Rome — The heads of two frontline United Nations agencies today urged donors to support a swift response to end the suffering of thousands of malnourished as well as sick women and children fleeing violence in Central African Republic (C.A.R.).

Executive Director of the UN World Food Programme (WFP) Ertharin Cousin and UN High Commissioner for Refugees António Guterres stressed the dire plight of the most vulnerable arriving in Cameroon from C.A.R. exhausted, often acutely malnourished and sick.

Almost 90,000 people have fled across the border between C.A.R. and Cameroon since December 2013.

Up to 2,000 people a week, mostly women and children, reach Cameroon through more than 30 entry points along a 700-kilometre stretch of border. Acute malnutrition rates among refugees are between 20 and 30 percent according to WFP and UNHCR screening, well above the emergency threshold of 15 percent.

"Women and children are arriving in Cameroon in a shocking state, after weeks, sometimes months, on the road, foraging for food. This is the most recent tragedy resulting from the escalating bloodshed that has torn C.A.R. apart. We must all act now or more children will needlessly suffer. We must intervene to save lives and prevent a worsening situation, " said Cousin.

"After they finally escape the danger they faced in C.A.R., children and women who flee must not die from malnutrition" she added.

"The needs of the refugees arriving in Cameroon are urgent and time truly is of the essence," said UN High Commissioner for Refugees António Guterres. "Many of the people we are trying to help are starved and dangerously ill, meaning that the challenge is much more than just ensuring safe haven - it's about trying to save people's lives after they arrive."

The two UN heads said in Rome that while WFP and UNHCR were saving lives, funds were nearly exhausted as the number of refugees continues to grow with each new round of fighting inside C.A.R.

WFP has provided 30-day general food rations to 44,700 refugees and stateless people since 22 May. In response to the grim condition of many new arrivals from C.A.R., WFP began in early May distributing specialized nutritious food at some entry points and refugee sites.

Distribution of highly nutritious food to all children under five is underway at Borgop Lolo, Mbile, Gado Ghiti and Kenzu in Cameroon. All pregnant women and new mothers are receiving fortified porridge.

The second of two WFP-chartered aircraft - with a total of 127 metric tons of WFP high energy biscuits and ready-to-eat especially nutritious foods - has arrived in Cameroon today from the UN's humanitarian hub in Dubai. The first plane arrived in Cameroon on Sunday.

The 90,000 people who have fled into Cameroon are spread over more than 300 sites across 50,000 square kilometres in the East and Adamawa regions. The logistical challenge of reaching them is compounded by rains and poor roads, which mean that conditions in camps and host settlements are bound to deteriorate.

More than 226,000 refugees and third country nationals have fled violence in C.A.R. since September. Of the refugees 86,068 are in Cameroon, 14,000 in Chad, 14,141 in Democratic Republic of the Congo, and 8,891 in Republic of Congo. All of them are in need humanitarian assistance.

WFP's operations to help feed the hundreds of thousands or people who have fled C.A.R. to four surrounding countries have an average shortfall of 70 percent or more.

In Cameroon, WFP launched an emergency operation to feed 100,000 people and is seeking US$15 million dollars over eight months. From now until the end of December: in Chad, WFP needs US$9.7 million to provide assistance, both through food and vouchers; in the Democratic Republic of Congo, WFP is appealing for US$11.6 million and in the Republic of Congo WFP requires US$2.7 million.

Currently, the Regional Refugee Response Plan for Central African Republic is only 9 percent funded. The plan involves UNHCR, WFP and 13 other partners in the four countries affected by the C.A.R. refugee crisis - Cameroon, Chad, the Democratic Republic of the Congo, and the Republic of the Congo.