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MOCHA, Yemen – The baby twitches his legs in pain in the video. He's crying but he is so dehydrated his eyes can't produce tears. His inflated belly is as taut as a balloon. It is easy to count the 12 rows of protruding ribs on his rapidly palpitating chest.
The video, filmed by a doctor, shows 8-month-old Fadl suffering not from disease, but from starvation.
Three years into a civil war, Yemen is starving and could soon start to see widespread death from famine. Houthi rebels hold the country's north, and a Saudi-led coalition, armed and backed by the United States, has sought to bomb the rebels into submission with a relentless air campaign in support of the Yemeni government.
Some 400,000 children are fighting for their lives in the direst state of hunger, severe acute malnutrition — the stage of swollen bellies and twig-like arms that are signs the body is eating away at itself for lack of nutrients and protein. In Yemen, around 2.9 million women and children are acutely malnourished, a stage of starvation just short of severe.
Fadl's mother, Fatma Halabi, recalled the life before the war in the western district of Mowza, near Yemen's Red Sea coast. In those days, the family had fish and vegetables often. Her husband, a woodcutter, could make the equivalent of $4 a day.
Mowza was in the hands of Houthi rebels for most of the war. Last year, government forces descended on the area to drive the rebels out. The fighting and airstrikes sent people fleeing, some of them scattering across the Great Valley.
Separated from her husband, Halabi led her four children and two goats across the Great Valley, the arid plain spilling down from the mountains toward the city of Mocha on the Red Sea.
These desolate stretches are historically a site of death. More than 400 years ago, a Muslim ruler forcibly sent almost the entire Jewish population of Yemen here for refusing to convert. Chroniclers say two thirds of them died in the heat and deprivation.
Halabi and the children hid in thorn bushes to avoid artillery and airstrikes along the shifting front line. One day in April last year, she went into labor and, alone, gave birth to Fadl under a tree.
Eventually, she and her husband reunited and settled in an abandoned hut in the valley.
Speaking from inside her makeshift home in February, Halabi sat with a rope cinched around her emaciated waist, even as her blue robe kept sliding off her bony shoulder.
She spoke in short, exhausted sentences. When asked what she had eaten that day, she said, "Bor," the local Arabic word for flour. "We stay patient," she said. "We have to feed the children." When she gets hungry, she lies down and tries to sleep.
Often she and her husband eat one meal in the morning, and nothing again until the next day.
Unable to breastfeed Fadl, she gave him goat or camel milk, which lack the nutrients of breast milk or formula. The newborn kept getting fever and diarrhea, so she repeatedly borrowed money to take him to the hospital in Mocha.
The hospital has seen 600 malnutrition cases within 10 months, but is so short on supplies it doesn't even have pain relievers for headaches, said one doctor, Abdel-Rehim Ahmed. It has no therapeutic feeding center. None of its doctors have been trained in treating malnutrition.
And Mocha is swelling with 40,000 displaced people.
Left untreated, prolonged malnutrition causes the body to lose its stock of carbohydrates, fats, and proteins. The brain struggles to find energy, the heart shrinks, and the skin cracks, exposing the body to infections. The kidney and the liver stop functioning properly, so toxins build up inside the body, leading to a vicious cycle of disease.
Fadl's last visit to the hospital was Nov. 29. At eight months old, he weighed 2.9 kilograms (6 pounds), a third of the normal weight. The circumference of his upper arm, a common measure for malnutrition, was 7 centimeters, less than 3 inches. That indicated severe acute malnutrition.
Unable to pay for a hospital stay, Fadl's parents took him home.
He gave his last breath not long after in the arms of his grandmother. His exhausted parents were asleep on the floor. The grandmother woke them and told them their boy was dead.
The only image of Fadl from his short life of hunger and pain is the video, taken by the head of the nutrition center. His parents don't have mobile phones or a camera.
"Sometimes I wake up in the morning and I remember he's no longer there and I start to cry," Halabi said. "Who wouldn't cry for their children?"
The AP's reporting on the war in Yemen is supported by a grant from the Pulitzer Center on Crisis Reporting.