Children are wasting away in southern Malawi. Mothers are distraught and beg for emergency feeding.
The season of hunger has started - the lean months between the planting of crops and the coming of harvest - and at a health centre in Chikhwawa district, the number of malnourished children worries nurse Ellen Ng'ombe. The figures are soaring, already 50 per cent higher than those of a year ago.
If the nurse had her way, every hungry child would be fed, but the centre must adhere to protocol: the weight-for-height measure that establishes who is malnourished and who is merely underfed. The mothers must wait, and agonize, until a child loses enough weight to qualify.
"There's no food at home," Ng'ombe says, and the women want to know why the downward slide cannot be prevented.
Of about two million people currently hungry in Malawi, children are among the hardest hit and, unless there is sufficient intervention by the end of the lean months, more than 36,000 youngsters under the age of five are likely to have suffered severe acute malnutrition.
Chikhwawa's farmers fight to keep food on the family table, but droughts and floods have stacked the odds against them. Coping for many means eating less. People have run out of options.
It isn't a dramatic turn of events that threatens southern Malawi, more calamity creep, but another failed harvest in April and May could have catastrophic consequences. As an appeal by the International Federation of Red Cross and Red Crescent Societies in support of the Malawi Red Cross Society has underlined, food aid is essential to see people through the short term. But what this drought-prone region desperately needs is an emergency response that develops into adequate food supplies for everyone in the long term.
More than 40 per cent of Malawi's population lives on less than US$1 a day, and 90 per cent of those living in affected areas depend on subsistence farming. The depletion of food stocks, the damage done to crops, seed supplies, livestock, the economic fabric and local markets has left people exposed and threatened. Red Cross operations would restore and diversify livelihoods, strengthen the ways in which people cope and leave communities more resilient.
The village of Lauji sits in the Lower Shire valley where the Red Cross is stepping in. People here contend with more than changing climate. There is rampant inflation - now above 30 per cent - with massive hikes in the price of food. Maize, the key staple, costs double what it did a year ago.
Lucia Genty, a young mother of two, says her family eats only once a day. Even if food is at the market, they can afford to buy little.
The meal today isn't much, just a little maize-meal porridge, and wild vegetables gleaned from the countryside. No one is starving in Lauji. There is no famine yet but the hunger is chronic.
Asked if their children's condition is worsening, a neighbour's vague answer is telling. "Yes," she says. "Some are unwell. More are unhealthy than there used to be but it's difficult to say. Things have been this way so long we are used to it." In many Lower Shire villages, listless children with headaches and stomach pains, who are prone to diarrhoea and vomiting, are no longer considered unusual.
As the lean times have grown, farmers have sold their assets and turned to casual labour, particularly in the less affected wetlands close to the river. Women head for those fields as well, and pull their children out of school to accompany them. The 60 or 70 cents a day earned from weeding partly explains a 20 per cent drop in school attendance, a figure which also reflects growing ill health.
Disease has increased with the hunger, but prostitution of the poor, food for sex, the vulnerability caused by urban drift, all contribute to the country's eleven per cent HIV rate. Flooding leaves stands of stagnant water and malaria is growing. In the past five years, cholera has returned to Malawi, particularly in the Lower Shire.
But the first substantial rains of the planting season have induced a cautious air of optimism. Elsewhere the deluge has damaged homes, fields and infrastructure, pouring from the uplands to trigger floods. As the rains eased, however, these villagers started planting.
Manuel Lauli, 33, pauses in the field he hopes will bring a crop of early maturing sorghum. He's had a bad time; four months without food he has grown, the longest gap he has known and one that is far from over. His 2012 cotton - his cash crop - did badly as well and the price he received for it was pitiful.
So he's wasting no time in the wake of the rain but says he'll need more than what is now falling. By early afternoon the clouds are dispersing. The sun comes through and the temperature soars. Will the fields dry up or will the clouds return and throw Manuel a lifeline?
He points to an army of bright red beetles. Known as Ana Rmulungu (the children of God), these minuscule creatures are a traditional early warning system. When the beetles appear, the villagers say, lots of rain can be expected. They clutch at straws in the Lower Shire.