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Even without a global pandemic, Haiti's children faced a hunger crisis. Now it's getting worse.

COVID-19, an economy already in free fall, droughts and intense tropical storms, gang violence and chronic instability are not only raising levels of hunger in Haiti but also leading to increased levels of severe child malnutrition, the head of the United Nations' leading child advocacy group in the Caribbean nation has warned.

The number of children suffering from "severe acute" childhood malnutrition has more than doubled, increasing from 41,000 last year to an estimated 86,000 children this year, said Bruno Maes, UNICEF's representative in Haiti,

"There are now 217,000 Haitian children ages 6 to 59 months who now suffer from acute malnutrition," Maes said, citing a U.N. survey.

Malnutrition in Haiti, he said, is related to several factors, including the drought-driven crisis in the 1990s and 2000s, and the 2010 earthquake, all of which have affected nearly 5 million people in Haiti.

Five out of eight children in Haiti, he said, suffered from chronic malnutrition last year.

UNICEF's estimates come as the agency launches an emergency appeal for $3 million to purchase meals for the next six months, and to support Haiti's Ministry of Health in protective measures like identifying children who need assistance and getting them help. The funding is urgently needed, UNICEF said, because in the next few weeks it will run out of lifesaving, ready-to-use therapeutic food.

"It puts 86,000 children affected by severe acute malnutrition [risking] the worst complications, unless additional funding is provided," Maes said. "It's a critical investment because investing at the very beginning of a child's life is the best investment a country can make."

Haiti has long suffered from high levels of food insecurity. A U.N. food analysis estimated that more than 4.4 million Haitians, or 40% of the population, will need food assistance this year as a result of the COVID-19 pandemic, tropical storm Laura and a sociopolitical crisis.

Now those crises have been compounded by COVID-19 — which is seeing a deadly resurgence in Haiti — and gang violence.

Haiti still remains the only country in the Western Hemisphere that has yet to administer vaccines to its population. Meanwhile COVID-19 infections and deaths are spiking. As of June 6, the most recent available data from the Ministry of Health, Haiti registered 16,079 confirmed COVID-19 infections and 346 deaths. A month earlier, on May 6, it reported 13,245 COVID-19 cases and 268 deaths corona­virus-related deaths.

Meanwhile, the latest round of violent gang clashes has forced thousands of Haitians, including children, to flee their homes in the Martissant neighborhood of Port-au-Prince. Some have sought refuge in nearby Carrefour in a gymnasium, or in public plazas in other communities. Others have left the capital altogether for the rural countryside. The Martissant neighborhood, which is largely controlled by armed gangs, is located not far from the National Palace.

During a visit Tuesday to the area where some of the displaced have sought refuge, Maes lamented the situation, especially for children who had lost days of schooling and were being exposed to diseases. UNICEF and partners, he said, are providing assistance to the displaced, "but more aid is urgently needed."

In a recent visit to South Florida, Haitian Bishop Oge Beauvoir, who runs Coconut Creek-based charity Food for the Poor in Haiti, said he's lived in Haiti 45 years out of his 65 years and "what we are experiencing today, I haven't seen that before." The country is "facing very tough challenges," he added.

A U.N. humanitarian-needs assessment found that as a result of the COVID-19 pandemic and other challenges, some Haiti households saw their income drop by more than 60%. Access to health care and water, hygiene and sanitation services have also been affected, leading to a drop in immunizations. That has led to an increase in diarrheal diseases, the main cause of malnutrition among children under age 5.