In a remote pocket of northern Yemen, many families with starving children have nothing to eat but the leaves of a local vine, boiled into a sour, acidic green paste. International aid agencies have been caught off guard by the extent of the suffering there as parents and children waste away. The main health center in Aslam district was flooded with dozens of emaciated children during a recent visit by The Associated Press. Excruciatingly thin toddlers, eyes bulging, sat in a plastic washtub used in a make-shift scale as nurses weighed them one by one. Their papery skin was stretched tight over pencil-like limbs and knobby knees. Nurses measured their forearms, just a few centimeters in diameter, marking the worst stages of malnutrition. At least 20 children are known to have died of starvation already this year, more than three years into the country’s ruinous civil war, in the province that includes the district. The real number is likely far higher, since few families report their children’s deaths when they die at home, officials say. In one nearby village, a 7-month-old girl, Zahra, cries and reaches with her bony arms for her mother to feed her. Her mother is undernourished herself and is often unable to breastfeed Zahra. She can’t afford formula for her baby. “Since the day she was born, I have not had the money to buy her milk or buy her medicine,” the mother said. Zahra was recently treated at the heath center. Now at home, she’s dwindling away again. With no money, her parents can’t afford to hire a car or motorbike take her back to the clinic. If they don’t, Zahra will die, said Mekkiya Mahdi, the health center chief. “We are in the 21st century, but this is what the war did to us,” Mahdi said. After she tours villages and sees everyone living off the leaf paste, “I go home and I can’t put food in my mouth.” The worsening hunger in Aslam is a sign of the gaps in an international aid system that is already overwhelmed and under pressure from local authorities. Yet outside aid is the only thing standing between Yemen’s people and widespread death from starvation. The conditions in the district may also be an indication that the warnings humanitarian officials have sounded for months are coming true: In the face of unending war, hunger’s spread is outstripping efforts to keep people alive. When AP approached UN agencies with questions about the situation in Aslam, they expressed alarm and surprise. In response to the AP’s questions, international and local aid groups launched an investigation into why food wasn’t getting to the families that need it the most, a top relief official said. As a response in the meantime, the official said, relief agencies are sending over 10,000 food baskets to the district, and UNICEF said it is increasing its mobile teams in the district from three to four and providing transportation to health facilities. The official spoke on condition of anonymity because of the sensitivity of issues involved in operating in the war-ravaged country. In first six months of this year, Hajjah province, where Aslam is located, recorded 17,000 cases of severe acute malnutrition, higher than in any full year on record, said Walid al-Shamshan, head of the Health Ministry’s nutrition section in the province. Malnourished children who were previously treated return to clinics in even worse condition — if they make it back at all. “Deaths happen in remote villages where people can’t reach the health units,” al-Shamshan said. “It’s a steady deterioration and it’s scary,” he said. Yemen’s civil war has wrecked the impoverished country’s already fragile ability to feed its population. The war pits Shiite rebels known as Houthis, who hold the north, against a Saudi-led coalition, armed and backed by the United States. The coalition has sought to bomb the rebels into submission with an air campaign in support of Yemeni government forces. Around 2.9 million women and children are acutely malnourished; another 400,000 children are fighting for their lives only a step away from starvation. The number of people nationwide who would starve if they didn’t receive aid grew by a quarter over the past year, now standing at 8.4 million of Yemen’s 29 million people, according to UN figures. That number is likely to soon jump by another 3.5 million because the currency is losing value, leaving growing numbers of people unable to afford food, the UN warned this month. Aslam is one of the poorest districts in the country, with hundreds of small villages, some isolated in the high mountains in the Houthi heartland. Its population of 75,000 to 106,000 includes both local residents and accelerating numbers of displaced people who fled fighting elsewhere. In terms of hunger, Aslam isn’t alone. Health officials say that other districts closer to war zones may not be getting food aid at all. But Aslam did see one of the province’s highest jumps in the number of reported children suffering from severe acute malnutrition: From 384 cases being treated in January, an additional 1,319 more came in over the next six months, according to local health records. That comes to around 15 percent of the district’s children. Published in Daily Times, September 15th 2018.