Ladawi is a 16-month-old girl with twigs for limbs, blotched skin, labored breathing, eyes that roll back and skin stretched tautly over shoulder blades that look as if they belong to a survivor of Auschwitz. She is so malnourished that she cannot brush away the flies that land on her eyes, and she does not react when a medical trainee injects drugs into her hip in a race to save her life.

"She's concerned only with trying to breathe," says the trainee, the closest thing to a doctor at a remote medical center here in southern Ethiopia. "Most likely she will not survive."

Ladawi would be the third child to die of malnutrition in three days just at this one little health center, and millions of other Africans are threatened by the specter of a famine rising over Ethiopia and neighboring countries. To bounce over the rutted roads here is to feel transported back to the Biafra crisis in Nigeria or the 1984-85 Ethiopia famine, for sick and dying children are everywhere.

We've all been distracted by Iraq, but an incipient famine in the Horn of Africa has been drastically worsening just in the last few weeks. It has garnered almost no attention in the West, partly because it's not generally realized that people are already dying here in significant numbers. But they are. And unless the West mobilizes further assistance immediately to Ethiopia, Eritrea and Somalia, the toll could be catastrophic.

On Sunday morning I checked out of my hotel room at the Addis Ababa Sheraton, so luxurious an establishment that stereo speakers play music underwater in the glistening pool, and by evening I was in Awassa in southern Ethiopia, surrounded by children with glazed eyes, toothpick limbs and hideously swollen bellies.

"We've been overwhelmed by this, especially in the last three weeks," said Tigist Esatu, a nurse at the Yirba Health Center, crowded with mothers carrying starving children. "Some families come and say, `We've lost two children already, three children already, so you must save this one.' "

Since weapons of mass destruction haven't turned up so far in Iraq, there's been a revisionist suggestion that the American invasion was worthwhile because of humanitarian gains for the liberated Iraqi people. Fair enough. But as long as we're willing to send hundreds of thousands of troops to help Iraqis, what about offering much more modest assistance to save the children dying here?

"How is it that we routinely accept a level of suffering and hopelessness in Africa that we would never accept in any other part of the world?" asks James Morris, the executive director of the World Food Program. Ethiopians worry that with attention diverted by Iraq, Africa will be forgotten. It's a legitimate fear: in the 1990's, aid was diverted to the former Yugoslavia and away from much needier parts of Africa.

So far, the U.S. and Europe have responded reasonably well — it was heartwarming to see bags of wheat marked "U.S.A." even in isolated hamlets — but the needs are growing much faster than the supplies, and children are dying in the meantime.

"Now I worry about my other children," said Tadilech Yuburo, a young woman who lost one child last month and has three left. In her village, Duressa, population 300, five children have died in the last month of malnutrition-related ailments. In nearby Falamu, population 400, six children have died. Down the road in Kurda, population 1,000, six children have died.

This famine has not yet registered on the world's conscience, and the World Food Program says no journalist had previously visited this region since the crisis began. But although this area of Ethiopia has been hit particularly hard, 12 million people around the country are affected — compared with 10 million during the 1984-85 famine.

In past African crises, like Ethiopia's in 1984-85 and Rwanda's in 1994, the international community reacted too slowly, and hundreds of thousands of Africans died as a result. This time, we can still avert a similar catastrophe, but we must act at once. "We are appalled by the lack of full rations to food aid beneficiaries in Ethiopia, which amounts to slow starvation for those without other sources of food," an alliance of aid groups warned recently, adding: "For the international community to allow this to happen in the 21st century is unforgivable."