MARADI, Niger - The little boy lies on the blanket at a relief centre wrapped in his own pain, lost to the world. The doctors are uncertain whether his life can be saved. He is one of 32,000 children the United Nations says is in danger of dying in Niger - "the number one neglected emergency in the world".
The Medecins Sans Frontieres camp in Maradi is one of the busiest trying to cope with the unfolding catastrophe. There are many other victims there.
Abdu Issafou, 15 months old, is suffering from acute diarrhoea and vomiting, diseases ravaging his young body left weak by malnutrition. His mother Hadiza weeps knowing the life of her son may be slipping away.
But for Mamadou Tandja, sitting in the presidential palace in the capital, Niamey, it is a matter of "crisis, what crisis?"
"The people of Niger look well fed, as you can see," President Tandja says.
All the talk of mass starvation is just "foreign propaganda", deception by relief agencies to obtain increased funding. "It is only by deception that such agencies receive funding," he tells the BBC. What problems there are, he assures, "are not serious".
Furthermore, maintains President Tandja, a former army officer, his government has reacted with alacrity to the "not unusual" food shortage with subsidies.
Increasing accusations that they have been guilty of neglect, of trying to tackle famine with disastrous "free-market" tactics were, he said, wide of the mark.
Hadiza Issafou, who has already lost four children in the disaster and is about to lose a fifth, begs to differ.
There was no help from the government when the drought scorched the crops on the piece of land where she and her husband scratched out a living. And there was no help when plagues of locusts descended afterwards and stripped off even the grass the family's few cattle depended on.
"We have nothing left. I have lost sons and daughters and so have others in my family and my neighbours. Once we had a farm and grew our own food, now we are beggars," she said standing in a queue at Baoudeta, a relief centre run by the British charity Save The Children.
"We did not get anything from the officials. We went to all the towns in our area asking for food, but they did not give us any. My son is sick all the time, he cannot keep anything down. I do not know what is going to happen, we have never faced anything so bad before."
There are now places in Niger where one no longer asks if people have died, but how many.
Al-Hanza Rakia Mohammed counts: "I have lost a daughter and brother, my cousin has lost a son. And there are three others among our neighbours. Most of all we need medicine, and there is no one giving it."
One of the main results of the attempted use of private enterprise to tackle malnutrition was to drastically push up the price of staple foods. The policies were not President Tandja's own.
The International Monetary Fund have pressed to carry out structural changes to the economy including the introduction of 19 per cent VAT on basic foodstuff and the scrapping of emergency grain reserves. As a result the price of basic food rose by between 75 and 89 per cent in five years.
But for President Tandja none of this was relevant yesterday. Reports of famine are "false propaganda" by the opposition and UN agencies.
"The people of Niger look well fed. Food shortage is caused by lack of grain and locusts and not unusual for this country. The situation has been exaggerated for political and economic gain by opposition parties and the UN aid agencies.
"If these problems were serious there would be shanty towns forming around the big towns and people will flee. Street beggars will be prevalent. This has not happened. We are experiencing, like all the countries in the Sahel, a food crisis due to a poor harvest and locust attacks of 2004."
The UN and aid agencies have been highly critical of the West's "grossly inadequate" response to repeated warnings of a catastrophe in the former French colony.
President Tandja, who was keen to stress that things were nothing like as bad as they had been painted by "foreigners", demanded to know why only US$2.5m had been received by his government of the US$43m pledged by the outside world.
Even officials are wary of overtly criticising the president as they embarked on food distribution.
Greg Barrow, spokesman for the UN World Food Programme would only say: "We have not spoken about famine but pockets of severe malnutrition."
However, senior aid workers in Maradi, in the centre of some of the most stricken areas, accused Mr Tandja of attempting to deflect criticism.
One said: "The international community was very slow in reacting to the crisis, but the Niger Government has contributed to the situation by its own actions. What he is saying now is just for face-saving purposes. But we must be careful of what we say."
Niger's own relief workers are less reticent in their criticism. Dr Alka Oumarou, who runs a medical centre at Baoudeta, said: "Our government has been negligent. We were saying for over four months how bad things were before they did anything. Even then they did not give out free food but made people buy it"
The government direction is that we should charge people. The number of patients I see has gone up from 25 per day to 75. We have to turn away those who could not pay, and some die. They are now getting treatment only thanks to the foreigners."
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'The people of Niger look well-fed' says President
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