The last three years have been so cruel here. We have malnutrition, we have drought. We never had anything but now we have nothing at all - Reinaldo Anaya, father of hospitalised Javier José
Dr Abudi Dasuki frowns as he flips through a paper chart, looks at the baby girl in front of him, and raises her tiny, reluctant arms.
"All these children have malnutrition," he says, looking around the children's ward in the Nuestra Señora de los Remedios hospital.
The room is so hot the children's hair sticks to their heads, while parents with crying babies sway slowly side to side. "This year we have seen 200 children with severe malnutrition, and 300 with malnutrition. One child leaves and they bring another one in."
La Guajira, a dusty but spartanly beautiful region in Colombia's desert north is in the grips of a crisis. Climate change, desertification and water shortages have combined to create a perfect storm for the local rural community: a drought so severe some places did not feel a drop of rain for three years.
This is one of the country's most indigenous regions, and the largest community, the Wayuu, traditionally live off their livestock and smallholdings in rural rancherias or communities. But year after year the rains have faltered, and as the livestock started to die, the crisis intensified.
The World Food Programme currently supports approximately 35,000 Wayuu people, while over the last few years the lack of water has killed more than 20,000 cattle. Already in 2016, dozens of children have died of malnutrition, and in the summer, the Colombian Supreme Court ordered the government to come up with a better way of dealing with the crisis.
"Wayuu children are dying from a lack of food, clean drinking water, and because of the precariousness of the health system," the Court said in August. "In 2015, 37 children under five died from causes related to malnutrition, this year the figure is already 41."
Ronald Socarras, who works for one of the local indigenous communities, says that in the last three years his community had survived "with no rain, not a drop" and points out that when the community starves, so does its children.
"Before there were cycles, you knew when the rains came. When was the drought, when to plant the corn. People could cultivate: two times a year the rains came. Now we don't have any water. We can't grow anything. And we are seeing children dying of hunger."
The children's part of the hospital here in the regional capital Riohacha sees new patients arriving daily. The building is run down, the paint faded. By the nurses station is a statue of Jesus and a bunch of faded dried flowers. It is does not look like much, but Dr Dasuki says this is a place where miracles happen, where children ‘on the brink' are brought back.
"This is the room where we have saved the most lives. The room of miracles, we call it. You need to have a lot of patience with these babies [suffering malnutrition] their defenses are very low. They can be doing well and suddenly things can go wrong."
He moves to another patient, gently murmuring as he pushes down on her stomach and she starts to cry. A 14-month old with the wild, red-tinted hair that is a marker for malnourishment, she came in with pneumonia but has also been treated for her low weight. The next patient, another baby girl with tiny yellow socks, weighs at eight months what a normal six-week old should.
"All my life children in La Guajira have died from malnutrition," says Dr Dasuki. "As a human being, as a father, it hurts. Not just as a medical professional."
In the corner of the ‘room of miracles', Reinaldo Anaya sits by the bedside of his son Javier José, who wears pale blue pajamas and lies quietly exhausted in his cot. He is three years and 10 months old but is so small he could be two. In his hand the boy clutches a rubber glove blown into a balloon but he is so weak when he squeezes it his fingers make little indent.
"The last three years have been so cruel here," says his father. "There's a shortage of work, food is expensive; you can't buy enough for the family. We have malnutrition, we have drought. We never had anything but now we have nothing at all."
He told me the family could only afford to give their three children grains once a week. Everything they have to buy - rice, oil, sugar - had become more expensive at the same time as his work as a labourer had become more precarious. "Before people had their smallholdings, their plots. Now it all seems like a desert from here to the Magdalena," he said.
Stevenson Marulanda, the regional health secretary, has said that the government is sending more resources, but that children recover only to go back to the "same precarious situation they were in before."
"Children keep dying, in spite of the food and medical assistance that is arriving, and that is worrying. But the problem is big, and we need to get to the root of the problem, which is the drought, the poverty and the lack of public services," he told the El Tiempo newspaper in September.
Carlos Valdivieso, from the ICBF, a state body which looks after the welfare of children, says that as many as 60 per cent of the children in the area are underweight, but they are most concerned about those suffering from chronic malnutrition. After these children reach 18 months of age, they can intervene to save their lives, but their prospects of making a full recovery are much more bleak.
He says the drought has made the situation worse but that the humanitarian crisis in the region "has been happening for many years".
"It is a structural problem, between here [Riohacha] and there [some of the rancherias] you will not find a single road or hospital, there are a few schools but really there is no state presence," he said. "Yes phenomenon like El Niño have made things worse, but the complex thing about La Guajira is that this is an area that for a long time has been abandoned by the State."
Less than a mile away from the city's main drag, Juliana Mercedes Epiayo, a mother of six, rocks back and forth on one of the hammocks outside a centre for underweight babies, her 14-month old son David José resting on her stomach. She rubs his back, her fingers trailing over his rib cage. "He had bones down here he was so thin. He was missing vitamins, and the other things that I could not give him as well."
"We don't buy food we grow it, but all the animals are dying. My grandma had sheep, goats, chickens, but what are we going to give them?" she asks. "You can't buy the food for them and you don't have enough for what you need to put in the ground for growing."
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Laura Dixon was a 2016 Adelante Latin America Reporting Fellow with the International Women's Media Foundation