♪ tonight, we're in somalia on the front lines of a hunger crisis. a tiny girl, malika, clinging to life, too weak to cry. >> i can see she's -- she's so incredibly thin. >> reporter: her mother overwhelmed and desperate for help. the toddler's life hanging in the balance like so many others here. >> i've never seen something this severe causing 7 mass human suffering. >> an historic drought turning grazing grounds to graveyards. >> the livestock is gone from these communities. no livestock, no life. >> the country on the brink of famine. >> look around you. what is this, if this is not

famine? >> the strength one little girl fighting for life, just like her country -- but is it too late? >> oh my god, they're freezing. these kids are so cold to the touch, it's actually very scary. >> "nightline," "saving malaika," will be right back. i ! (cat 1) it's friskies farm favorites! (cat 2) the winning farm-ula. (woman vo) feed their fantasy. ♪ friskies ♪ (cat 1) look! friskies ocean favorites! yum! [sfx: stomach gurgling] it's nothing... sounds like something. ♪ when you have nausea, heartburn, indigestion, ♪ ♪ upset stomach, diarrhea. ♪ pepto bismol coats and soothes for fast relief... when you need it most. life is expensive. so why is omar snoozing like a baby? because he made the smart choice to shop with ikea,

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>> reporter: the toddler's arm was as thick as my thumb. at just 18 months old, malaika's body is shutting down. garan hassan, holding her daughter, baby malaika, pulled me aside. what is she trying to say? she pointed out her child. i can see she's -- i mean, it's -- she's so incredibly thin. >> reporter: tonight we take you to te heart of the hunger crisis in somalia through the eyes of mothers desperate to save their children. >> 10 centimeters? >> less than 10, 9.5. >> malaika's arm is less than 2.5 inches in circumference. this means she's pretty significantly malnourished. >> reporter: even surrounded by the starving, malaika is so

critically malnourished, they rush her to the front of the line. too weak to stand on the scale, they weigh her in that bucket. as it twists slowly around, the 18-month-old doesn't fuss. tonight, malaika's journey to survive. >> oh, no, she's cold. >> reporter: the teams on the ground rushing to save her. her life hanging in the balance, like so many other children in somalia. she's one of more than 500,000 children under 5 with severe acute malnutrition. experts say up to half of them could die, according to the world health organization. and the u.n. saying this week that things could only guess worse in the coming months if adequate help doesn't arrive soon. >> i've never seen something this severe, a drought that has lasted this long and at this level of severity, and is causing such mass human suffering on a scale that is over half the country. >> reporter: an historic drought coupled with soaring global food prices triggering what could be

the world's deadliest hunger crisis in east africa. at least 22 million starving, according to the u.n. world food program. somalia the epicenter. more than two years without significant rain has turned grazing grounds into animal graveyards. somalia has yet to declare an official famine, but many agencies believe it's already here. >> for me, the declaration of famine is irrelevant. look around you. what is this? if this is not famine? >> reporter: we've traveled to the front lines of what could be the world's deadliest climate change disaster to accompany a mission by the fao, the u.n.'s food and agriculture organization. off the country's north-south highway, our convoy carving through the dust to communities deep in the bleached moonscape. at one of the scoops, fao senior technical adviser absure youssef tenderly kneels near a dying sheep. you're watching animals and

humans both get weaker and weaker? >> livestock is critical for these communities. no livestock, no life. >> reporter: we are following fao tankers delivering water, a desperate attempt to keep livestock alive. this community moved here about five years ago during the last severe drought. it's near a road and a town, and they relied on u.n. agencies for food and water. that has now dried up. u.n. agencies said they can't afford to feed them because what they've been doing in this country is taking food from the hungry to feed the starving. what is he pointing at? >> reporter: sheikh bashir is the leader of this community in northern somalia. this milking camel is his sixth camel to die, leaving him and his family destitute and desperate. he's been relying on groups like

the fao, but with donor attention on covid and ukraine, humanitarian organizations tell us they are woefully underfunded and struggling to meet demand. what if they don't have more food or money, what are they going to do? >> reporter: beshear uses the little food he has not only to keep his family alive, but his few remaining camels. oh, wow. you have been eating milk and meat your whole lives. is it strange that you and your animals are now eating the same food? >> reporter: his family hasn't had any meat in nine months. when he sleeps at night, what rain.he dream of?-

they pray for rains that climatologists predict will be too little, too late, making the coming wet season, typically running from october to december, the fifth consecutive failed rain. which is why out here they sing to the camels. ♪ ♪ coaxing them to the trough to drink their hunger away. because this drought has broken atoe ite ali mohammad says his family has survived off the land here for 500 years.

he showed us his four remaining camels. literally skin and bones. it's a skeleton. so they're drinking now, but how much can they drink water and not eat food? >> reporter: that life support provided by those tankers from the fao make the rounds to >> normally it would be enough spacing between droughts that the farmland and the pastureland can get by. now there's nothing left.

