An unprecedented 815 million people are in need of emergency food assistance in 2017. The U.N. has declared the global hunger emergency the largest humanitarian crisis since 1945. Across East Africa, the Lake Chad Basin and Yemen, starvation threatens over 20 million people — more than the populations of New York City, Los Angeles, Houston, Chicago and Philadelphia combined. Ethiopia, Somalia, Yemen, Nigeria, and South Sudan are already experiencing emergency levels of food insecurity and face a credible risk of famine.

The crisis is the result of prolonged drought, violence and insecurity. Consecutive years of poor rains and harvests have decimated crops across South Sudan, Somalia, Ethiopia, and Kenya. Families are dying not only from starvation, but also from diseases such as cholera and measles because they lack clean water and sanitation. Plus, ongoing fighting in countries such as Yemen prevents humanitarian workers from reaching many of the children, women, and men who need lifesaving assistance. And as families are forced to flee their homes to escape violence or find food, their needs begin to multiply.

This mass displacement compounds the crisis. East Africa is home to approximately 4 million refugees and more than 11 million internally displaced people, who, though they have not crossed an international border, still live in tent cities, dependent on food aid and other external assistance. Women and girls bear the heaviest burden of these famine conditions, fetching water from increasingly remote locations, and making compromises to access food for their families — putting them at increased risk of sexual violence.