough funding to support 300,000 people a month through July, a fraction of the nearly 2 million people a month it was reaching in early 2025.

Humanitarian relief organizations now contemplate a surreal hierarchy of suffering.

"There are different categories of starvation," said Hameed Nuru, the World Food Program's Somalia director. "We are only able to reach those who are really on the verge of, if you don't give them something now, they will not be there tomorrow."

In some areas, children are still getting food, but not pregnant mothers. "Literally, it's who dies first," he said, "and who dies next."

A Feedback Loop of Trouble

In scores of countries, overlapping crises are now reinforcing one another. Higher prices for food and fuel are limiting the benefit of what aid remains.

Marine traffic diverted from the strait has overwhelmed the port of Salalah in Oman, a hub for cargo that is transferred onto smaller vessels bound for destinations in West Africa.

Because of traffic jams in Oman, a World Food Program shipment that included split peas from Kenya and cereals from Belgium recently arrived 40 days late at the port of Berbera in the north of Somalia. That held up enough supplies to feed 500,000 women and children for a month.

In Sudan, scene of the world's most dire humanitarian disaster, some areas are suffering famine, and 41% of the population is acutely short of food, according to the U.N. Food and Agriculture Organization. Yet in late April, UNICEF had to scrap plans to ship five trucks loaded with emergency supplies to two cities in the south of the country.

In addition to the hurdles of moving goods in a country besieged by civil war, trucking companies were refusing to make the journey from Port Sudan. They were afraid of getting stuck in the hinterland, unable to refuel given shortages of oil.

"Kids are dying," said Sheldon Yett, UNICEF's representative to Sudan.

Four years ago, as Somalia confronted its most severe drought in years, it received $2.4 billion in humanitarian aid, more than half from the United States.

But when Trump returned to office last year, he brought animus toward Somalia, deriding immigrants from the country as "garbage."

Last year, the United States slashed humanitarian assistance to Somalia to $70 million from $467 million in 2024. Over the first four months of this year, less than $3 million came from American government donors -- only 2% of all relief for Somalia. Britain, Germany, Denmark, Sweden, Canada and Qatar each contribute considerably more.

Still, many European governments have also retreated, spurred by Trump's insistence that they spend more on defense rather than relying on American protection.

Relief organizations now reckon with a process they describe as "hyper-prioritization." What aid remains has been concentrated on the neediest 21 of Somalia's 90 districts.

This was the situation before the United States and Israel started a war on Iran.

Food, Fertilizer and Fuel

Somalia is dependent on imports for oil, most of it from the United Arab Emirates. As Iran launched retaliatory strikes on production facilities in the Persian Gulf, and as transport through the strait effectively ceased, the price of gasoline and diesel more than doubled.

Some people in the camps sell fruits and vegetables that they buy in markets in town. The fares for transporting their wares by motorized rickshaw have more than doubled. They were passing on the extra costs to their customers.

Trucking companies doubled and tripled prices for bringing sacks of corn over the border from Ethiopia. The cost of hauling rice shipped into Somalia's ports rose by similar margins.

At a fish market in Mogadishu, the city of more than 3 million that is Somalia's capital, Fatumo Abdi Noor, 45, tended to her stall as men used machetes to hack tuna and king fish into steaks. She had nearly doubled her prices. Owners of fishing boats could no longer afford to venture out to the deeper waters of the Indian Ocean. They were settling for smaller fish closer to shore, reducing the catch.

Faced with higher prices for fish at the market, customers were buying smaller quantities. Noor's sales were down by half.

At a trade school in Dollow, a half-dozen women trained to be seamstresses, operating manual sewing machines. Materials used to maintain the machines had nearly tripled in price. Thread and fabric from Mogadishu had become difficult to secure.

At some public wells, the price of water had tripled, given that many pumps are fueled by diesel. Faced with the loss of funding from USAID, Mercy Corps, the American development organization, had halted programs installing solar cells to power public wells. Aid organizations like UNICEF were paying more to truck water to drought-afflicted areas.

Somalia also depends on the Persian Gulf for about one-third of its fertilizers. With stocks marooned on the wrong side of the Strait of Hormuz, farmers were contending with higher costs.

At a 10-acre cooperative farm in Dollow, a tractor tilled the ground in preparation for the planting of onions. The diesel that powered the machine had more than doubled in price. A 30-kilogram bag of nitrogen fertilizer had jumped to $35 from $20.

The cooperative planned to recoup its costs by demanding more for its harvest.

As he sat beneath the shade of a mango tree, its branches sloping toward the river dividing Somalia from Ethiopia, Adan Bare Ali, deputy mayor of Dollow, said his community was suffering from troubles that had been concocted far away. The drought was worsened by climate change -- primarily the result of industrial polluters in larger, more powerful nations. The war was the handiwork of foreign actors.

