Dadaab, Kenya (CNN) -- Hundreds of Somali refugees arrived here Monday looking for food, water, shelter and hope. They are among 4,000 to 5,000 Somalis who arrive each week at this complex of three refugee camps in Kenya's North Eastern Province, nearly double the rate a year ago.
For many, their arrival at the Dadaab Refugee Camp marks the end of a trip of many miles on foot over many days in scorching heat. Several people said they had abandoned along the side of the road friends and relatives too weak to continue. They said they don't know their fate.
Those who could afford the fare -- as much as $40 per person -- are ferried in by car from the border, which is 80 kilometers (50 miles) away. But most make the journey on foot. Upon arrival, many say they have had nothing to eat for days.
Those who reach the camp at night wait outside its gates till dawn, when processing begins.
Though July is usually a difficult time in this part of the world, aid workers say this year has been worse than previous years. Aid organizations have been unable to deliver major food aid directly to Somalia, which has been wracked by drought and political instability.
By shortly before noon, people were still waiting to get into the camp's reception area, and many more had joined the line.
"We could have died if we stayed," said Mohammed Mahmoud, a Somali refugee who appeared gaunt and tired. "If we died or live, it is in God's hand. But the drought destroyed everything I have, so I have come here to stay alive."
Upon their arrival, he and the others were given a two-week supply of cornmeal, flour, beans, oil, sugar and salt. However, it can take a month before their registration is completed and their two-week supply is replenished, said Somalis and officials with the aid group Medecins Sans Frontieres, also known as Doctors Without Borders.
At a nearby hospital, three doctors were attending Monday to nearly 150 patients, most of whom shared a diagnosis that had stretched their ability to treat.
"Mostly malnourished with complications or malnourished with severe medical conditions as well," said Dr. Edward Chege, the acting hospital director and a member of Doctors Without Borders. "It is too much work for the few hands that we have."
He appealed for more staff, more resources and more space.
"This is truly the worst drought that has happened in many decades," he said. "We have not seen numbers like this."
Chege said it was difficult to see such suffering. "They have not only lost everything they own, but they are almost losing hope," he said.
"We are seeing some particularly poor cases," said Roger Naylor, a field officer for the U.N. High Commissioner for Refugees. "I mean, people are obviously walking long journeys. A high volume of the new arrivals are small children, and that is a long way for them to walk. If you look at the condition of their feet, you can see them bruised. You can tell by the caking of mud how far they have walked."
He too pleaded for more aid: "Water, food, shelter and medical care in equal amounts ... and we need land," he said. "We need land for people to settle to receive those services."
But aid agencies here say they are underfunded and nearly overwhelmed. U.N. aid agencies say they have received only half the money they need.
The complex of camps here was designed to hold tens of thousands of people. That number has been exceeded many times over and is now approaching 500,000, making Dadaab the world's largest refugee camp.
Children bear the brunt of the woes. Norea, age 2, weighs no more than a newborn. Aden, too sick to eat, is fed through a tube.
And the refugees keep coming. "When they arrive, they may have had some supplies that came with them," Chege said. "But as soon as they run out of food and basic necessities, that is when they come to the hospital."
Those who set up camp on the wind-blasted outskirts of the camps must walk miles to get water and wait days for food. But, they say, even that is better than enduring the horror they left behind.
Bowing to pressure from abroad, the Kenyan government has said it will allow a fourth camp, Ifo 2, to open soon but has set no date. Though the camp is better equipped than the other camps, it sits empty. Government officials have blamed security concerns for the delay, but aid workers accuse the government of dragging its feet in order not to attract even more Somalis to the country.
Somalia is battling its worst drought in 60 years. Earlier this month, Al-Shabaab pledged to lift a ban and allow aid agencies in areas under rebel control to avoid a humanitarian disaster.
The al Qaeda proxy banned foreign aid organizations from operating in the country in 2009, accusing them of being anti-Muslim.
Aid agencies estimate that 10 million people in Kenya, Ethiopia, Djibouti, Uganda and Somalia are at risk of famine.
Conflict in Somalia is adding to the problem as government forces battle militants in the capital of Mogadishu. The Horn of Africa nation has not had an effective government for two decades.