East Africa drought: Somalis engulf Ethiopian town

Some refugees have to wait for days to be registered to get assistance

This small, remote border town is rapidly becoming one of the focal points of the drought emergency in the Horn of Africa.

Two thousand or so Somali refugees who are now arriving here each day from across the border are forcing a long-running refugee assistance operation to be ramped up to deal with this emergency.

And aid officials acknowledge that it is a severe challenge.

From early morning until the evening - in corrugated shelters alongside a sandy, stony track running from the border a few hundred metres away - the new arrivals are registered.

They stand or sit outside the shelters patiently waiting for their turn, which is announced by an official through a loudspeaker. It is a critical part of the operation, opening the way to the assistance they will be entitled to.

High-energy food

But it is a bottleneck. At present some may be waiting for two or three days, and an effort is now under way to speed up the process.

While I was there, a medical worker did go through the throng of people, measuring the circumference of the children's arms to spot cases of serious malnutrition. It is at alarming levels in the children now being brought across from Somalia.

The medical worker reached Owlio's nine-month-old son Mahmoud. His arm was so thin that the colour-coded circumference measurement was unquestionably red - meaning severe acute malnutrition.

Mahmoud had become like this just recently, his mother said, and she was very worried about him.

Such children receive special high-energy food when they are discovered.

But like every other aspect of the relief operation, the challenge is to keep up the pace.

Paul Spiegel, chief of public health with the UN refugee agency - who has been visiting Dollo-Ado and the refugee camps nearby - says the numbers are fluid, but up to 10% of the children are showing signs of severe acute malnutrition.

And that is something, he says, he has not seen in a decade - and one of the reasons they are now responding "in a more forceful manner".

Filling up fast

One of the risks associated with malnutrition is increased susceptibility to infectious diseases.

The good news, Mr Spiegel points out, is that there has not been any measles outbreak nor any significant outbreak of diarrhoea.

But the potential for such outbreaks is adding to the pressure to get all the refugees into properly organised camps as quickly as possible and - crucially important - to step up the supply of water.

The problem at the moment is that camps are filling up as fast as they can be opened.

The Kobe camp, opened only on 24 June, is already nearing a capacity level of 20,000 that was set at least in part with the environment around the camp in mind.

In other similar situations, refugees cutting down trees for firewood has, for example, led to tension with local communities.

A number of the refugees I have spoken to say they intend to stay on this side of the border.

In every case, they say they were fleeing not only the drought but also conflict between Somalia's weak government and the al-Shabab Islamist militant group.

Mother's story

The UN High Commission for Refugees, Antonio Guterres, who visited the camp on Thursday, said it was through solving conflict in Somalia and bringing aid to Somalia itself that the crisis here could be mitigated.

Many involved in dealing with the emergency on the ground here would agree.

They say the reason so many refugees are arriving here in a bad shape is the lack of access aid organisations have had to them in Somalia.

Some attention is already being given here to longer-lasting shelter for the refugees - beyond the tents they are being housed in for now and to what will be needed to help them become more self-reliant.

I met one aid worker, who was dealing with trauma suffered by the refugees during their uprooting.

She is likely to be busy, to go by the example of one mother among the most recent arrivals, who said she had to leave her youngest child - a three year old - behind in Somalia because she feared he would hold back her flight with her other children.

She said she had no idea what would happen to him.