Five-year-old Fatime moves in slow motion, barely able to lift her skeletal arms and legs. Flies land on her face, and she is too weak to brush them away. She struggles to drink a cup of therapeutic milk, the only food she can swallow.
Her parents were nomads who owned dozens of camels that provided meat and milk for their family. Then the rains stopped coming. The thorn trees began dying, the vegetation withered up and the big herds of camels ceased to roam.
"I've never seen this before," says her 29-year-old mother, Halime Djime, who has already lost two of her four children to malnutrition and disease. "Even when there were no trees, there would be vegetation. This is the first time that the land is all white."
Fatime weighs just seven kilograms - barely half of what she should weigh at her age. Teetering between life and death, her emaciated body evokes memories of Ethiopian famines in the 1980s. Yet she is not a poster child for a celebrity benefit concert or a charity campaign. Ignored by much of the world, the starving children of the African Sahel represent a new global challenge: How to respond to the climate crisis that the world's politicians have failed to fix, and how to break the cycle of endless emergency aid in an era of donor fatigue.
Fatime's father has been on the move for years, selling his few remaining camels and seeking work in Libya and eastern Chad. His wife does not even know where he is any more. These are the days of the "climate refugees" - families splitting apart as migrants flee from increasingly harsh conditions where survival is nearly impossible.
As the desert relentlessly expands and rainfall disappears, the villages in this part of the Sahel are almost empty of men. Most have trekked to Libya or Nigeria in search of jobs. Of the people who remain, 80 per cent are women and children.
Across the Sahel, a band of semi-arid land south of the Sahara stretching from the Atlantic Ocean to the Red Sea, an estimated 10 million people suffered food shortages this year, including 850,000 children who are acutely malnourished and could die without urgent care. In the Sahel region of Chad, more than 20 per cent of children are acutely malnourished, on top of a chronic malnutrition rate of about 50 per cent. In some regions, mothers are desperately digging into anthills in search of tiny grains and seeds for their children. And this is just one of many places around the world where the changing climate has left the people dependent on foreign aid.
When the 190-nation climate conference in Cancun, Mexico, staggered to an end last weekend, there was no binding agreement on curbing carbon emissions and no sign of a treaty to replace the soon-expiring Kyoto Protocol. The negotiators will try again next December. But regardless of those negotiations, the facts on the ground will not change: The climate is growing more precarious, and millions of people are on the move. The question now is whether to encourage them to migrate - or to salvage their ravaged land with long-term investment, instead of simply handing out emergency aid.
Unable to agree on a climate treaty, the wealthy nations at Cancun promised to help the poorer countries "adapt" to climate change. The people of the Sahel, however, have already been adapting for years - mostly by voting with their feet, abandoning their barren fields and migrating hundreds of kilometres in search of work.
"Anyone who could afford to leave has left," says 71-year-old Adji Goukouni, deputy chief of the village of Mampel, a collection of beehive huts and stick fences in the sandy wastes of the Sahel.
"I am too old to move," he says. "I have no strength left to work. If I have to die, I will die here."
For more than a decade now, he has been bewildered by the changing weather patterns. Fifteen years ago, he had more than 30 cows, 10 donkeys, five camels and five horses. Then they began dying. Within the past three years, his last remaining livestock perished.
"The rainfall has been diminishing all the time," he says. "The wind is stronger than before, and animals are fleeing. We have nothing left - we only have goats. All the animals are gone, and the wild animals too, even the geckos and hyenas and guinea fowl."
This year, the village suffered a perverse twist of fate. When everyone had given up on the rains, suddenly there were torrential storms, more rainfall than the village had seen in many years. But the farmers gained nothing. They had not gambled on the cost of seeding their fields. "We weren't expecting any rain, so I didn't plant anything," Mr. Goukouni said.
In the region around his village, farmers need 400 millimetres of rain annually to produce a crop. Over the past four years, rainfall has varied from 135 millimetres to 358 millimetres - not enough to sustain a harvest. And much of the rainfall is produced in torrential storms that cause more damage than benefit.
In the nearby town of Mao, the strange combination of drought and sudden torrential rain has had an unexpected result: huge fast-growing ravines that threaten to swallow up the town. This year alone, 350 houses were destroyed by the eroding sand, which also threatens to destroy a local school and the local airport. Sandbags and concrete walls have failed to hold back the rapid growth of the ravines.
