Madagascar's most intense drought in 40 years, along with other man-made environmental phenomena, has triggered what the World Food Programme calls the "first climate change famine".
"We have some pockets of Integrated Food Security Phase 5, which means famine-like conditions. This is basically the only, maybe the first, climate change famine on earth," said Arduino Mangoni, deputy director of the World Food Programme (WFP) in Madagascar.
After a recent "heartbreaking" visit to an emergency nutrition centre in the south of the country, the UN agency official said he had encountered "silence and joylessness", children staring at you and really made of skin and bones.
"I have been working with the programme in several countries on this continent, in several emergencies, including the Democratic Republic of Congo, the Central African Republic, in Darfur, and I have never seen children in the situation they are in".
Speaking to journalists in Geneva via Zoom, Mangoni explained that the region has been hit by the most intense drought in 40 years. "The older people we assist in the south keep telling us that this is the most severe phenomenon - the Kéré, they call it - since 1981," he said.
In total, some 1.3 million Malagasy people are suffering to varying but high degrees from food shortages. All of them fall into stages 3, 4 and 5 of the Integrated Food Security Phase Classification, according to the latest available data from April. The next forecasts will be published by the end of the year.
The number of people in phase 3 and above, around 1.3 million, is now higher than in 2016, during the crisis triggered by the El Niño weather phenomenon, the agency official continued, noting that there was in fact little difference between categories 3 to 5.
"If we look at the forecasts for the next few months, the situation is very alarming," he said, noting that the trends since last year have gone up.
"So, if you just look at category 4, about 200,000 people (were) in this category in the last quarter of last year. Now, we have about half a million; with a forecast of people in phase 5 also of about 30,000, between now and the end of the year, when the new classification results will be available," he explained.
Unlike the other famines in Yemen, South Sudan and Ethiopia, which are conflict-driven, the Madagascar crisis is probably the result of devastating climatic factors, the food programme official said.
"We have some acute phenomena, like... consecutive droughts in the last five years, a new phenomenon of sandstorms probably caused by soil erosion, deforestation over the last 20 to 30 years and then, of course, the consequences, and the effects of COVID-19," he said.
Because of the pandemic's impact on tourism and supply chains, villagers who had previously sought work in cities during times of scarcity have been left without this alternative, Mangoni said.
People have also exhausted their usual survival techniques, such as selling their cooking utensils: "We have high prices, inflation is staggering, especially in food prices, including water," he added. "And we also suffer from insecurity, there is a new phenomenon called dahalo, the bandits that plague the area".
According to the World Food Programme, some 500,000 children under the age of five are believed to be malnourished; 110,000 of them are estimated to be severely malnourished by April 2022.
"These are the children who are at risk of dying if they are not supported," Mangoni said, adding that measuring the effects of famine on very young babies is complicated, as deaths in those under six months old are often not recorded.
To help those most in need, WFP has already scaled up rationing and nutrition programmes; it also plans to reach more than a million people in emergency phase 3-5 from December, the height of the lean season, "until the next good harvest", which is expected to arrive in April 2022.
To provide this emergency assistance over the next six months, the agency has requested $69 million.