one-third of the livestock in this country has expired over the last year. >> reporter: the memory of the 2011 famine, which killed over 250,000, the majority of them children, remains fresh. so trucks bearing whole families and their livestock are on the move. this group of four families has hired this truck. all their livestock are packed in there. on top is where they have tarps, tents, all their possessions. over 1 million have given up on finding green pastures. they are climate refugees. many head south, but to get there, they've got to go through areas under al qaeda's affiliate, al shabaab, and its iron rule. those who can escape head for a southern town called baidoa, a town of checkpoints, men with guns, and shattered streets. and everywhere around, those

tents. beyond the threat of allal shabaab, the journey itself can be deadly. >> it ends up being a perilous journey because most of them die on their way to camp or die immediately they reach the camp, out of exhaustion. >> reporter: here where the need is so immense, save the children has opened centers. at this nutrition site, they assess the children's level of malnutrition and get them on a treatment program. >> last week, 8 kilos, so improving. >> that's a lot. >> reporter: this is the center treating malaika. the staff recommends she be hospitalized in a special ward for severely malnutritioned children called a stabilization center. it's across town. but there's a complication. she's saying she can't take her baby to the stabilization center because she's got six other children. she's got tablets and pills and some of this nutritional food

she's going to try to feed her baby. >> reporter:us like that, garan what han and baby malaika disappear into the camp. so this is garan hassan's house. it's just the tent they built. the next day, we accompany a save the children medical team for a welfare check. oh, no, she's cold. does she have a fever? they are taking her to the stabilization center? the ambulance is coming. right now, save the children staff have determined that a day later, malaika's even sicker, so cold to the touch it's a little scary. they're going to take letter to the hospital right now. >> reporter: her older brother. nadifa, is also very sick. >> the children are very serious. both of them, they had different

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it's okay, it's okay, it's okay. >> reporter: famine is a slow-motion catastrophe witnessed mostly by mothers.

guran hassan is one of them. her daughter, 18-month-old malaika, and 3-year-old son madifa, critically malnourished, slowly dying in this sprawling camp in somalia. she says there's no question her children need to be hospitalized. a staffmember from save the children carries the boy, the girl strapped to her mother's back. they're taking them to the stabilization center, basically a hospital. and her brother. these kids are too sick to be here, and they need immediate care. they bump through the town's prone streets toward the hospital. finally arriving at the stabilization center. nurses take malaika's measurements. that arm. the weight. the height. all on the critical end of malnutrition. the siblings are admitted,

processed, and within minutes, begin treatment. little malaika gets an iv inserted, even adjusted. but the toddler is so weak, she hardly makes a peep. her first sip of formula, heartbreakingly exhausting just to swallow. her brother confirmed to have pneumonia. but garan is one of the luckier moms. 800 miles away in northern somalia, 18-year-old barlin and husband jama raise livestock. like so many millions, that historic drought leaving them unable to make a living. the couple is struggling to eat and feed their 5-month-old son, mohammad. they buy plain powdered milk by the ounce, stretching it as far as possible.

is this one of the most valuable things that you have in your home right now? >> reporter: climate is only part of the story. the other is also a global phenomenon we experience at home, soaring inflation and food prices. it's in a small shop like this where barlin buys mohammad's powdered milk. the store owner telling us prices have stabilized. basically this is almost twice as much as it was two years ago. does it make you feel sad when people can only afford just a little bit? >> there's no business. >> zero, zero. so the drought and the hunger affects everyone, even you? and where they once delivered

sacks of food, aid groups are now trying to pump money into communities like this one. the idea is to keep their economies intact for as long as possible and head off the need for families to travel hundreds of miles to find support. so you're bringig aid to them, often in the form of money so they can go purchase things in the market. so they don't die on the way to the internally displaced persons camps? >> exactly. they can be able to use that money within the community to buy the food that they want. but the fact that they don't embark on this perilous journey and they stay tied to their livelihood, it means that post-drought, they still have the livelihood activities to fall back to. >> reporter: those sprawling camps like this symbolize the end of communities. for individuals like garan hassan and her children, they also symbolize salvation. when you saw malaika come in, how sick was she?

>> she has whooping cough. >> may like character the little one? >> and measles. >> and measles? >> yes. >> reporter: now that she's here, it's likely that she's going to survive? >> she will be okay. >> she will be okay, insha law, that's what we hope. >> reporter: the nurse gives him easiest to digest formula for the mal malnourished. he pushes it away but a nurse props him on his lap and hands him the cup. he gulps it down. then another cup. his face framed by a milk moustache, and for the first time in a long time, on his mother's face, a smile. the family quarantining in their room. the children finally sleeping with a full belly. garan devouring a first full meal of her own and pondering

her next move. going back to your village after this? when we come back, an encouraging update from malaika and her brother. sus®. man tc: my a1c wasn't at goal, now i'm down with rybelsus®. son tc: mom's a1c is down with rybelsus®. song: a1c down with rybelsus® anncr vo: in a clinical study, once-daily rybelsus® significantly lowered a1c better than the leading branded pill. anncr vo: rybelsus® isn't for people with type 1 diabetes. anncr vo: don't take rybelsus® if you or your family ever had medullary thyroid cancer, or have multiple endocrine neoplasia syndrome type 2, or if allergic to it. anncr vo: stop rybelsus® and get medical help right away if you get a lump or swelling in your neck, severe stomach pain, or an allergic reaction. anncr vo: serious side effects may include pancreatitis. gallbladder problems may occur. tell your provider about vision problems or changes. anncr vo: taking rybelsus® with a sulfonylurea or insulin increases low blood sugar risk.

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♪ "nightline," "saving malaika," continues. here again, matt gutman. >> just eight days after being admitted, garan hassan is back at home with her children. as she talks, she struggles to hold malaika, who's squirming and flopping around like a healthy toddler should.

so different from the glassy-eyed baby we saw in the bucket. which is why officials say there is still hope for children like her, even now, even in somalia.