The World Food Programme (WFP) has warned that harsh weather conditions, economic and political instability and HIV/AIDS could see the 2.6 million people it is currently struggling to feed in Southern Africa double when regional assessments are completed in May.
"The situation is extremely critical," said Judith Lewis, WFP regional director for East and Southern Africa.
"We are helping 2.6 million people now in five countries, but I am sure that will double," Lewis told journalists in Johannesburg as a WFP team moves through Southern Africa to conduct urgent food assessments.
Malawi, Zambia and Zimbabwe were worst off with Lesotho, Mozambique and Swaziland making up the list of the six most needy countries in the region.
In February Malawi's president Bakili Muluzi declared a national disaster saying over 70 percent of the people struggled to find food.
"Malawi has seen an accumulation of disasters over the years. They had flooding, followed by dry spells and people couldn't recover from problems from the year before. They started harvesting green maize prematurely and families will run out completely in a few months.
"Traditional African customs are being violated as farmers are having their fields decimated by theft. People are afraid to go to weddings and funerals because they are afraid their crops will be stolen. This was previously unheard of," said Lewis.
"I saw women trying to harvest grass stalks and they were pounding grass seeds to make a paste to feed their children. They have never had to resort to such measures.
"Kids are dropping out of school because they have to help their parents forage for food. In Blantyre I saw children of nine and 10 years old with severe malnutrition."
Malawi has the added complication of a cholera outbreak with almost 1,000 deaths reported since November.
In March a US $4.2 million emergency programme targeted 301,000 people. WFP provided US $1.5 million from its internal emergency credit reserve to buy food but this must be repaid.
In Zambia "whole fields" of drought resistant sorghum had wilted, Lewis said. Even cattle, allowed to eat it as fodder, rejected it as it was too bitter.
"We are worried that the cattle will die. Cattle are linked to status and selling them is seen as a last resort and an indication of the seriousness of the situation. People then get very low prices and for some, there is no food to buy.
"One farmer sent his wife and children away saying he would stay behind to die. There is absolute hopelessness and depression," Lewis said.
"I saw a whole village in Zambia deserted and found that women were migrating to the border towns - walking 50 km with their babies on their backs. They were carrying jerrycans and sleeping wild with one small pot of food to share - then begging truck drivers and border officials to buy water from them so they could buy small bags of mealie meal. People are trying everything."
Malawi and Zambia also have about 125,000 refugees who depend on food aid for survival.
"In Zimbabwe and Malawi there were a lot of man made causes of food shortages," Lewis said. In Zimbabwe the government has a monopoly over grain reserves and Malawi sold grain reserves to pay interest on money borrowed."
In February the WFP launched an emergency operation for 558,000 people in Zimbabwe.
In addition to a drought and future predictions of poor rainfall, food production in Zimbabwe have been hit by farming disruptions caused by the government's land acquisition programme. The country also has high food prices, food shortages and crippling inflation.
Sugar, vegetable oil and staple foods are beginning to disappear and fuel is soon going to be a problem, Lewis said.
Attempts to politicise food distribution saw one programme temporarily suspended. "We had to issue a statement saying 'we will not have our food politicised'," Lewis said.
In Mozambique people who were affected by floods now had to deal with dry spells. In Lesotho Prime Minister Pakalitha Mosisili declared a famine on Monday.
"Because Lesotho is a small country their needs are small but it is difficult to deliver food because of the layout and very mountainous areas. They usually import 50 percent of their food but a serious situation is developing," explained Lewis.
WFP withdrew from Swaziland when they could provide food for themselves but preliminary indications show that several thousands people will need some kind of assistance.
HIV/AIDS makes the situation worse. Lewis said women were trying to grow crops and find food for their family and now also had to care for the sick. Some households were headed by children who had to forage for food. The number of people affected reduced the number of people who could go out and work.
The exact number of people affected in the six most desperate countries would be known by the end of May. But the WFP says it urgently needs US $69 million to be able to help now. An appeal launched in March yielded only US $3 million.
"We have had good meetings with donors who are starting to respond, but it is not enough. We are going to need so much more if we want to address this crisis," Lewis said.