Islamist militants in Somalia have imposed a ban on humanitarian assistance in areas they control, forcing hundreds of thousands of people to choose between death from starvation and disease or brutal punishment.
In some towns, hungry and weak people have been ordered by extremist leaders to remain where they are to act as human shields against US airstrikes.
Interviews with villagers in the swaths of land controlled by al-Qaida-affiliate al-Shabaab, in the centre and south of the east African state, reveal a population on the brink of catastrophe, with children and older people already dying in significant numbers.
Al-Shabaab has told people they will be punished – possibly executed as spies – if they have any contact with humanitarian agencies.
Strict British and US counter-terrorism laws are also discouraging humanitarian organisations from delivering vital emergency assistance, aid agencies have said.
Although aid officials say a huge international effort and donations by Somalia’s vast diaspora have so far averted a repeat of the 2011 famine, when 250,000 people died, conditions in much of the country have continued to deteriorate in recent months.