A couple of hundred kilometres to the south, fishermen and farmers have been devastated by the dramatic disappearance of Lake Chad, one of the biggest lakes in Africa. The lake, shared by four countries, has lost 95 per cent of its size since the 1960s, partly because of climate change and partly because of overuse for agricultural irrigation. Experts say it could completely disappear within the next two decades.
Where once the lake had 150 species of fish, only about a dozen species are still alive today. The fish catch has dropped by 60 per cent, and thousands of fishermen have been forced to abandon the lake. From an airplane overhead, the lake is now revealed as a vast collection of shallow inlets and fingers of water, choked with weeds. It's an environmental catastrophe that imperils the 30 million people who depend on the lake, yet it has been virtually ignored by the world.
"When the water was deep, I could just throw out a net and it would fill with fish," says Paul Mbayou, who has been fishing on the lake for 17 years. "I used to get enough to sell in Nigeria. But now the fish are too small."
He takes a boat to check the traditional basket nets that he left in the weeds at the edge of the lake. But most of the nets are empty, and only one has a few tiny fish in it. "Nothing, nothing," he mutters as he checks each net.
The region around Lake Chad was once the breadbasket of the Sahel, but its farmers have seen their crops decline by 40 to 60 per cent in the past decade, as irrigation canals are left dry by the receding lake. Thousands of cattle have died, and the surviving cows are producing less than half as much milk. Even in this former breadbasket region, more than a fifth of the children are acutely malnourished.
The village of Ngambia was built in the 1940s on an island in Lake Chad. Then the lake receded, the village was left stranded in the middle of the desert, and the villagers had to stop fishing. They tried to grow crops, but they could produce only enough to feed their families for a few months of the year. So now the men have moved away in search of work, leaving the women and children behind.
The biggest town on the Chad side of the lake, Bol, has lost more than half of its population since the 1990s. Its mayor, Ahmat Tidjani Boukar, says the men have journeyed to Nigeria or Libya to become labourers or security guards, or have joined the Chadian army. Many of the women, he says, have become prostitutes or beggars.
"The community has always depended on the lake, but now there are no fish," the mayor says. "In the past, we exported fish everywhere. Now, we can't even produce enough for ourselves. It's very likely that people will just keep moving away."
Evidence like this is convincing some experts that the Sahel is becoming uninhabitable. Across most of Africa, average temperatures have been steadily rising for decades, while rainfall has been declining. The Sahel is one of the worst-hit regions. Climate change and human exploitation have left it vulnerable to extreme weather and a destructive cycle of drought and floods.
For more than a decade, child malnutrition in the Sahel region of Chad has been above the emergency threshold (defined by the United Nations Children's Fund (Unicef) as a 15-per-cent rate of acute malnutrition). The Sahel countries, including Chad and Niger, are among the poorest and hungriest in world, with nearly one-quarter of their children dying before their fifth birthday. An estimated 225,000 children die annually of malnutrition in five Sahel countries: Chad, Niger, Mali, Mauritania and Burkina Faso.
"Before, we had crises, but they came and went," says Maina Abakar, a nutrition expert in Chad. "Now, the crisis just stays."
The changing climate has created a dilemma for wealthy donor countries such as Canada. Instead of spending millions of dollars on emergency food for the region's malnourished children, should they be encouraging the people to leave? When the Cancun conference promised $100-billion annually to poor countries to help them adapt to climate change, does it mean helping Africa ship its people out of uninhabitable areas?
"If the conditions in the Sahel continue to worsen because of climatic deterioration, it's obvious that it can't sustain a large number of people," says Jean-Luc Siblot, director of the Chad operations of the World Food Program, the UN food agency.
The WFP is providing supplementary food rations to about 60,000 children and 81,000 pregnant women and young mothers in Chad alone. It has asked for $300-million from donors to support the Sahel countries this year. But Mr. Siblot questions whether this kind of assistance is the best solution for the region in the long term.
"When it is likely that the climate will worsen over the next 20 to 30 years, I'm not sure whether we'll be able to sustain it," he says in his office in Chad's capital, N'Djamena.
"The desert is expanding every year. You can't have a big percentage of the population living in those conditions. They're migrating away, in a very disorganized way. I don't see a solution for it. You can dump as much food as you want into the Sahel, but it won't solve the problem."
Unicef sees it differently. In its view, its primary obligation is to prevent starvation and save the lives of the families in the Sahel, even if this encourages them to remain in a region where the climate is deteriorating and the desert is spreading.
"This is where our parents and ancestors were born," says Yakoura Maloum, a Unicef officer who was born in the town of Bol. "The tombs of our sultans are here. It's not possible for us to move away. Individuals can move, but the community cannot move."
