The FAO and the Famine Early Warning Network say more than two million people still need emergency assistance. That is almost one-third of Somalia's population.

The United Nations says tens of thousand of people have died since the famine was first declared in parts of southern Somalia in July. Now, refugees have started slowly returning after a good harvest in the recent rainy season.

Hundreds of thousands of Somalis fled to camps in Kenya, Ethiopia and the Somali capital, Mogadishu, in search of food and water. Part of the problem: the militant group al-Shabab has restricted international aid in the areas it controls.

In any conflict area, helping those in need can require complex negotiations and compromise. The medical aid group Doctors Without Borders works in many conflict areas, including Somalia. The group is also known as MSF, for Medecins Sans Frontieres in French. The group has published a book called "Humanitarian Negotiations Revealed: The MSF Experience."

In recent years, medical and humanitarian workers have been increasingly in danger.

MICHAEL NEUMAN: "We got ourselves five workers killed in Afghanistan in two thousand four. We got three workers killed in Somalia, expulsion in Niger and in Sudan."

Michael Neuman is director of the MSF research center in Paris and co-author of the book. He says there is no way to avoid negotiation if medical treatment is to be provided in conflict areas. Negotiations center on a search for common interests between different sides and opposing groups. In the end, he says, "you fight for what you believe in to the maximum, but know that you may not achieve it all."