The death toll from Cyclone Pam, which hit Vanuatu nine months ago, is still being added to – at least one child has died from malnutrition.
The food shortage caused when the cyclone destroyed crops is now being made worse by El Niño.
The only doctor on Vanuatu's Tanna Island is reporting a spike in the number of children suffering from malnutrition.
"Usually the weight, which is supposed to be around 9kg, is going down to 7kg or 6kg. That's under the weight of what we'd be expecting," says Dr Robert Vocor from Lenakel Hospital. "That's a dangerous weight."
"My daughter's had diarrhoea and I've been unable to continue breast feeding because I don't have enough food to eat," says the little girl's mother, Kamna Jimmy.
The family's been relying on nothing more than local potatoes and imported two-minute noodles.
It's become an all too familiar story for Dr Vocor, who's had 19 cases like this in the past two months where he's had to introduce antibiotics, vitamins and milk powder to help babies gain strength. He says he needs more help.
"We, the hospital especially, needs manpower. Since I'm the only doctor here working, and normally we need two of us because the population of Tanna is 20,000-plus – quite big.
"I've seen a lot of kids come in with chronic chest infection, acute diarrhoea, severe dehydration."
So we travelled north with Andrew Finlay from the aid and development agency Tearfund to find out exactly how the most remote communities are coping.
The soil is red, dry and barren. The El Niño weather conditions mean staples like kumara simply won't grow.
"Here they've been growing for six months already and they're not much bigger than your finger, just because it's been so dry. The soil is not as rich as other areas," says Mr Finlay.
Because of food shortages in the village, adults are generally restricting themselves to only meal a day so the children have enough to eat. But even that one meal is very basic and lacks proper nutrition.
Mary Jimmy, the village chief's wife says two children in her village have died from malnutrition and she's seriously worried.
She says, "We have no food in the garden, and we really need rice to sustain us".
The last government rice distribution to northern communities like this one was in October. But there's nothing left from that and the people say more help is needed urgently.
If you would like to help struggling communities on Vanuatu's Tanna Island, you can donate to Tearfund's El Niño Famine Prevention Appeal by visiting tearfund.org.nz or calling 0800 800 777.
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