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Mogadishu, Somalia in September, 2011: By the time the world started paying attention to the famine, it was too late for a vast number of people. Here, a child lies on a bed in the stabilization area of a hospital after receiving treatment.

Peter Power/The Globe and Mail

The first drought warning was issued in August, 2010. Over the next few months, the warnings became increasingly dire and urgent. By March, 2011, experts were predicting a famine in Somalia unless the rains came soon.

The world ignored the warnings, even as tens of thousands of Somalis were already quietly dying and many more were fleeing their homes in a desperate race for survival.

Incredibly, there were a series of 16 warnings by official analysts as the crisis deepened, along with many briefings for relief agencies and donors, yet the world paid little attention. Finally the United Nations declared an official famine in two regions of Somalia in July, 2011. Only then did substantial amounts of humanitarian aid begin arriving.

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By then, it was too late for huge numbers of people. Nearly 260,000 Somalis died in the famine, according to new data released on Thursday in the first scientific study of the death toll. The study gives overwhelming evidence to show that this was one of the worst catastrophes since the Ethiopian famine of the 1980s. More than half of the dead were children under the age of five.

Until now, most experts had thought that perhaps 50,000 to 100,000 people had died in the Somalia disaster. Many reports just said "tens of thousands" and left it at that. But the new study establishes that the famine was far more terrible than the world had believed.

"The magnitude of the mortality figures today is truly unsettling," said Philippe Lazzarini, the UN humanitarian co-ordinator for Somalia, in a statement on Thursday.

"The suffering played out like a drama without witnesses," he said. "The report confirms that we should have done more before famine was declared. ... Warnings that began as far back as the drought in 2010 did not trigger sufficient early action."

The estimated 258,000 deaths from the famine were in addition to Somalia's already sky-high death rate from war, disease and other causes. During the 18 months of the famine, about 290,000 Somalis died of other causes – twice as high as the sub-Saharan average death rate.

The famine added a massive new burden. In Southern and Central Somalia, the famine killed about 10 per cent of all children under the age of five. In some regions, up to 18 per cent of children perished.

"We now have a picture of the true enormity of this human tragedy," said Mark Smulders, senior economist at the UN Food and Agriculture Organization.

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The famine had its origins in the failed rains of 2010, the driest year in the eastern Horn of Africa in 60 years. Harvests were small and livestock were dying. But the drought was soon compounded by man-made factors. War was escalating in Somalia, and the extremist al-Shabab militia was restricting movement in the vast territory under its control. It banned the UN food agency from its territory in 2010 and then banned another 16 relief agencies a year later.

The security risks were a deterrent to relief agencies, which provided less humanitarian aid than they had in earlier crises. Another deterrent was a U.S. law allowing criminal prosecution of relief agencies if their aid reached the hands of groups such as al-Shabab. As a result of all these factors, humanitarian aid fell by about half from 2008 to 2011, even as the needs were rising sharply.

The reduced supply of food triggered a dramatic rise in food prices, at a time when household incomes were collapsing. The combination was catastrophic. Hundreds of thousands of Somalis, already weakened by food shortages, had to flee their homes in search of help. Many were forced into an arduous trek to refugee camps in Mogadishu, Kenya and Ethiopia. Thousands more died on the road, or shortly after arriving in the camps.

After the Somalia disaster, agencies and donors said "never again." They vowed to learn the lessons and apply them to the next crisis. Yet even as the Somalia famine was easing, a new crisis was rapidly escalating in the Sahel region of West Africa, where 18 million people were affected by food shortages. There, as elsewhere, aid decisions by donors are often still highly politicized and arbitrary, critics say.

"Fundamentally, little appears to have changed," wrote Rob Bailey, a food-security researcher at the Chatham House think tank in London, in a blog commentary on Thursday.

"There are no rules for how early warnings should lead to early action, and a lack of clear processes for how decisions should be triggered, escalated and justified," he said. "Ultimately, despite having the early warning systems and resources needed to prevent famine, accountability for doing so remains minimal."

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In a report last month, Mr. Bailey called for better emergency response plans, stronger supply lines, more advance purchasing of emergency supplies, more flexible planning, and constant revisions as the risk factors change.

The threat of more food crises in the Sahel and the Horn of Africa is increasing, his report said, because of rapid population growth, low farm productivity and rising environmental change.

"Full-blown famine remains a serious threat. The number of people affected by drought-related crises each year in the Horn and Sahel is on an upward trend."

In Somalia itself, the UN estimates that 2.7-million people still need assistance today because of food insecurity. Many regions of the country are inaccessible. The government in Mogadishu has little control of anything outside the capital, and al-Shabab has retained its grip on much of southern Somalia.

One prominent relief agency, Save the Children, says the situation for children in Somalia is still "extremely serious," and Somali children are dying of hunger.

"While conditions in Somalia have improved in recent months, the country still has one of the highest rates of child malnutrition and infant mortality in the world," said Carolyn Miles, president of Save the Children.

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