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Halima Abdullah Aden was just a teenager when she watched her father and two brothers die during the last famine that hit Ethiopia's remote south-east Somali state six years ago.

Now in her 20s, she is haunted by memories of the gnawing hunger that engulfed the region in 1999-2000 claiming tens of thousands of lives, and fears for the health of her own children as famine looms once more amid a searing drought that threatens millions across East Africa with starvation.

"I never expected to experience again what I saw in the 2000 famine," Halima says at a clinic where she brought her ailing and malnourished eight-year-old son and daughter, four, for treatment.

"I lost my father and two of my young brothers, now I am here wondering if my children will suffer the same fate."

"I know how cruel famine is," says the grim but determined woman who walked four days through brutal heat to reach the clinic in Denan, about 120km from her home village, as her children, vomiting and suffering from diarrhea, grew weaker by the day.

After five days of intense treatment, Halima's children are showing improvement, but they may well be a minority in the region, where some estimate that 93 000 people died of hunger and related illness in 1999-2000, said Sadik Mohammed, a doctor at the clinic run by the Ogaden Welfare and Development Association.

"These are a few lucky ones who were able to reach the clinic," he says. "We have no idea what is going on in the villages far away. However, it is an indication that a problem is ahead of us."

The clinic, set up in 2004 to serve Denan and its estimated 5 000 local and surrounding population, is now seeing desperately sick, hungry and thirsty people from as far as 300km trudge to its doors for emergency help, Sadik said.

According to the United Nations and relief agencies, as many as 11-million people in four nations in the Horn of Africa -- Ethiopia, Kenya, Somalia and Djibouti -- are on the brink of imminent famine as the two-year-old drought bites.

This week, the United Nations put the number at risk in Ethiopia's Somali state and adjacent areas at 1,75-million, up from an earlier estimate of one million, and issued an urgent appeal for help.

"We are crossing the red line," said Mohammed Sheik Aden, a project officer the United Nations children's agency (Unicef). "In 1999-2000, the alert came as late as March while the famine had started in December, [this time] we are alerting the international community earlier."

"We are in the early days of what could turn into a major humanitarian catastrophe," said Bjorn Ljungqvist, Unicef country representative for Ethiopia. "The alarm has been raised in time but if we don't get the support in need, the result will be catastrophic."

Although no hunger-related human deaths have been reported here, thousands of cows, goats and camels have already perished, an ominous sign for the livestock-dependent pastoralists who make this barren, rugged part of the world their home.

Many of those animal deaths have occurred around Denan and the larger town of Gode, about 75km south, where local officials have sounded alarms about impending disaster.

"What we are seeing now is early warning of famine," said district health officer Abdullahi Ali Hajji. "Livestock have started to die, pastoralists have started migrating in search of pasture. Unless we intervene on time famine at the scale of 2000 is ahead of us."

At the government-run district hospital in Gode, doctors are struggling to cope with a surge in cases of severe malnourishment among children, many of whom are also suffering from tuberculosis, malaria and diarrhea made worse by hunger.

"Since the beginning of last month, we are seeing big numbers of children with malnutrition problems," said Dr Zelalem Gizachwe, adding that the hospital was built to serve 250 000 people but is now serving more than a million.

Fordosa Mohammed (25) is one of them. She trekked for three days to reach the hospital with her emaciated two-year-old daughter, who is now recovering from severe malnutrition.

"I never expected to reach here," she says, her teary eyes never straying from her daughter as doctors examine the child. "I was wondering if she had died on the way what I would have done. But thanks to Allah she seems to be making a comeback."


Source:AFP