By Hilary Andersson
BBC correspondent in Zinder
The southern belt of Niger is lush and green with abundant crops almost ripe for the forthcoming harvest.
Few people can afford to buy the food there is
If you were just passing through as a traveller you could drive for hundreds of miles along the narrow strip that hugs the bottom of this giant country - the only arable land in Niger - in the happy belief that there wasn't a problem.
The only thing that might tweak your concern would be the regular sight of malnourished children standing naked outside their huts.
But were you to take a left or a right off the main road - the only tarred road in the region - and travel into the villages, you'd find one of the ugliest and saddest human plights on this continent.
Few can afford the little food there is, and although the next harvest looks promising people are still starving to death.
I have just returned to Niger six weeks after filing the first reports on the huge hunger crisis in July, expecting things to be better. But if anything what we saw this time was worse.
Massive amounts of foreign aid have flowed into Niger since the world woke up to the crisis, but the food has not yet reached around a million people. It arrived too late and is still being distributed.
Aid agencies working on the ground feel ashamed at the world's slow reaction - every day they see children dying right before their eyes.
The terrible truth is that this is the world we in the West accept in this day and age
We went to village after village, and each time we were immediately surrounded by a crowd of women begging us for help, showing us their sick children, thinking we were foreign and so could do something.
Looking around almost every child was malnourished, some with pot bellies and the tell-tale orange hair of kwashiorkor, the type of malnutrition that leaves your body bloated with fluid, and with open wounds. Others were emaciated and frail, with protruding ribs - their bodies starving to death slowly by wasting away.
Fighting for breath
In a crowded feeding centre in Zinder in the east of Niger we met Mohammadu Nakilou, a boy of about two, one of 1,000 children admitted to feeding centres every week because they are in the severe stages of starvation. The doctors were overwhelmed and could accept only the very worst cases, like Mohammadu, into intensive care.
We found Mohammadu on a respirator because of his lung infection. Starvation slows the immune system down, and the children can't fight the bacteria who are quick to feed on their weakness.
His breathing was slow and desperate. He would take a long slow breath in with a painful rasping noise, and throw his head backwards to try to get more air in. Each time he took a successful breath - and each one looked as if it would be his last - his eyes would be wide with utter fear.
He moved close to his mother's chest, clinging. Then his struggle would begin for the next breath. It was so terrible to watch that I had to walk away.
Most of the children in the extreme stages of starvation are listless, and if they open their eyes show few reactions. Mohammadu was different. He looked entirely alive and aware, acutely terrified at what was happening to him, and madly confused.
Files of the dead
We went back to find him the next morning to see if he had progressed. His bed was empty. I could think of no reason why he would have been transferred to another part of the feeding centre. The doctors said two children had died overnight and he was not one of them.
There are so many dying they don't keep a record of names, but put the medical files of those who have died in a pile that gets picked up and dumped somewhere else after 12 hours or so.
In the intense frenzy of the centres where the first priority is saving lives, not counting the dead, it took some investigation to find out that Mohammadu had died shortly after we had left him the evening before. He had been buried that morning.
When you see such intense suffering of children day after day, the young, the most vulnerable people on this planet - children under five born into the poorest country on earth through no fault of their own - dying before your eyes, questions flood your mind.
Why is this happening? Who is to blame? What do we do? Will it happen again?
The political answers at least are relatively easily. Niger is phenomenally poor. It has an ongoing crisis of development. More than 80% of the country is desert - it is barely viable economically.
It has a policy, encouraged by the Western world, of privatised health care so that it costs $14 (£8) for a mother to get a baby a medical consultation. That means almost no-one in the country can afford to see a nurse or a doctor.
The privatisation of medical care also plays a part in the crisis
Illiteracy is massive, so education about breast feeding, child bearing, and nutrition is virtually non-existent. About a quarter of children under five die even in normal years.
And so the next time a drought comes along this will all happen again. A massive injection of foreign development aid over the long term is probably the only answer.
The other issue is how the world responds to Africa and its crises. Why was the world late? It is in no-one's interest. It is costing the international community many times more than it should to feed Niger now than it would have had this crisis been nipped in the bud.
Not to mention the human cost.
On my last day in Zinder a young woman sat on a bed in a feeding centre weeping. Her child had died an hour before. The child was a boy called Safiana. His temperature had dropped by 2 degrees in the early hours of the morning and a slight chill in the air proved to much for him.
He was also badly dehydrated, had malaria and scabies. So did his mother. This is the second child she has lost.
Food shortages like this have happened in Africa time and time again over the decades, so often in fact that it is valid to ask why should we be surprised by this any more.
The terrible truth is that this is the world we in the West accept in this day and age, and we assuage our consciences by dipping into our pockets when it gets so bad we can no longer bear it.