Jalalo is worried. His wife has brought their one year old twins to the Médecins Sans Frontières (MSF) stabilisation centre in Shashemene, in the Oromiya region of southern Ethiopia, to be treated for malnutrition; but his ten other children are at home with no food.

"I used to work on the farms, guarding the food," he explained. "But there's been no rain this year so there's very little work. Some days we eat, but mostly we go to sleep with no food."

And Jalalo is not alone. Since MSF started its intervention in the Oromiya region on May 13, over 700 children with complicated severe malnutrition have been admitted to its three stabilisation centres in Shashemene, Ropi and Senbete Shinquille. More than 1,500 additional chidren, who are not suffering from complications, such as severe dehydration or malaria, are being treated on an outpatient basis in eight different clinics around the region.

In a country where around seven million people routinely rely on food aid, malnutrition is nothing new. However this year a number of different factors have made the situation much worse than normal.

"In Oromiya, most of our patients tell us that they have no food because the early rains did not come this year," explained Francois Calas, MSF Head of Mission. "But other factors such as high rates of inflation and an increase in food prices have also played a part. For most people here life is a daily struggle and for many of them this year that struggle became too much to bear."

Whatever the reasons, the levels of malnutrition that MSF teams are seeing are alarming. When launching nutritional interventions, rapid assessments are done to get an idea of the seriousness of the situation. An emergency nutritional project will generally be started if a rate of three percent severe acute malnutrition is found. In some areas of the Southern Nations and Nationalities People's Region (SNNPR), recent assessments revealed a rate of 11 percent. As a result, MSF has set up a stabilisation centre in Kambata, one of the most densely populated parts of the region.

As an emergency medical organisation, MSF is focusing on treating the most severely malnourished. But the impact of treating people will be limited unless more general preventive measures are taken.

As Calas explained, "Sometimes we have to turn people away because they're not malnourished or sick enough yet. It's hard because we know they have no food at home and it may just be a matter of time before we see them again. We give therapeutic food and family rations to the patients that we discharge, but unless there's a huge increase in general food distributions I imagine that we'll continue to see malnourished children for some months to come."