The medical aid group Doctors Without Borders describes the humanitarian crisis in Somalia as catastrophic. And it says conditions in the country are getting worse, as international assistance plummets due to insecurity and the targeting of aid workers.
Nicolas de Torrente, executive director of Doctors Without Borders-USA, says, "Every time that we think it can't get much worse, it does. And at this point, we feel that we've reached really a new low and that we're no longer on the verge of a catastrophe, but the disaster is really happening now. We've seen an increasingly deteriorating situation, particularly over the last 18 months, which is really a turning point."
It was then, he says, that there was an "internationalization" of the conflict, with other countries getting more involved politically and militarily. "That has led to an escalation and intensification of the conflict," he says, "with violence perpetrated against civilians by all sides involved. You can only conclude that the situation really has become catastrophic for the Somali population."
Children are very much affected by the conflict, especially children who've left Mogadishu and are living in the Afgooye area. Dr. Greg Elder, deputy operations manager for Somalia for Doctors Without Borders, says many are being treated for malnutrition.
"The numbers are quite frightening. We've got nearly 3,000 children in the nutrition program at the moment in the Afgooye corridor. And those numbers don't appear overnight. We're seeing 500 new admissions every week," he says.
Dr. Elder says Somali families face difficult choices as a result of food shortages.
"They sell everything that they have to try to buy extra food. Then they drop out the expensive food items, that are usually the most nutritious. Finally, they start to ration what they do have. They go from three meals a day to one meal a day and then one meal every two days. And finally they're in the very difficult situation of having to decide which members of the family are expendable," he says.
Elder says Somalis are trapped in a corridor of internally displaced persons between Mogadishu and Afgooye, which he calls a "corridor of misery, where they have a very, very poor access to food. Where they have poor access to water. "
He says water must be trucked in on a daily basis to help over 300,000 people in the region survive. Poor sanitation and shelter only make matters worse, including medical conditions.
"We are seeing cholera. We will see respiratory tract infections in the coming months. And the mortality rate will be catastrophic for that population," he says.
The number of internally displaced persons (IDPs) continues to grow due to insecurity in Mogadishu. Many civilians are being treated for gunshot wounds or injuries caused by bombs. Elder describes it as "a disproportionate number of civilians caught in the crossfire."It's estimated 700,000 people fled Mogadishu in 2007, and at least another 30,000 this year.