A desperate plea for help as 4 African nations near a famine crisis

ABC's David Muir reports on the U.N. refugee agency's urgent warning that the risk of mass deaths from starvation in the Horn of Africa is growing.
6:52 | 05/03/17

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Transcript for A desperate plea for help as 4 African nations near a famine crisis
Tonight an urgent warning from somaliland where four countries in that region are now on the brink of famine. ABC's David Muir, anchor of "World news tonight," joined the American woman who runs save the children on her quest to bring relief and hope to the millions of people there facing starvation. Reporter: The journey begins at first light. A more than eight-hour trek across the unforgiving desert of somaliland. Under the searing sun we are told there are urgent crisis now unfolding. A crisis unnoticed by most of the world. And we're about to see it. Families and children at risk of starvation. In the first village the line begins forming early in the morning, as far as the eye can see. They know the trucks are coming. How many hours away? That would be like two hours. Close to two hours, yes. To get from the nearest water site? Yes. Reporter: Here it's not just food they need but water. Save the children is trucking it in. You haven't had a drenching rain here for years? Yeah, has not rained in close to three years now. Three years? That's why it is so dry, yes. Close to three years. Reporter: Felina, mother of five, stands in line. We asked the last time there was any rain. She remembers the day. It happened once last year. On the hill sit two trucks to deliver water for hundreds of families. If you look over my shoulder you'll actually see that this is what it's like as these families come here every single day to get water. We witness a rush of families trying to get to the hoses. That would give them enough water to last a couple of days. 17-year-old Abdullah fills two jugs of water for his entire family. As he begins his trek home, we journey from west to east. 70% of the livestock, the farm animals, have died. It's really everywhere you look. You can see the livestock that used to belong to these families. Nothing but carcasses out here in the desert. Which explains why the families have now lined up, because they have no other means to support themselves or really to feed their families. So this is the line here -- Reporter: We witness an urgent new effort. Save the children now giving out mobile phones with a credit on them. This mother tells us she will use it to buy water. It was $1.04, now it costs $4 for the same jug of water. Reporter: This mother is among the many who have been forced to move closer to the village, hoping for food. She had 200 goats. There are just 10 left. This is now her home. She shows us where she sleeps with her children. Five sleep here? Her days are spent worrying about food. She worries every day. She's the mother and the father. As we journey deeper into the desert, we are told we have yet to see the worst of it. They are on the brink of fall nip now here. April is supposed to be the wettest month. As you can see, it is bone dry. Authorities say more than 6 million people are struggling to find food, 200,000 children are at risk of starvation. Our first hospital, we see the urgent effort to keep the children alive. The little boy being weighed, his eyes filled with fear. Then there was hamda, nearly 2 years old. She's been here 18 days. And still weighs just 11 pounds, half of what she's supposed to. The hunger breaking her immune system. She now has pneumonia. The nurse tells us hamda was so weak they feared she W die within minutes after arriving. She is still holding on. More than 100 miles away, we arrive at a hospital where we're told there aren't enough beds. The moment we walk in, we see it. This little girl is 2 years old. Her eyes hollowed. Dr. Ali is on the front lines. These are the lucky ones who reach the hospital. There are so many kids that do not make it to the hospital. Reporter: He tells us many children have already died. You believe you're on the verge of famine? That's what I believe. You're seeing it? We're seeing it. It's here. I don't need a witness. To prove it. Because you can see these patients all over he who are malnourished. Reporter: Even this boy is still losing weight. It's critical condition. Reporter: Suffering from severe diarrhea brought on by the hunger. You can see the bones. There's no flesh on the bones. Just skin and bones. That's all they are. Reporter: The doctor says there are no promises. Still in critical condition. And we don't know if he's going to make it or not. Reporter: There was Samira, almost 2, though her tiny frame says otherwise. Four days in a row she's lost weight. Reporter: Hunger breaking down her defenses. She had measles, now pneumonia. In this hospital where you hear the cries of the babies, equally as haunting is the silence from the toddlers. Oswan has lost the strength to talk. His tiny hand in mine. The images on the walls here do not distract from the truth -- they are running out of time. Do you think you're losing these children? We are losing them. Reporter: Aware of that reality, we travel with the American who runs save the children. Carolyn miles takes us another hour east where they're now sending mobile clinics to isolated villages to measure the children, to weigh them. We find a little boy too weak to stand. So they ask his mother to step on the scale. They do the math and quickly put a band on his arm. The red signaling severe malnutrition. You'll bring him to a hospital? Yes. It's one of the worst crises we've seen since World War II. 20 million people across four countries at risk, half of them children. Reporter: Aid workers on the ground across the horn of Africa are aware the U.S. Is now debating whether to give less. Are you concerned at all about the notion that the U.S. Might be considering giving less foreign aid? The U.S. Government has been a true leader in these kinds of crises. It's always the U.S. That kind of makes those commitments first. It's a tiny, tiny part of the budget that we're talking about. And America has to lead. Reporter: As the children are weighed, parents here are given pumpina, the nutrients that in the early stages can bring a child back. Where are you? Where's your face? Reporter: In a brief escape we see the smiles here when we show some of the children their own faces in our phone. A rare moment of joy in a region crushed by hunger. That boy with the armband now sent off for emergency care. The next wave of children right behind him. Our thanks to David Muir for that excellent reporting. Learn more about this dire situation and how you can help on our "Nightline" Facebook page.

This transcript has been automatically generated and may not be 100% accurate.

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