In the Sahel region of Chad alone, Unicef is providing food for 50,000 malnourished children in about 200 emergency feeding centres. Last year, it supported 12,000 children, so the number has quadrupled this year as the crisis deepened.
"I've never seen a situation as bad as this," says John Ntambi, a Unicef nutrition specialist in the Mao district.
"You see thousands of children all the time, and it never ends. It never gets any better. The population is less and less capable of feeding itself, so it's more reliant on external support. The levels of malnutrition are very alarming."
Even after the feeding centres were created this year, it can be a long ordeal for mothers to reach one. Distances are vast, and roads almost non-existent. When her child fell ill, it took five days for Halime Djime to travel 700 kilometres to the hospital in Mao.
The irony is that the Sahel countries could do more to feed themselves, but they are hamstrung by poor land policies, low education levels, a lack of money for investment, and autocratic regimes that spend more money on weapons than on children. If donor countries refused to help the malnourished children of the Sahel, the children would simply starve.
"I've never worked in a region where the government is so unresponsive," Mr. Ntambi says. "All of the life-saving supplies are being provided by Unicef, and nothing is being provided by the government. The priorities are wrong."
Many experts believe that the Sahel has huge potential to sustain crops and livestock if its water resources were managed properly. Scattered among the sand dunes and scrub land, there are thousands of oases and valleys where crops can grow. But less than 10 per cent of the population has access to these oases, which are owned by a privileged few. And since the water is deep underground, the owners often lack the money to dig wells and pump out the water for crops.
In the region surrounding Mao in the Sahel of western Chad, 750 oases are underused because their owners cannot afford to dig wells, according to the UN's Food and Agriculture Organization. It estimates that only 10 per cent of the oases are properly developed for agricultural use.
Another key factor is the government's preference for military spending. Chad has received billions of dollars in oil revenue in recent years (it is the sixth-biggest African supplier of oil to the United States), yet most of this revenue is spent on its security forces, despite its earlier promises to spend the oil money on poverty alleviation.
"People think Chad is a rich country because of its oil - and it's true," says Jean-Baptiste Ndikumana, the Unicef deputy representative in Chad. "If they used this money for social services, there could be some improvement. Instead, they use it for weapons."
Poor levels of education are another crucial problem. Knowing little about nutrition, many people in the Sahel turn to traditional healers when their children are starving. The "healers" usually do more harm than good: They cut incisions in children's mouths or burn their bottoms to "treat" diarrhea.
Grandmothers, meanwhile, encourage their pregnant daughters to eat less food so that their babies will be smaller; or they advise mothers to give water, instead of milk, to newborns. Both are dangerous practices. Breastfeeding is one of the best ways to improve a child's health, yet only about 3 per cent of Chad's children are exclusively breastfed in their first six months. And because of cultural traditions, women with starving children are reluctant to travel to a feeding centre without the permission of their husbands, who are often unreachable because they have migrated in search of work.
Education and agricultural development are the keys to saving the people of the Sahel from climate change. Yet only a small handful of international agencies are present here, in contrast to the hundreds of agencies in Haiti or Afghanistan.
There are no dramatic earthquakes or civil wars to draw attention to the Sahel - only the slow grind of climate change, wreaking its gradual chaos on the land. Relief agencies tend to respond late, or not at all. The UN was aware of the drought in Chad in the fall of 2009, yet it did not send emergency aid until the spring of this year. "We came too late," Mr. Siblot admits. "We wasted three months, scratching our heads and trying to decide on a response."
The FAO is one of the UN agencies that should be helping Chad to improve its agricultural productivity, yet it has only a small presence here. In effect, the UN and the world's donor countries have channelled their funds to emergency aid, rather than long-term agricultural development - which means that Chad will always be dependent on aid. "We are saving lives, but we are not solving the problems," says Mr. Ndikumana of Unicef.
The Sahel may symbolize the future of foreign aid: responding to climate-related crises that leave millions at risk of hunger and death. The solution, as Mr. Siblot acknowledges, is to do more than "dumping food" into a region. There needs to be much heavier investment in education and agriculture, so that massive numbers of people aren't forced to abandon their homes. And if a regime prefers to spend its billions on soldiers and military weaponry, the buyers of its oil might have to use their influence to press for new priorities. Otherwise, the vast human migration in places such as the Sahel will spin out of control forever.
Geoffrey York is The Globe and Mail's Africa bureau chief.