More than 20 million people in four countries – Yemen, Somalia, South Sudan and Nigeria – are facing starvation and famine, in what the UN says could become the world's largest humanitarian crisis since 1945.

Doctors of the World has been working in Yemen, Somalia and Nigeria for several months, delivering health and nutrition programmes to the most vulnerable. Last night, we launched an urgent appeal to help us scale up our emergency activities, as the situation has taken a turn for the worse.

“It is vital that doctors and aid workers reach people in desperate need. In many areas, we could prevent the threat of famine from becoming a reality,” says Leigh Daynes, executive director of Doctors of the World UK. “No one should die of starvation in the 21st century.”

The four countries concerned are all in or directly next to the arid belt of the Sahel desert, where droughts often occur. But the driving reasons for this emergency are man-made – there are violent conflicts in each country that stop many people getting enough to eat.

Yemen, where 17 million people face severe shortages of food, is gripped by a civil war between the government army, supported by Saudi Arabia, and Houthi rebels. We have worked in the capital Sana’a and in western Yemen since 2015, supporting five health centres and one maternity clinic, and focusing on food supply and on children. We have already put one emergency team in place in Yemen’s worst affected areas.

We also work in north-eastern Nigeria, where the terrorist group Boko Haram has operated since 2012. As the Nigerian government has pushed Boko Haram out of certain territories in recent months, the extent of people’s suffering in these areas has become clearer. In December, the UN described the situation as “the largest crisis on the African continent.”

“The situation is alarming and the access to food is at risk, because cattle breeding, farming and fishing are impossible to do,” says Jean-François Corty, the director of international operations for the Médecins du Monde network, to which Doctors of the World UK belongs. “Boko Haram’s attacks have also destroyed health centres and killed medical personnel - 90% of the current health infrastructure is not equipped to take in undernourished children.” 

The UN has officially declared famine in parts of South Sudan, and humanitarian agencies urgently need donations to reach the most vulnerable in all the countries concerned. The last time the UN declared famine was six years ago in Somalia, when 260,000 people died.

In Somalia today, 2.9 million people are at risk of dying from starvation. Nearly 1 million children under five will be acutely malnourished this year if assistance does not reach them. Large areas of central and southern Somalia are controlled by the Islamist group Al-Shabaab. This is severely exacerbating the impacts of a drought that is killing crops and livestock.

Our network is the only international health agency operating in Bosaso, northern Somalia.  Working with local partners, we support and a mobile nutrition team, as well as eight health facilities and five primary healthcare units.

Please donate to our appeal and help us send more doctors, nurses and urgently needed medical supplies to these countries, as well recruit more staff locally.