Kiruzi, Burundi - It was having to beat his kids before they'd go to bed on an empty stomach that finally forced Avito Ndikumasabo to stop working his own small patch of land and join forces with the countless others in northern Burundi that hunger has haunted for years.
"I used to feel so bad about having to beat them," says the 34-year-old father of four from Kiruzi province.
"I pitied them and myself," he adds, his small hands rested on a spade that almost reaches his chin, in an area where the majority of adults are the size of children due to chronic malnutrition.
Ndikumasabo is one of 5,700 Burundian farmers that receives a small daily wage from the UN's World Food Programme to conserve land to stop the area's top soil from being washed away, and to help this bite-size country in Africa's Great Lakes region from being the hungriest on earth.
Burundi holds the bottom spot on the International Food Policy Research Institute (IFPRI) yearly global hunger index, and a 2010 household study showed that more than half its children under five years of age were stunted from a lack of food.
Many, such as Ndikumasabo, fled Burundi's 12-year civil war in the 1990s and returned empty-handed to land that was unproductive.
|The land can no longer support the people trying to live off of it [Hannah McNeish/Al Jazeera]
The price for surviving the bloodshed was that no amount of sweat and tears could rejuvenate fallow fields to feed a family.
Widespread poverty, climactic disasters, overpopulation and a lack of materials to make it productive, means that a staggering one in 10 people suffer from severe acute malnutrition.
It's a figure usually associated with emergencies, but in northern Burundi, it barely raises an eyebrow.
"You can see in their faces that they haven't had enough to eat," says Jean-Dominique Masumbuko, agricultural coordinator for charity World Vision that runs WFP's local cash for assets scheme.
"A telltale sign is the lack of blood. It's like you can see that they're almost dry."
Farmer Janine Irankunda used to sacrifice her only daily meal to feed her children.
But when she couldn't, she could only "tell them to be quiet, as there was no other option".
But the silence couldn't stop her hunger from gnawing away at her in her sleep, as she dreamt of a time when "there was meat, corn and carrots to give the children and they were smiling and so happy".
|Before the war, food was more abundant, the land more giving [Hannah McNeish/Al Jazeera]
When the project started in late 2014, the 80 workers, dressed in shoes without laces, jackets to their knees and tattered clothes, were barely able to lift a spade.
"Before, they had no strength, even to work, and before, some people didn't even speak," says supervisor Maria-Rose Ndikuenea.
Some had been trapped in cycles of self-inflicted slavery where they'd work other people's land for as little as 20 cents a day despite the fact that this was insufficient to buy enough food for their families.
When Ndikumasabo couldn't find the most menial of jobs, he would beg his struggling, but not starving neighbours for scraps, his children slumped in a corner at home.
"The children couldn't play as they didn't have enough energy," he says.
They have gone from weakness to strength with the programme, and his children play football now as they know he will return with flour.
|A baby is weighed at a feeding centre [Hannah McNeish/Al Jazeera]
Irankunda says her children are physically and mentally stronger.
"Before it was really difficult for them to concentrate at school and they'd come home so down. Now they complain sometimes but they're much better."
At a clinic in neighbouring Ngozi province, Pascaline Minani sits with dozens of other women and small children waiting to be measured to see if she is skinny enough to receive the food supplements that her six-year-old son has survived on from birth.
He has never recovered from kwashiorkor - a severe stage of hunger categorised by a balloon-like belly and stick-thin limbs.
"He just stayed that way and now he's so small - only 94 centimetres," she says.
If not caught early enough, the effects of hunger can destroy a child's life, as they typically drop out of school, earn and produce less, breeding more poverty and passing down hunger to the next generation.
In northern Burundi where the birth rate is growing at six percent a year - twice the national average - hunger spreads quickly and down through the generations.
|A mother at a feeding centre [Hannah McNeish/Al Jazeera]
"The effect on a country is cumulative - a smaller, less productive workforce, with greater health costs - presenting, for Burundi, an even greater challenge to build and develop a fragile post-conflict economy in one of the world's poorest nations," says WFP spokesperson Challiss McDonough.
Data from five African countries surveyed as part of a WFP and government project to measure the effect of past generations' under-nutrition shows that it costs the economy between 1.9 to 16.5 percent of annual GDP.
"That's millions of dollars each year in some of the most fragile developing nations on the planet," says McDonough.
In Burundi, hunger is such a way of life that questions about how many times a day people eat cause giggles that spread around the room.
"This is one of the poorest places on Earth," says nurse Jean-Claude Nyonburo, who enrols more than 200 malnourished mothers and children in a supplemented feeding programme in pre-harvest months.
He can only advise mothers to feed their children more, and more varied foods, while knowing that 90 percent of the population are farmers who earn nothing and simply can't.
"No one eats any protein as they can't afford it. Animals will never be slaughtered as they provide fertiliser or are sold for other things," Nyonburo says.
"I eat once a day or sometimes I don't and give the little food I have to my kids," Minani says.
She has 15 friends with children in the feeding programme and walked six kilometres to the clinic with her baby only to find out she's not thin enough to get help.
|A baby sleeps at a feeding centre in Ngozi, where food supplements are offered to malnourished children under five [Hannah McNeish/Al Jazeera]
Over the wails of babies being weighed and their saggy upper arms measured to see if they've tipped the balance enough to get high fat and sugar rations, she tries to express what real daily hunger means.
"I can't stop thinking about food. When I'm hungry, I try to get some, but when I don't, I don't feel well. I just drink water or just stay still, as there's no other choice. I can't explain how it is to live like this," Minani says.
In an area where so many people don't have enough land, or had lost it during the war or exile, disease can wipe out whole harvests and with the population growing at six percent a year, hunger is becoming increasingly bloody.
"Brothers beat each other for the land left by their fathers or grandfathers," says Bonaventure Nduwimana, the head of land and planning at Ngozi's department of Agriculture and Livestock.
"In the local courts, 90 percent of cases are over land. You can totally understand why many conflicts are born from a lack of land. Between neighbours there are huge quarrels. Even if it's just two or three feet of land, there's a dispute."
|Workers toil on the hillsides of others in Burundi's Ngozi province after years of trying and failing to feed themselves [Hannah McNeish/Al Jazeera]
With decreasing arable land, increasing poverty and a "galloping population", the situation is set to "explode", he says.
"Imagine that five people have just 0.5 hectares, and then they have three sons, and they have to divide that. You can see the issue."
Only better farming methods, seeds and organic fertiliser can save the area, Nduwimana says, but almost no one has the necessary cash and small livestock in this extremely poor area.
With the help of the WFP wages and a microfinance scheme between fellow farmers, Ndikumasabo is saving up to buy a $15 goat that would make his land fertile again and he "would never have to beat a hungry child again".
Source: Al Jazeera