Some 11 million children in eastern and southern Africa face hunger, disease and water shortages as a result of the strongest El Niño weather phenomenon in decades, the United Nations children’s fund (UNICEF) said on Tuesday.

Food and water shortages caused by drought and floods are causing malnutrition, which increases children’s vulnerability to killer diseases like malaria, diarrhoea, cholera and dengue fever, it said.

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“The consequences could ripple through generations unless affected communities receive support,” UNICEF said in a statement, referring to stunting, which affects children who are getting too few proteins, vitamins and minerals in their food.

Stunted children have poor cognitive development and health, achieve less at school and, as adults, earn less than children who had adequate nutrition, studies show.

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El Nino, caused by Pacific Ocean warming, has caused drought in several parts of Africa, including Malawi and Zimbabwe.

The worst affected country is Ethiopia, which has the second largest population in Africa and is suffering its severest drought in 30 years.

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More than eight million Ethiopians need food aid, and this number could rise to 15 million by early 2016, the United Nations said.

Some 350,000 Ethiopian children have severe acute malnutrition, UNICEF said, which means they are likely to die without therapeutic feeding.