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A Somali woman, dehydrated and gaunt from severe diarrhea, lies in a corridor due to lack of bed space at the Banadir hospital on August 14, 2011 in Mogadishu, Somalia.John Moore/Getty Images

Even as drought and hunger grew to disastrous levels in Somalia this year, Islamist militants told destitute farmers to "depend on God" instead of the "infidels" at foreign relief agencies.

A new report, which will be released Monday, documents how the religious radicals of al-Shabab blocked humanitarian aid, imposed a reign of repression and brutality in their territory, and arrested those who tried to flee to refugee camps.

The investigation by Human Rights Watch describes Somali refugees suffering a litany of abuse and war crimes from all sides of the conflict, resulting in a humanitarian catastrophe as famine deepens in the Horn of Africa.

More than 29,000 children have died in the famine so far, according to the United Nations. Of the estimated 2.8 million Somalis who are at risk of dying from starvation if they don't get food assistance soon, about 2.2 million are in territory controlled by the Islamic insurgents.

The report makes clear that the insurgents are far from the only source of abuses in Somalia. Government soldiers, pro-government militia forces, African peacekeepers and Kenyan police have all committed serious abuses – including arbitrary arrests and the indiscriminate shelling of civilian areas. In one case, the report said, Somali government troops ordered a relief agency to stop delivering food aid to about 600 families in Mogadishu.

But the most shocking details came from refugees who fled from the vast regions of southern Somalia that are now controlled by al-Shabab. Some refugees were forced to hide in vehicles or take hazardous back roads to escape from the militants.

One farmer described how his 40 goats and 20 cattle died of starvation as al-Shabab refused to allow any help from relief agencies. "They were telling people to just depend on God and forget about depending on the agencies," he told the human rights researchers.

Another refugee said the insurgents told him: "We don't want the food of disbelievers." And a woman described how she fled in desperation to a refugee camp when she was nine months pregnant, giving birth in the bush on the way, rather than remain in a region where aid was banned. "I think they wanted the people to die," another refugee said.

Al-Shabab has "violated humanitarian law" by prohibiting food aid and banning about 20 humanitarian organizations, the report said, and the impact on the Somali people has been "devastating."

In the territory under its control, the Islamist militia "continues to carry out public beheadings and floggings, forcibly recruits both adults and children into its forces, imposes onerous regulations on nearly every aspect of human behaviour and social life, and deprives inhabitants of badly needed humanitarian assistance, including food and water," the report said.

When hungry civilians tried to flee from Somalia to neighbouring Kenya to escape the abuses, their buses were often stopped by the militants, who arrested them or forced them to return home. Even if they avoided the militants, they faced the threat of harassment and arrest by Kenyan police, and the risk of robbery and rape by well-organized bandit gangs.

"Abuses by al-Shabab and pro-government forces have vastly multiplied the suffering from Somalia's famine," said Daniel Bekele, the Africa director at Human Rights Watch.

In a similar report last month, Amnesty International concluded that humanitarian aid was "severely restricted" for displaced people in camps near Mogadishu. Access to aid has been "drastically reduced" in the past four years in southern and central Somalia because of armed conflict and deliberate decisions by al-Shabab to ban relief agencies or impose rules on them, Amnesty said.

Last weekend, al-Shabab withdrew from most areas of Mogadishu, but fighting has continued and the city remains too dangerous for most relief agencies to operate in. Somalia's Prime Minister, Abdiweli Mohamed Ali, announced this weekend that a 300-man security force would be created to protect food aid and secure humanitarian convoys.

The report by Human Rights Watch warns, however, that the Somali government has been "ineffectual" in providing security in the limited regions under its control. "Broadening those areas is only likely to exacerbate existing problems," it said.

The United Nations says it has managed to expand its relief activities in southern Somalia, and it is aiming for a dramatic increase in aid in the coming days. It estimates that more than 12 million people need food aid in the Horn of Africa region, including Somalia, Kenya, Ethiopia, Djibouti and Eritrea.

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