Four-year old Moussa died the morning after another 18 tons of food aid was unloaded at Maradi's airport. Compounding the grief felt by his family, the boy's father, a poor bean, peanut and millet farmer from the village of Nyelwa, on the outskirts of Maradi, Niger, had to ask strangers for money so he could transport the body of his dead son home.

During the many days Moussa unsuccessfully fought for his life at the Médecins Sans Frontières (MSF) feeding center in Maradi, two-year old Aboubakar fell sick with diarrhea nearly 75 miles to the east, in Gazaoua.

"I have no money," said his young mother, Rabi, adding that even if she could manage the 700 CFA ( /- $1.50) it costs just to enter a health center, she could never afford the additional fees for a consultation and medicines. Predictably, Aboubakar's condition worsened, and he slipped into a state of severe malnutrition. When he arrived at the MSF feeding center in nearby Aguile in early August, he was on the brink of death.

Moussa and Aboubakar are just two of the latest victims of the hunger stalking children in the poorest families of this vast, land-locked West African nation of 12.5 million. And even as aid pours in, the situation may deteriorate further before improving.

"August will be the worst month," said Dr. Milton Tectonidis, a nutritional specialist for MSF in Niger. "It will take some time for other groups to set up. And as we enter the rainy season and get closer to the next harvest, there will be even less food and more malaria and diarrhea."

Many factors contributed to the current disaster. Yes, people in Niger face chronic food insecurity. Yes, a brutal lack of rain ruined part of 2004's harvest. And yes, locusts destroyed some more. A young farmer in Dan Gamji, a few miles outside of Maradi, pointed to his ankles to show how high his field of millet grew last year. Today, the field is full and the millet is head high. And while not abundant food like millet, onions, mangoes, bread and meat is still found in Maradi's market place. The poorest families, though, especially in more remote villages, simply cannot afford it.

The effects from these natural events could have been addressed with a vigorous response when the first signs of a food crisis appeared in early 2005. The Nigerien government though was urged by international financial institutions, key donor countries and UN agencies to act in ways that would not destabilize the local food market or drain resources from ongoing development projects.

So rather than organizing free food distributions to the most at-risk families, like one carried out in the Sahel region of neighboring Burkina Faso, and providing free medical care to children under five, officials tried to a series of 'market-based' approaches.

First, they offered cereals at reduced prices to impoverished people who could not afford the subsidized price and were already going hungry. The cost-recovery, or user fee health care system, was kept in place. As the situation worsened, authorities then tried to loan grain to people. Even as thousands perished by late June, some donors praised the Nigerien government for respecting the market and not distributing free food.

The results of this callous logic can be seen now in the gaunt faces and wasted bodies of the more than 1,200 children arriving each week at MSF's six inpatient and 26 outpatient therapeutic feeding centers in Maradi, Aguie, Keita, Tahoua, Dakoro, Zinder and surrounding areas. Since January, medical teams have treated nearly 16,000 children for severe malnutrition, and they expect to treat more than 25,000 by the end of the year. While it offers no consolation to parents grieving the loss of a child like Moussa, the overwhelming majority of children treated by MSF survive.

"There has to be a better safety net for the poorest of the poor during a crisis even while long term development continues," said Dr. Tectonidis. "But in Niger, the entire emergency response was sacrificed for development projects. So many died here for nothing."