SANAA, Yemen - A doctor would have recognized the signs of chronic malnutrition immediately in the 7-month-old girl - the swollen stomach, the constant cough.
Her mother, though, had only traditional healers to turn to in her Yemeni mountain village, and they told her to stop breast-feeding.
Her milk had spoiled, they said. Their solution: stuff the baby's nose with ghee - clarified butter.
When that didn't work, the young mother, Sayeda al-Wadei, made the arduous 60-mile journey through the mountains to the closest hospital with facilities to treat her daughter, in the capital, Sanaa.
More than 50 percent of Yemen's children are malnourished, rivaling war zones like Sudan's Darfur and parts of sub-Saharan Africa. That's just one of many worrying statistics in Yemen.
Nearly half the population lives below the poverty line of $2 a day and doesn't have access to proper sanitation. Less than a tenth of the roads are paved. Water is running out. Tens of thousands have been displaced from their homes by conflict, flooding into cities. The government is riddled with corruption and has little control outside the capital, and its main source of income - oil - could run dry in a decade.
As a result, al-Qaeda is far down on a long list of worries for most Yemenis, even as the United States presses the government to step up its fight against the terror network's affiliate here.
Donor nations will meet in February in Riyadh, Saudi Arabia, to gather millions of dollars for development in Yemen. Aid groups, economists, and officials are scurrying to develop poverty reduction and economic restructuring plans for this nation of 23 million.
The United States has already dedicated $150 million in development money, alongside its counterterrorism aid to fight al-Qaeda, which is to grow to from $150 million to $250 million over the next year.
Other donor countries have given millions more, acknowledging that the terror network cannot be uprooted unless Yemen is pulled out of poverty.
"The neighboring countries and Europeans and U.S. have a lot at stake, not only in Yemen, but in the Middle East. I don't think anyone wants to see Yemen failing," said Benson Ateng, the World Bank's Yemen country manager.
Some aid workers fear that the government, which clings to power through patronage, will direct aid to allied tribes while leaving others out in the cold, fueling resentment. A focus by donors on steering aid to areas with a known al-Qaeda presence, not necessarily the poorest zones, may also backfire.
Too narrow a focus
"Donors are focusing on development as a tool to address security issues, and not as an end in itself," said Ashley Clements, Oxfam representative in Sanaa. "There is a risk that the tendency will increase over the years. Focusing on one issue alone will be to the detriment of the well-being of Yemen's people."
Malnutrition typifies how overlapping problems lead to crisis.
Much of Yemen's agriculture - and 30 percent of its water - has turned to cultivating khat, the mildly stimulating leaf that Yemenis addictively chew, leaving the country a net food importer with little cash to pay for it.
At the same time, health infrastructure and education is lacking; the rate of breast-feeding for children younger than 6 months is only 10 percent.
Moreover, the rise in malnutrition was able to pass largely unnoticed because the weak government was not keeping valid statistics and had no commitment or ability to head it off.
"There is no single other country in the world where we ever have seen such high levels of malnutrition," said Greet Cappelaera, Yemen country director of UNICEF.
At the Sanaa hospital, Wadei's daughter Maram has recovered after treatment. But another of her four children - a 21/2-year-old daughter - can barely stand, another malnutrition symptom, and the family can't afford to treat her.
"I don't want kids anymore," mourns Wadei. "I don't even want myself."
Yemeni officials say their resources are strained by security challenges, including a northern rebellion, a southern separatist movement and al-Qaeda.
"If there is no security and stability, there will be no development, no poverty alleviation and no investment," said Hesham Sharaf, deputy minister of planning and international cooperation.
Oil revenues make up at least three-quarters of the government budget, but oil production is steadily declining.
Yemen could become a net importer in the next five years and its oil reserves could run out completely by 2021, according to IMF and World Bank estimates.