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."