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Ethiopians have endured years of drought and water scarcity, and they now carry the added burden of an armed, ethnic conflict
I have worked in the humanitarian field for almost 20 years in places like Afghanistan and South Sudan, yet I did not grasp how dire the situation in Ethiopia is until I saw it firsthand.
I had monitored the situation from my office in Nairobi, reading reports and humanitarian updates, but it was my time on the ground there that has really brought into focus the severity of the crisis.
Ethiopians have endured years of drought and water scarcity, and they now carry the added burden of an armed, ethnic conflict, after clashes between Ethiopia's Oromo and Somali regional states have escalated in recent months, driving more than 850,000 of them from their homes this year alone.
This week, the Ethiopian government signed a peace deal with the Oromo Liberation Front, and I look forward to a pause in hostilities and a chance for those who have been affected by the conflict to rebuild their lives - because what I saw constituted one of the worse crises I have ever seen.
They take shelter wherever they can, including in a school I saw, in which 1,000 people make their home, all living, cooking, eating and sleeping in overcrowded conditions.
Children run unaccompanied, making it hard to tell who among them is just playing and who is actually separated from their family.
In support of CARE's work there, I spent three weeks in southern Ethiopia last month - specifically in the towns of Dilla, Yegachefe and Gedeb - where thousands of displaced people have sought refuge.
In Gedeb, temperatures fall below 10 degrees Celsius at night, yet I saw many people, especially children, with very light clothes, hardly enough to protect themselves from the brutal cold.
Families have fled their homes with nothing more than the clothes they were wearing. Many sleep on the bare floor without a cover. Cases of pneumonia have already surfaced, raising fear of an outbreak. Acute respiratory infections are a problem, too, and, with no adequate bathrooms, so is a lack of sanitation, particularly as it increases the risk of acute watery diarrhea.
Given the overcrowded conditions, a disease outbreak could infect thousands of people within days.
As I walked inside the crammed schools and government buildings that also had become refugee shelters, parents described the challenge of trying to feed their children and survive on meagre food rations.
People asked for sleeping mats, blankets, food and jerry cans for fetching water. In one location, 25 people shared one 10-litre jerry can, and many walk more than a kilometer to fill their cans at community water points, as there are no water pipe systems in most of these sites.
CARE is scaling up its response, distributing cooking sets, jerry cans, water purification tablets, blankets and other household items.
We are setting up water tanks on-site to improve communities' access to water, and we will set up toilets and safe spaces for women, and others for children where they can play and engage in activities, such as arts and crafts, with specialised guidance. They will also receive psycho-social support to help them process and cope with the growing crisis.
"We were forced to flee without anything," one single mother told me. "Now I cannot provide food for my 4-year-old child or keep him or myself clean."
In crises like these, meeting the physical needs is the most pressing priority for humanitarian organisations like CARE, but there are substantial psychological issues that we must address as well.
Before violence took root in southern Ethiopia in April, almost 1 million people, most of them farmers, were self-sufficient and able to provide for their families. Their children had health care and attended school. Then they lost their land, their homes and life as they had known it - in many cases, literally overnight.
The needs run too deep and number too many to portray sufficiently in words or photos. And if more resources don't arrive, those needs can't and won't be met.
CARE and other humanitarian organisations need much more international support if we are to respond adequately to this underreported emergency. Eight months into the year, less than 20 percent of the Ethiopia Humanitarian and Disaster Resilience Plan has been funded.
The Ethiopian government and humanitarian organisations are providing basic support, but it is not enough to meet people's needs. The government is working remarkably to drum up resources, both technical and financial, to fund a more robust response, but given the massive scale of the emergency, additional support is needed from the international community.
I urge this global community to stand with the government and people of Ethiopia to counter this crisis before it becomes a fully-fledged humanitarian disaster.
Fred McCray is the managing deputy regional director for the Horn of Africa for CARE International.