One-year-old Mohammed put a nasal drip to make sure he was getting the vital fluids he needed. Another Mohammed was being examined on the bed above him. Just two months old, he was born two months premature. He is the second son of his 17-year-old mother. She traveled 400 miles to get him to the hospital and did not think she would make it. “I was very, very upset and worried about his condition,” he told Sky News. “I was worried he was going to die. I was very, very worried and I was in pain and I could not sleep.” Ward patients in Hargeisa, the capital of the self-proclaimed republic of Somaliland, have all been victims of the region’s worst drought for a generation. The rains have been failing for four years. Ward doctor Dr. Abdul Rahman Abdulahi told Sky News he feared for the immediate future. “If the rains do not come quickly, the situation will get worse day by day and the number of patients will increase even hour by hour and day by day and we can not handle it or we can not save them.” Just across the Horn of Africa they are preparing for the double impact of war and famine. Image: Dr. Abdul Rahman Abdulahi says “if the rains do not come quickly the situation will get worse day by day” The worst drought in 40 years is accompanied by the effects of the Russian invasion of Ukraine. The war there may be thousands of miles away, but it is raising grain and fuel prices to unprecedented levels. Somalia and Somalia generally receive 90% of their grain imports from Russia and Ukraine, which has now been gradually reduced. Russia and Ukraine account for almost a third of world wheat supplies. However, Ukraine’s grain shipments from Black Sea ports have stalled since the Russian invasion, with about 20 million tonnes of grain stuck. At the market in Hargheisa, the capital of Somalia, the grain sellers all told us the same story. The price has skyrocketed by 75% in three months. Image: The price of cereals in Somaliland has risen by 75% in three months As if not catastrophic enough, the price of fuel has almost doubled, making it more expensive to deliver grain to those who need it. In the second poorest country in the world, water comes to most people in trucks that fill tanks on the road. Water is rarer on land, but also much more expensive due to the cost of fuel, increased by 60%. The impact of the drought has become much, much worse than a war that is happening thousands of miles away. Drought is now threatening the worst famine in years. The camps are already filled with people who have lost any means to support their families. The parents are desperate. Picture: Sophia was a wealthy breeder but now she is poor We met Sofia who was a wealthy breeder. She is now destitute and lives in a makeshift tent in the Mandera camp halfway in Somalia, after a drought killed all her animals. “My grandfather was a shepherd,” he told Sky News. “My father was a shepherd, I grew up in this life and ended up with 500 goats and four camels and they are all gone, I have nothing now.” In the background, they used long sticks to pull branches and leaves from the trees to feed the goats without grass to eat. But feeding the people who need it will be a huge challenge. Across the region, millions are facing acute famine in the worst drought in a generation that has been exacerbated by the war in Ukraine. And without international aid they say hundreds of thousands will starve to death.