The flow of refugees from famine-stricken Somalia into Ethiopia has slowed in recent weeks, but new arrivals are in worse shape than those who arrived months ago at the peak of the exodus.
We?re here now at the border between Somalia and Ethiopia at the point where refugees are coming across. The refugee flow has diminished from a high of several thousand a day to now about a hundred a day. But still people are arriving in pretty bad shape. And the concern of the refugee authorities and humanitarian workers is the deteriorating condition of children as they come across.
"These people haven?t chosen to flee, and especially these new arrivals have waited until the drought and famine are at a worse critical stage within Somalia, so conditions there are difficult. Most of these refugees are goat herders, pastoralists, they?re here because their livestock have died, so it?s for that reason they?ve decided to flee because they?re unable to feed their goats and themselves," said Laura Padoan.
Padoan is the spokeswoman in Dollo Ado for UNHCR, the United Nations refugee agency. She says many of the new arrivals come with horror stories of life under al-Shabab, the Islamic extremist group that controls much of the famine zone and blocks access to western aid groups.
"The presence of al-Shabab has been a major cause of refugees to flee Somalia. There is ongoing conflict between the Transitional Federal Government and al-Shabab. Many of the refugees have been caught in the crossfire," she said.
Among the new arrivals at the transit camp is Mohamed Ahmed, who says he has been trying to escape from al-Shabab for nearly two years. He lifts his robe to show the scars on his legs and buttocks he says were the result of not following al-Shabab?s orders.
Ahmed says he lost most of his family before he got away. Ahmed says al-Shabab gunmen shot dead two of his wife?s brothers and his seven-year old son while they were trying to leave. And on the trek to Ethiopia, a two-month old son died of malnutrition. And after that ordeal, his wife is suffering mental illness.
But while refugees say they are happy to be free from al-Shabab, the life they face as refugees in Ethiopia is harsh and uncertain. The Dollo Ado camps are huge tent cities far from home in a desolate area prone to severe duststorms, where death and disease are never far away.
Hilaweyn Camp, the newest, where most new arrivals are being placed, has a child malnutrition rate of more than 25 percent, and a death rate several times higher than what authorities consider alarming.
Hilaweyn is operated by the humanitarian group Doctors Without Borders, which in one month has built and staffed a health clinic for the burgeoning population. Already the clinic treats more than 100 patients a day, many of them severely malnourished children.
Emergency coordinator Voitek Asztabski has traded a comfortable life in the U.S. state of Florida for a tent at Hilaweyn, where he oversees the clinic operation. Asztabski says despite the alarming death rate, four doctors working round-the-clock are now saving more lives than are lost.
"Last week we lost eight children, [but] most of them definitely will survive, and the whole team here feels like we are saving lives every day, and this is great and it keeps us going here in these extremely difficult conditions as you see in the camp, constant wind, constant dust. Everybody?s exposed to it so working conditions are extremely difficult, but saving lives this is what keeps us going. Every day there?s a life saved," he said.
Asztabski expects it will be mid-October before the health of Hilaweyn?s refugee population stabilizes. With the entire region in the grip of one of the worst droughts in decades, and a long range forecast of poor rains until at least early next year, officials say the 120,000 refugees at Dollo Ado could be here for a long time to come.