The biggest refugee camp in the world is full, creating a humanitarian emergency that threatens thousands of malnourished children, a medical charity has warned.
Dadaab, a sprawling desert "city" in Kenya with a population expected to reach 450,000 by the end of the year, has run out of space, Medecins sans Frontieres (MSF) said.
Children who have fled war in neighbouring Somalia are left without food or shelter in dry heat of 50C (122F) and are said to be vulnerable to attack by animals.
"We've got nothing to build a shelter with," Fatima, a 34-year-old refugee from Mogadishu, told MSF. "It's very unsafe here - at night, we're scared that wild animals will eat the children, and we've had threats of violence from local people who say the land is theirs. Children are even being killed by hyenas because they have no protection."
Stranded in the barren desert of Kenya's north-eastern province, surrounded by sand and scrubby bushes, the refugees - most of whom are women and children - arrive with no money, no food, no water and no shelter.
MSF's report said it takes an average of 12 days for new arrivals to receive a first ration of food and 34 days to receive cooking utensils and blankets from the UN's refugee agency, which runs the camps.
The last empty plot of land in Dadaab was allocated in August 2008. Since then, new arrivals have had to search for unoccupied space in which to build a hut. They use branches and brushwood, tied together to form domed structures which they cover with cardboard, polythene or torn fabric.
The UN announced in 2008 that it had no more room for new arrivals, but conflict and the worst drought in years have forced 44,000 Somalis to seek admittance into Dadaab since the start of this year.
Joke van Peteghem, MSF's head of mission in Kenya, told AlertNet: "The camps are completely full. People are arriving and they do not find any space any more, meaning they don't have access to water and other facilities.
"You get more and more people sitting outside the camp without proper protection and proper support."
On arrival at the camp, 60% of families report illness, having walked through the desert for days. Some 40% of the children have never received vaccinations.
"People, and especially children under five, are coming in worse physical condition," van Peteghem said. "We are observing more and more children being malnourished.
"If you take a week before they get proper food and they need healthcare, for sure the status of these children will deteriorate."
The in-patient therapeutic feeding centre for severely malnourished children is so full that tents were initially set up in the hospital grounds. In May, a new 60-bed extension ward opened to accommodate them.
Gedi Mohammed, the director of the hospital, said: "Health indicators are now at an emergency level."
The underfunded and overcrowded Dadaab complex consists of three camps - Dagahaley, Ifo and Hagadera - established 20 years ago to house up to 90,000 people. An extension to the camps lies unfinished and empty following a breakdown in negotiations between Kenya and the UN last year.
"More refugees are on their way," Nenna Arnold, an MSF nurse, said. "We are already at bursting point, but the figures keep growing. This situation is a humanitarian emergency."