"The situation has become unbearable," he said. "The American regime is led by a person who really doesn't care about anything happening outside his gates. The Americans are not honoring their commitment to the world."

An Emergency Unchecked

Throughout Somalia, unaffordable food combined with fewer medical clinics meant that children were more likely to suffer malnutrition and at greater risk of developing dangerous complications.

On a sweltering morning, more than 100 women sat on wooden benches with infants and toddlers in their arms at a nutrition center in Mogadishu. They were waiting their turn to lay their children on an examination table. Attendants applied cuffs to tiny arms, measuring their circumference to assess the extent of malnutrition. Babies shrieked as their mothers deposited them into a plastic bucket attached to a scale.

Those deemed moderately malnourished were given special foods. Those recorded as severe cases were administered therapeutic milk formula and antibiotics to ward off infection.

And those in greatest peril were sent to a so-called stabilization unit run by UNICEF inside a local hospital. There, babies and toddlers lay on cots, many with feeding tubes curling into their nostrils, and some attached to oxygen.

Eighteen-month-old Mohamed Abdi Abdullahi leaned against his mother, Fartum Abokor Omar, his ribs protruding from his chest. Folds of skin slumped from his arms.

The family had arrived a week earlier from their village north of Mogadishu. The river had dried up, decimating crops. When her son began vomiting, unable to hold down their single daily meal, Abdullahi traveled to the nearest town to seek help.

There, a nurse at a clinic urged her to continue on to Mogadishu to seek care at Banadir Hospital. The bus fare was normally $12, a relative fortune. Now, it was double that. She wandered the town, begging for the needed money.

Inside the hospital, doctors had stabilized her baby. He was likely to be discharged within a few days. Which made this a positive ending in Somalia: a child spared from hunger.

Yet his story ran counter to the trend.

Throughout the country, UNICEF had closed 205 of its 800 local health clinics. These were the facilities best positioned to arrest the severity of malnutrition. When people were assessed and treated earlier, they had better odds of recovery.

Since January, the hospital had admitted 768 infants and toddlers with medical issues caused by severe malnutrition -- double the pace of the previous year. Doctors estimated that one-third of those children could have avoided hospitalization had they been seen earlier.

Greater Need, Less Relief

Abdirahman and his family knew little of this context as they proceeded toward Dollow.

What they knew was hunger, fear and exhaustion. They walked dirt roads, traversing a largely treeless plain. They slept wherever they happened to be when the sun went down, resuming their journey as the first light seeped from the horizon.

On a sweltering morning in January, they reached the camp where international aid workers had previously provided help.

"There was nothing here," said Abdi, still nursing a palpable sense of disbelief. "There are no services."

They set up a tent alongside a fence of thorn bushes, taking shelter under leftover plastic sheeting held aloft by sticks.

Since their arrival, Abdirahman has been working as a farm hand, earning $1 a day. His wife, Sadia Abdirahman, walks across a bridge into Ethiopia where she washes clothes for better-off families. But as the cost of food rises, fewer households can afford to employ her.

"Sometimes, we go out begging," she said.

In the center of the camp, a health clinic formerly financed by UNICEF sat empty, save for a volunteer midwife. The organization used to fund prenatal services, dispensing iron pills and medicines. It paid for ambulances to take women to local hospitals when they suffered complications during labor. Not anymore.

In late April, a woman in a neighboring tent, Muslima Ibrahim Mohamed, 38, went into labor. Her sisters helped her to the clinic. It was the middle of the day, but the building was locked. They borrowed money for a motorized rickshaw ride to a hospital in town. She lay on the bench for the half-hour journey, suffering the bumps of the rutted dirt road.

"I was in real pain," she said. "I was terrified."

At 38, she had lost four children to disease and hunger. Now, she cradled her newborn son, Noor Mohamed, against her chest. He had entered the world in a moment of extraordinary vulnerability.

A school inside the camp had also lost funding from UNICEF. The head teacher, Abdulnasir Mohamed Farah, 30, was still there, working without pay, because his fingerprint unlocked a digital payment card stocked with cash from the World Food Program. He used the money to buy rice and beans, typically the only meal of the day for his students.

"I can't abandon the children," he said.

The World Food Program has traditionally relied on U.S. government support for nearly half of its budget. Given the cuts, it had reduced its allocation to the school by 60%. And that money was buying less at local markets. The school enrollment had swelled beyond 800 from less than 600 as the drought sent more families toward the camp.

At the World Food Program's local headquarters, high walls were encircled in barbed wire. The head of the operation, Josephine Muli, surveyed her warehouse space -- 13 A-frame tents used to store medicines and nutritional supplements.

Twelve of the tents were empty.

A single tent held cardboard cartons loaded with a peanut-based paste for malnourished children and pregnant and breastfeeding women.

The cartons were emblazoned with the American flag, the USAID logo and a message: "From the American people."

"This will last for two months," Muli said. "The pipeline is dry. Beyond July, the pipeline will be zero."