Some of the youngest refugees are too weak to eat, too weak to cry
The head of the United Nations refugee agency, Antonio Guterres, says he wants aid agencies to go into Somalia to help drought victims.
In a BBC interview, Mr Guterres said the UN was negotiating to overcome security obstacles.Delivering aid would involve deals with local groups including al-Shabab, which is listed by the US as "terrorist".
Somalia is worst hit in a drought affecting around 10 million people in four countries of the Horn of Africa.
Thousands of Somalis have trekked to neighbouring Ethiopia or Kenya to reach help, but many others are trapped inside the country by conflict, said Mr Guterres.
"We are absolutely sure that the level of suffering of the Somali people at the present moment is absolutely appalling, and that is why we have been insisting that we should do everything at the level of international community with all the actors involved in the conflict, to make it possible to deliver massive humanitarian assistance inside Somalia," Mr Guterres told the BBC World Service Newshour programme.
"There are very severe obstacles and links to security that need to be removed, but I think it is essential to move in that direction."Mr Guterres said that the UN was negotiating the delivery of aid in areas of Somalia controlled by militant Islamist group al-Shabab.
"The UN mission in Somalia is dealing with that, and trying to find a clear answer to the conditions that are necessary for assistance to be delivered in the areas controlled by the group.
'Desperate and vulnerable' "There are other areas in Somalia controlled by other actors, and so I think it is perfectly possible - at least in part of the territory - to extend assistance inside the country."
Some de facto camps have already started forming inside Somalia, according to the aid agency Medecins Sans Frontieres. One camp holds around 5,000 people.
The aid agency can provide medical help, but has no food to give them.
Joe Belliveau of MSF told the BBC the development of camps inside Somalia was a "most desperate and vulnerable moment".
MSF is one of a few aid agencies still managing to operate in those areas of Somalia controlled by al-Shabab.
Mr Belliveau said the recent statement by the militant group lifting its ban on aid agencies working in areas it controls was welcome, but so far it had made no difference on the ground.
American law prohibits agencies in its jurisdiction from providing aid that might help sustain what it defines as terrorist groups, such as al-Shabab.
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